“Look on the sunny side of life.”
“Turn your face toward the sun, and the shadows will fall behind you.”
“Every day may not be good, but there is something good in every day.”
“See the glass as half-full, not half-empty.”
Researchers are finding that thoughts like these, the hallmarks of people sometimes called “cockeyed optimists,” can do far more than raise one’s spirits. They may actually improve health and extend life.
There is no longer any doubt that what happens in the brain influences what happens in the body. When facing a health crisis, actively cultivating positive emotions can boost the immune system and counter depression. Studies have shown an indisputable link between having a positive outlook and health benefits like lower blood pressure, less heart disease, better weight control and healthier blood sugar levels.
Even when faced with an incurable illness, positive feelings and thoughts can greatly improve one’s quality of life. Dr. Wendy Schlessel Harpham, a Dallas-based author of several books for people facing cancer, including “Happiness in a Storm,” was a practicing internist when she learned she had non-Hodgkin’s lymphoma, a cancer of the immune system, 27 years ago. During the next 15 years of treatments for eight relapses of her cancer, she set the stage for happiness and hope, she says, by such measures as surrounding herself with people who lift her spirits, keeping a daily gratitude journal, doing something good for someone else, and watching funny, uplifting movies. Her cancer has been in remission now for 12 years.
“Fostering positive emotions helped make my life the best it could be,” Dr. Harpham said. “They made the tough times easier, even though they didn’t make any difference in my cancer cells.”
While Dr. Harpham may have a natural disposition to see the hopeful side of life even when the outlook is bleak, new research is demonstrating that people can learn skills that help them experience more positive emotions when faced with the severe stress of a life-threatening illness.
Judith T. Moskowitz, a professor of medical social sciences at Northwestern University Feinberg School of Medicine in Chicago, developed a set of eight skills to help foster positive emotions. In earlier research at the University of California, San Francisco, she and colleagues found that people with new diagnoses of H.I.V. infection who practiced these skills carried a lower load of the virus, were more likely to take their medication correctly, and were less likely to need antidepressants to help them cope with their illness.
The researchers studied 159 people who had recently learned they had H.I.V. and randomly assigned them to either a five-session positive emotions training course or five sessions of general support. Fifteen months past their H.I.V. diagnosis, those trained in the eight skills maintained higher levels of positive feelings and fewer negative thoughts related to their infection.
An important goal of the training is to help people feel happy, calm and satisfied in the midst of a health crisis. Improvements in their health and longevity are a bonus. Each participant is encouraged to learn at least three of the eight skills and practice one or more each day. The eight skills are:
■ Recognize a positive event each day.
■ Savor that event and log it in a journal or tell someone about it.
■ Start a daily gratitude journal.
■ List a personal strength and note how you used it.
■ Set an attainable goal and note your progress.
■ Report a relatively minor stress and list ways to reappraise the event positively.
■ Recognize and practice small acts of kindness daily.
■ Practice mindfulness, focusing on the here and now rather than the past or future.
Dr. Moskowitz said she was inspired by observations that people with AIDS, Type 2 diabetes and other chronic illnesses lived longer if they demonstrated positive emotions. She explained, “The next step was to see if teaching people skills that foster positive emotions can have an impact on how well they cope with stress and their physical health down the line.”
She listed as the goals improving patients’ quality of life, enhancing adherence to medication, fostering healthy behaviors, and building personal resources that result in increased social support and broader attention to the good things in life.
Gregg De Meza, a 56-year-old architect in San Francisco who learned he was infected with H.I.V. four years ago, told me that learning “positivity” skills turned his life around. He said he felt “stupid and careless” about becoming infected and had initially kept his diagnosis a secret.
“When I entered the study, I felt like my entire world was completely unraveling,” he said. “The training reminded me to rely on my social network, and I decided to be honest with my friends. I realized that to show your real strength is to show your weakness. No pun intended, it made me more positive, more compassionate, and I’m now healthier than I’ve ever been.”
In another study among 49 patients with Type 2 diabetes, an online version of the positive emotions skills training course was effective in enhancing positivity and reducing negative emotions and feelings of stress. Prior studies showed that, for people with diabetes, positive feelings were associated with better control of blood sugar, an increase in physical activity and healthy eating, less use of tobacco and a lower risk of dying.
In a pilot study of 39 women with advanced breast cancer, Dr. Moskowitz said an online version of the skills training decreased depression among them. The same was true with caregivers of dementia patients.
In a related study of more than 4,000 people 50 and older published last year in the Journal of Gerontology, Becca Levy and Avni Bavishi at the Yale School of Public Health demonstrated that having a positive view of aging can have a beneficial influence on health outcomes and longevity. Dr. Levy said two possible mechanisms account for the findings. Psychologically, a positive view can enhance belief in one’s abilities, decrease perceived stress and foster healthful behaviors. Physiologically, people with positive views of aging had lower levels of C-reactive protein, a marker of stress-related inflammation associated with heart disease and other illnesses, even after accounting for possible influences like age, health status, sex, race and education than those with a negative outlook. They also lived significantly longer.