The Optimism Revolution

Faced with a health challenge instead of an anagram, the active, problem-solving approach stands people in good stead. Carol Farran, a professor of nursing at Rush University Medical Center and author of Hope and Hopelessness, was diagnosed with breast cancer 20 years ago at age 42, when her children were in junior high school. Farran had already been conscientious in dealing with two other chronic health problems: endometriosis and fibromyalgia. "For fibromyalgia, I use low doses of antidepressants, massage, and yoga, and I say to myself each day, 'Well, Carol, you can choose to sit around and mope or you can live an active life anyway.' To me, that decision is the axis around which optimism truly turns."

Farran's proactive outlook may have saved her life—it was she who discovered a lentil-size node in her breast. When it turned out to be breast cancer, Farran first suffered crying jags and panic attacks. Shortly after surgery, "I was out with my kids and panicking. We went to a music store, and I got a metronome. Symbolically it was very important. I could set the metronome to whatever speed I wanted, and it reminded me that I could set my life to my own time, fast or slow." Whenever she listened to the metronome, she remembered that it was her choice to reframe and reappraise her life. "It gave a certain meaning to my struggle," she concludes, and it is meaning that helps us regain a sense of control and mastery over our own lives. "You make new choices in life," says Farran. When one goal becomes impossible, the dispositional optimist will find another goal to work toward and bring satisfaction instead.

That ability to reframe life, to find new meaning, is part of an optimistic strategy. "When a crisis strikes," says University of Virginia psychologist Jonathan Haidt, author of The Happiness Hypothesis, "optimists tend to alternate between active coping and reappraisal. If active coping fails to fix the problem, they reappraise the situation, looking for hidden benefits, and, invested with flexibility, write a new chapter for their life." For instance, optimistic patients who received bone-marrow transplants for cancer were able to sustain relationships and re-enter the world more readily than their pessimistic counterparts, largely because they used emotional coping and tried to gain something positive from a generally negative experience. Optimism also predicts whether people will remain actively engaged with life after falling ill. In a study of 250 adults with chronic illnesses such as arthritis and cancer, Farran found that 85 percent had to give up meaningful activities (exercise, gardening, traveling). But the hopeful among them replaced lost activities with new and meaningful ones (playing music, writing, socializing) to remain fulfilled.

The Limits of Optimism

It isn't that optimism stirs up some neurochemical elixir that enhances health. Rather, it mobilizes personal power: Exercising, staying compliant with treatment, getting regular checkups, regrouping to overcome roadblocks—these are the pragmatic things that help keep us well.

Optimism is not a panacea. It can't overcome overwhelming odds—it cannot cure end-stage cancer, or brain diseases like Alzheimer's, or autoimmune diseases like lupus. One telling study looked at lung cancer, which has a high mortality rate because it is often discovered late. More optimists were alive after one year (75 percent of very optimistic folks, compared to only 60 percent of moderately optimistic or pessimistic folks) but by the third year the grim reaper had completely evened out the score, and only 20 to 25 percent of all sufferers were still alive. Similarly, HIV studies are mixed: In one study, optimism did not slow down the decline of special immune cells, while in another, it did and lowered viral load. "The places where we see mixed or no effect in optimism tend to be in populations like those with cancer, HIV, or the elderly," says Segerstrom.

Not only is optimism inadequate to change the course of a lethal illness, but it may, in some situations, be a source of stress. For instance, Segerstrom found that when optimists were exposed to loud noises they couldn't control or were asked to perform tasks that became increasingly difficult, their immune systems became temporarily suppressed in ways that would impair their ability to fight infection. This is due to the conscientious nature of optimists, who try to meet multiple goals, she says.

Why might optimism fail in these challenging circumstances? Perhaps optimists just can't face failure. Some experts argue that although optimists are typically less distressed than pessimists, they might get especially anxious and demoralized when their expectations are dashed and their efforts fail. By this rationale their disappointment leads to negative affect that subsequently decreases immunity.