The Ailing Middle Class

The U.S. middle class consists mostly of fine, upstanding citizens who mind the conventions and obey the law. And what does it get them? Ulcers and trouble with their wives, say Drs. Jurgen Ruesch and Karl M. Bowman of the University of California's division of psychiatry.

Middle class folks,* the doctors reported in last week's Journal of the American Medical Association, are particularly prone to psychosomatic (mindbody) troubles and chronic illnesses. One big reason is the American yen for "making good." The middle class works especially hard at trying to make good. The constant effort produces strains and tensions (people "feel the necessity to improve their condition, rather than to enjoy their existence"), which in turn produce unhappiness and maladjustments.

The trouble is, the middle class is too respectable to blow off its tensions by getting mad, beating somebody up, and then being hauled away in the paddy wagon to cool down. Instead, it grits its teeth and swallows its hurts, thus producing duodenal ulcers or harsh treatment of the little woman. All the patients studied were above average in intelligence, which prompted the two doctors to conclude that "the more intelligent persons tend to have difficulties with recovery and adjustment to disability."

Social climbing is something the doctors specifically warn against: "We have been able to show that among patients with chronic disease in general, with duodenal ulcers and with thyroid disorders there is an unusual number of social climbers and strainers, that is, persons who want to improve their social status."

*Drs. Ruesch and Bowman do not bother to define "middle class." Peter H. Odegard and E. Allen Helms in American Politics (Harper; 947) say, "Definitions of social and economic classes in modern society are difficult to make, nd particularly so in the United States. . . . The middle class might be defined as including those whose income is derived from salaries, commissions, or fees paid for services."

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