An Utterly Unexpected Risk Factor for Malignant Melanoma

This article is part of a series on personality and diseases. There are many personality typing systems, and those various types generally fall into these four categories. We explore the emotional pitfalls of each “type” and explained their causative relationship with disease; it is possible to identify with traits across types, as well as the respective ailments. Read on for an in-depth explanation of this particular type.

In 1985, Lydia Temshok and her colleagues made a surprising discovery—some facets of personality were found to be related to cancer prognosis.

In a study on the relationship between personality and skin cancer, Temoshok and colleagues recruited 59 adult participants with stage I or stage II cutaneous malignant melanoma—a potentially lethal form of skin cancer—from around northern California.

The study was intended to study if there are any potential psychosocial factors to cancer severity. Malignant melanoma was selected because of the fact that it presents several advantages for this investigation, especially because there are precise and reliable staging systems for defining the extent of disease.

The research team took two measures of the skin cancer tumors: the thickness as measured by Breslow’s thickness criterion and the level on Clark’s scale. They also conducted structured interviews and issued self-report questionnaires as a way of identifying personality traits.

Unsurprisingly, patient delay in seeking medical attention for suspicious lesions was found to contribute the best prognostic indicator for variance to tumor thickness.

Separate from delay behavior, it was surprising for the physicians to find that there were positive correlations between several personality traits as part of a Type C personality—passive, appeasing, helpless, placing faith in external authority—and lesion thickness. Individuals who had these traits tended to have thicker lesions than those who didn’t.

Temshok and her colleagues’ work was novel because it was one of the first to connect psychosocial factors like personality and behavior patterns with cancer prognosis.

Personality Typology in the Health Field

Temshok’s work was built on a robust body of literature connecting personality traits with health outcomes.

Meyer Friedman and Ray Rosenman were some of the first to make the connection.

They were cardiologists, and they came to the conclusion that personality could affect health outcomes in one of those happy accidents that we find throughout the history of health discoveries: they noticed a strange pattern of wear on the chairs in their office. Only the front edge of the chairs seemed to be used.

Their patients apparently tended to sit on the edge of their seats.

Friedman and Rosenman began a research program that eventually demonstrated that people with what they called Type A behavior patterns were more likely than others—people with Type B and Type C behavior patterns—to develop heart disease and high blood pressure.

People with Type A behavior patterns are characterized as ambitious, rigid, high achieving, and impatient. They are very concerned with time management and are often considered workaholics. They often experience more stress than Type Bs and Type Cs.

In contrast, people with Type B behavior patterns are considered to be people who lack those traits. They typically work more steadily, are not as ambitious, are more patient, and are more flexible. They typically live with less stress and higher job satisfaction. And, they’re less likely to suffer from cardiovascular diseases.

Friedman and Rosenman also proposed that people with Type C behavior patterns are often similar to Type As, but the people who had them also experienced chronic anxiety and insecurity. Another distinct trait is that they do not easily express or process their negative emotions but rather accumulate a lot of negative emotions inside themselves.

It was this Type C behavior pattern that Temshok and their contemporaries eventually connected with the risk of developing cancer.

Sharpening the Definition of Type C Personalities

Temoshok and her colleagues expanded on Friedman and Rosenman’s idea of a “Type C” behavior pattern. Whereas Type B is the absence of Type A characteristics, they proposed that the Type C behavior pattern was constructed to be the polar opposite of Type A. These were hypothesized to exist on a spectrum, with Type A on one end, and Type C on the other.

According to Temsok and her colleagues, people conforming to a Type C behavior pattern are characterized as cooperative, patient, and unassertive. They suppress negative emotions, including anger, and comply with authorities. They may also feel helpless, hopeless, and with tendencies toward depression.

People with Type C personalities have a number of strengths. They are typically calm with a consistent and controlled demeanor. They tend to be creative and cooperate easily with others. They can be dedicated to their projects, helpful, and thoughtful about planning for the future.

