The Scientific Discoveries Behind Positive Thinking

If you're a "cup is half full" sort of person, chances are you're in better health than your "half empty" counterparts. But according to Hilary Tindle, MD, MPH, assistant professor of medicine and epidemiology at the University of Pittsburgh, the reasons for that are more complicated than attitude.

Since the mid-80s when Michael Scheier, PhD, and his colleague Charles Carver, PhD, published their influential study, "Optimism, Coping and Health: Assessment and Implications of Generalized Outcome Expectancies" and devised a method—a six-question assessment—for establishing positivity, an enormous amount of research has been generated, says Tindle.

"Scheier's simple tool is easy to use and helped bridge the gap between medicine and biology. Plus, optimism is something everyone can relate to since we all have a relationship with the future," the researcher explains. "Some people have a great deal [of] hope (expecting a positive future) than fear or resignation (expecting negative outcomes) and these attitudes color our beliefs, feelings, and motivate our actions."

Most research today connects optimism to positive physical health outcomes—including decreases in the likelihood of re-hospitalization following surgery, the risk of developing heart disease, and mortality.

Why do optimists do better than pessimists? Tindle says the answer lies in the differences between the coping strategies they use. "Pessimists give up more easily than optimists and won't necessarily look for a way around a difficulty. Optimists will."

In terms of health, research also shows that positive people are more likely to engage in behaviors that help protect against disease and promote recovery from illness. "They're less likely to smoke, drink, and have poor diets, and more likely to exercise, sleep well, and adhere to treatment," says the Pittsburgh-based researcher and physician. "There is also some evidence that optimists have better coping skills in response to stress. Fewer episodes of stress means less strain on the body's neurologic, hormonal, and immune systems. In other words, less wear and tear over time."

Pessimists, on the other hand, tend to deny, avoid, and distort their problems, and dwell on negative feelings. So it's no mystery why optimists fare better physically. "They are coming from a healthier place to begin with," says Tindle.

Not All Optimists Are Created Equal

With regards to health there's an important distinction that needs to be made between realistic and unrealistic optimism. Unrealistic optimism can get in the way of health; realistic optimism can improve it. "In the medical and psychological literature there are three main categories of optimism and though they are quite different, they are commonly confused," Tindle explains.

Dispositional Optimism is positive future expectation. "People who strongly endorse expecting the best in uncertain times and expecting more good things to happen than bad in general are true optimists," Tindle says. "But that doesn't mean they are unrealistic."

Comparative Optimism is how people compare their own risk of certain outcomes (a heart attack, for example) to their peers. Someone who actually is healthier than average, and believes this, is comparatively optimistic. "The problem comes in when a person inaccurately rates his risk lower than average, when it is in fact at or above average. Then the comparative optimism becomes unrealistic.

Unrealistic optimism (also known as "optimistic bias") is constantly confused with dispositional optimism and is a major barrier to correctly translating the research findings on dispositional optimism, according to Tindle who offers the following example:

Let's take a 50-year-old diabetic man who has already suffered a heart attack, smokes, has hypertension, and high cholesterol. He is at much higher risk than the average 50-year-old male but if he is an unrealistic optimist he doesn't necessarily think so.

"The unrealistic optimist may falsely believe that because he exercises, he is at average or lower than average risk of another heart attack. In his mind, the exercise cancels out the other risk factors," says Tindle. "These folks are in denial about their own health risks and therefore don't make the effort to protect and strengthen their health. That's where attitudes can be dangerous. A person with all these symptoms can't just sit back, relax and think positively. That won't improve his health."

If you have heart disease as well as pessimistic tendencies that bad things will happen, these may negatively affect your beliefs about your health. "For example, if your attitude is, 'I'm going to have a heart attack early and die just like my father did so it doesn't matter what I do,' then your attitude definitely needs some reorientation if you want to improve your heath and remain independent longer into old age," says Tindle.

Believing that you cannot exercise, take medication to lower your blood pressure, etc. or that these things will not lower your risk of disease gets in the way of your health.

Optimists are happy and healthy not necessarily because of who they are (part of it is a genetic predisposition and part is influenced by our lives and experiences into young adulthood) but because of how they act. Fortunately some research shows that optimism can be learned.




Interview with Hilary Tindle, MD associate professor of medicine and epidemiology at the University of Pittsburgh

The American Psychological Association

The National Institutes of Health
NIH Public Access Author Manuscript (PDF)
"Attitudes and Cardiovascular Disease"