Patients Shouldn't Feel Pressured to Stay Positive, Experts Say
By Salynn Boyles
WebMD Medical News
Nov. 7, 2002

Psychiatrist Jimmie Holland, M.D., says she will not forget the call from the widow who felt responsible for her husband's death from lung cancer.

"She was feeling tremendous guilt because she had not gotten him into a support group that stressed mind-body techniques," says Holland, who chairs the department of psychiatry and behavioral sciences at New York's Memorial Sloan-Kettering Cancer Center. "She was convinced that even in the face of advanced lung cancer, a positive mental attitude would have made the difference."

Like the woman described by Holland, many cancer patients and their families have been led to believe that positive thinking is critical to beating the disease. But a newly published review of research finds no evidence to back up that belief.

Researcher Mark Petticrew and colleagues examined 26 studies assessing the role of psychological coping styles on cancer recurrence and survival, and concluded that none conclusively linked any one style to positive outcomes.

Writing in the latest issue of the British Medical Journal, the researchers concluded that "people with cancer should not feel pressured into adopting particular coping styles to improve survival or reduce the risk of recurrence."

"We certainly aren't saying that a positive mental attitude is not beneficial," Petticrew tells WebMD. "I think the message here is that while it is good to think positively, it is also OK to feel bad. It is probably not going to influence your outcome." Petticrew is a health researcher with the MRC Social and Public Health Sciences, Glasgow, Scotland.

Holland wrote the book, The Human Side of Cancer, to dispel what she calls "the tyranny of positive thinking" -- the idea that an upbeat attitude is a necessary component of cancer treatment. She tells WebMD that the not-so-subtle message is that the patient is to blame for his or her cancer.

She says the idea that psychological attitude is key to cancer survival stems from a desire to explain and control an illness that we don't really understand.

"Before we knew what caused tuberculosis, it was widely believed that stress and attitude played a big role in the disease," she says. "The same was true with hypertension, peptic ulcers, and other illnesses. But now that we know what causes these diseases, there is little mention of psychological attitudes in relation to them."

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