Sarah Cotterill, PhD

The Science of Adversity

Rethinking Marriage...and Cancer

Can a technique to save marriages also help us confront cancer?

Posted Jun 14, 2016

Can a technique shown to preserve the quality of marriages also help us confront illnesses like cancer?

In this post, I suggest it can. The technique in question is called cognitive reappraisal. Pioneered by psychologists at Stanford, reappraisal entails approaching our challenges from a relatively objective point of view—from the vantage point of a neutral third party. For example, when spouses find themselves in the midst of an argument, they might try to view their disagreement the way an impartial friend would see it. And indeed, research suggests that such a strategy can thwart emotional distress and longer term damage to the relationship.

Grant Wood [Public domain or Public domain], via Wikimedia Commons
Source: Grant Wood [Public domain or Public domain], via Wikimedia Commons

In one experiment, couples who were instructed to approach their disagreements from the perspective of a neutral observer saw no decrease in the quality of their marriage over the course of the study, whereas other couples, who weren’t given the reappraisal instructions, did. In other words, just a 21 minute intervention (in which couples practiced reappraisal) preserved marital satisfaction over the year the couples were tracked (for more information see this interesting New York Times op-ed; see here for a less scientific commentary on marriage).

Reappraisal has been studied in many different domains—including mental health concerns like depression. And in this post, I suggest that we can also think about illnesses like cancer with reappraisal in mind. 

The idea here is that we might feel more at peace with a life-threatening diagnosis when we think of it objectively- the way a medical doctor sees it, as a scientific process playing out in the body. For example, a cancer diagnosis might feel more psychologically manageable when we disavow the tendency to see the cancer as an evil thing that is waging war on us. And here reappraisal is a relatively easy alternative to embrace. Because the truth is cancer isn't an evil thing. It doesn't have feelings, or emotions, or ambitions to take us down. We might feel calmer when we see it for what it is: a collection of cells multiplying within. 

Now, this stands in contrast to the idea I took up in my first post. There, I discussed how anthropomorphism- that very tendency to see illnesses as having evil aspirations- can in some circumstances actually help one cope. Thinking of cancer through the lens of human behavior—as an agent with goals and desires—helps us make sense of the unthinkable and make predictions about the future.

So what we have is not an issue of “right” or “wrong”- that one coping strategy is better than the other. Rather, which of these strategies—anthropomorphism and/or reappraisal—is most helpful in any given circumstance could depend on aspects of the situation or on an individual’s personality.

For example, people high in what’s called “need for structure”—these are people who like to figure out or make sense of the world around them—might prefer anthropomorphism, for the sense of order and predictability it buys. On the other hand, those high in “need for cognition”—people who enjoy engaging in elaborated thinking—might prefer a strategy like reappraisal.  

The distinction between the two can also be understood in terms of how we think—in particular, that we have two modes, or “systems,” for thinking. System 1 is relatively spontaneous, fast, and effortless. It guides our intuitive thoughts and reactions. Thus, we might think of  anthropomorphism—a relatively spontaneous mental shortcut or heuristic—as falling under its purview. On the other hand, System 2 is slower, effortful, and deliberate—it’s where our conscious processing takes place. We can therefore think of cognitive reappraisal—a relatively deliberate process involving elaborated thinking and reasoning—as largely falling under the purview of this second system. 

It's important to note, though, that while I’ve brought reappraisal and anthropomorphism together in the context of illness, they aren't considered two sides of the same coin, nor are they mutually exclusive processes. For example, we could reappraise the goals of a tumor so as to not be so evil. And it's also the case that these are but two of many possible coping strategies (in future posts, I'll take up others). 

But research suggests that thinking about a disease itself in different ways, not only its consequences, has implications for coping, including living well after life-altering diagnoses.

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Gross, J., John, O. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348-362.

Finkel, E.J., Slotter, E.B., Luchies, L.B., Walton, G.M., Gross, J. (2013). A brief intervention to promote conflict reappraisal preserves marital quality over time. Psychological Science, 24, 1595-1601.

Ehring, T., Tuschen-Caffier, B., Schnulle, J., Fischer, S., Gross, J. (2010). Emotion Regulation and Vulnerability to Depression: Spontaneous Versus Instructed Use of Emotion Suppression and Reappraisal. Emotion, 10(4), 563–572. 

Epley, N., Waytz, A., Cacioppo, J.T. (2007). On seeing human: A three-factor theory of anthropomorphism. Psychological Review, 114 (4), 864-886.

Neuberg, S.L., Newsom, J.T. (1993). Personal need for structure: Individual differences in the desire for simple structure. Journal of Personality and Social Psychology, 65(1), 113-131. 

Cacioppo, J.T., Petty, R.E., Morris, K.J. (1983). Effects of need for cognition on message evaluation, recall, and persuasion. 45(4), 805-818. 

Kahneman, D. (2011). Thinking, fast and slow. New York: Farrar, Straus and Giroux.

(C) Sarah Cotterill. All rights reserved.