Thursday, June 23, 2011

The Perils of Thinking Positively

A solar eclipse
When I discovered something abnormal in my right breast, I was scared. But people told me to think positively and it might not be cancer. 

When my diagnostic mammogram was abnormal and I felt like I was slammed against a wall, I was once again blitzkrieged with the positive-thinking mantra.

While waiting for my biopsy results, I felt despair. Yet, individuals tried to cajole me -- in an upbeat sort of way -- to be positive.

And, after listening to all the "think positive" mumbo jumbo, I discovered I was positive after all -- for breast cancer, that is.

Maybe if I thought more positively, that pesky breast cancer would've just magically disappeared or never appeared in the first place. Adding insult to physical and emotional injury, I kept hearing the whole think-positive garbage throughout my treatment. And this verbal garbage isn't even the biodegradable kind, for it stays with you forever.

I remember my very first chemotherapy treatment. I went into it with an upbeat, take-charge attitude -- determined to fight the good fight, determined to be a warrior, determined to win the battle against my breast cancer. I had what well-wishers would term a positive state of mind.

Instead, I ended up sick on the floor that very evening, feeling like I was imploding, and sobbing. Treatment had already brought me down to my knees, and I wasn't even up to my knees in treatment yet.

I guess I hadn't been upbeat enough.

The language of positive thinking that inundates our culture is just plain harmful to those whose lives are forever altered by cancer -- regardless of the patient's outcome.

I want to distinguish between the "think positive" culture and the idea of having hope or optimism. A hopeful, optimistic attitude that comes from within is a great thing. After all, as a patient, I was hopeful that the treatments would work, and I was guardedly optimistic that I might eventually pick up the tattered pieces of my shattered life. I hoped that one day I would be able to birth a child (it didn't happen, but at least I had hope). That seed of optimism came from within me.

However, the "think positive" culture is an external source that tries to define the afflicted person's reality and therefore undermines his/her psychological well-being. By telling patients to think positively, our society is telling us what to think: that we are responsible for our outcomes.

Therefore, if we happen to "survive" cancer (whatever that means),  those who live can be credited with positive thinking as the reason they lived. Those who die from the disease....well, they just didn't think positively enough.

Now that's a mighty heavy burden -- and a damaging one -- whatever the side of the cancer spectrum one is in.

And it's some pretty heavy nonsense, too.

To those who tell others in a medical crisis to think positively, think again. External positive-thinking mantras harm patients. Telling cancer patients how to think -- i.e., that a sunny disposition and attitude are in order -- need to remember that sunny days are not all they are cracked up to be.

Just ask a solar eclipse.

For a related post see Breast Cancer and the Blame Game.

Have you or a loved one ever been told to "think positively"?

Please feel free to share any insights you might have on this topic. I really want to know your opinions and experiences.

To obtain these postings regularly, please subscribe to this blog by clicking the orange subscribe button. I am a professional writer and have published numerous academic and magazine articles, as well as an essay on my breast cancer experience in the anthology Voices of Breast Cancer by LaChance Publishing. I can be contacted at and


  1. Beth, I just reposted an older post of mine about this [] after some nonsense this week from a cancer retreat facility regarding positive thinking that purports to help cancer patients 'overcome negative forces' that may be 'toxic.' I am deeply offended by this nonsense. Labelling emotions and attitudes is a judgment call that no one has a right to foist on anyone else. Not only that, it's magical thinking to believe that our thoughts and feelings have some miraculous effect on anything, frankly. That's the kind of nonsense that drives blame-the-victim attitudes toward everything from cancer to rape, and it's also the sort of idiocy that leads people like Bernie Madoff & Alan Greenspan to think for a decade that the housing price bubble would 'just sort itself out' & that greed & graft are okay.

    It's brass-plated, self-serving baloney. We can choose how to respond to an event, but we don't need to tyrannize our feelings and invalidate them in the process.

  2. New age positive vibes never helped anyone, but there is a documented connection between attitude and health. Take it from one who struggles with anxiety and irritable bowel. Our hope comes from a very real God who loves us even in the worst of circumstances. I just read a book called Choosing To See by Mary Beth Chapman. The pain this woman has experienced is heartbreaking, but she has chosen to see God even through the worst of it. The book documents here daily struggles. It is NOT sugar coated which is why I liked it!

