Optimism, Physical Therapy and Everything Else

Optimism. Clin Psychol Rev. 2010 Nov;30(7):879-89. Carver CS, Scheier MF, Segerstrom SC.

Abstract
Optimism is an individual difference variable that reflects the extent to which people hold generalized favorable expectancies for their future. Higher levels of optimism have been related prospectively to better subjective well-being in times of adversity or difficulty (i.e., controlling for previous well-being). Consistent with such findings, optimism has been linked to higher levels of engagement coping and lower levels of avoidance, or disengagement, coping. There is evidence that optimism is associated with taking proactive steps to protect one’s health, whereas pessimism is associated with health-damaging behaviors. Consistent with such findings, optimism is also related to indicators of better physical health. The energetic, task-focused approach that optimists take to goals also relates to benefits in the socioeconomic world. Some evidence suggests that optimism relates to more persistence in educational efforts and to higher later income. Optimists also appear to fare better than pessimists in relationships. Although there are instances in which optimism fails to convey an advantage, and instances in which it may convey a disadvantage, those instances are relatively rare. In sum, the behavioral patterns of optimists appear to provide models of living for others to learn from.

Full text and PDF available HERE

My comments:
This was a fascinating review paper, for which I link the full text, as I think everyone ought to read it for themselves. I got thinking about it after reading a few sports psychology books, some papers on positive psychology in general and noting that one of my new physical therapy techs had probably the best disposition of anyone I know (genuinely happy and positive without being annoying). It had a noticeable beneficial effect on my patients when she was taking them through their exercise programs. I asked her if she had always been that way, and she said a couple years ago her parents were going to send her to psychologist for depression and she said she just decided to change her outlook and look at the bright side of things regardless of how bad they seemed at the time. I said that sounded just like Polyanna’s “glad game” and found a youtube clip of it, and she said, yeah that’s pretty much it. She thought that if you start off pessimistic you have to fake it till you make it, but eventually it becomes how you look at things. She reports the positive impact on her life has been immeasurable. I asked if she read any books on it, and she said she hadn’t. Emily Porter apparently hadn’t either and the above paper appears to show that her 1913 ideas are holding up better than her contemporary Sigmund Freud’s psychoanalysis.

The paper discusses a good number of health related effects secondary to taking a positive view on things. Taking a positive rather than negative view on things leads to better outcomes, less depression and greater feelings in well-being even when dealing with serious health issues ranging from heart surgery to breast cancer. None of the studies specifically addressed diagnoses frequently treated in physical therapy such as low back, neck, or arthritic pain, however the benefits did seem largely general such that I would expect the positive benefits to be widespread. I have been a critic of the biopsychosocial model of back pain for an example, but I do think that much of the newer research on positive psychology likely has considerable application to physical therapy as well as life in general.

Part of the paper I thought pertinent was that optimism heritability was estimated to be about 25%. Optimists were more likely to take a proactive approach to problems rather than avoidance/denial, and in my physical therapy practice, which is largely exercise based, a being proactive is a big part of recovery. Interestingly all the studies indicated that optimists did a better job of dealing with disappointments and if a goal became truly hopeless optimists were more likely to adopt a new goal and do better at it. Optimists also tended to have less heart disease, less mortality, earned more lifetime income, had better personal relationships, and greater social network.

Interestingly the paper reported there was still uncertainty as to whether and to what extent a pessimist can become an optimist. They suggested cognitive behavioral approach, which it seems the cognitive aspect is what my tech did intuitively, basically changing her inner dialog to more positive thoughts.  The finding was that optimism is 25% genetic, that leaves 75% to be affected by controllable factors, so the glass is three quarters full right from the start.

Being a long-time fan of philosophers Schopenhauer and Voltaire (though Voltaire reads like the worlds happiest and best humored pessimist) I think pessimism is often more realistic and perhaps more intellectually satisfying, however if you just want a better recovery from your injuries and illnesses, more friends, better relationships, more income, greater happiness and what appears to be a better life overall, research seems to indicate that you you are better off looking at the bright side of things.

As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.

Chad Reilly is a licensed physical therapist, located in North Phoenix, practicing science based medicine with treatment protocols unique and effective enough to proudly serve patients from Phoenix, Scottsdale, Mesa, Chandler, Tempe, Peoria, and Glendale.

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