The Power of Positivity

by GRACE LEE

Inspirational quote of the day: “believe in yourself.” The first step towards success is optimism and confidence--even when it comes to optimizing your physical health. In fact, a positive attitude can benefit your bodily health more than you may think. A 30-year study by the Mayo Clinic found that optimists have 50 percent lower risk of early death than pessimists.  Conclusion: “The mind and body are linked” while “attitude has an impact on the final outcome--death.” Creating positive expectations can add years to your life, and make all the difference when it comes to health and healing.

The Power of Positivity

Believe in yourself: the notoriously overused Inspirational Quote-of-the-Day.  But did you know this little piece of advice has a scientific basis?  In fact, numerous studies have shown optimism to be associated with positive health consequences, including lower blood pressure, and slower disease progression for HIV and certain cancer patients.  The more positive you expect your future to be, the better your ability to adapt to challenging situations, including college transition.

Dispositional optimism, or generalized positive expectations, predicts a healthy psychological mindset.  It has been long established that people with optimistic expectations report better physical health (though it may be due to positive bias), as published in 1989 in the Journal of Personality and Social Psychology.  Nevertheless, a positive attitude can benefit your body more than you may think.  The Mayo Clinic sys optimists have 50 percent lower risk of early death than pessimists.  Creating positive expectations can add years to your life, and make all the difference when it comes to health and healing.

The Science Behind It

A relatively new science is devoted to studying brain-body interactions and examines how psychological well-being affects the rest of the body.  Psychoneuroimmunology (PNI) is an interdisciplinary field of how our thoughts and feelings (psych) influence our brain and nervous system (neuro), which temper the body’s disease-fighting mechanisms (immunology).  

Amongst other mind-body relations, PNI explores the health outcomes of dispositional optimism. In general, optimists tend to engage in positive health practices including higher levels of exercise, reduced levels of smoking, and healthier diet. Evidence also indicates that optimists are physically better off due to their ability to moderate the negative impacts of stress.  In 1998, a study by former UCLA psychologist Suzanne Segerstrom, PhD, found evidence that tied optimism to better mood, coping, and immune response to stress.

Communication between the brain and immune system occurs via two major pathways -- the autonomic nervous system and hypothalamic-pituitary-adrenal axis (HPA axis), both of which are key stress response systems.  Responses to physical and mental challenges are correlated with activity in immune cells (such as T cells and natural killer or NK cells) and cytokine messengers molecules (such as interleukin-6 or IL-6).  Stress triggers high levels of NK cells and IL-6 in the blood, as part of the inflammatory response.  

High levels of immune cells and cytokines indicate inflammation in our bodies, which is a natural immune response to deal and daily stressors in our lives.  The ability for inflammation signals a healthy, responsive immune system; however, prolonged inflammation is never a good thing.  The drawn-out, heightened immune response to constant stress greatly damages the body.  

A 2007 study in Brain, Behavior and Immunity found increased circulating IL-6 to be correlated with psychological stress.  More notably, a more recent 2009 study in Brain, Behavior and Immunity found the subjects with high levels of dispositional optimism had smaller IL-6 responses in stressful situations, demonstrating the impact of a positive mindset on acute stress.

An Example: A Man Who Laughed His Way Back to Life

The Cousins Center for Psychoneuroimmunology at UCLA was founded by a man who laughed in the face of death.  Literally, American journalist and medical professor Norman Cousins applied his own research on the biochemistry of human emotions to his own battle against a heart attack, heart disease and Ankylosing Spondylitis, a life-threatening collagen illness involving deteriorating connective tissue in the spine.  Doctors speculated his chance of survival to be i1 in 500, with only a few months to live.

Faced with impending death, Cousins chose a treatment process simply unheard of: (1) an abundant supply of Vitamin C with (2) a check-out from the hospital and into a hotel room and (3) funny films to provide him with massive doses of positive attitude and laughter.  The result? Cousins survived to a ripe old age of 75 -- a miraculous number of years past what was expected of surviving a collagen illness, a heart attack, and heart disease.  The remarkable survival of Cousins is but one case supporting this holistic approach to health and recovery, demonstrating how optimism and a positive attitude can strengthen the body’s ability to counteract disease.

“The more serious the illness, the more important it is for you to fight back, mobilizing all your resources -- spiritual, emotional, intellectual, physical.”

- Norman Cousins, Anatomy of an Illness

A Note on the Placebo Effect

The power of positivity is perhaps most convincingly portrayed when examining the role of optimism on the placebo effect. The “placebo effect” is an all-too-familiar concept in which an inactive treatment produces an actual physiological or psychological reaction, such as symptom relief or analgesia (decreased pain perception). It turns out the dispositional optimism can actually predict placebo response.

A 2010 Journal of Pain study plied to a placebo hand cream on subjects, who then immersed their hand in ice for 2 minutes. Half of the subjects were told the hand cream would block pain (analgesic) from the cold pressor task while the other half were told the cream was just a cleanser.  Only the subjects who were told the hand cream was an analgesic and were optimistic experienced less pain. Increasingly enough, subjects who were told hand cream was analgesic but weren’t optimistic still reported levels of pain.

