The Optimism Revolution

Optimism as you know it isn't always the best medicine. In the new view, behavior trumps positive outlook. Why a healthy mentality paints the world in light and shadow. By Jill Neimark, published on May 01, 2007 - last reviewed on July 17, 2007 The pain was blinding," recalls Larry Dossey of the afternoon last August when he was thrown by two different horseswithin a mere two hours. Dossey, his wife, and another married couple had just spent two weeks camping and fly-fishing in the Wind River Mountains of Wyominga place so beautiful, he says, that it makes him feel like he's "in touch with the gods." Dossey, a doctor as well as an early champion of mind-body medicine, cracked his ribs when the first horse spooked; but he allowed the wranglers to mount him on a second horsetheir most experienced onewith the hopes of reaching civilization soon. The second horse bolted up the mountain, lunged over an embankment, and sent Dossey flying. He fractured his spine, though he didn't know that at the time. After testing his ability to wiggle his toes and turn his head, Dossey concluded his best chance for survival was to walk out of the wilderness. "I realized that this was an extraordinarily serious situation with no good solution that I nonetheless had to overcome," he recalls. "And somehow I knew I could overcome it with sufficient courage and resolve." So he suggested that the women, wranglers, and pack horses ride ahead, and that his friend accompany him by foot. Night fell. For 10 hours he walked, in pain "with every step, one flashlight between us, across some of the most rugged territory I've ever seen," says Dossey. "How do you eat an elephant? One bite at a time. I focused on the act of putting one foot in front of the other. I put my consciousness down in my feet. I stopped every 15 minutes to get on top of the pain."

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At about 4 in the morning, they reached the wranglers' base camp, and from there his wife drove him to the small town of Lander, Wyoming, an hour away. But his back pain only worsened, so that he could hardly stand. Two days later they located a spinal specialist in Bozeman, Montana, who diagnosed the fractured vertebra and hospitalized Dossey, putting him on intravenous morphine. For months he wore a body brace , encased in plastic from chin to hips. He now wears a lighter brace and suffers from daily back pain. His conclusion: "I'm absolutely grateful I didn't land on my head or neck. I came within just a whisper of being a quadriplegic. I reflect on this every day." That's an optimistic appraisal if there ever was one, but Dossey's background as an experienced physicianhe's knowledgeable about both trauma and the impact of attitude on healthhelped prepare him for what he calls "grounded optimism." So did his experience as a seasoned outdoorsman who'd made annual treks into wild country for three decades, and the fact that he'd served as a battalion surgeon in Vietnam, where he'd often observed the limits of human endurance. As he puts it: "Characterizing optimists as smiley-faced romantics is unfair. Optimists are actually realists who take steps to solve problems"for instance, the literal steps Dossey took for 10 hours. According to this definition, Dossey and other true optimists are flexible, and anchored in reality. And most important, they get things done.

Optimism: The New View

Optimism has long been considered a straightforward asset when battling illness or adversity. And, broadly speaking, it is. Harvard graduates who were optimists at age 25 had better health outcomes for the next three decades. As Dossey explains, "Optimists have more stable cardiovascular systems, more responsive immune systems, and less of a hormonal response to stress compared to pessimists. They have a stronger sense of self-efficacy, so they're more likely to invoke healthier behaviors because they think it can make a difference." Of course, to be considered optimistic you have to have a positive long-term outlook and some degree of hope for the future. But a new view of optimism holds that to have a real impact on health, outlook is less important than behavior. By this definition, it is the act of engaging with the world, of taking concrete steps toward goals, that improves health. But there's a wrinkle: Under trying circumstances, optimism can actually lead to fatigue and temporary immune suppression. That finding has helped researchers rethink optimism and how it really works. It turns out that our standard view of optimism is simplistic, and it is only by observing the nuanced impact of "optimistic" behaviors on the immune system that we can get a more

complete picture of this coping style. Grounded optimism gives the brain a built-in action potential: It replaces emotion with motion. In the end, the hidden key to optimists' better health outcomes may be their propensity to engage with the world and to persist in the face of difficulty, whether it's a night of agonized walking through the wilderness or the willingness to seek out second and third opinions for a medical condition. "Here's the really important piece to understand," says Suzanne Segerstrom, a University of Kentucky psychologist and author of Breaking Murphy's Law: How Optimists Get What They Want from Lifeand Pessimists Can Too. "If you're an optimist and working harder at a task, your stress hormones may go up. Your immune function may dip a bit. But it's like doing crunches at the gym. Short-term, more crunches hurt. Long-term, you get a big payback in terms of health and fitness. Optimism leads to increased well-being because it leads you to engage actively in life, not because of a miracle happy juice that optimists have and pessimists don't." Segerstrom herself embodies this principle: She suffered an injury (also involving a horse) that led to unexpected complications, including bursitis and sciatica. "My attitude was, well, somebody has to fix this. So when one doctor couldn't help me, I found another. And I made progress."