Emotional Factors in Coronary Heart Disease

ANYONE intrepid enough to discuss the 2 role of the emotions in coronary disease exposes himself to stresses that are asserted by some to be lethal. Thus, when I essayed, Canute-like, a few years ago, to challenge the concept that Western civilization is inevitably emotionally bad for the coronaries, I was told, in print,1 that it was "almost incredible" that I should have considered the terrors of grief, war, suicide, manic depressive insanity, and horrendous primitive taboos (stresses under which man has always suffered) as approaching in deadliness the hazards of our socioeconomic existence; and this in spite of the assertion by other psychosomaticists that fear, anger, resentment, frustration, and depression produce a greater cardiac output for a longer time than standard exercise. Naturally this social disapproval, this failure on my part to be "agin Sin," has been very hard on me. My friend, Dr. Louis Katz, has rightly said, concerning this matter of the emotions in atheroselerosis, ". . . too much has been said on this subject on too little evidence. We should do more research and less talking!" However, he stated that the Committee on Emotions and Cardiovascular Disease of the Chicago Heart Association has proposed that it devote 2 years to exploring the field. through a series of conferences, to decide whether or not even to undertake a major study of it.2 I predict that the Committee will decide in the negative, but, at any rate, they must still be in the talking stage and will perhaps allow me a word at this meeting. Dr. Katz has admirably outlined the many questions needing answers. What, I think, is the difference between the two major schools in this clouded area is really the emphasis upon the relative influence