Optimism, Pessimism, Mental Health & Chronic Illness

“Positivity is not about how to maintain a positive attitude, but how to produce positive emotions.” – Frederickson, 2009.

“Research indicates that pessimism correlates with depression, lowered achievement, and health problems.” – Martin Seligman, 1998.

If you don’t know who Seligman is, that’s totally okay and to be honest totally normal if you haven’t studied psychology. He’s the founder of positive psychology (which does not say that positivity is the cure to mental health, just to be clear) and has done a lot of research in this area. For me, the interesting part of the statement isn’t the mental health aspects, which are a bit less surprising, but the physical health part, because what does that mean for people with a chronic illness?

Are you an optimist or a pessimist?

Okay, so here’s a quick overview of some research of optimism vs. pessimism and chronic pain or illness. According to Forgeard and Seligman (2012) disease may progress slower for optimists than for pessimists. Optimists typically have better cardiovascular (heart) functioning and less heart disease, and they may have better immune functioning (though the research is more mixed on that the later). They also found that cancer patients had better survival rates one year after diagnosis if they were optimists, and that in general optimists are about half as likely to die from whatever disease they have than pessimists are. They do caution that some studies don’t show this effect and/or the results are negative, but it’s theorized that the stage of disease may play into this. They also theorize that unrealistic vs. realistic optimism plays a role. (I’ve often said that you can be – and that I am – a realistic optimist).

Life of a realistic optimist.

In terms of chronic pain, Ramirez-Maestre et al. (2012) found that optimism leads to better overall well-being and this might have to do with coping strategies that optimists and pessimists use. Basically, pessimists are more likely to use passive coping strategies such as avoidance and optimists are more likely to use active coping strategies such as acceptance. Active coping leads to lower pain severity, less depression, and better daily functioning.

I don’t know about you, but less pain always sounds good to me!

I can hear some of you saying, “But I’m naturally pessimistic! I can’t help it!” Positive psychology actually shows that we can have learned helplessness and learned optimism – yes, I said it, we can learn optimism. It’s not necessarily a fixed part of personality and there is research to support that. Basically, if we learn to combat negative self-talk, we can become more positive. Pessimism is caused by selecting our attention to certain things as well as a lack of internal confidence in our abilities to control or change parts of our lives (learned helplessness) so when we fail at something, we blame it on something within us we can’t change. I hope I didn’t lose anyone during this.

Seligman explains this way better than I do.

If you want to be more optimistic here’s something things you can do, according to Seligman:

  • utilize gratitude (maybe use a gratitude journal or write a gratitude letter)
  • help others in need (by volunteering for example)
  • challenge your negative thoughts and believes (what’s the evidence for and against them)
  • tackle your negative self-talk (trying changing it)

In the Science of Well-Being course taught by Yale professor Laurie Santos, she explains that only 50% of our happiness comes from genes. So, if you’re still believing that you can’t change from being a pessimistic to an optimistic because it’s how you are born, then remember that. 10% of our happiness comes from our circumstances, and the last 40% comes from our actions and thoughts. Which means, you can still improve your levels of happiness (and thereby some aspects of your health) even if you’re not naturally inclined to optimism.

If you haven’t checked out The Science of Well-Being course yet (it’s free), then I highly recommend it!

I hope this was helpful for some of you! Let me know how it goes with those four techniques to learning optimism! Keep on making the most of it!

Mental Strength & Resilience for Spoonies

My mom actually suggested I do a post on mental strength and I thought about it for a bit because I find that it is very similar to resilience, which I’m fairly certain I’ve posted about before. However, I did some research and found that while there are similarities there are differences as well and to be honest, both are pretty essential when you’re a chronic illness warrior and can increase positive mental health. I’m going to give you an overview of each concept and how they tie together and some ways that can help you increase them (many of which I have personal experience with) so that we can all grow stronger together in our own separate battles.

It’s not easy to find strength in illness.

First, let’s define resilience. Resilience is our ability to respond positively and to adapt to negative, traumatic, and stressful events, in a way that is constructive. Now let’s define mental strength. Mental strength is our ability to effectively handle stressors and challenges in our lives the best we can despite the situation we find ourselves in. As you can see there are similarities, what I think the biggest difference in is that resilience occurs in the face of significantly impactful events such as trauma, whereas mental strength helps us with less significant (yet still impactful) stressors. We often hear of mental strength in regards to athletes and their ability to practice the same thing over and over. People who are mentally strong like adversity because it’s a challenge not a threat.

Kids are the most resilient of us all – me as a baby circa. 1986/87

The great thing is that both resilience and mental strength can be learned! According to the American Psychological Association (APA), the thoughts, and behaviours involved in resilience can be learned. They state that what makes up resilience includes:

  • your ability to make “realistic plans” and accomplish them
  • self-confidence and self-esteem
  • problem-solving and communication skills
  • emotion regulation

How does this apply to chronic illness? I see it as (1) making realistic plans is including limitations you do have because of your illness but not letting your illness limit you; (2) you can still have self-confidence and self-esteem with a chronic illness; (3) problem-solving and communication actually become more important when you have a chronic illness; and (4) emotion regulation is essential for everyone.

Everyone can build resilience and mental strength.

