21st Century Aging

Living longer and better.

Keeping a Positive Outlook When Dealing With Chronic Illness

How to Stay Realistic When Coping With Medical Disease

Friends and family often encourage people with illness to stay positive. Is this really helpful?

For people who are medically ill, keeping an optimistic outlook can be tough. Illness is scary and forces them to deal with uncertainty, a lack of control, surrendering to doctors, and the reality that life is finite. All of that is pretty frightening and difficult, so I am not surprised when someone cannot feel positive all of the time when coping with illness.

People who are sick do not need to feel positive all of the time.

It can be trying for people who are ill when friends and family encourage patients to feel happy or optimistic. When a well-intentioned friend says such things as, “Everything happens for a reason,” or “I am sure that you will be stronger from this,” it can (albeit, unintentionally) pressure patients into acting cheery, when they may not feel that way.

In my experience, people struggling with illness want acknowledgement about how hard their situation is. Those who are ill may not want to dwell on how difficult things are. Yet, when friends and family are overly focused on being positive, it can result in patients feeling pressured to articulate how much they are suffering! Hence the paradox: When the loved ones of people suffering with illness make space for negative emotions, hopeful feelings and better coping often follow.

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Being positive all of the time when dealing with illness is unrealistic. In fact, being excessively upbeat is sometimes linked with the denial of illness. Being Pollyannish or in denial can lead to negative psychological and even physical consequences. For example, avoiding the reality of illness can lead to people not taking care of themselves.

What I recommend is finding a balance between acting falsely buoyant and feelings of despair. Being hopeful is reasonable. Complete disavowal of negative information about illness can be problematic; cautious optimism is often ideal.

People who are ill do best when they focus on what they can control—diet, exercise, and decisions about physicians and treatments. Attitude is important as well. Being positive can be helpful; patients should just make sure there are enough loved ones who can listen when the chips are down. People who are ill need friends and family who can tolerate hearing about all kinds of feelings.

 

Tamara McClintock Greenberg, Psy.D., M.S., is an Associate Clinical Professor of Psychiatry at the University of California, San Francisco.

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