[acb-hsp] A Fighting Spirit Won't Save Your Life
paltschul at centurytel.net
Thu Jan 27 13:48:00 GMT 2011
January 24, 2011
A Fighting Spirit Won't Save Your Life
By RICHARD P. SLOAN
GABRIELLE GIFFORDS's remarkable recovery from a bullet to her
head has provided a heartening respite from a national calamity.
Representative Giffords's husband describes her as a "fighter,"
and no doubt she is one. Whether her recovery has anything to do
with a fighting spirit, however, is another matter entirely.
The idea that an individual has power over his health has a long
history in American popular culture. The "mind cure" movements
of the 1800's were based on the premise that we can control our
well-being. In the middle of that century, Phineas Quimby, a
philosopher and healer, popularized the view that illness was the
product of mistaken beliefs, that it was possible to cure
yourself by correcting your thoughts. Fifty years later, the New
Thought movement, which the psychologist and philosopher William
James called "the religion of the healthy minded," expressed a
very similar view: by focusing on positive thoughts and avoiding
negative ones, people could banish illness.
The idea that people can control their own health has persisted
through Norman Vincent Peale's "Power of Positive Thinking," in
1952, to a popular book today, "The Secret," by Rhonda Byrne,
which teaches that to achieve good health all we have to do is to
direct our requests to the universe.
It's true that in some respects we do have control over our
health. By exercising, eating nutritious foods and not smoking,
we reduce our risk of heart disease and cancer. But the belief
that a fighting spirit helps us to recover from injury or illness
goes beyond healthful behavior. It reflects the persistent view
that personality or a way of thinking can raise or reduce the
likelihood of illness.
The psychosomatic hypothesis, which was popular in the mid-20th
century, held that repressed emotional conflict was at the core
of many physical diseases: Hypertension was the product of the
inability to deal with hostile impulses. Ulcers were caused by
unresolved fear and resentment. And women with breast cancer
were characterized as being sexually inhibited, masochistic and
unable to deal with anger.
Although modern doctors have rejected those beliefs, in the past
20 years, the medical literature has increasingly included
studies examining the possibility that positive characteristics
like optimism, spirituality and being a compassionate person are
associated with good health. And books on the health benefits of
happiness and positive outlook continue to be best sellers.
But there's no evidence to back up the idea that an upbeat
attitude can prevent any illness or help someone recover from one
more readily. On the contrary, a recently completed study of
nearly 60,000 people in Finland and Sweden who were followed for
almost 30 years found no significant association between
personality traits and the likelihood of developing or surviving
cancer. Cancer doesn't care if we're good or bad, virtuous or
vicious, compassionate or inconsiderate. Neither does heart
disease or AIDS or any other illness or injury.
And while we may be able to point anecdotally to a Gabrielle
Giffords as an example of how a fighting spirit improves medical
outcome, other people with a spirit just as strong die -- think
of Elizabeth Edwards, for example. And many patients who employ
negative thinking nevertheless recover from illness every day.
We want good things to happen to good people and this desire
blinds us to evidence to the contrary.
But such beliefs have implications for how we regard people who
are ill. If people are insufficiently upbeat after a cancer
diagnosis or inadequately "spiritual" after a diagnosis of AIDS,
are we to assume they have willfully placed their health at risk?
And if they fail to recover, is it really their fault? The
incessant pressure to be positive imposes an enormous burden on
patients whose course of treatment doesn't go as planned.
Very early in my career, I participated in a study of young women
who were hospitalized and awaiting the results of biopsies to
determine if they had cervical cancer. While I was interviewing
one of my patients, the biopsy results of the woman in the next
bed came back to her -- negative. The fortunate woman's father,
who was there with her, said in relief: "We're good people. We
deserve this." It was a perfectly understandable response, but
what should my patient have said to herself when her biopsy came
back positive? That she got cancer because she wasn't a good
It is difficult enough to be injured or gravely ill. To add to
this the burden of guilt over a supposed failure to have the
right attitude toward one's illness is unconscionable. Linking
health to personal virtue and vice not only is bad science, it's
Richard P. Sloan, a professor of behavioral medicine at Columbia
University Medical Center, is the author of "Blind Faith."
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