Friedman and Rosenman’s findings have aroused bitter controversy and antagonism within the medical establishment. Until recently their work was ridiculed or ignored, their federal funding often in jeopardy. Now, after twenty years of accumulating hard evidence, they have finally attained some measure of respectability. But their theories are still phobic-ally resisted by the majority of heart researchers, who remain myopically committed to the standard studies of diet, smoking, exercise, or drugs—which is where the big research money goes.9
This resistance is undoubtedly due in part to the traditional reluctance among scientists to acknowledge phenomena that cannot be measured precisely and objectively. But the reasons are more complex than that.
The Type A condition, as Friedman and Rosenman define it, contains both psychological and socio-economic components: Though related to personality and behavior, it depends equally on the challenges and conditions of the environment. And its increased prevalence is due to the special rewards our society offers those who can think, perform, and live rapidly and aggressively.
It is a condition, therefore, that is intimately related to the values of our contemporary American society—a society shaped primarily by men, and now being steered primarily by men. Which means that while the lethal Type A pattern may indeed be an indictment of stress American style, it is even more specifically a stinging indictment of masculine ideals that are deeply engrained in our culture.
Machismo kills—that is the key finding and the most threatening implication of Friedman and Rosenman’s heart research. No wonder, then, that the mostly male medical community has been reluctant to accept the Type A pattern as a “sickness.”
No doubt the day will come when the dangers of this pattern will be widely acknowledged by the medical profession and the corporate power elite. Then values will be changed, and solutions found, to ensure the survival of the American male. But at the moment the concept is still too new—and too threatening—to be accepted on a large scale. Which means that every coronary-prone man in his middle years is on his own.
A great deal can be done to change this destructive pattern, say Friedman and Rosenman, who in 1974 published their advice in a book called Type A Behavior and Your Heart (and we will discuss some of their recommendations later). But as a first step, they counsel a man to stop running long enough to take a good hard look at himself, his life, and his goals. And that is exactly what the mid-life crisis compels many men to do in any case.
A sign of growth and a healthy phenomenon, this self-appraisal may turn out to be a life-saver as well.