February 05, 2023

Power of Positve Thinking vs. Realistic Thinking?


One of many things that would kill me faster than my slow growing cancer is adopting the mindset of positive thinking. It is so against my nature. I’m sure this makes me sound like a curmudgeon. But why? The opposite of positive thinking isn’t negative thinking; it’s realistic thinking.

I woke up the day after my diagnosis and began thinking hard about these realities: My cancer could spread. I could live, I could die. My doctors might make mistakes. My activities might be limited. My finances might be impacted. And of course, there was the realistic hell of finding out that I had no insurance.

I didn’t spend much time wishing away these circumstances.  Instead, fully absorbing the reality of these putrid situations helped me stratagize and meet my needs.  It encouraged me to research like mad, and turn this bundle of research into resources for other cancer patients to use.  Spending sometime staring at these scary realities has helped me feel my feelings instead of bottling them up. It has allowed me to live fully with ‘what is’, which has made a lot of room for both sadness and joy.

I deeply want positive outcomes in my life, but I don’t believe that thinking positively about them will make them manifest.  Instead I believe that positive health outcomes occur by using smart science, making the best rational decisions possible, encouraging good public health policy, having enough money, support, or resources, and being on the right side of medical mysteries for which there are explanations that we have yet to discover.

Do I have times when I think positive thoughts? Yes. There are many instances where I am encouraged by the world around me and by the direction of my own life. But as a mantra or a mind set – no thanks. If someone could prove with solid evidence that thinking good thoughts would change the course of my life, my cancer, or my treatment for the better – would I become a positive thinker? Show me the proof and I’ll get back to you on that one.

I was recently interviewed in a slide show feature by Lori Hope called When Positive Thinking Isn’t Working, Get Real,  along side  Barbara Ehrenreich and Dr. Jerome Groopman and others. I loved seeing realistic thinking addressed as a valid and practical tool to help cancer patients cope with the emotional and practical side of living with this disease. It’s a must read.

Do you consider yourself a positive thinker, a realistic thinker? What does that mean to you?  If you are not big into positive thinking - how do other people respond to that?

For more cancer conversations about realistic thinking, check out Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s.

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  1. Ellie Says:
    February 5th, 2010 at 11:22 AM

    Thank you for saying this. I am also a realist. When I was diagnosed, I set about finding out what my best choices were and deciding and sticking with the best path for me. This included sending a note to some VERY close friends asking them all to respect my feelings on any given day and for their support in realistic not pessimistic attitudes. I got slammed. I was ‘rejecting the power of ‘ various things: creating your own destiny, THE SECRET, that any negative thought would manifest as illness or symptom and my favorite: that the thyroid cancer I had was to tell me to be silent and listen to the cosmos. Spare me , please.

    I am a cheerful and optimistic person, but not an idiot. If it make someone feel better, I am very happy for them. But please please please.. don’t BURY me with the negativity of your positivity.

    Even my doctor told me to guard against the ‘believe and everything will happen for your benefit’ people. It makes my blood boil because by the very act of deciding that everything we experience is manifest in our health , we are blaming ourselves, the most negative thing you can do with cancer or with life.

    My best friend in the world was barely civil, and I understand that others have fears, but when I needed her the most, she was disgusted that I would not be Pollyanna.

    Now you have me started, I will stop. I hope that people will consider that we have to live with cancer and our lives, and that each of us must choose our approach. Slapping us with overbearing ‘ positivity’ can actually hurt us terribly.

  2. Donzie Says:
    February 5th, 2010 at 11:52 AM

    Hi Kairol!

    I find there isn’t much difference between what’s called “positive thinking” and “magical thinking.” The expected results are the same: problems will somehow solve themselves just by adopting a “positive” attitude.

    Human life is hard, and most people want to believe in magic. They don’t want to be challenged, because realistic/skeptic views have no comfort to offer, just more work.

    Example: my cousin is getting married in July and other family members have already gotten in touch with me about plans to attend, which I thought was a little odd. They say: “It’s something to look forward to.” Of course if I disagreed, they’d think I was nuts. The pathetic thing is, do they mean they have absolutely NOTHING else exciting or positive going on in their lives for six whole months? Really? Or does it have to do with the “romance” and “magic” of a wedding?

    Anyway I have to go, because it’s lunchtime, and if I think really positively and pray really hard, something to eat will come my way. :) You rock as always.