However, they can also be resistant to conflict, which can sometimes turn into emotional repression. They can also be prone to perfectionism, anxiety, pessimism, or even depression. They have a tendency to defer their own needs to the needs of others.

While there’s nothing inherently wrong with having a Type C personality, it may come with an increased risk of some health issues.

And one of them could be cancer.

Repressed Emotions and Cancer

In a study in the European Journal of Personality, Hans Eysenck and colleagues sought to determine whether personality types might predict deaths from heart disease and cancer. They gave 3,235 European subjects interviews and personality assessments to determine various personality traits. Then they tracked these subjects over the course of 10 years.

At the end of the 10-year period, the subjects were contacted again. If they had died, the researchers reviewed the cause of their death from their death certificates. In that way, the research team was able to connect personality traits with the ultimate cause of death.

At the 10-year follow-up, they found that 1,341 individuals from their original sample had died. These they categorized into different personality types based on their earlier personality assessments.

They found that 45 percent of those with what these researchers called “Type I” personality traits (similar to Temshok’s Type C behavior pattern in that they inhibit emotions) died of cancer. This group was much less likely to die of other causes, like heart disease.

Similarly, people that Eysenck categorized as “Type II” (which is similar to Temshok’s Type A behavior pattern of people with high stress) were much more likely to die of cardiovascular diseases like heart attacks and strokes. They also found that people with other patterns of personality were less likely to die from either cancer or cardiovascular diseases.

Epoch Times Photo
Hans Eysenck found that people with Type C traits were much more likely to die from cancer. People with Type A traits were more likely to die from cardiovascular diseases.

Eysenck’s study suggests that the only relevant personality characteristics for cancer risk are repressing feelings or inhibiting closeness with loved ones.

Other research suggests it’s a tendency towards depressive symptoms that matter most.

For example, one systematic review and meta-analysis of 25 studies that together included over 1.4 million participants found a significant association between depression and overall cancer risk. Tendencies toward depression make up an important part of what we call the Type C personality.

Similarly, another review of 70 longitudinal prospective studies on personality research found that helplessness and repression of emotions are perhaps the most promising in explaining a potential contribution of personality on cancer prognosis.

People with Type C personalities also tend to be cooperative. Social support—having a strong network of family and close friends—was found to be a protective factor against this type of Cancer. Some aspects of Type C personality may actually foster health.

So rather than it being a Type C behavior pattern that’s associated with cancer, it may actually be a few traits within that pattern that matter most.

Does Personality Influence Cancer Risk?

If there really is an influence of personality on cancer risk, how would that work? What’s the physical mechanism?

One explanation is that people who often feel depressed have decreased lymphocyte proliferation and an overall decreased function in the body’s anti-cancer and anti-viral immunity. This may create greater susceptibility to cancer.

Indeed, in one prospective case-control study out of Finland, researchers found that patients with breast cancer were significantly more likely to have a high commitment—a feature of Type C personalities.

They suggest that it could be that the Type C pattern “could contribute to cancer risk through immune and hormonal pathways.” In other words, it may not be the personality traits themselves that affect cancer risk, but that patterns of thinking and behavior could impact the body’s immune system and hormones, and those changes may influence cancer risk.

So what does that mean for people with Type C personalities? Are they doomed to a life of increased cancer risk?

No, not necessarily.

First, let’s remember that we’re talking about risk. No one is ever guaranteed to get cancer, even if they engage in high-risk activities, like smoking. It’s simply that particular patterns of thinking or behaving may put you at greater risk.

It’s the same here with personalities: it appears that some characteristics may increase the risk of developing cancer, but no personality characteristics guarantee you’ll develop it.

Not all Traits of Type C Personalities Are Harmful

Another important thing to remember is that not all the traits within Type C personalities are problematic. Indeed, many of the traits, like being calm, creative, and cooperative, are quite positive. They can help you develop relationships with others, increase your circle of social support, and in so doing, may contribute to greater health and happiness.

