The Power of Positive Thinking?
Can what is going on in your mind affect your physical wellbeing? If so, how can we take advantage of this to improve our mental and physical health?
We know that depression increases the risk of dying, including the risk of stroke – a leading cause of death and permanent disability.
Conversely, patient expectations can influence clinical outcomes (how effective their treatment is). That is what a number of studies have concluded, including this two year study of 88 breast cancer patients, reported in 2016, which found the relative risk of side effects was higher in patients with negative expectations than those with more positive expectations.
So what do research findings more generally suggest?
The Placebo Effect – Myth or Reality?
We’ve probably all heard of the placebo effect – the idea that if we expect a treatment to work it will and that it may be our belief rather than the treatment which is having the effect. The existence of the placebo effect has been widely recognised, even within the NHS. In fact it is sometimes used to explain why complementary medicine may work for some people.
In recent years, though, there has been debate as to how real the placebo effect is. A major challenge came in 2010, with the publication of a systematic review of the research. This found little evidence of the placebo effect in practice, other than a possible effect in reducing pain.
However a recent re evaluation of the evidence (in 2013) concluded placebos did have an effect and stated, ‘Placebos with comparatively powerful effects can benefit patients either alone or as part of a therapeutic regime.’
Interestingly, several small studies published in 2016 suggest that placebos can work even when people know they are placebos. For example a study of 97 patients with lower back pain reported that patients who knowingly took placebos reported 30% less pain and 29% less disability than a control group who weren't taking placebos.
What else does research suggest?
A study of 640 outpatients suggested that personality traits such as optimism and pessimism can have an effect on health and wellbeing
Higher levels of positive thinking (described as ‘positive affect’ in the study) among people with heart problems meant they were more likely to exercise and had a lower risk of dying within a 5 year follow up. That’s according to a 2013 study.
This may not be true in cancer patients. According to a 2010 study there was no positive correlation between positive thinking and increased immune functioning.
That may not be the full picture though. If positive thinking encourages people to exercise more (as seen in the heart patients mentioned earlier) then it may have health benefits even for cancer patients. This 2011 report identified that exercise for cancer patients increased overall health benefits, decreased overall BMI and body weight and improved quality of life.
The Mayo Clinic suggests a correlation between eliminating negative self-thoughts and stress. Whether your attitude is glass half full or glass half empty, the perception of your life can affect your health.
The core philosophy of Positive Psychology is a “build what’s strong” approach to augment the “fix what’s wrong” approach of traditional psychotherapy. (Dr Martin E Seligman, University of Pennsylvania)
Positive thinking usually starts with self–talk. If you believe and act on positive thoughts then a cycle of pessimism can be avoided. This can also reduce the chances of spiralling into mental health problems. A strategy for achieving this is described in Ten Ways to Fight your Fears (NHS Choices).
‘There are few risks involved when someone discovers his or her strengths or focuses on the positive side of life — and there may be valuable benefits.’
Positive Psychology in Practice (Harvard Health Publications)
Cognitive behavioural therapy (CBT) is a type of psychotherapy in which people learn to identify and deal with negative thoughts and patterns of behaviour. An important aspect of this approach is positive thinking. This doesn’t mean ignoring life’s problems. It does means rethinking how you respond to them.
The Royal College of Psychiatrists gives an example. You've had a bad day, feel fed up, so go out shopping. As you walk down the road, someone you know walks by and, apparently, ignores you. This starts a cascade of negative thoughts, emotions and feelings. CBT might suggest rethinking the situation, for instance like this: He/she looks a bit wrapped up in themselves - I wonder if there's something wrong. The focus shifts to concern for the other person, a more positive response, which doesn’t trigger such negative feelings and emotions.
Improving your mental wellbeing
Meditation can help us relax and feel less anxious, stressed and worried - so make it easier to think positively. One popular form of meditation is Mindfulness, which encourages us to appreciate the present moment rather than just going through the day on auto-pilot. There is some question as to whether the positive results from Mindfulness seen in published studies would be as significant in real life. However, the effects seem generally positive. For example a study of 143 adults over twenty days, published in 2016, reported that mindfulness could help people manage daily stress.
Mindfulness, an Introduction (NHS Choices) suggests that there are five steps we can all take to improve our mental wellbeing. They seem useful conclusions for positive thinking more generally – for ourselves and those we care about:
- Take notice. Be more aware of your feelings and thoughts, your body and the world around you.
- Connect. Connect with the people around you: your family, friends, colleagues and neighbours.
- Be active. Find an activity that you enjoy, and make it a part of your life.
- Keep learning. Learning new skills can give you a sense of achievement and a new confidence.
- Give to others. Even the smallest act can count, whether it's a smile, a thank you or a kind word. Larger acts, such as volunteering, can improve your mental wellbeing and help you build new social networks
Regine Wong, May 2014, Reviewed and updated by Chrlotte Christopherson, January 2017, Next review date December 2019