  3. Corinne Says:
    February 5th, 2010 at 12:21 PM

    Thank you so much for this. I too tend to be more realistic than positive. At the moment I’m off the synthroid to prep for a WBS and we are expecting tons of snow (I live on a hill on which I’ll be stuck). I am already freezing if we lose power and our heat as a result I will not be able to tough it out. If one more person tells me to relax, stop worrying, or to think positive I think I’ll scream.

    I feel like crap, reality. I will feel so much worse before I feel better, reality. If we are stuck in our house (which is highly probably) and I have a medical emergency or my testing is compromised as a result it will be very bad for me short and or long term, reality!

    My husband tends to be reactive and sometimes I’d like to throttle him. I want to have a plan in place for the worst possible event then I can be pleasantly surprised with good news and NOT knocked out of orbit by bad news.

    I do occasionally take a break and try to focus on what is positive. Like we have lots of food stocked. Right now we do have power. I have lots of books to read. Right now I am fairly warm in 2 layers of clothes, under my covers with the space heater adding to the warmth of central heating. Those are fortunately positive realities for me right now. But never fear I’ll soon be back to worrying and planning for that power outage!!

    Thanks Again Kairol! I’m happy to hear I am NOT alone!

  4. Melissa Says:
    February 5th, 2010 at 12:44 PM

    I am admittedly a glass half-empty, mildly neurotic kind of person. It’s not like I sit here wishing for the worse, but I do have a tendency to try to anticipate crappy outcomes. Honestly, I don’t think that’s necessarily a bad thing - though it may make others uncomfortable. I think positive thinking has the risk to prevent action. You know, it will be OK. I KNOW it will be OK. I prefer to assume that it may, or may not be OK, which prompts me to research, make plans, ACT. I don’t know how to do it any other way. It’s in my DNA.

  5. Jetty Says:
    February 5th, 2010 at 2:02 PM

    I am an incredibly positive person and I know the reason why I kick my cancers ass is because I am positive, but there is a vast difference in being positive and working towards a positive goal than wishing and living in an illusion.

    I just finished Barbara Ehrenreich’s book and I loved it. I found no discrepancies with her writing and my own positive thinking. Positive thinking worked for me because I am a naturally happy person. I have lots of bad luck, but I work to have a happy life with a smile on my face. I am a realist, I don’t for a second believe in the crap of The Secret, you cant wish your cancer away, nor did you get cancer because you were a negative person. I just don’t see realism and being positive as opposites. You can still understand that you could die, I could die tomorrow but that doesn’t mean I need to put off that vacation or stop playing my video games now because of it.

    My cancer has a very low 5 year survival rate, so low in fact that my oncologist has never had anyone make it that far, my 5 year is April 4th. While the realist side of me says, “You’re not gonna make it” the positive side of me say “Screw you! I’m going to Vegas in March!” My point is, for me, I think you can be a realist and still be positive. When I was rejected for scholarships (which I was MANY times) and when I had to fight for aid to help pay my bills, I took my anger and used it to get what I wanted and I smiled while I did it. Life is hard that’s the realism of it but maybe it is just me who would rather be having fun while fighting then focusing on the bad parts. The bad parts are to be addressed but not the center of your life.

  6. Anita Says:
    February 5th, 2010 at 2:14 PM

    Hi Kairol,

    Positive thinking was hard on my mom when she was suffering and people wouldn’t let her not think positively. It was very harmful indeed. I let her think whatever she wanted to think and gave her space to let whatever she felt was safe with me. I now have type 2 diabetes and I’m a realistic thinker, yes I have good days when I exercise and I feel good when my blood sugar numbers are good. I put that down to being a realist and knowing that it could be worse and I could have problems with my idabetes and it may come in the future. Today is a good day and I intend to enjoy it as much as possible within my limits of course.

  7. Greyash Says:
    February 5th, 2010 at 2:29 PM

    I also am a realist. Yes, I try to act positively, and to think positively to the point that I don’t go around bringing my family down. But being a realist has helped me make decisions about myself, my life, my well being. Being a realist has helped me make decisions on “quality of life” instead of just “quantity”. That has been one of the best things it being real has done for me. Do I want to live a long life and see my son get married and have babies. OF COURSE! Do I want to do it in constant debilitating pain and being a terrible rotten person to those around me, including him, because of it? Hell no. So, I make decisions based on how will I feel, how will this affect me and my family and my life right here right now… AND in the future… because let’s be real - I could get hit by a bus tomorrow and then the 4 surgeries and painful disabilities I have because of them would all be for nothing!

