Edited by Robert Allan, PhD and Jeffrey Fisher, MD
Coronary heart disease (CHD) is the number one cause of death and disability worldwide. Factors such as cigarette smoking, high cholesterol, hypertension, and diabetes are well-known risk factors, but research also links numerous psychosocial factors with CHD. Since the seminal book Heart and Mind: The Practice of Cardiac Psychology was first published in 1996, the research linking psychosocial factors with CHD has expanded enormously. The second edition distills this research, providing chapters by the world’s foremost authorities on the major psychosocial risk factors linked with CHD, including depression, social isolation, and anger, as well as several emerging factors, such as “Type D” (distressed) personality, anxiety, post-traumatic stress disorder, and work stress. Also included are chapters on CHD in women, “triggers” for myocardial infarction, the type A behavior pattern, and cardiac denial. Clinical interventions involving psychotherapy, stress reduction, exercise, and transcendental meditation are also explored.
This volume will appeal to a wide range of psychological and medical professionals, including psychologists, psychiatrists, social workers, psychotherapists, cardiologists, internists, primary care physicians, exercise physiologists, and cardiac nurses. 2012. 496 pages. Hardcover.
Robert Allan, PhD is Clinical Assistant Professor of Psychology in Medicine at Weill Cornell Medical College and Professional Associate at New York-Presbyterian Hospital. In 1982, he established the first cardiac stress reduction-support group in the New York metropolitan area at the Nassau County chapter of the American Heart Association In 1983, with cardiologist Stephen Scheidt, MD, he cofounded the Coronary Risk Reduction Program at New York-Presbyterian Hospital. Since then, Dr. Allan has taught twice-weekly classes on the Step-Down Cardiac Care Unit, educating over 10,000 patients and their family members. In addition, he leads the stress management programs at New York-Presbyterian Hospital’s Cardiac Health Centers. Dr. Allan has treated hundreds of cardiac patients in individual therapy and has conducted more than 2,500 cardiac support groups. He led the first stress management program for officers and wives at the U.S. Military Academy at West Point. In 1996, with coeditor Stephen Scheidt, he compiled the first edition of Heart and Mind: The Practice of Cardiac Psychology. Dr. Allan is a Fellow of the New York Academy of Medicine. He has written many journal articles and book chapters on cardiac psychology, including contributions to Braunwald’s Heart Disease series (W. B. Saunders). Dr. Allan is also the author of Getting Control of Your Anger (McGraw-Hill, 2006);; he had an extensive interview about anger management with Diane Sawyer on Good Morning America. Dr. Allan is the recipient of the 2002 Timothy A. Jeffrey Award for “outstanding contributions to clinical health psychology” from the American Psychological Association.
Jeffrey Fisher, MD is Clinical Professor of Medicine (cardiology) at Weill Cornell Medical College and Attending Physician at New York- Presbyterian Hospital. He graduated with an AB with “distinction in all subjects” from Cornell University (College of Arts and Science) in 1972. He double majored in biology (neurobiology and behavior) and psychology (physiological psychology) and was an undergraduate teaching assistant for Professor James Maas’s famous “Introduction to Psychology–Psych 101,” Professor William Lambert’s “Theories of Personality,” and Professor Parker Marden’s “Sociology of Medicine.” Anticipating a career as a psychiatrist, he attended the Albert Einstein College of Medicine, where he became enamored with internal medicine, specifically cardiology. After graduating with honors, Dr. Fisher completed his internship and residency at Einstein and did his cardiovascular fellowship training at Johns Hopkins University Hospital. Dr. Fisher joined the faculty of Cornell University Medical College in 1981 as an invasive cardiologist and began private practice in 1989. He has continued to teach and write, and has authored and/or coauthored original articles and reviews on cardiovascular anatomy and physiology;; coronary, valvular, and congenital heart disease;; pulmonary hypertension;; cardiogenic shock;; cardiac tumors;; metabolic cardiopulmonary disease;; cardiac psychology;; and medical history. He has served as a cardiologist to both the New York City fire and police departments. Dr. Fisher has been the recipient of numerous academic scholarships, awards, and honors. His coediting of this book, and cowriting Chapter 3 (“Psychocardiac Disorders”) have taken him full circle to his long-standing interest in how the psyche affects the soma.
For the past three Saturday evenings I have had the extraordinary good fortune to practice in Steinway Hall on several of their 9 foot Model D Concert Grands. Deep in the basement on West 57th Street in Manhattan is Steinway’s concert department, where instruments are readied for performances at such legendary sites as Carnegie Hall and Lincoln Center. On November 4th, the first concert of my sextet will take place in a brownstone that is often the home to classical concerts. I am grateful to Arash (Joey) Amini, the cellist in the group, for arranging the venue, which boasts a Steinway Model D Grand. My piano, a gorgeous Steinway M, meticulously maintained by Ismael Cunha, a master tuner from their concert division, is considerably smaller and plays differently than a D, and so I have needed some experience on the larger instrument in order to be comfortable in November. So there I was, surrounded by posters of such luminary Steinway artists as Vladimir Horowitz, Vladimir Ashkenazy and Mitsuko Uchida, practicing on the very instruments they have used in concert. What a thrill!
The bass notes from these massive pianos are really deep and full. The treble has been voiced with a beautiful, singing, bell like tone that is a delight to play. Wow, am I lucky!
Many people believe the myth of “accumulating anger:” if they don’t express their anger, somehow it will “build up” and they will develop high blood pressure, have a heart attack or a stroke. There are many terms to describe this belief. We speak of “pent up,” anger that can “boil over,” or “leak out.” Moreover, we can “explode” – thus somehow “releasing” the anger and freeing us. (I hereby offer $10,000 for a quart of anger!) Expressing anger in an angry way, however, makes nearly any situation worse! Others often react to our anger, rather than the message we wish to impart. While we may hope that another individual will see the light and the error of their ways, this rarely occurs. When was the last time you expressed your anger in an angry way and were met with a response like, “please accept my apology, I am so sorry?”
The “hook” is a metaphor for avoiding the temptation to directly express anger. While there is nothing wrong with anger – it signals some kind of unhappiness or unmet need or goal. Gaining control of your anger and expressing it in a calm and collected way can help a great deal. The intelligent fish realizes that injustice and incompetence are good reasons for our anger. However, biting the hook can result in a loss of freedom and even life. Our first reactions are often not as effective as our considered responses. And about 1½ percent of heart attacks and sudden cardiac deaths are triggered by anger. The emotionally intelligent fish swims on by and returns to the subject later on. As the Sixteenth Century philosopher Montaigne said, "there is no passion that so shakes the clarity of our judgment as anger. Things truly seem different to us once we have quieted and cooled down."
Michel de Montaigne (1533-1592)
Welcome to my new website and blog (skillfully designed by my daughter)! I will be blogging about cardiac psychology and anger management.
My all time favorite quotation about anger comes from the sixteenth-century French philosopher / essayist Montaigne:
"There is no passion that so shakes the clarity of our judgement as anger. Things truly seem different to us once we have quieted and cooled down."