  3. 'The tyranny of positive thinking' has been a long time favorite article of mine, I loved it when I first read it years ago. I get tired of trying to educated people that keep telling me to be positive, I know they mean well but.... Ann T

  4. Great post Beth and it echos a lot of what I have written too about strong societal expectations that cancer patients "should" be stoic and positive to "beat" the disease. Another thing we are advised to do is to repeat positive affirmations of the every day, in every way, I am getting better, ilk. Now I am not saying that we should all abandon positive self talk, and yes, for some people affirmations and positive thinking are an aid to good mental health, but I agree with you that this pressure to feel positive all the time can also be damaging if it becomes another stick to beat ourselves with.

  5. I think there is also a certain expectation borne of being drilled in being a good sport. I was at a support group meeting and a newly dx'd woman was there. I don't think she had her pathology report yet, just preliminary tests. The dr. told her she would need surgery and chemo, so I guess either to get it over with or take charge, she went ahead and shaved her head.

    Well, she had surgery first. By the time she was due to start chemo, she had stubble...I think she just wanted to show the "positive attitude" you referenced.
    To paraphrase Molly Ivins, cancer could give a rat's ass about your attitude...

    She is actually a hilarious woman. I don't think she could have reconstruction or it had to be delayed. She was telling us this and she said "Well who's gonna throw beads at that

  6. Beth,
    Oh my, this is one of my biggest "cancer pet peeves"! A positive attitude does not determine your cancer outcome. That is just a fact. Too many people (like my mom) had wonderfully positive attitudes, but still did not survive cancer. Well intentioned people mean no harm when they tell you to stay positive, but there is a hidden, implied message in there that says if you just try hard enough and stay positive enough, things will be alright. Obviously, this is not always the case, or as you put it, pretty heavy hogwash!

    Of course as you also said, having hope or optimism is something else entirely. Thanks for this great post on a hot topic. I posted on it recently myself and here is the link:

    Thanks so much, Beth, for this brilliant post!

  7. Ditto to all that. Think positive is one of the least helpful things someone can say. It's right up there with 'let me know if there is something i can do'.


  8. Wow, it appears as though there is alot of resentment and anger on these posts. I personally consider hope and optimism a form of positive difference in my mind. What other category could you put them in? As one of these posts stated, "there is a documented connection between attitude and health". Try reading "The Secret" or "Anatomy Of The Spirit". It is now commonly accepted that thoughts, feelings, and emotions can have a vital effect on one's health.
    As far as the last post...when someone says "let me know if there's something I can do" can you be so negative about a friend or relative wanting to help? In my experience, people mean it or they wouldn't say it. When people say "think or be positive", it is their way of being supportive and caring...if you decide to interpret it that way. I am fighting my dis-ease with positive thinking, prayer, and all the help I can get from loved ones. When people in my world offer help, they mean it. Positive thinking creates a shift in your consciousness and helps to get through the tough times. If you have a choice of being positive or negative about your health situation, which would you rather choose? Being positive beats the alternative.

  9. Well meaning people equate Think Positive to YOU ARE CURED and if you don't have that chronic smile slapped on your face and you are not carrying the cheerleader pom poms uhoh....guess that means you are Not going to be cured. How stupid is that!

    Don't you ever just want to to them to SHUT UP!!

  10. Kathi,

    Thank you for your thoughtful comment. I read the posting you provided a link for and LOVED it. You hit the nail right on the head by discussing such positive-speak.

    Sorry you had to endure some think-speak at that retreat recently. There is definite toxicity: in people making value judgements on those afflicted with cancer. "Think positive" is one of those phrases that conveys a toxic value judgement.

    You are right when you say: "It's brass-plated, self-serving baloney." Because when it really comes down to it, the subtext of "Think positively" is "Blame the victim."

  11. Ron,

    I appreciate your response to my posting and your readership. As individuals, each of us has a right to have faith in a higher power or not. Many, many people are comforted by their religious and spiritual beliefs.

    I have no problem with this. If a person is comforted by belief in a higher power, then that is wonderful.

    This issue of "think positively," however, undermines the purity of hopefulness and optimism. "Think positively" nowadays is said to indirectly tell the sufferer that thinking happy thoughts will help cure him or her.

    And this is not the same as being anchored in one's spiritual beliefs.