  8. Jen Says:
    February 5th, 2010 at 3:09 PM

    Thank you. I loved this post of yours. You sound exactly like me in terms of the way you think things through. I love my oncologist, but sometimes I feel frustrated when he says things like, “Well, there were some areas of activity on your PET scan that we are going to wait and watch, but I have a really good feeling that everything is going to be okay” (EYE ROLL). I want to know, personally, what are the options here? What could be the case? It helps me to prepare myself emotionally to know the possibilities that are inherent in this. It helps me deal. Sometimes it stresses me out, but mostly it helps me to confront the reality of my situation, my illness, my life, my mortality; these things are important to me. It is important to the core of my being to be honest and truthful, even when the truth is hard to hear or imagine.

  9. carolbe Says:
    February 5th, 2010 at 4:13 PM

    Your column should be mandatory reading for well-meaning well-wishers. They fall into two categories.

    The first is that our illness is our fault. Questions like “Are you still eating red meat?” “Didn’t you used to smoke, back in college?” “You quit going to the gym, didn’t you?”

    The second is your magical thinking, a term I will adopt. These comments are “You will do fine, because you have such a good attitude.” “Keep smiling, and it will send healing vibes to your cancer.” “My aunt drank lots of apricot pit tea and her cancer went away by itself.”

    I picture myself smiling as I strangle them.

  10. H Lee D Says:
    February 5th, 2010 at 10:43 PM

    As a person who is both positive and realistic, I take offense to “the opposite of positive thinking is realistic thinking.”

    There is a difference between “everything is fine” positive thinking and mentally putting yourself in the future better than where you are.

    My advice to those going through cancer is that the most insidious advice givers are the ones who “are just being realistic.”

    I am very realistic and down-to-earth. I was quite aware of what was (is) going on. But I didn’t marinate in it. I don’t need people to tell me that this might happen and there are these potential side effects and I might die. I know I know I know. I choose not to dwell there.

    There is research that adolescents with leukemia who played video games depicting their cancer being destroyed had better survival rates than their peers who didn’t. Video games help cure leukemia? No. Brains do.

    I have been trained in a program called 21 Keys. I use it at work, I use it for personal things, I used it through cancer. It deals with the power of the mind over the body. Would I have used that in lieu of chemo? No. But it is absolutely real.

    You see what you focus on. My single girlfriend “sees” a lot more hot guys when we’re out than I do. Because there are more in her line of vision? No! Because that’s what her radar is set on.

    I can choose to set my radar on potential disaster — ensuring I will step right into it — or I can set it on where I *want* to go. Have you ever tried to turn on a bike (or even in a car) without looking where you’re going? You go where you’re looking, and I believe that’s largely true in life. (100%? Certainly not. I wasn’t looking at cancer when it hit, but within 6 hours, I was looking past it.)

    But it’s not “positive thinking.” I think what people assume positive thinking is is really denial.

  11. Pat Steer (Gaelen) Says:
    February 5th, 2010 at 10:43 PM

    I’ve taken a lot of heat on colon cancer support forums because I am realistic, and I do periodically point out that manic positivity just doesn’t work for me. I know, I know - pointing that out to what someone once described as an ‘over-caffeinated cheerleader personality’ is kinda like poking a snake with a stick…no good will come of it.

    In fact, flamewars came of it, a couple of times. But I can’t help it; some days another chorus of ‘don’t read the stats, just stay positive and you’ll be fine’ makes me want to scream that I’m *positive* stage IV is usually fatal within about three years.

    And when they bring out the ‘you could get hit by a bus tomorrow’ line…that’s when I want to point out that ‘yeah, but my bus is the stage IV rectal cancer express.’

    I try not to use those lines, unless I can clearly go for the dark humor. But to this day someone takes offense, even when others support a realistic and informed response. I wish I could say flamewars don’t happen on support forums, but they still do. And I wish I could say that some of the people who were most vocal about staying positive so people new to the boards were still around. But unfortunately, more than a couple of them have passed. Being positive may have helped them feel better while they were alive, but it didn’t keep the realities of stage IV cancer from kicking in.

    I do make a distinction about pessimism - because I don’t consider realism automatically pessimistic, either. Obsessing over the horrible things that could happen - I.do.not.do.that. - and that’s a lot of mental work, but over time you get better at it.

