Repressive/defensive coping, blood pressure, and cardiovascular rehabilitation.

The emotional style of repressive coping in relation to blood pressure and cardiovascular disease has received increasing attention during the past 25 years. Repressive coping describes the capacity to render events and feelings inaccessible to consciousness. Intrapsychic conflicts involving unacceptable wishes, fantasies, and impulses can be hidden from conscious awareness. Repressive (or defensive) coping has been associated with elevated blood pressure levels, essential hypertension, and paroxysmal hypertension. Cardiovascular patients who use a repressive style have shown mixed results during recuperation. The repressive coping style is easily assessed with two pencil-and-paper measures, which clinicians could administer. Knowledge that a patient uses repressive emotional coping could help physicians better treat this unique group. For patients recovering from cardiovascular events, intervention styles can be adopted that fit the repressive personality. More research in this area will be a challenge to psychologists and internal medicine specialists.