Duke University Alumni Magazine

Lifeskills

By Virginia Parrott Williams '62, A.M. '73, Ph.D. '80 and Redford Williams. Times Books, 1998. 345 pages. $24.

n the hardscrabble 1930s, a politician-entrepreneur that only Louisiana could produce cooked up a brown, foul-tasting mixture of al-cohol, vitamin B, and assorted

other cheap ingredients in a barn. State Senator J. Dudley LeBlanc--"Coozan Dud" he called himself--had made his first batch of Hadacol. LeBlanc's potion, with its promise to cure everything from "feelin' peaked" to impotence, would soon make him a wealthy man. Many a teetotaling Southerner conveniently overlooked the fact that Hadacol contained enough alcohol to drop a black bear in his tracks--LeBlanc's elixir worked. No less than Hank Williams said so.

Hadacol, of course, was just one more in a long line of over-the-counter stump-jumpers to exert a powerful placebo effect. People wanted to believe Hadacol was happiness in a bottle, though any beneficial effects probably had as much to do with the product's alcohol content than anything else.

Almost seventy years since Dudley LeBlanc's triumph of marketing, today's health-care marketplace offers a far greater variety of self-help remedies, many based on medicinal herbs such as St. John's Wort, said to be effective against mild depression, and purple coneflower, advertised as an immune-system booster. The names and formulations may change, but the get-rich quick dreams of promoters and the hopes of consumers never do.

Into this cyclone of claims and counterclaims come two refreshing voices with impeccable credentials, Redford and Virginia Williams, a husband-and-wife team at Duke Medical Center. The Williamses (he's a physician, she's a writer-historian) don't bottle good health. Instead, they put a recipe for it between the covers of Lifeskills, a book-length program for achieving what medicine shows promised but could not deliver: How to live a less stressful, happier, and longer life.

The Williamses overlay their structured program on Redford's pioneering work in the 1970s that helped identify the link between anger and coronary disease. Much of what Redford Williams has learned about the body's response to continual stress, put into layman's terms in Anger Kills, their first collaboration, seems like common sense today. But twenty years ago, the idea that an unsound mind-body connection can lead to serious, even fatal, illness was by no means universally accepted in the medical community.

It still isn't, but the Descartian separation of mind and body has lost much of its currency. We now know, thanks to the work of investigators like Redford Williams and Eduard Suarez, a colleague at Duke, that mind and body intermesh in ways that would dazzle the great French philosopher.

Indeed, a latter-day Descartes would be intrigued by one of the most useful aspects of Lifeskills, a true-and-false questionnaire that gauges the reader's level of hostility and what the Willamses call "social support." The 114-question test lies at the heart of what the duo urges people to understand and practice: relationships matter. They matter so much to our mental and physical well-being that we place ourselves at great risk by ignoring or belittling their effect.

The question, of course, is why? What is it about a universe of sound relationships that affects our health, our mood, even our chances of living a long time? For the Williamses, the answer lies in our past. Humans may be at the top of the planet's food chain--we made it through Darwin's evolutionary maze when our less-adaptive hominid cousins didn't--but we did so with the aid of an instinct that haunts us today.

We inhabit bodies that in some ways are still more at home on the savannas of Africa than in high-tech office suites. Hominids used their autonomic fight-or-flight response skillfully--otherwise we probably wouldn't be here--but what helped these proto-humans live for another day now works to our communal disadvantage. Fear and hostility flood our bodies with a powerful cocktail of adrenaline and other hormones. But instead of using this self-defense mechanism as hominids did, to fight or flee, society demands that we submit to complex, non-violent rules of civil behavior. It's no longer acceptable to work off hostility by wielding a femur against real or imagined enemies or, as we see all too often these days, an assault rifle or a pipe bomb.

Philosopher Immanuel Kant believed the answer to this conundrum lay in his categorical imperative: Always act as if what you do possesses the force of universal law. Lifeskills is the categorical imperative writ large for achieving better individual health through better group relationships. The Williamses' chart an eight-fold path for positive change:

• Identify your thoughts and feelings, especially those such as fear, jealousy, and anger, that work against an upbeat, affirmative worldview. To understand negative feelings better, analyze them and their importance in your life. Do we control these feelings, or do they control us?

• Listen to others, even if we don't like what they are saying. Better interpersonal communication helps defuse health-threatening behavior such as anger and even prejudice.