    I think there’s a difference between being realistic about my disease, whether I’m in treatment or remission, and sitting around listening for cancer cells to grow. After dx, I took care of business, made sure my affairs were put and stay in order. But that’s done now; next? I don’t let myself spend a month worrying about a scan…either before or after.

    I try to stay in the present, and I do plan for the things I want to do, as long as they are within the next three months. But I don’t make many plans or reservations more than 90 days in advance (that’s where the realism kicks in.) I don’t think making some short term plans is either positive or optimistic. For me, it’s just being organized. I still do plenty of things spur-of-the-moment. But I wasn’t being ‘positive’ or ‘optimistic’ when I put my vacation for the last week of April on the calendar last December - I was making sure I’d be the first to reserve those days, in case more than a couple of us wanted the same week off. Prepared - because I’m realistic about vacation conflicts. Not ‘positive’ because I know that I’ll still be NED after my April scan.
    Big difference. ;)

  12. Kairol Rosenthal Says:
    February 6th, 2010 at 3:11 AM

    Anita - It is really cool to hear the perspective of a caregiver on this one. It really is an incredible thing when people such as yourself are able to step aside and let a patient feel whatever they are feeling. What a gift you gave to your mom.

    H Lee D - I believe the study you are referring to is the 2008 study where adolescent leukemia patients were engaged in playing education video games. The study did not measure survival but rather behavior outcomes related to medication adherence. They found that the teens who played the video game, which educated them about the purpose of their medication and how it worked in their body, were much more likely to take their medication than the study participants who were not given the additional education about their medications. So the study was not related to positive thinking but rather if we educate patients about the biological functions of their medication and cancer are they more likely to want to take their medication. The answer was yes. It makes a lot of sense to me. The more a patient learns about and becomes engaged in their healthcare the more likely they are to participate in adhering to treatment guidelines.

    Lastly - I think it is really interesting the issue that two of you touched upon about doctor’s attitudes. It is super confusing to me when my doctors have said things to me like, “No need to worry,” when in fact the information they have given me provides reason for real concern. Sometimes I think they say it to make themselves feel better because maybe it is hard for them to day in and day out dish out uncomfortable news, especially to someone as young as me. I actually empathize with doctors who face this hard, hard part of working with cancer patients.

    I think there is a lot of interesting work to be done studying the gap between what doctors think patients want to hear, what patients actually want to hear, and what patients need to know. These are three different things. And as the study that H Lee D pointed out, patients who are better informed about the parameters, side effects, and functions of their treatments are more likely to adhere to medications or procedures that have been scientifically proven to improve outcomes.

  13. H Lee D Says:
    February 6th, 2010 at 11:59 AM

    There are two sides to every stat.

    If there’s a 60% chance that I’m not going to live for five more years, there’s a 40% chance that I will.

    If I choose to put myself in the 40% pile, why is that “unrealistic”? *Someone* has to be in that 40% — why not me? As long as I’m doing the work that needs to be done to get me there, why not believe it?

    There are odds like this all the time in all parts of life, and if one always looks at the down side, one isn’t going to have a happy life, regardless of what happens.

    You’re more likely to be divorced if your parents divorce. So do you not get married? Do you not date? Or do you try to buck the odds?

    You’re more likely to die of heart disease than cancer (well, we’re not, but the general population is), but this doesn’t stop most people from leading lifestyles that promote heart disease.

  14. alk Says:
    February 6th, 2010 at 3:04 PM

    All we have is today. There’s freedom in that thought for me. Whatever the stats, whatever your risk factors, the fact is that no one REALLY knows. Your doctor never saw anyone live more than 5 years? well that’s one mortal’s experience. You might be the first. I am not a polyanna, don’t agree that positive thinking can actually affect outcome — although psychologically, it does typically make one feel better though and can help one to adapt to a difficult situation. As someone who spent most of my 30s with bad (and sometimes housebound bad) health, I do think hope is important. Even a glimmer. But the people who say:everything will be OK, you have to think positively BLA BLA BLA. they make me angry much of the time, so I ignore them, as best I can.

    Some prefer to know every possible detail about their disease/condition/illness, others like to just do what the doctors say, and still others in between. What’s important is that each needs to find their own way. the challenge si when our lovedones, or well intended friends don’t have the sophistication to give us the space we need to get through things in our own way. When dxd with Thyca, my bf printed everything from the internet about worst case schenarios so I would know what I was up against. This freaked me out and it took my SCREAMING at him to stop to get it. No amount of polite thank you’s seemed to help.

