Lori Anderson: Too much optimism can be positively bad for you

THE diagnosis of cancer should come with a helmet, for those involved are swept away into a campaign of militaristic jargon. They are now embroiled in a "fight" or "battle" against a cunning "enemy" that must be "defeated".

Of course the only weapon the patient has to hand is his or her attitude and it must be rigidly fixed, like a sharpened bayonet, to positive; anything less than a forced grin and a "can do" spirit and the "enemy" will over run them with defeat almost inevitable.

I have always believed this attitude to be suspect and terribly unfair on the patient, that they should be bullied into adopting an attitude so diametrically opposed to the circumstance in which they find themselves.

For the cool, level-headed facts, as laid out in a new book, Smile Or Die: How Positive Thinking Fooled America & The World by Barbara Ehrenreich, are that no amount of "positive thinking" will kill off cancer cells and that too much "positive thinking" can ruin otherwise healthy lives, leading us into foolish financial speculation and pipe dreams.

It is, in many ways, a paean to Scots realism and Presbyterian pessimism.

While there is no doubt that patients who adopt a robustly optimistic attitude and embrace the "power" of positive thinking will experience a degree of mental comfort and a raising of their spirits, those patients who do not feel or act in this manner should now be relieved to know that they are in no way harming their chances of recovery. The facts are that the most optimistic patient might die whilst the most pessimistic may live.

Penelope Schofield, who conducted a study on lung cancer patients which found no survival benefit for optimism, wrote: "We should question whether it is valuable to encourage optimism if it results in the patient concealing his or her distress in the misguided belief that this will afford survival benefits … If the patient feels generally pessimistic … it is important to acknowledge these feelings as valid and acceptable."

The public perception that happiness or a positive attitude has health benefits is tied to a belief that happy, positive people have "feistier" immune systems. Let us set aside the fact that the immune system has almost no role in tackling cancer and focus instead on the key research paper that claimed a link.

This was a 1998 paper by Suzanne Segerstrom, a researcher at the University of Kentucky, who reported that optimism was linked with greater immune competence, as measured by levels of key immune cell types. The problem is that three years later, in a second study she found that "some contradictory findings have emerged" and, it gets worse, in some circumstances more optimistic people "fare worse immunologically" than pessimists. It's not really the headline you want to read.

A number of studies have shown that happiness or a positive outlook may have no effect on one's health. An improved mental outlook, generated in support groups or through psychotherapy, does not extend the lives of breast cancer patients, while similar studies have found the same results for those suffering from threat or neck cancer.

In fact, other studies have found the direct inverse, that pessimism can be healthier than optimism and happiness. In 2002, one study found that women who are mildly depressed are more likely to live longer than non-depressed or very depressed women.

Then there was a longitudinal study of more than 1,000 school children in California that concluded that optimism was likely to lead to an earlier death in middle age or old age, perhaps because optimistic people were more likely to take risks.

Those who were capable of rationally examining their circumstances without need to don rose-tinted glasses fared better as in a recent study which found that pre-teenagers who were realistic about their standing amongst their peers were less likely to become depressed than those who held positive illusions about their popularity.

Yet surely the power of positive thinking can help re-shape our lives? A smile is always more attractive than a frown and, anyway, who wants to spend their life scanning the horizon for storm clouds and brooding that a delicious glass of vintage Chateau Petrus is not half full but half empty? After all, life is to be lived and enjoyed, not endured and feared. There is also evidence to support optimism, for academic studies, just like a weapons' bazaar, can arm both sides of the argument.

Happy, positive people do appear to be more successful in the employment market. A number of reports have discovered that those with a warm smile, relaxed manner and engaging positive presence are more likely to get through to the second round in job interviews, then, once happily ensconced behind a desk can expect more positive write-ups from management than the office grinch who started the same day.

There have always been rewards for those who applauded the emperor's new clothes, for example those senior bank executives who happily projected perpetual growth and subsequently thrived, whilst those worrying about bursting bubbles and who urged caution were canned. (OK, perhaps not the best example.)

In the realm of health, positive emotion can, according to other studies quoted by Barbara Ehrenreich's book, make a difference. According to some studies, positive emotion can protect against coronary heart disease and also hasten recovery from it. However, she does add that while "negative" people complain more about angina, they are at no greater risk of pathology than cheerful people.

The key to success must surely be a mix of the two, we should not be blinded by brilliant hopes and dreams to the dangers of the world such as financial slumps and ill-health, but instead have courage to stare into the darkness and figure that next careful step.

Optimism and positive thinking can be a potent brew and will intoxicate us into a state of dangerous drunkenness during which we will weave through our own lives, leaving a trail of destruction, bad debts, false hopes and impossible, but still broken, dreams.

Like strong drink, positive thinking should be supped moderately and always mixed with two parts of pessimism.