Case No. 158
An attractive, amiable boy from a working-class background, you struck the study staff as happy, stable, and sociable. “My general impression is that this boy will be normal and well-adjusted—rather dynamic and positive,” the psychiatrist reported.
After college, you got an advanced degree and began to climb the rungs in your profession. You married a terrific girl, and you two played piano together for fun. You eventually had five kids. Asked about your work in education, you said, “What I am doing is not work; it is fun. I know what real work is like.” Asked at age 25 whether you had “any personal problems or emotional conflicts (including sexual),” you answered, “No … As Plato or some of your psychiatrists might say, I am at present just ‘riding the wave.’” You come across in your files as smart, sensible, and hard-working. “This man has always kept a pleasant face turned toward the world,” Dr. Heath noted after a visit from you in 1949. From your questionnaire that year, he got “a hint … that everything has not been satisfactory” at your job. But you had no complaints. After interviewing you at your 25th reunion, Dr. Vaillant described you as a “solid guy.”
Two years later, at 49, you were running a major institution. The strain showed immediately. Asked for a brief job description, you wrote: “RESPONSIBLE (BLAMED) FOR EVERYTHING.” You added, “No matter what I do … I am wrong … We are just ducks in a shooting gallery. Any duck will do.” On top of your job troubles, your mother had a stroke, and your wife developed cancer. Three years after you started the job, you resigned before you could be fired. You were 52, and you never worked again. (You kept afloat with income from stock in a company you’d done work for, and a pension.)
Seven years later, Dr. Vaillant spoke with you: “He continued to obsess … about his resignation,” he wrote. Four years later, you returned to the subject “in an obsessional way.” Four years later still: “It seemed as if all time had stopped” for you when you resigned. “At times I wondered if there was anybody home,” Dr. Vaillant wrote. Your first wife had died, and you treated your second wife “like a familiar old shoe,” he said.
But you called yourself happy. When you were 74, the questionnaire asked: “Have you ever felt so down in the dumps that nothing could cheer you up?” and gave the options “All of the time, some of the time, none of the time.” You circled “None of the time.” “Have you felt calm and peaceful?” You circled “All of the time.” Two years later, the study asked: “Many people hope to become wiser as they grow older. Would you give an example of a bit of wisdom you acquired and how you came by it?” You wrote that, after having polio and diphtheria in childhood, “I never gave up hope that I could compete again. Never expect you will fail. Don’t cry, if you do.”
What allows people to work, and love, as they grow old? By the time the Grant Study men had entered retirement, Vaillant, who had then been following them for a quarter century, had identified seven major factors that predict healthy aging, both physically and psychologically.
Employing mature adaptations was one. The others were education, stable marriage, not smoking, not abusing alcohol, some exercise, and healthy weight. Of the 106 Harvard men who had five or six of these factors in their favor at age 50, half ended up at 80 as what Vaillant called “happy-well” and only 7.5 percent as “sad-sick.” Meanwhile, of the men who had three or fewer of the health factors at age 50, none ended up “happy-well” at 80. Even if they had been in adequate physical shape at 50, the men who had three or fewer protective factors were three times as likely to be dead at 80 as those with four or more factors.
What factors don’t matter? Vaillant identified some surprises. Cholesterol levels at age 50 have nothing to do with health in old age. While social ease correlates highly with good psychosocial adjustment in college and early adulthood, its significance diminishes over time. The predictive importance of childhood temperament also diminishes over time: shy, anxious kids tend to do poorly in young adulthood, but by age 70, are just as likely as the outgoing kids to be “happy-well.” Vaillant sums up: “If you follow lives long enough, the risk factors for healthy life adjustment change. There is an age to watch your cholesterol and an age to ignore it.”
The study has yielded some additional subtle surprises. Regular exercise in college predicted late-life mental health better than it did physical health. And depression turned out to be a major drain on physical health: of the men who were diagnosed with depression by age 50, more than 70 percent had died or were chronically ill by 63. More broadly, pessimists seemed to suffer physically in comparison with optimists, perhaps because they’re less likely to connect with others or care for themselves.
More than 80 percent of the Grant Study men served in World War II, a fact that allowed Vaillant to study the effect of combat. The men who survived heavy fighting developed more chronic physical illnesses and died sooner than those who saw little or no combat, he found. And “severity of trauma is the best predictor of who is likely to develop PTSD.” (This may sound obvious, but it countered the claim that post-traumatic stress disorder was just the manifestation of preexisting troubles.) He also found that personality traits assigned by the psychiatrists in the initial interviews largely predicted who would become Democrats (descriptions included “sensitive,” “cultural,” and “introspective”) and Republicans (“pragmatic” and “organized”).
