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Tyranny of Positive Thinking

Posted 3/29/2013

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I wish that I could take credit for the wonderful (I think) phrase that titles today's entry. Instead, the credit goes to Dr Jimmie Holland at Memorial Sloan Kettering in New York. It is a phrase that we can all immediately recognize and relate to. All of us have been warned by others that "you have to think positively" or "don't be negative" or some other injunction that suggests that the flavor of our thoughts and attitudes will make the difference between life and death from cancer.

  Nary a week passes that I don't have this conversation with at least one person in my office. Here is the truth: It makes absolutely NO difference, in terms of prognosis, whether you have a positive attitude or the most negative attitude possible. What matters is the particular cancer you have and its response to treatment. We all know that attitude or mood or outlook impacts the quality of our days and lives. Surely, we are happier and have a better quality of life if we are more hopeful and optimistic, but I promise it will not impact the cancer.

  It also would be impossible for anyone living with this serious diagnosis and difficult treatments to be constantly positive. I actually would worry more about a woman who cheerfully insisted that she is "just fine" in the throes of chemotherapy. Cancer is serious business, and all of us are going to worry sometimes about our futures and about dying and about our children or partners or finances or jobs. That's life.

  This is a delightful essay from Kevin; I give you the beginning and a link--and my full permission and support to be as negative or not as you choose.

Cancer patients who are positive in the face of terrible adversity

Bruce Campbell, MD | Physician | March 19, 2013

Bruce Campbell, MD | Physician | March 19, 2013

God helps those who help themselves.

-Something that sounds like truth but fortunately isn’t mentioned in any religious text

-Something that sounds like truth but fortunately isn’t mentioned in any religious text

“I’m gonna beat this thing again, Doc! I just know it!”

Over the course of several years, I helped care for a man with a very rare cancer that recurred over-and-over. With each new tumor, he became more focused on beating the disease and despite the repeated setbacks, he remained eternally positive. He spent hours researching every available experimental treatment. He trekked from center to center for therapy.

His determination was inspirational. Despite the intensity of his effort, he eventually lost his battle and died. His wellattended visitation and funeral were testimonies to his remarkable life, his outgoing personality and the respect everyone had for his determination.

My super-positive patient told me more than once that his attitude was helpful. “It’s why I’m still alive,” he said. His intensity prompted me to ask: How does attitude affect survival? If a patient tries “hard enough,” can cancer be controlled?

It’s a difficult issue. It is wonderful being with people who are optimistic. As a physician, patients who are positive in the face of terrible adversity are inspirational. Of course, many patients dealing with cancer are devastated both physically and emotionally. With the tobacco-related cancers for which I care, many of my patients carry an extra burden of guilt.

Memorial Sloan-Kettering Cancer Center Psychiatrist Jimmie Holland, MD works with many patients who carry this burden. He refers to a patient or family’s insistence that he or she maintain a positive attitude at all times as “The Tyranny of Positive Thinking.”


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