Optimism and health

Optimists are healthier and live longer. Large epidemiological studies consistently show that individuals who are most pessimistic have more health problems and die on average around eight to ten years earlier than the most optimistic.⁴⁰ Pessimists succumb more easily to the major killers of cardiovascular disease, respiratory problems and cancer. One major contributing factor is chronic stress. We have already flagged the fight-flight response as a potential mechanism related to stress in Lesson Two. The link between these diseases and the role of chronic stress on the body's immune and inflammatory response systems to combat disease and infection is well established. Stress is compounded by perceived threat and uncertainty about the future. As optimists view the future more positively, this outlook enables them to adopt healthier lifestyles aided by greater social support.

It is important to clarify that optimism is not the same as hope. Hope is an emotional state most closely related to wishing for important – but less likely – outcomes that are more out of our control.⁴¹ Optimists go further in that they believe outcomes will be better and so work harder, longer and persevere when pessimists give up. This has implications for leading healthier lifestyles and adhering to health recommendations to prevent disease progression.⁴² A second advantage is the optimistic mindset. Optimists are resilient. They persist in overcoming stressors, which may test the body's physiological system to the extreme but, in the end, is more likely to lead to eventual resolution of the stressor. In contrast, pessimists give up more readily, but even then the stressors are not resolved as the problem is not perceived as going away.⁴³ This leads to chronic stress and a negative impact on our immune function and our reaction to chronic stress, as noted in Lesson Two. A third explanation is related to social support and loneliness. Optimists are perceived as more likeable, attractive and friendly compared to pessimists. They have larger social networks and greater social support.⁴⁴ In later life, optimism predicts greater defence against loneliness and all the negative implications that being isolated can have for one's health.⁴⁵

Overall, optimists are less likely to give up in the face of health challenges. They are also more likely to reframe situations as challenges rather than threats, and engage in healthier practices to ensure better futures. They have goals and the confidence to achieve them, which bolsters their ability to combat disease.

But a word of caution. Optimism might be a healthier frame of mind and the spur that drives one on to achieve goals, but unrealistic optimism can lead to recklessness. If you are some- one with attributional styles that lead you to regard failures as isolated, temporary and not your fault, then you may not learn from your mistakes. If we don't learn from our mistakes, then we are likely to repeat the same errors. If you don't think health risks apply to you, then you may lead an unhealthy lifestyle. We should seek to be more optimistic, but we must also temper this positive mindset with a degree of realism.

I advise combining positive outlooks with reasonable foresight and planning. One technique that has proven successful is mental contrasting, which combines exercises for motivation, planning and execution.⁴⁶ It is called contrasting because you are expected to mentalise achieving the desired outcome contrasted with the challenges that stand in the way. First, in order to strive for goals, one has to imagine that these are achievable. As many sports psychologists advocate, visualising or imaging achieving a goal stimulates the motivation to pursue that objective. The more specific the target the better, as this adds tangible performance indicators to determine whether progress towards the goal is being achieved. However, just wishing for a future goal is not enough. That would be hope, which is not a good strategy for success. As the psychologist Gabrielle Oettingen has argued, wishful thinking leads to inertia.⁴7 You need to also think about future obstacles and how you might overcome them.

Oettingen has developed a technique called WOOP that uses mental contrasting to achieve goals.⁴⁸ WOOP stands for Wish, Outcome, Obstacles, Plan. Begin by identifying what you 'wish' for in as much detail as possible. Don't be vague – 'I want to lose weight' – but, rather, set specific gaols – 'I want to lose 10lbs'. Specific goals are more tangible and achievable. They provide a measurable yardstick for progress. Next, imagine the 'outcome' of losing 10lbs. Visualise standing on the scales and how good you will feel when you see you have lost that weight. Wish and outcome are necessary to motivate you to change your lifestyle. However, you need a strategy. What are the 'obstacles'? Perhaps: 'I don't have time to prepare my own fresh food. Buying processed food is easier.' Consider these obstacles and what plans you can implement to overcome them – 'Don't buy cakes. Put temptation out of sight. Eat more fresh fruit and vegetables. Learn to cook simple nutritious meals', etc.