    I preferred taking things one step at a time. After surgery, for example, I became very afraid that the cancer would come back- so I called my dr and he talked me through what would happen (more surgery and radiation) and he reassured me enormously that I could handle things one step at a time.

    Also, Corrine, good luck with the withdrawl! That is so hard. I did it almost 3 years ago and it’s no fun. Kairol probably knows more and of course I don’t know the specifics of your Thyca, but protocols have changed recently, so maybe you’ll just have to do withdrawl 1x. (now they let many people with low to medium risk do the thryrogen shot for withdrawl. Once you get through the testing, you can check into that.)

    PS like many on the withdrawl, I was a lunatic-depressed-crazy-maniac when going off synthroid so I understand where you are coming from. As for wanting to throttle your husband — I hated pretty much everyone — and how hard it is and tomorrow is one day closer to it being over. That’s probably the most encouraging thing I can think of to say. You will get through it along with the (evil) diet…”Positive” let alone even thinking was impossible for me when super hypo. ….those w/thyca know what I am talking about. It’s really hard. Hang in there. Hope you weather both the storm outside and the one going on in your hypo state.

  15. Kim Says:
    February 6th, 2010 at 5:52 PM

    Along the lines that H Lee D just posted, part of the problem for me in trying to remain “positive” after being diagnosed with cancer is knowing that, going into my thyroid biopsy, there was only a 5-10% chance it would be malignant. I and everyone I talked to thought for sure it would be “fine,” meaning, not cancer. However, I read all about the ultrasound features of my thyroid nodule and the realistic part of me knew that actually, there was probably a good chance it would turn out to be cancer, and it did. Now I struggle b/c I really do want to believe things will turn out fine, but when you fell into the small odds to begin with, why would you think you would fall into the larger odds for things in the future? I’ve been reading the book, “21 Reasons Why Bad Things Happen to Good People,” and it helps for me to just think, even if bad things happen in the future, it will happen for a very good reason.

  16. Shannon Says:
    February 6th, 2010 at 8:35 PM

    I had to call my husband into the room and read this post to him out loud. He is very much a “glass is half full” kind of guy where as I worry and overanalyze everything…

    We have gotten into many a discussion about how I just need to not worry and think positive. I believe it is his way of trying to “fix things” as med tend to want to do. It is what he says when there is no other way to “fix” it.

    After my clean WBS and ultrasound, my tumor markers were still elevated. The doctor said everything was good and not worry as it is a slow growing cancer….my husband was practically jubiliant. I sat in the room wondering why on earth I was the only one still concerned….I voiced my this only to get the requisite “dont worry sweetie, it is all good!”

    ummm, okay….naturally I ignored him and went home to spend the next three days researching medical journals to learn more about what was going on.

    bottom line…all the positive thinking, not worrying, “it is all goods” in the world doesn’t change a thing about how I go about my business of living with cancer. I have my way, my husband…well he has his.

    I say whatever works, just dont push it off on me and expect a polite response everytime.

  17. Pat Steer (Gaelen) Says:
    February 7th, 2010 at 2:50 AM

    Regarding this comment from H. Lee D: “There are two sides to every stat. If there’s a 60% chance that I’m not going to live for five more years, there’s a 40% chance that I will. If I choose to put myself in the 40% pile, why is that “unrealistic”? *Someone* has to be in that 40% — why not me? As long as I’m doing the work that needs to be done to get me there, why not believe it?”

    60/40 is actually a pretty good split, says this bettin’ woman. Heck, it’s almost 50/50. ;) But the problem I’ve seen, still see, is that in some stage IV cancers, the split is nowhere near so good as 60/40. In my own cancer, it’s closer to 80/20 (where 20% is the make-it-to-five-years number, and 80% is the dies-within-3yrs-of-dx number.) When I was dx’d, the number of patients who survived *to* five years was under 5%, and the bare few who survived more than 5 years didn’t even make up a whole number percentage.

    So if ‘doing the work’ to put you into a teeny tiny survival percentage, and believing that you will be one of those bare few survivors helps you get through the day - well, that’s your coping mechanism. I’m not going to take a coping mechanism away from anyone. But as Shannon mentioned, just don’t push an individual coping mechanism off on everyone else and expect a polite response from all comers.

