Dr Phil Hammond, broadcaster and GP returner in Bristol

Let's start with a quiz. Who sang 'You've got to AC-CENT-TCHUATE the POSITIVE, eliminate the negative'?1 If you know the answer, the chances are you lived through at least one war and possibly two; and if you survived reasonably unscathed in the psychological department, the chances are it had a lot to do with optimism.

There were no post-traumatic stress counsellors in those days, mainly because it hadn't been invented. When faced with appalling personal tragedy, there were no therapists to run to; you just picked yourself up off the floor and looked on the bright side of life.

Psychiatrist Raj Persaud says that depression is triggered by automatic negative thoughts (ANTS), which creep up on you and lower your self-esteem. His advice is to chant to yourself: 'To stop my daily RANTS against myself, I must kill my ANTs.'2

On reflection, I think I prefer Bing Crosby's version of positive thinking or, if you're a pedant, the version written for Bing and the Andrews sisters by Arlen and Mercer. None of them were psychiatrists – they didn't even clean the floors at The Maudsley. So how could two humble songwriters develop such a sophisticated theory of staying sane 40 years in advance of Dr Persaud? Makes you think…

The point is that when both experts and the Andrews sisters agree that something is good for you (e.g. positive thought, or a little bit of sunshine), then it generally is. A series of long-term studies in the USA, which tracked volunteers for over 30 years, found that pessimists were more prone to illness and, on average, died younger than optimists.3 The pessimists were not gloomy because of ill-health, but in fact the gloominess preceded the sickness. Optimists also did better at work and on the sports field.

Positive thinkers have also been shown to have better immune systems as they get older, recover more quickly from surgery, cope better with cancer, and to have a better quality of life after treatment.4,5 So what is behind the power of positive thought? Clearly there are very sophisticated links between mind and body at play here.

What's most interesting is that there even seem to be benefits in being over-optimistic, i.e. believing in a happy ending even when the odds are really stacked against you. We all do this on a crowded train – crammed in with lots of other smelly, groping Homo sapiens, with no room to breathe, the only option is to mentally distance ourselves from the horrible reality and fantasize about something else.

Positive thinkers believe that they have some control over their environment and destiny, and that everything isn't just down to fate. Whether or not this is true isn't the point. The fact remains that this belief tends to reinforce their efforts so they achieve more and really do seem to be in control. They're more likely to pass exams, get a job, or score in the last minute of the European Cup final. Even when over-optimistic people fail, they do not label it as a failure, but rather as a life-experience that will contribute to future success; and they do usually end up succeeding.

So optimism pays, whatever the situation. But clearly, there's a fine line between over-optimism and delusion. Believing you can fly out of your attic sky-light after six pints of industrial strength cider is unlikely to bring success. Positive thought is all very well, but it's no match for gravity.

Guidelines in Practice, October 2006, Volume 9(10)
© 2006MGP Ltd
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  1. Arlen H, Mercer J. Ac-cent-tchu-ate the positive. New York: MPL Communications, Inc., 1944.
  2. Persaud R. Staying Sane. New York: Bantam Press, 2001.
  3. Maruta T, Colligan R,Malinchoc M et al.Optimists vs. pessimists: survival rate among medical patients over a 30-year period. Mayo Clin Proc 2000; 75 (2): 140–143.
  4. Kamen-Siegel L, Rodin J, Seligman M et al. Explanatory style and cell-mediated immunity in elderly men and women. Health Psychol 1991; 10 (4): 229–235.
  5. Scheier M, Matthews K,Owens J et al. Optimism and rehospitalization after coronary artery bypass graft surgery. Arch Intern Med 1999; 159 (8): 829–835.