What are some ways we can build resilience? Let’s break each of these down further:

  • making realistic plans & accomplishing them: includes gaining skills (like going back to school or just learning something new in general); and taking action toward the goals you make for yourself while keeping a positive and hopeful outlook on your ability to accomplish them!
  • self-confidence and self-esteem: accepting change because nothing stays the same, including your illness; engaging in activities that help you learn more about yourself (try something new, be creative, get as active as you can, etc.); view yourself in a positive way (stop the negative self-talk and write down things you like about yourself); and of course, self-care!!!!
  • problem-solving and communication: setting goals for yourself; and making connections with friends, family and colleagues because support is important.
  • emotion regulation: controlled exposure (I would suggest with the help of a therapist); taking a realistic view of crisis situations (I like the phrase, “if that happened, then what would I do?”); and activities such as journaling, meditation and other spiritual practices can help with emotion regulation (I’ll probably do a longer post on emotion regulation at some other time).

So if that’s how we build resilience, what can we do to build mental strength? Turner (2017) states that the elements of mental strength include having a sense of control and purpose of your life and emotions; making a commitment by setting goals for yourself; challenging yourself when necessary; and having that self-confidence. Very similar to what we just talked about for resilience. I’ve got to say that I possess all of these, and I’m not sharing that to make anyone feel like they aren’t enough because they are currently not mentally strong. I’ve had times when I haven’t been strong, it takes a lot of work to get here. My point in sharing is that you can come from a place of anxiety and stress over your health condition and get to a point where you can deal with most things that come your way (I say most because no one can deal with everything perfectly). It just took me a few years of hard work to get here. Here are some ways you can develop your mental strength:

  • gratitude – write down 5 things every day that you are thankful for. I also recommend taking the free Science of Well-being course offered by Yale University. Here’s the link!
  • practice mindfulness – in whatever way you like. I prefer meditation and body scans, and throw in the occasional mindful walk.
  • act “as if” – this is an interesting concept developed by psychologist Alfred Adler. He stated we should act as if things are the way you want them to be (essentially you get to reauthor your life). This one is a bit more complicated and may also deserve its own post.
Image from the Science of Well-Being course.

Before I wrap up this very long post, I want to share research by Pickering & Holliday (2010). They stated that “mental strength contributes to resilience processes and resilient behaviour.” So basically develop your mental strength and you’ll develop your resilience. I mean as we’ve seen there is a lot of overlap between the two so it totally makes sense!

Also, from the Science of Well-Being and I thought it’s great to end on.

Let me know what you think of mental strength and resilience! Comment on the post or shoot me a DM on Instagram (@janeversuspain). I would love to hear from my readers! For now, keep making the most of it!

The Importance of Flexibility

I’ve been thinking a lot about cognitive flexibility lately. It’s often a topic that comes up at school, but beyond that, it’s something we need to think about, not only if we have a chronic illness but also during a pandemic, like the one we’re currently in. Some of you may be asking, what do I mean by cognitive flexibility, so here is my short explanation: it is your mental ability to change your thoughts and behaviour as needed to adapt to different environments and situations. An example would be if you were to move to a different country, with a different culture, and how easily you were able to adapt living there. I’m going to break this post into two parts. First, being cognitively flexible as a chronically ill person, and second, being cognitively flexible as any human being living during a pandemic.

How easily do you adapt to changing situations?

Having any chronic illness or dealing with chronic pain for any reason requires us to be cognitively flexible in order to more easily cope. People with poor cognitive flexibility tend to be more prone to mental distress, though of course that is also a more complicated process. In terms of dealing with chronic illness, I think about how I have to adjust to social outings or exercise or work. Recovering from hip surgery, how am I adapting to being on crutches, and not bending past 90 degrees in the hip. It can be difficult to adjust and adapt to these types of situations. This process is going to be different for everyone. Understanding what your limitations are is certainly important, as is the ability to not give up. One thing that’s important for me is being able to exercise because I’ve found it decreases my overall pain levels. But how do I do that now? Chair workouts is what I came up with. Why? Because they are available on YouTube and I can adapt them to what I can do. Another example from my own life is about cleaning. I’m not a neat freak but I do like a clean house. However, I can’t sweep or mop (I have laminate floors) so in my opinion, my place is a disaster. However, I tend to let that go because it isn’t helpful right now, because I literally can’t do clean the way I normally would (plus I live alone right now so there is no one else to do it for me). I have one good friend who always says, “I know you’re a strong and independent woman but you can ask for help.” What he isn’t taking into account is that I do ask for help when I need it (literally different people bring me groceries, take out my garbage and help me with laundry, including him!). When I don’t ask for help, it’s because I don’t need it, but I am flexible enough to ask for help when I do.

My favourite chair workout channel.

Now, during this pandemic I’ve seen a lot of people post on social media about many things, but I’m going to just use one example for this post, and that is gyms being closed (here in Canada at least). The most common argument against closing gyms (even though it is known that the virus is airborne and we all breathe hard at the gym) is that working out is good for your mental health. 100% it is! As a therapist-in-training I will not argue that fact. What I will say, is how flexible are we being with our workouts? I was someone who worked out at the gym between 3-5 times a week before the pandemic. The first thing I did when the gyms closed was figure out how to utilize the limited space I have in my place to do workouts at home. With zero equipment. Apps, YouTube, online gym programs (my gym literally offered free access to all kinds of stuff to members even though we weren’t paying fees anymore). Yes, it is not the same as going to the gym. It doesn’t offer a social environment, maybe not the same type of workout, but I actually got in better shape working out from home because I didn’t have to go anywhere, just change my clothes. I think it’s important that we look at what we are upset about during this time and figure out ways to do actively make the most out of the situation we are in. I’m not saying it’s easy, nor that there is a solution for every person or situation. For some situations we just need to adapt our mindsets to our current reality.

I hope this give you some food for thought. For now, keep making the most of it!