    For instance, on an entire forum of Stage IV survivors who are all asking ‘why can’t that 5%, 10%, even 30% be me?” - well, the realist understands that not all of those 100 stage IV patients will make it into the teeny tiny survivor percentage who live for five years or more. While individuals may not wish to acknowlege the laws of big numbers (aka stats), that doesn’t mean that they don’t or won’t play out. It makes me a little crazy to watch that kind of group-think until an entire forum full of people are saying ‘well, why can’t it be me?’ Because when faced with tiny survival percentages and heavy odds of fatality, survival can’t happen for all of us.

    Re: “There are odds like this all the time in all parts of life, and if one always looks at the down side, one isn’t going to have a happy life, regardless of what happens.” - that’s not always true, either. There’s understanding that there is a down side, preparing for it, doing what needs to be done to avoid it if there is any chance to avoid it. That doesn’t mean obsessing about all of the worst of life. There is a difference between being a realist who recognizes that bad things have a high likelihood of happening (which I am) and a pessimist who believes that the worst absolutely will happen every single time and worries uncontrollably about that worst case (which I am not.)

    Maybe a clearer characterization is that (for me) the opposite of positive thinking is pessimistic thinking. For me, a realist can be hopeful for certain things while accepting that survival isn’t going to be one of those things, without either cheerleader ‘it’s all okay’ or chicken little ‘the sky is falling’ reactions to every little thing.

  18. alk Says:
    February 7th, 2010 at 11:20 PM

    The other argument of the stats story is that in order to believe in them, you assume that they are factual. Stats speak to populations, not to individuals.

    The medical establishment is known for changing its mind, coming out with new studies, refuting old studies and revising. This all in the name of “science.” And we patients hang on it as “truth.” I am not saying that we should ignore what they say, but what they say is NOT the gospel.

    Percentages include EVERYONE, do not exclude for things like age of person being treated, quality of care, how compliant individuals are with follow up care, the skill of the surgeon, or a host of other things which can affect the outcome for an individual.

    I prefer no labels. Someone’s pessimist is another’s realist. One person’s positive is another person’s polyanna. This stuff is really hard and there are no answers.

    It just is what it is. Do what you need to do. Try to cope best you can.

  19. Kate Says:
    February 8th, 2010 at 11:51 AM

    Have I told you lately that I love you?

    This cult of positivity is what led me to start blogging myself. I am a realist bordering on pessimist and have been so frustrated by some of the crap people have given to me during my illness.

    My least favorite? Everyone in the city I live in that is diagnosed with cancer is given a bag full of stuff that I’ve started calling the consolation prize. In there is Love, Medicine and Miracles by Bernie Siegel which if you make the mistake of reading can break your heart, especially if you’re not Susie Sunshine.

    As for statistics the biggest mistake I ever made was asking for a prognosis. It’s taken a lot of work to get that number out of my head and I wish I hadn’t pushed for it.

  20. Laura M Says:
    February 8th, 2010 at 7:43 PM

    In answer to your orignal question, I’m a positive person…which has led me to be mosty a positive thinker even though I have Stage IV colon cancer.

    Soon after my diagnosis, I sat down, evaluated my life and figured out that even if I do die tomorrow (not likely by the way), I’ve lived a hell of a full life.

    The fact that I want to continue to do so, to “deeply want positive outcomes” AND that I believe that there is something to mind/body connection does not make me a magical thinker. It makes me hopeful. It leads me to practice meditation, visualization (about which there are studies indicating at minimum an increase in quality of life), and affirmations along with chemo, surgery, exercise and a healthful diet. I am also one of the most proactive and informed cancer patients I know…so I’m definitely not just wishing away my disease.

    Where I think many of us go severely off beacon here is in assuming (as Jetty, H Laura D and Galean have all intimated from one point of view or the other) that we’re talking about opposites here. Positive thinkers can be realists, well-versed in the science and the latest medical techiques. Realists can read all the stats, believe that they’re not likely to make the statistical cut and still live life with verve and joy.

    I propose that attitude is a matter of taking the information in, deciding how meaningful each piece of the information is to you and choosing how you will react.

    I’ve seen “realists” who accept diagnoses and essentially resign themselves to dying on schedule. That approach was not for me and it rankles me a good deal…and I also believe that each of us gets to make our own choices about our coping mechanisms.