Again and again, Vaillant has returned to his major preoccupations. One is alcoholism, which he found is probably the horse, and not the cart, of pathology. “People often say, ‘That poor man. His wife left him and he’s taken to drink,’” Vaillant says. “But when you look closely, you see that he’s begun to drink, and that has helped drive his wife away.” The horrors of drink so preoccupied Vaillant that he devoted a stand-alone study to it: The Natural History of Alcoholism.
Vaillant’s other main interest is the power of relationships. “It is social aptitude,” he writes, “not intellectual brilliance or parental social class, that leads to successful aging.” Warm connections are necessary—and if not found in a mother or father, they can come from siblings, uncles, friends, mentors. The men’s relationships at age 47, he found, predicted late-life adjustment better than any other variable, except defenses. Good sibling relationships seem especially powerful: 93 percent of the men who were thriving at age 65 had been close to a brother or sister when younger. In an interview in the March 2008 newsletter to the Grant Study subjects, Vaillant was asked, “What have you learned from the Grant Study men?” Vaillant’s response: “That the only thing that really matters in life are your relationships to other people.”
The authority of these findings stems in large part from the rarity of the source. Few longitudinal studies survive in good health for whole lifetimes, because funding runs dry and the participants drift away. Vaillant managed, drawing on federal grants and private gifts, to finance surveys every two years, physicals every five years, and interviews every 15 years. The original study social worker, Lewise Gregory Davies, helped him goad the subjects to stay in touch, but it wasn’t a hard sell. The Grant Study men saw themselves as part of an elite club.
Vaillant also dramatically expanded his scope by taking over a defunct study of juvenile delinquents in inner-city Boston, run by the criminologists Sheldon and Eleanor Glueck. Launched in 1939, the study had a control group of nondelinquent boys who grew up in similar circumstances—children of poor, mostly foreign-born parents, about half of whom lived in a home without a tub or a shower. In the 1970s, Vaillant and his staff tracked down most of these nondelinquent boys—it took years—so that today the Harvard Study of Adult Development consists of two cohorts, the “Grant men” and the “Glueck men.” Vaillant also arranged to interview a group of women from the legendary Stanford Terman study, which in the 1920s began to follow a group of high-IQ kids in California.
In contrast to the Grant data, the Glueck study data suggested that industriousness in childhood—as indicated by such things as whether the boys had part-time jobs, took on chores, or joined school clubs or sports teams—predicted adult mental health better than any other factor, including family cohesion and warm maternal relationships. “What we do,” Vaillant concluded, “affects how we feel just as much as how we feel affects what we do.”
Interestingly, while the Glueck men were 50 percent more likely to become dependent on alcohol than the Harvard men, the ones who did were more than twice as likely to eventually get sober. “The difference has nothing to do with treatment, intelligence, self-care, or having something to lose,” Vaillant told Harvard magazine. “It does have to do with hitting bottom. Someone sleeping under the elevated-train tracks can at some point recognize that he’s an alcoholic, but the guy getting stewed every night at a private club may not.”
But Vaillant has largely played down the distinctions among the samples. For example, while he allows that, in mortality rates, the inner-city men at age 68 to 70 resembled the Terman and Harvard cohorts at 78 to 80, he says that most of the difference can be explained by less education, more obesity, and greater abuse of alcohol and cigarettes. “When these four variables were controlled,” he writes, “their much lower parental social class, IQ, and current income were not important.” But of course those are awfully significant variables to “control.” Vaillant points out that at age 70, the inner-city men who graduated from college were just as healthy as the Harvard men. But only 29 Glueck men did finish college—about 6 percent of the sample.
Having survived so many eras, the Grant Study is a palimpsest of the modern history of medicine and psychology, each respective era’s methods and preoccupations inscribed atop the preceding ones. In the 1930s, Arlie Bock’s work was influenced by the movement called “constitutional medicine,” which started as a holistic reaction to the minimalism engendered by Pasteur and germ theory. Charles McArthur, who picked up the study in the mid-1950s, was principally interested in matching people to suitable careers through psychological testing—perfect for the Man in the Gray Flannel Suit era. Vaillant’s use of statistical technique to justify psychoanalytic claims reflected the mode of late-1960s academic psychiatry, and his work caught on in the 1970s as part of a trend emphasizing adult development. Gail Sheehy’s 1976 best seller, Passages, drew on the Grant Study, as well as on the research of Daniel Levinson, who went on to publish The Seasons of a Man’s Life. (Sheehy was sued for alleged plagiarism by another academic, Roger Gould, who later published his own take on adult development in Transformations; Gould’s case was settled out of court.)
