
It can be hard to have a positive outlook when you’re chronically ill. If you’ve tried to cultivate a more optimistic version of yourself – but find that you feel worse, there are a good few reasons why.
We’ve been in the throes of a positivity movement for years. If you’ve tried to cultivate a more optimistic version of yourself, you may have noticed that your efforts can leave you feeling worse. You’re not alone. There are reasons why you might be doing yourself more harm than good.
I’ve never been accused of being an optimist. For as long as I can remember, I’ve been cautious, skeptical, and analytical.
Some might say I’m a pessimist. But it’s nothing that a self-help book can’t fix, right?
I envy people who are hardwired for positivity.
I am sure that while a positive outlook may not change the outcome of a situation it may make it less difficult to deal with. But I am not wired that way.
More years ago than I can count, I read a book titled Success Through a Positive Mental Attitude. Written in 1960, the book became a best seller.
Its premise is that you can reach your goals if you have a positive mental attitude.
It had been out for more than 20 years before I discovered it in the self-help section of the bookstore.
I was ready! I wanted desperately to cultivate a PMA (that’s how the book refers to “positive mental attitude”) and change my life!
But I failed.
Because life, I’m afraid, is not that simple.
Especially when you’re in a crisis. And chronic illness is a crisis in its own right.
Three ways positivity does more harm than good
Think positive! Fake it ’til you make it! Just be optimistic!
It sounds so easy, doesn’t it?
News flash: Achieving a constant state of positivity is not that simple.
Because if it was we’d all be 100% mentally healthy.
We often forget that there’s a perfectly acceptable place to be on the spectrum from pessimism to optimism: it’s realism.
I’m not suggesting that there aren’t advantages to trying to be positive – whether you’re chronically ill or not.
But there are at least three risks to feeling like you have to be.
1. Chronic illness and positivity: Are you fooling yourself?
Optimism has its place. After all, logic tells us that worrying won’t change anything anyway – so we need to “look at the bright side” and “hope for the best”.
There is nothing wrong with either of these approaches.
As long you remember that optimism without realism is nothing more than wishful thinking.
But it can’t hurt, right?
Wrong. Positivity – and the expectation of it can be toxic.
In her 2009 book, Bright-Sided, author Barbara Ehrenreich explores the negative side of positive thinking and how it doesn’t guarantee happiness or success, but instead can have the effect of diluting our ability to be prepared for real threats.
In other words, thinking something – or hoping for it – doesn’t make it so.
Ever planned an outdoor party? Then you know this already.
If the extended forecast calls for a 70% chance of rain (or if you live in an area where the seasonal weather is wildly unpredictable), you have a Plan B. Maybe you rent a portable canopy or make some space in the garage for tables and chairs just in case.
The same is true for those of us who are chronically ill. We can “think positive” and hope that our current treatment will continue to help us manage our condition.
But deep down we know that that’s not enough.
For that reason, we monitor our own symptoms and test results closely so that we reduce the chance of being caught off guard and ending up in a flare.
If we have a progressive disease, we learn about its potential course and can consider how best to prepare – physically, emotionally, financially.
We don’t expect that having a rosy outlook alone will offer us complete protection from a downturn in our condition.
So we keep our doctors informed and are likely to ask about or understand what other treatment options might be available if we need to change course more quickly than we would have expected.
But it’s hard to do because it means that we have to consider all of the potential outcomes – not just the one we’re hoping to have.
It takes courage to face the reality of chronic illness. It requires that we step alone into the dark and shine a light into all of the unlit crevices in order to confront what we’re dealing with.
We can be pro-realism without being anti-optimism.
It’s precisely the understanding of what may be ahead of us that encourages us to have our Plan B.
And, just as importantly, it allows us to be authentic.
It removes the cognitive dissonance between what we know about the reality of our condition and the false comfort of pretending that a positive outlook is only solution to coping with it.

2. You’re putting pressure on yourself to make others feel better
It’s natural to want to shield others from the burden we carry because we have a chronic illness.
We don’t want our children to see us as weak, ill or incapable of caring for them. And we definitely don’t want them to worry.
After all, beyond loving them, our job is to protect them and equip them to navigate in a world of change and uncertainty.
We need to be their rudder and their anchor, guiding them but keeping them moored.
And we don’t want our partner, spouse or other members of our family to have to alter their lives for us.
Worse yet, we don’t want to be seen as a burden.
When we’re chronically ill, we’re often reluctant to be completely open about it with our friends.
What if they don’t believe us? Or what if they don’t understand and don’t know how to relate to us to anymore? Will they start to exclude us from activities?
So what we do we do?
Pretend.
Act positive.
We try to fake being well.
I assure you that all the optimism you can muster will not offset the energy that you’ll spend trying to act like you’re perfectly fine – emotionally and physically.
Your first obligation is to your mental and physical health.
Your ability to manage your health relies on being real – being honest with yourself so that you can adapt your life to accommodate your condition.
3. Faking positivity when you’re chronically ill makes you feel responsible for your illness
If we’re voting, this is the winner.
Expecting yourself to be positive in the face of chronic illness – or any serious illness – can be toxic.
After all, if you are told or if you believe that the right attitude will heal your body, you’re most likely going to be disappointed.
Because what you’re really doing is placing the burden of your ability to heal squarely on your own shoulders.
It makes it feel as though you’re still sick because you’re not optimistic enough.
When I was diagnosed with cancer in 2004, my daughters were young – 7 and 4 years old. Early on during my treatment, I must have asked my oncologist about my prognosis.
I wasn’t sure if I really wanted the answer, but it’s a natural question and I needed to know. I had kids to raise and I needed my Plan B.
He had such a gentle presence and was genuine in the way he communicated.
Never rushed, and always calm, he was also good at listening.
He’d rub his hands to together before examining me and would always apologize in advance that they were cold. He was feeling my lymph nodes when I asked him the question.
“I can make it go away,” he said, in a nonchalant way that made it sound like it was a given. “But the real challenge is making it stay away.”
And there it was, a metaphorical relay: optimism handing the baton to stark, cold reality.
But it was the truth, and despite the chronic undercurrent of fear and anxiety, I felt an authentic sense of hope.
Why?
Because he didn’t say that the outcome of this race would depend on me being optimistic.
Instead, he lifted the burden from my shoulders, and in many ways, carried it on his own – as a physician, with expertise, resources and tools that I didn’t have.
I decided, in that moment, to be cautiously optimistic about the first leg of the relay.
After all, I had to finish the first leg before I could hand off the baton to the second.
The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.
William Arthur Ward
Contrary to what we might think, it’s liberating to acknowledge that there are things we cannot control – even if we have the most optimistic perspective ever.
Letting go of the burden of having to fake feeling positive is what allows us to live forward, with hope that is tempered by reason, supported by a plan, and realistically optimistic.
Thank you for this! So well-written, and I didn’t realize how much I needed to read this.
I’m so glad that it came at a time when you needed it!
This message is so desperately needed in the chronic illness community. So many people think being positive can fix everything, but it cannot. I like the choice of realism. I especially like your conclusion.
Carole – You’re right. If only the “right” attitude was the solution. I’ve found that it can be more difficult emotionally to try to “force” ourselves to think or feel in a way that doesn’t feel true to who we are. We can still find hope, meaning and happiness by taking a more realistic view.