    I also think, as humans, we have a right to feel sad, depressed, and lonely in our diagnosis and treatment. It is the human way to react. There's nothing wrong with it.

  12. Hi Ann,

    Thanks for your link: I read "The Tyranny of Positive Thinking," and marvel how insightful it is! The author is spot-on. Thank you for providing this.

    You are right: it is tyranny to be told to think positively.

    I also like the author's point that staying positive and doing good things for oneself is a good thing; there's just no proof that this affects cancer outcomes.

  13. Nancy, thanks for your response and providing the link to your fantastic blog about attitude.

    Like you, this is one of my big pet peeves regarding cancer or any kind of illness for that matter. You are right when you say, "A positive attitude does not determine your cancer outcome."

    I wish people would get that.

    Your mom is an excellent example. She sounds like she was a wonderfully positive woman.

    I just wish more people in society would get it.

  14. Knock Knock,

    You said it perfectly! Ditto.

  15. Dear Anonymous:

    Thank you for commenting on my posting; I do appreciate your point of view, although I don't necessarily agree with all of it.

    First of all, there's a reason there is anger and resentment re: "think positively." There's a difference between feeling hope and optimism and being told by perhaps well-meaning people to "think positively."

    A great attitude and psychological health are really important and wonderful to have. However, when faced with a diagnosis of a serious illness, it is totally acceptable to feel negative.

    The problem is that many people who tout the think-positive mantra may mean well, but they also may have an agenda: telling the afflicted person to essentially deny his/her negative feelings. Many people use "think positively" as a way to shut the afflicted up so they don't have to deal with the unpleasantries of cancer or whatever disease the person is facing.

    You are right when you say, "thoughts, feelings, and emotions can have a vital effect on one's health." But there is no proof that a positive, upbeat attitude or a negative attitude affect cancer outcomes.

    The "let me know if there's something I can do" statement, if said sincerely, is a wonderful thing, and it's great you have a terrific support system.

    However, too many people say this but don't mean it. I have encountered this, as have many patients. When many people say, "think or be positive," they may think they mean well, and in many cases they do mean well. However, saying this statement is also a way of dismissing the patient's need to cry or be depressed at a cancer diagnosis.

    And I would argue that being upset during a bad medical moment is normal and psychologically helpful because it is cathartic.

    There are so many angry, resentful responses to the "think positively" statement for a reason. This statement essentially says that patients need to take ownership of their disease and that how they think will affect their disease's outcomes.

    And this is false.

    Personally, I try to be positive and stay upbeat, but I have times of great sadness. It's because I'm human. If I have beaten cancer, it has been more due to random luck than how I've been thinking.

    That all being said, I do agree with you that some people are really supportive and want to help patients they know and love.

  16. Alli,

    Great comment. Yes, people wrongly assume if one is positive, one is cured.

    Yes, it makes me want to scream!

  17. Marie,

    I like the way you put it: that this is another way to have a stick to beat ourselves with.

    Your comment is completely on target! Thank you so much for your readership.

  18. Dear I Hate Breast Cancer:

    You're right about the "good sport" concept being drilled into us. That woman who prematurely shaved her head must've regretted it after the stubble grew in.

    By the way, I love Molly Ivins' work!

  19. Great post, Beth! I love that you distinguish between positive thinking & having an optimistic attitude.

    I'm a 10 year survivor now of an aggressive cancer & mostly positive lymph nodes - an old timer. I got here, in part, because my doctors & I were total realists. I always looked at my situation honestly, no matter how frightening. Only in that way could I make the best choices for my care. Thinking positively would have left me ill-equipped to fight.

    I like to think of myself as an optimistic realist. I look at the situation with brutal honesty, but still find myself moving forward with an optimistic attitude toward my life.

    I know people mean well when they tell us to be positive; generally they don't know what else to say. Or they say that because they just don't want to face the truth. I always tried to remember they're speaking as much from their own fears. But they do risk some harm.

    Thanks for writing this.

  20. You are welcome, Julie. I agree with you that people who say "think positive" often don't know what else to say.

    Congratulations on your 10-year milestone. I was diagnosed 10 years ago....

  21. Beth, this is a great post and yes, something we all have to deal with eventually. I think I may be repeating some of the comments here, but my feeling is that people just don't know what to say. It's easier to lay a positive attitude on us, then deal with our reality. That of wanting to sink into a corner and hide for a while. I guess we can't blame them, but no one wants to be told to smile when we don't feel like it. I hate that.

