Disabusing Patients' Belief in the Power of Positive Thinking

In my last post I promised to address whether linking health to personal virtue is "good" or "bad" medicine. Followers of this blog know what I'm going to say:

It depends.

It's awful if in addition to the burdens of progressive illness patients also feel guilty that their "wrong" attitude is allowing their condition to deteriorate. Disabusing these patients of their belief that they must be cheerful and optimistic all the time IS good medicine. It can free them to feel whatever emotions they are feeling and then to use the unpleasant feelings to help them move forward.

But I've become more circumspect when it comes to criticizing patients who are doing well now and insist it's because they have the "right" attitude. Their belief likely encourages them to feel optimistic and surely helps calm their fear of tomorrow. In doing so, their belief helps them live as fully as possible.

Disabusing these patients may, indeed, have a benefit down the line if their condition takes a turn for the worse. However, your challenging their belief may cause them to feel angry, alienated or fearful at a time they were feeling fine. Your efforts to enlighten them may disrupt a coping mechanism that was helping them.

Is it wrong to hold your tongue and let them believe what they want to believe while they are doing well, if it's helping them feel better emotionally and is helping them get good care?  

Comments

[Lisa Escaloni]

I think it's very freeing for cancer survivors/patients to feel or think whatever they want, negative or positive. Consider that if you have a positive attitude, it may also help the people AROUND you including caregivers, and perhaps you'll get better care. Consider also that whatever attitude someone has, if it relieves stress, that's a good thing.

[Wendy S. Harpham, MD]

Lisa, I agree. If family, friends and caregivers can tire of caring for and about someone who is chronically pessimistic or angry. Thus, a patient stuck in a negative emotional place can compromise the first criteria of Healthy Survivorship: Getting good care.
More on this in future posts.
With hope, Wendy

[Jonnie Hickman]

This is very true Dr Wendy. I have lost many good friendships since my diagnosis because I am not always happy my life has changed. I miss me from before.

A friend said she saw a man/friend who was 18 and in a wheelchair at the grocery. She asked why I couldn't be more like him. He was always smiling. I said, "Yeah, for that 15 minutes." I am a pretty positive person most of the time, but sometimes I am a whiner.

Thanks for emotional freedom.

Jonnie Hickman

[Lori Hope]

Thank you for posing this question.

I believe that disabusing patients' belief in the power of positive thinking is wrong, not because I believe in the power of positive thinking to heal or cure, but because I believe in supporting the faith and belief of anyone rendered raw, vulnerable and traumatized by disease.

"Whatever gets you through the night," I say - just so it's not hurting someone else, which compels me to add one more thing.

It’s not appropriate to brag to other patients, in the context of a cancer support group, that thinking positively has helped put the speaker’s cancer in remission. That may make those who are not faring as well blame themselves for not looking enough, or being able to see at all, the bright side.

There’s one more question that comes up: What if someone’s belief in positive thinking and the power of the mind preclude their getting conventional treatment that could improve their health or assuage their pain? Are we obligated then to point out the limits of positive thinking? I faced that situation with my dear friend, a Christian Scientist. It was heart-wrenching. But I knew that she understood the implication of her choices (and my beliefs), so I respected hers.

[Denise]

I thought that the point of the article was that friends or family members should not constantly tell cancer patients to be positive or keep a good attitude. I did not think it was advising cancer patients themselves what attitude they should choose. Thanks,

[Wendy S. Harpham, MD]

I agree, Denise. The primary focus was about the impact of family and friends telling patients they need to be upbeat.

Lori,you asked about your obligations if a patient's belief in the power of positive thinking keeps the patient from good care.

Your comments provide a perfect seque into my next post. Thanks!

With hope, Wendy

[Lift]

Well said. I never thought I would agree with this opinion, but I’m starting to see things from a different point of view. I have to analyse more on this as it seems very interesting. One thing I don’t understand though is how everything is related together.

[Wendy S. Harpham, M.D.]

Dear Lift,

Every post on this blog is related to my belief that striving for Healthy Survivorship -- i.e., striving to get good care and live as fully as possible -- paves the way for what happiness is possible under the circumstances

I look forward to your future comments.
With hope, Wendy