Following a mental contrasting strategy like WOOP is much more likely to work than simply wanting to change. In one study of over 10,000 German women wishing to eat more fresh fruit and vegetables, two groups were educated about the benefits of switching to a healthier diet, while one group was also taught the WOOP technique.⁴⁹ For positive visualisation, they were told to imagine how great the outcome would be if they actually ate more fresh fruit and vegetables. But what are the obstacles? Maybe finding a regular supply of fresh produce is challenging. Or maybe you enjoy a weekly pizza night. Forewarned by the potential obstacles, they could make contingency plans – 'In that case, I will need to join a cooperative food group or sign up to a home delivery service that specialises in fresh produce and delivers it every week. I will limit my pizza night to once every two weeks for the first two months and then once a month.' The other group just went about their normal routines without the contingency planning.

Initially there was no difference between the two groups in terms of healthy eating. By four months, however, the groups were beginning to diverge, with the normal routine group eating less fresh produce; two years into the study, they had returned to their original eating habits. The WOOP group, meanwhile, had maintained healthier eating. Being optimistic is all well and good, but one also has to take action to live healthier.

In this lesson we have learned that different facets of our lives generate different expectations for the future, and although we each have dispositions to think both optimistically and pessimistically, we can all learn to become more positive. We reviewed the benefits of thinking positively and the challenges of negative biases. Both are valuable, so long as they are not taken to the extreme. It is useful to pay attention to warning signals but negativity must not come to dominate our thinking. It is better to be optimistic for our health and happiness but we should also exercise a degree of caution to avoid recklessness. Recognising attributional styles and thinking less egocentrically are solutions to becoming more optimistic. Another is to imagine a better future for ourselves and planning the necessary actions to get there. In the next lesson we highlight a major challenge to becoming happier, which is what happens to our minds when we are inactive or not actively engaged in some task or other. It's a time when our minds are not focused and when negativity biases can dominate our thoughts. However, armed with the strategies we've learned in this lesson, we will be able to take back control of our attention.

The Science of Happiness: Seven Lessons for Living Well by Professor Bruce Hood is out now (Simon & Schuster, £22.00)'

Footnotes

40 Lee, L.O., James, P., Zevon, E.S. et al.(2019),'Optimism is associated with exceptional longevity in 2 epidemiologic cohorts of men and women', Proceedings of the National Academy of Sciences, 116(37), pp. 18357–62.

41 Bruininks, P. and Malle, B.F.(2005),'Distinguishing hope from optimism and related affective states', Motivation and Emotion, 29(4), pp. 324–52.

42 Sheier, M.F. and Carver, C.S.(2018),'Dispositional optimism and physical health: a long look back, a quick look forward', American Psychologist, 73(9), pp. 1082–94.

43 Segerstrom, S.C.(2001), 'Optimism, goal conflict and stressor-related immune change', Journal of Behavioral Medicine, 24(5), pp. 441–67.

44 Andersson, M.A.(2012),'Dispositional optimism and the emergence of social network diversity', Sociological Quarterly, 53(1), pp. 92–115.

45  Rius-Ottenheim, N., Kromhout, D.,vander Mast, R.C. et al. (2012), 'Dispositional optimism and loneliness in older men', International Journal of Geriatric Psychiatry, 27(2), pp. 151–9.

46  Cross, A. and Sheffield, D.(2019),'Mental contrasting for health behaviour change: a systematic review and meta- analysis of effects and moderator variables', Health Psychology Review, 13(2), pp. 209–25.

47  Oettingen,G. and Gollwitzer, P.M.(2004),'Goalsetting and goal striving' in M. B. Brewer and M. Hewstone (eds.), Emotion and Motivation (Oxford: Blackwell Publishing), pp. 165–83.

48  https://www.woopmylife.org (accessed27September2023)

49  Stadler,G.,Oettingen,G. and Gollwitzer, P.M.(2010), 'Intervention effects of information and self-regulation on eating fruits and vegetables over two years', Health Psychology, 29(3), pp. 274–83.