My Dad Passed away late November 2009. He waged a 10 year battle against cancer. I include some of his writing in this blog as a way of keeping his advice around.
OPTIMISM: THE MISSING FACTOR IN WELLNESS
Note: The following material is excerpted from an article by Dr. Michael Evans that appeared in the Globe and Mail, September 29th, 2009.
Physicians spend their days talking to people about their cholesterol, their depression, their stress levels, their activity levels, as well as their various treatments. All these issues are important but maybe one important issue is being missed.
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% had a 9% lower chance of developing heart disease and a 14% lower chance of dying of any cause during the study. The reverse was true for people at the other end of the spectrum, those the researches call “cynical hostiles”. They had 34% more cancer-related mortality and 16% 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.
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 a long time. The opposite is true of optimistic patients. It’s not that they are overly 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 physicians or support workers actually inject it into patients?”
Martin Seligman, a psychology professor at the University of Pennsylvania answers the question of whether we can learn optimism and unlearn helplessness with an emphatic “yes”.
In his seminal work, Learned Optimism, he reviews the evidence, his own clinical research trials, and the mechanisms for learning optimism in different populations (children, organizations, sports teams). He doesn’t frame optimism as something that works for everyone in every situation but as a helpful habit and not a panacea.
He reverses the question 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 usually are 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”.
Credit: Dr. Michael Evans is an associate professor of Family & Community Medicine at the University of Toronto, a staff physician at St. Michael’s Hospital and leader of the Health Design Lab at the Li Ka Shang Knowledge Institute. For Dr. Michael Evan’s resource guide for optimism, including videos and tests, visit globeandmail.com/life.
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