  22. Beth, this is one of my favorite topics. In my talk on tips of what to say or not to say to a cancer patient, positive attitude is on my top five list. I've been told that I have a positive attitude, but fortunately never been urged or ordered to have one. I don't believe my attitude was ever positive, only hopeful for a good outcome, as you posit.

    In her book "Ice Bound: A Doctor's Incredible Battle For Survival at the South Pole" Jerri Nielsen, the doctor who treated herself for cancer at the South Pole, writes about her colleagues telling her to have a positive attitude. As a result any time she felt depressed or anxious about the future, she would worry that she might die due to her negative thinking. How cruel to put that burden on her along with everything else she was facing!

    Thanks for adding to this discussion. The more voices devoted to the subject, the more the message will get out to ban positive thinking from the lexicon of well-meaning friends and relatives. I think they say it because they don't know what else to say. It makes them feel better. But that's not a viable excuse.


  23. Stacey,

    I agree wholeheartedly that people say these things because they don't know what to say. It's hard for all parties involved.

    Sometimes just listening to the person afflicted with cancer is sufficient.

  24. Jan,

    Thank you for pointing out the example of Dr. Nielsen. I can't imagine how isolating her experience was.

    Yes, the "think positive" mantra is designed to disarm up and to blindly follow in positive-speak, when it's perfectly OK to mourn and grieve the diagnosis of breast cancer -- or any disease for that matter.

    Thanks for your insightful comment.

  25. Interesting post, Beth. I agree that no one should be pressured into feeling one way or another. Acting positive when you're hurting inside is unhealthy for sure. You are right that people need to grieve; I certainly needed to do that. For me, though, I needed to feel those feelings then let them go, so I wasn't living my life in misery.

    I think it's all a matter of semantics. I don't know if I'm being positive or optimistic because I choose to look at the good things in life rather than focusing on all the awful aspects of cancer all the time. I am not doing this out of pressure; I'm doing this to lead a happier life.

    As a person with metastatic disease, mortality becomes a big issue. I am grateful for all the things I experience because I know life is precious. Do I still get mad, sad and frustrated? Do I hate f*^%in cancer when it takes a friend's life? You bet. This is no easy road.

    Interviewing people for my book who have beaten the odds has helped. I know that "terminal" cancer isn't necessarily a death sentence. And that's reason for optimism to me.

  26. Tami,

    I think your attitude is wonderful, as is your book. Like you, I try not to dwell on all the negatives and try to be optimistic. I agree it's important to appreciate life's great moments rather than wallow in misery all the time.

    I wrote this posting as a response to all the people who blank-faced would tell me to think positively, thus negating my feelings. As you know, during a time of crisis, it's really hard to just try to think positively. We do need those moments of grief.

    I've always admired your attitude. Having a positive one on one's own terms is really the ideal.

    Thank you for sharing your thoughts.

  27. Hi Beth,
    I linked to this post on a recent blog post ( This is a topic I've written about before, but I wanted to share your post - it's such a good take on the subject.

  28. Cancer care Fruits are a pleasant way of keeping cancers at bay! The nature is kind enough to give us these fruits as a delicious tingle to our pallets and at the same time keep us immune to dreaded cancers.

  29. Julie,

    Thank you so much for your linking to this posting on your blog. I really appreciate it!

  30. To HCG Oncology,

    You have to be kidding me, right?

    I have eaten lots of fruit my entire life and still got cancer anyway. Maybe it was the pesticides on the fruit that led to my cancer.

    Humanity was unkind enough to give us these chemicals as toxins to our bodies and at the same time make us vulnerable to cancer.

    And, by the way, no one is immune to cancer.

  31. I've had some time to think today and as I read along here it came to me, telling someone with cancer to think positive is like telling someone with a cold to think positive. *shakes head* You can think positive all you want that cold (how is there not a cure for colds by now) is going to do what it is going to do and you've just gotta ride it out happy or sad.

  32. Hi Carol Anne,

    It's really horrible when people tell those diagnosed with cancer and enduring treatments to think positively. I felt really angry when told that by people who were seemingly healthy.

    I think it's when the healthy people who tell the unhealthy ones to think positively that gets to me. It's like they are trying to control our reality.

    Thanks for visiting my blog and commenting.