As Freud was displaced by biological psychiatry and cognitive psychology—and the massive data sets and double-blind trials that became the industry standard—Vaillant’s work risked obsolescence. But in the late 1990s, a tide called “positive psychology” came in, and lifted his boat. Driven by a savvy, brilliant psychologist at the University of Pennsylvania named Martin Seligman, the movement to create a scientific study of the good life has spread wildly through academia and popular culture (dozens of books, a cover story in Time, attention from Oprah, etc.).
Vaillant became a kind of godfather to the field, and a champion of its message that psychology can improve ordinary lives, not just treat disease. But in many ways, his role in the movement is as provocateur. Last October, I watched him give a lecture to Seligman’s graduate students on the power of positive emotions—awe, love, compassion, gratitude, forgiveness, joy, hope, and trust (or faith). “The happiness books say, ‘Try happiness. You’ll like it a lot more than misery’—which is perfectly true,” he told them. But why, he asked, do people tell psychologists they’d cross the street to avoid someone who had given them a compliment the previous day?
In fact, Vaillant went on, positive emotions make us more vulnerable than negative ones. One reason is that they’re future-oriented. Fear and sadness have immediate payoffs—protecting us from attack or attracting resources at times of distress. Gratitude and joy, over time, will yield better health and deeper connections—but in the short term actually put us at risk. That’s because, while negative emotions tend to be insulating, positive emotions expose us to the common elements of rejection and heartbreak.
To illustrate his point, he told a story about one of his “prize” Grant Study men, a doctor and well-loved husband. “On his 70th birthday,” Vaillant said, “when he retired from the faculty of medicine, his wife got hold of his patient list and secretly wrote to many of his longest-running patients, ‘Would you write a letter of appreciation?’ And back came 100 single-spaced, desperately loving letters—often with pictures attached. And she put them in a lovely presentation box covered with Thai silk, and gave it to him.” Eight years later, Vaillant interviewed the man, who proudly pulled the box down from his shelf. “George, I don’t know what you’re going to make of this,” the man said, as he began to cry, “but I’ve never read it.” “It’s very hard,” Vaillant said, “for most of us to tolerate being loved.”
Vaillant brings a healthy dose of subtlety to a field that sometimes seems to glide past it. The bookstore shelves are lined with titles that have an almost messianic tone, as in Happier: Learn the Secrets to Daily Joy and Lasting Fulfillment. But what does it mean, really, to be happier? For 30 years, Denmark has topped international happiness surveys. But Danes are hardly a sanguine bunch. Ask an American how it’s going, and you will usually hear “Really good.” Ask a Dane, and you will hear “Det kunne være værre (It could be worse).” “Danes have consistently low (and indubitably realistic) expectations for the year to come,” a team of Danish scholars concluded. “Year after year they are pleasantly surprised to find that not everything is getting more rotten in the state of Denmark.”
Of course, happiness scientists have come up with all kinds of straightforward, and actionable, findings: that money does little to make us happier once our basic needs are met; that marriage and faith lead to happiness (or it could be that happy people are more likely to be married and spiritual); that temperamental “set points” for happiness—a predisposition to stay at a certain level of happiness—account for a large, but not overwhelming, percentage of our well-being. (Fifty percent, says Sonja Lyubomirsky in The How of Happiness. Circumstances account for 10 percent, and the other 40 percent is within our control.) But why do countries with the highest self-reports of subjective well-being also yield the most suicides? How is it that children are often found to be a source of “negative affect” (sadness, anger)—yet people identify children as their greatest source of pleasure?
The questions are unresolved, in large part because of method. The psychologist Ed Diener, at the University of Illinois, has helped lay the empirical foundation for positive psychology, drawing most recently on data from the Gallup World Poll, which interviewed a representative sample of 360,000 people from 145 countries. “You can say a lot of general things from these data that you could never say before,” Diener says. “But many of them are relatively shallow. People who go to church report more joy. But if you ask why, we don’t know. George has these small samples—and they’re Harvard men, my goodness, not so generalizable. Yet he has deep data, and he brings so many things together at once.”
Seligman describes Diener as the “engineer” of positive psychology, “trying to do better, more replicable, more transparent science.” Vaillant and his work, though, remind Seligman of the roots of psychology—the study of the soul. “To practice scientific psychology is to have as few premises as you can, to account for as much of the soul as you can get away with,” Seligman says. “Everyone in positive psychology who seeks to explain the mysteries of the psyche wants deeper stuff. George is the poet of this movement. He makes us aware that we’re yearning for deeper stuff.”
When Vaillant told me he was going to speak to Seligman’s class, he said his message would be from William Blake: “Joy and woe are woven fine.” Earlier in his career, he would use such occasions to demonstrate, with stories and data, the bright side of pain—how adaptations can allow us to turn dross into gold. Now he articulates the dark side of pleasure and connection—or, at least, the way that our most profound yearnings can arise from our most basic fears.