According to a trial that followed 97,000 women for eight years, released recently in the journal Circulation, optimism is an important predictor of disease resilience
Marie was 64 when she contracted a rare form of cancer in the bile duct. Her prognosis was poor. We tried many interventions and had some success but, alas, only in the short term.
Marie was a teacher and had researched a new therapy based in, of course, California. It seemed to be a hybrid of unproven but promising new medical treatments with some alternative treatments added to the mix.
She had the money and an incredible, even refreshing, faith in this therapeutic cocktail, and wanted to try it while she was still relatively healthy. Tickets were bought and I wished her bonne chance .
She received a call the day before she was to leave to say there’d been a mistake, and she didn’t qualify for their program. Marie died the following week.
I spend my days talking to people about their cholesterol, their depression, their stress and activity levels, as well as their various treatments. All these issues are important and some likely contributed to Marie’s demise, but maybe I am missing one key factor that Marie lost that day with just one phone call: optimism.
According to a trial that followed 97,000 women for eight years and was released recently in the journal Circulation, optimism is an important predictor of disease resilience.
Women whose optimism scores were in the top 25 per cent had a 9 per cent lower chance of developing heart disease and a 14 per cent lower chance of dying of any cause during the study. The reverse was true for people at the other end of the optimism spectrum, those the researchers call “cynical hostiles.” They had 23 per cent more cancer-related mortality and 16 per cent more total mortality.
Another study, published in the Archives of General Psychiatry, showed similar findings in older men and women.
Optimism and cynicism were measured with a questionnaire. For example, agreeing with such statements as “In unclear times, I usually expect the best” pointed to optimism. Cynics agreed with such statements as “It is safer to trust no one.”
Now, the cynical among you might be wondering if people who are optimistic are that way because they have more money or better education, are more active, smoke less, are less obese or are not depressed.
It’s true, there were associations, but when known risk factors such as the ones above were accounted for, the positive effects of optimism still held up.
Optimism is more than being a Leafs fan (which I am). Optimistic people are in many ways defined by the pessimistic ones.
Pessimistic people think that a misfortune is their fault, that the event will negatively affect everything else in their lives, and that it will last for a long time. The opposite is true of my optimistic patients. It’s not that they are over- cheerful, but that their automatic response is to know they will have to endure the odd rainstorm to see a rainbow. They have confidence about the future. They see people as inherently good, and think things will work out for the best.
So, if we accept that optimism is protective, my question is: Is optimism something you are just born with, or can I actually inject it into my patients?
Martin Seligman, a psychology professor at the University of Pennsylvania, would answer the question of whether we can learn optimism and unlearn helplessness with an emphatic yes.
Dr. Seligman’s seminal work for the public has been a book called Learned Optimism . In it he reviews the evidence, his own clinical research trials, and the mechanisms for learning optimism in different populations (children, organizations, sports teams).
He has a scientist’s approach to writing that is appealing in that he doesn’t frame optimism as something that works for everybody in every situation. A helpful habit, certainly, but not a panacea.
He reverses the questions of mental health by focusing on wellness instead of just illness. He acknowledges that the study of mental illness is incredibly important, but, as he says in his book: “When you lie in bed at night and contemplate your life and the lives of the people you love, you are usually thinking about how to go from a plus 2 to a plus 6, not how to go from a minus 5 to a minus 2.”
Whether we’re troubled or not, most of us want more satisfaction, contentment and joy, not just less sadness.
A key optimism skill to learn is how to explain events to yourself. People who score high on the optimism test attribute successes to internal, stable and global factors. Failures are typically explained by external, unstable and specific causes. These can be subtle. For example, a pessimist might say, “I always forget to make that turn” (internal), while an optimist might say, “That turn can sure sneak up on you” (external).
We know that a pessimistic explanatory style can predict poor health, and that cognitive therapy can change this style. However, we still need more delineation, based on the work of Dr. Seligman and others, of how best to deliver this therapy to the general public.
Ideally, it won’t be just health-care providers but also teachers, advertisers and businesses that will be part of the solution.
While more work is needed on how much optimism is a symptom, rather than a cause, of good health, and how much it can be learned by all, this new trial reveals the significance of your thinking style.
As they say, we can’t predict the wind, but we can set the sails.
Optimism resources recommended by Dr. Michael Evans.
A one-minute YouTube video from the Foundation for a Better Life. Very good starting point
A slightly tongue-in-cheek example of a therapist employing Learned Optimism
A video of Martin Seligman, PhD, talking about positive psychology
Teaching optimism to kids
Learned Optimism by Martin Seligman, available in some bookstores for $16
Test your optimism or pessimism
Many more tests on positive psychology and other resources for optimism are available at here
Dr. Michael Evans is an associate professor of Family & Community Medicine at the University of Toronto and staff physician at St. Michael’s Hospital and leader of the Health Design Lab at the Li Ka Shing Knowledge Institute.
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