HAMBURG 253success, and that opens up possibilities for disease prevention that have
been pursued in recent years. For example, there are toxic and non-toxic
ways of trying to cope with the stress of early adolescence. The toxic ones
include heavy smoking, high intake of alcohol or other drugs, wild driving,
unprotected sexual activity, and a preference for violent pseudo-solutions.
Early adolescence is a crucial phase of human development that had
been scientifically neglected until the 1950s. My wife, Beatrix Hamburg,
a child psychiatrist with pediatric training, played a crucial role in clarify
ing early adolescence, delineating it as a distinctive phase of adolescence,
a distinctive phase of the life cycle in which crucial choices are made in
the face of high-risk behaviors.
The high-risk behaviors are typically undertaken on an exploratory
basis. By understanding the developmental tasks and coping strategies,
preventive measures may be taken before these exploratory patterns get
cast in concrete, before health-damaging patterns are firmly established.
There is currently much interest in discovering ways to help people im
prove their coping strategies, and further utilization of basic learning
principles in this field is a line of inquiry well worth pursuing.
In years to come, a deeper understanding of human coping behavior
can be useful in devising reasonable therapeutic and preventive interven
tions. The promise of such interventions is clearest in mental health;
but they also have direct relevance to general health, because health-
damaging coping efforts, such as smoking, alcohol use, and risky driving
weigh heavily in the burden of illness. Epidemiologists roughly esti
mate that about half the burden of illness of the American population
is behavior related, so how we cope matters in a lot of ways.
Let me write a word about sleep and its disorders. It was my privi
lege to establish a sleep laboratory at the NIMH headed by Frederick
Snyder, with Irwin Feinberg as a major contributor in that effort. Since
the mid-1950s, psychiatrists have joined with scientists of various dis
ciplines, and we have awakened–no pun intended–to the fact that we
spend one third of our lives in a state about which very little was then
known. In the intervening years, the problems of sleep have become a
major frontier of science through the efforts of such pioneers as William
Dement, with whom I had the privilege of working for many years at
Stanford. These scientists’ studies of brain waves, heart rate, breathing,