    Do I want to be in the teeny tiny percentage that survives Stage IV for longer than 5 years? You bet. Do I believe, for me, that focusing on life and living it with verve and a positive belief that I can be part of that teeny tiny percentage helps?

    Maybe. What I can say for sure is that it doesn’t hurt.

    One last point, I noticed several folks who were talking about being realists were actually engaging in some (negative) prognostication. “I could…” “What if…?” The difference in coping mechanism seems to come largely from completion of the sentence. I could see medical changes that allow me to live a full life span. What if I am able to beat the odds? Or I could have my cancer spread. What if I’m one of the x% that die from this relatively soon?

    All are legitimate questions and I agree with Gaelen on putting one’s proverbial house in order. But on a day to day basis? You’ll find me dwelling in hope.

  21. Roger R Says:
    February 9th, 2010 at 12:43 AM

    I was allowed to be a positive thinker by everyone around me. My employer guaranteed to take care of me 100%, they paid me every week no matter what. My wife was with me at every appointment, and therapy. My team of doctors worked so well with each other, I never had to worry about test results or paperwork getting lost. My insurance was excellent. With all this working for me, I had no choice but to be a positive thinker.

  22. Cat Says:
    July 26th, 2010 at 11:15 AM

    I agree with many of the posters here that there is likely a three-part makeup of approaches: positive thinking, realistic thinking, and negative thinking. My approach from day one was, “This thing is happening whether I’m on board with it or not, so I might as well commit to handling it as best I can.” But my mental response to “Why me?” feelings was not the perky “Why not me?” but was typically, “Why anyone? This sucks no matter who it happens to.”

    So I would describe myself as someone who strives to be a realistic thinker. This means that my fiance and I continue to look forward to our wedding, and are planning as many elements of it as we can, but have not yet set a date, since we’re not sure how long it will take after the end of my treatment for me to feel well enough to enjoy the party. I should note that being realistic sometimes actually makes me more optimistic, at times when my worst fears threaten to take over my mind and emotions. The scariest statistics for my cancer, ALL, have 40% of adult patients making it five years, which could have me dying before age 30. Terrifying. But, as my stats-genius fiance, an actuary, reminds me, stats represent the outcomes of the whole spread of a given population, from the very worst to the very best cases. While they’re useful as a tool for researchers, they don’t represent any given individual’s chances. So I pay attention to what my oncologist says about my personal case, my own cancer: that based on the pathologist’s report, my condition at the time of diagnosis, and my response to treatment, I have at least a 70% chance of being permanently cured. This realism can really boost my mood.

    Kate: I cannot believe “L, M &M” was pushed on you like that, how horrible and traumatic. “Why did you need this cancer?” is an appalling question to pose of the newly-diagnosed. I stumbled across Barbara Ehrenreich’s “Bright-Sided”, and it was the perfect antidote, I can’t recommend it enough. The “think happy thoughts” approach to cancer (or any illness, major professional setback, whatever) drives me right up the wall. Though not nearly as much as the Oprahtastic fatalism of “everything happens for a reason”, though I digress…

  23. sandgroper Says:
    August 18th, 2010 at 7:50 AM

    My Mum died last year. She was dx with cancer in 1977. In my youth and desire to help I bought her many books which she seemed to ignore. SHe went through many rounds of chemo and other treatment. She did not do things the way I would have.

    Now I hae ve a chronic condition which is not life threatening but very disabling on a day to day basis and I have had to endure much of the positive thinking attitude I thought my Mum should adopt. It has been an extremely painful life lesson.

    The only thing I can say that I did for her was let her know that I could accept her decision to stop treatment which she did. As it happened the cancer did not kill her but an infection (probably a result of the treatment).

    In that 32 years I saw cancer go through a readical shift in terms of is perception in the community. Now I face the same ignorance that my Mum once faced when she was originally dx.

    I got sick 5 years after my Mum and fully believed in the power of a healthy lifestyle, positive thinking etc. Finally I realise that I wanted to believe that I had control. As my health deteriorated and I became more and more disabled I finally had to let go of any illusion of control.

    Now I have learned about the many diseases for which we have no cure or even proper treatment and it is very scary. Its that fear that drives people to tell me I can control my disease if I just do (whatever they think I should do).

  24. Josh Saville Says:
    February 21st, 2011 at 12:53 PM

    Lol…such an undeveloped philosophy. First, realize that emotions guide logic - not vice versa. We use logic to optimize positive emotions. I have no time to elaborate.

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