• Practice empathy to put yourself "inside" others so that you can better understand their behavior and points of view.

• Deconstruct problems that send your stress level off the chart. For example, if your new CEO is another "Chainsaw Al" Dunlap, evaluate the importance of such a problem in your life, how much you can do about it--and be ready with alternatives.

• Don't be a wallflower. Speak up and act for positive change. As Mark Twain said, this will please some people and astonish the rest.

• Learn to accept what cannot be changed. Jimmy Carter was right when he said life is basically unfair, but learning from experience steers us around many of the snares.

• Accentuate the positive and be realistic about the negative. Yes, it sounds as simplistic as the song lyric, but seeing the glass as half full instead of half empty works.

Writing in a genre justly criticized for human-potential psychobabble, the Williamses immediately reveal themselves as an exception. Redford and Virginia (from page one, the reader feels on a first-name basis with them) sprinkle their own foibles and discoveries throughout the book. It's a subtle way to bond with the reader--to form a relationship, really--and they succeed with one of the highest compliments in the healing arts: They have a superb bedside manner.

Even "Coozan Dud," who clearly believed in the power of the half-full glass, would have agreed.

Letters Home: How Writing Can Change Your Life

By Terry Vance Ph.D. '71. Pantheon Press, 1998. 288 pages. $23.

he simple act of letter writing can enable us to confront our problems and heal our psyches, says psychotherapist Terry Vance in her groundbreaking book, Letters Home. After reading her book and employing the techniques with several of my own patients, I am convinced that the system she describes can produce dramatic and rapid change for the letter-writer.

Vance, the director of Psychology Associates in Chapel Hill, details in her book the method she has perfected in her clinical practice over the last twenty years. She has used confrontational letter-writing to deal with damaging and traumatic experiences, as well as ordinary conflicts. Letter-writing becomes a form of healing for patients--a process that can unearth unresolved conflicts and point the way to growth. Even when letters were not sent, the writing promoted dramatic changes in the writers' lives.

Vance writes: "Initially, I thought of letter-writing as a crutch preparatory to 'real' communication, but over the years I discovered that this form of letter writing enables people to fully express what they think and feel. The writers can free themselves from crippling conflicts and impasse, even when there is no 'real' (face-to-face) communication. Letter-writing has proved an effective, goal-oriented way to work out these conflicts. Because letters are documents that can be reread, progress is easily measured and concretely visualized."

Letters Home reveals the innermost lives of sons and daughters, brothers and sisters, and husbands and wives as they strive to transform themselves. Letters written by actual patients to confront the most significant people in their lives will inspire readers to articulate their own experiences and assure them that they are not alone. Sharing experiences is one of the primary benefits of being in a therapy group; readers of this book can derive a similar benefit.

In her book, Vance provides drafts of letters that are not effective, as well as revisions and final versions that produced positive results. Some of the letters are haunting, even shocking, to read because they are by patients who suffered physical and psychological abuse. She presents lucid and reasoned discussions of controversial subjects--blame and responsibility, abuse and memory of abuse, religious faith, and the keeping of secrets.

The book's subtext is a discussion of what causes people to get stuck in self-defeating patterns and how honest confrontation of feelings and thoughts can enable them to break out of these patterns. The reader comes away with insight into the emotional dynamics of individuals and families.

No one has previously elaborated a coherent system of confrontational letter-writing that could be taught to others. Vance's step-by-step system can help anyone compose a clear, strong letter to a parent or "significant other" with whom he or she is having difficulty. She describes this system in a matter-of-fact style, complete with theoretical discussion and steps to be taken and to be avoided. She shows how successive drafts help writers sharpen their message, clarify their thinking, and avoid language that could dampen the letter's factual or emotional impact. She presents how the letter-writers have changed their lives as a result of the process--whether they get a positive or, in fact, any response from the addressee.

Written to appeal to the lay public as well as to the seasoned therapist, this book brings the knowledge Vance has gained in her clinical practice to a wider audience. It will be welcomed by anyone concerned with personal development. Her system will also benefit those whose problems may not require professional therapy, such as adult children seeking to establish warmer, closer relationships with their parents, divorced spouses trying to resolve problems in the interest of their children, or old friends who have grown apart.

I recommend this book to anyone who wants to break out of rigid patterns, resolve conflicts, heal old wounds, or increase intimacy. Letters Home will inspire people, whether they're in therapy or not, to make changes in their lives.