It’s just some tendencies—like being prone to repressing feelings and depressive symptoms—that may be more harmful. Depressive states could result in a suppressive function of anti-tumor immunity, thus increasing the chance of tumor progression.

In other words, if you see yourself represented in the description of Type C behavior pattern, it’s not that your personality is necessarily a problem.

Instead, there may simply be an opportunity for self-reflection about patterns of thinking that may not be serving you. And you may therefore work to shift those habits of thinking and behaving to be more healthy.

Helpful Habit 1: Learn New Patterns of Expressing and Dealing With Emotions

We all feel a range of emotions: sadness, disappointment, anger, joy, frustration, disgust, fear, and many more.

The question is how we deal with those emotions.

Exploding with anger, hostility, and aggression isn’t the answer. Not only do you put yourself at risk for heart disease (as research on Type A behavior patterns suggests), but you also put your relationships at risk. On the other hand, repressing your emotions isn’t the answer, either. We’ve seen how this tendency for repressing emotions in Type C personalities can also be harmful.

Instead, it may be more useful to practice expressing and communicating our feelings in a way that’s honest but not aggressive.

Alternatively, we may try to learn to change our mindset first so as to have a more calm attitude to deal with interpersonal relationships. The more inner peace we have, the less likely that we would have conflicts or interpersonal stress.

Helpful Habit 2: Develop a Meditation Practice

Mindfulness and meditation have consistently shown themselves to be powerful ways to cultivate well-being. For example, some researchers have found that meditation practice can prevent relapse of depression and anxiety. Others have found that it may play a role in supporting the body’s immune system.

In a meta-analysis of 29 studies on meditation for cancer patients, meditation was found to reduce fatigue, stress, anxiety, and depression, and ultimately contribute to greater quality of life.

Mindfulness and other forms of meditation can contribute to health for anyone, but it may be especially useful for those who want to improve their emotion regulation.

Helpful Habit 3: Improve Our Character and Be Happier

The most harmful components of Type C traits are being prone to repressing feelings and depressive symptoms. One strategy for better health may simply be to change our lifestyles to improve our character and be happier.

For example, one doctor shared an example of a patient—a bright, young professional—in her 30s who was diagnosed with stage III ovarian cancer. Two years after cancer treatment, her cancer was back. She followed her doctor’s advice and took up a “less stressful” job. But, unfortunately, her tumor markers started to rise again, suggesting yet another relapse.

This time around, her doctor did not prescribe any treatment but simply advised her to take a holiday. She toured around France for a whole month, visited friends, drank lots of French wine, and enjoyed herself. When she came back to see her doctor, she not only looked rejuvenated, but her tumor markers were also normal. It was remarkable.​​

It is very likely due to the fact that her positive and happy attitude made her depressed immune cells start to function again till they killed the cancer cells.

There are a number of methods to be happier, including but not limited to:

  • Learn to smile more often and be more grateful to others
  • Think positively, turn negative situations into unique opportunities
  • Go to bed on time and get up early in the morning
  • Enjoy sunlight and outdoor activities
  • Take time for a vacation in natural scenic places, turn off the wireless network
  • Do regular, slow, relaxing aerobic exercises
  • Reduce the amount of time working and take more time for hobbies
  • Cultivate flowers, try forest bathing or mountain climbing

The Mind and the Body Are Intertwined

We like to distinguish between our mind and our body, but the truth is that they’re connected. And that insight came in part thanks to an upholsterer in a cardiologist’s office.

The big idea is this: the way that we take care of our body has very clear implications for our mental health. And it’s becoming increasingly evident that our patterns of thought can influence our physical health.

Some of our patterns of thinking may be particularly unhelpful, and some of those in the Type C constellation of traits may even have connections with cancer.

But we can shift those through careful practice.


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