The implications of this study are huge. According to these results, the placebo effect may be due - at least in part - to positive expectation effect. Only those who believed in the placebo and were optimistic about it actually had an effect, which indicates the necessity to account for the optimism factor in certain placebo studies. The take-home message: thinking optimistically about your body’s defense mechanisms, or any therapy or medication taken, can make a difference in its actual effects.

To What Extent Does Optimism Help?

It is important to note that the relationship between optimism and immunity is far from simple, and exact mechanisms have yet to be defined.  Despite findings which indicate optimism to be positively related to cell immunity when stressors are more minor, some experiments have shown that this doesn’t always hold when stressors are particularly difficult, complex, persistent or uncontrollable.  A 2004 study from Psychology & Health reported optimism to be associated with lower HIV viral load among HIV+ gay men, but only at moderate levels -- high levels of optimism did not confer any additional benefit.  According to Segerstrom, there may be a couple reasons for this:

1. The Disappointment Hypothesis

It’s the same concept as an over-hyped movie. Optimists are more likely to set themselves up for disappointment whenever the envisioned future doesn’t pull through. A 1999 study from UCSF published in Brain, Behavior and Immunity measured higher T cell and natural killer (NK) cell levels in optimists facing brief stressors, but a decline in immune cells when stressors were prolonged. Likewise, another 1992 Yale study published in the same journal found that optimists exposed to loud noise stressors had higher NK cell levels when they believed they were able to control the noise offset. Taken together, these results show that when optimists can’t terminate persistent and uncontrollable stressors, their positive expectations are violated, leading to distress and decrements in the immune system.

2. The Engagement Hypothesis 

Knowing when to stop trying is important.  In a difficult situation, optimists are more likely to remain struggling whereas pessimists would give up.  Though “giving up” is commonly frowned upon in today’s goal-driven society, it can be physiologically protective by minimizing stress exposure.  When circumstances are easy or straightforward, keeping engaged can lead to problem-solving and the ultimate termination of the stressor.  When the situation is difficult or complex, however, persistence means continued exposure to ongoing stressors.  Segerstrom’s 2005 study found that optimistic subjects were more likely to work longer in attempt to solve difficult anagrams, raising levels of cortisol (the stress hormone).

“It is clear that to the question of whether optimism is good or bad for immunity: the answer is ‘yes’.”

-Dr. Suzanne Segerstrom, PhD

Benefits of Specific Expectancies

The disappointment and engagement hypotheses are the case for general positive expectations.  Specific positive expectations, however, can reduce the stress impact on your immunity.  In a 1998 Journal of Personality and Social Psychology study conducted by Segerstrom, law students with specific expectancies about school had higher immune cell levels, increasing self-efficacy to successfully achieve their academic goals.

Ties between optimism, immunity, and health vary case-by-case.  On one hand, dispositional optimism and specific expectancies can effectively buffer the immune system.  Sometimes, however, optimists pay a physiological cost for opting to overcome particularly difficult and persistent situations.  This only means higher stress for the short-term, however, in the long run, optimists can definitely enjoy better outcomes.  Whereas optimists solve problems to the best of their ability, pessimists choose to temporarily avoid persistent problems in their lives.  

As Segerstrom puts it, “it is clear that to the question of whether optimism is good or bad for immunity: the answer is ‘yes.’”

Q + A

HOW DO YOU MEASURE OPTIMISM?

Dispositional optimism can be assessed using questionnaires, such as the Life Orientation Test, which evaluates generalized expectations of positive and negative outcomes.  

HOW DO MEASURE THE IMMUNE RESPONSE IN RELATION TO OPTIMISM?

Many studies monitor and analyze levels of T cells, natural killer cells, cytokines (such as interleukin-6), and cortisol (the stress hormone) to indicate the strength and activation of the immune system.

more in mind well

Scientific Glossary ▾

Cytokine: A small protein released by cells that has a specific effect on the interactions between cells, on communications between cells or on the behavior of cells. The cytokines includes the interleukins, lymphokines, and cell signal molecules, which trigger inflammation and respond to infection

Immune system: A complex system that is responsible for distinguishing our cells from all other foreign substances, and for protecting us against infections. The immune system works to seek and kill invaders

Hypothalamic pituitary adrenal (HPA) axis: A complex set of direct influences and feedback interactions between: the hypothalamus (in the brain), the pituitary gland (located below the hypothalamus), and the adrenal gland (located at the top of each kidney). The fine, homeostatic interactions between these three organs constitute the HPA axis, a major part of the neuroendocrine system that controls reactions to stress and regulates various body processes including digestion, the immune system, mood and sexuality, and energy usage

Immune-brain loop: The immune system and the brain communicate with each other through signaling pathways. During an immune response the brain and the immune system “talk to each other” and this process is essential for maintaining homeostasis. Two major pathway systems are involved in this cross-talk: the hypothalamic-pituitary-adrenal axis (HPA axis) and the sympathetic nervous system.

Definitions from Medicine.net and Webster’s Online Dictionary

Winter 2011| Vol. 11| Issue 2