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Flourish: Optimism and Health

Positive Psychology Shifts into High Gear

“I now think that the topic of positive psychology is well-being, that the gold standard for measuring well-being is flourishing, and that the goal of positive psychology is to increase flourishing,” Martin E.P. Seligman, PhD, Flourish (Simon & Schuster, Atria Paperback, 2013).

With each book (Learned Optimism & Authentic Happiness are two I’ve written about) Martin Seligman expands and strengthens the case for “Positive Psychology,” a branch of psychology that he leads. Flourish, written 10 years after his last book, breaks down the elements and goals of positive psychology into positive emotion, engagement, meaning, positive relationships, and accomplishment. Taken together these elements equate to psychological well-being. Increasing these elements is to flourish. “No one element defines well-being, but each contributes to it,” Seligman explains. The details are complex, but the general idea is clear enough.

Positive psychology is about being optimistic and progressing at what you enjoy and do best. It makes you happier and healthier. Sounds like pie in the sky, I know, but it is proving to be true. If a crane falls on your head, you are going to die. While that’s true, mindset can make a difference at the margins, sometimes a big difference. If your mind thinks you are functioning well and healthy, your body is more likely to follow. 

More than before, Seligman’s new book delves into the specific physical benefits of positive psychology, where the evidence is fast emerging. Generally speaking, optimists do better healthwise than pessimists. They’re also more satisfied with their life.

We’ve long believed that negative mental states such as depression, anger, anxiety, and hostility are harmful to physical health, especially cardiovascular health. Many observational studies strongly suggest that positive mental states, such as optimism, promote physical health in humans. Many planned animal experiments have shown a causal connection. Seligman tells us about the only planned experiment in humans which has found a causal connection. He also postulates why optimists are less vulnerable to disease.

Dr. Seligman, an acknowledged master of research, summarizes the current state of the science, relating well-designed observational studies to support each conclusion:

“I conclude that optimism is robustly associated with cardiovascular health, and pessimism with cardiovascular risk. I conclude that positive mood is associated with protection from colds and flu, and negative mood with greater risk for colds and flu.  I conclude that highly optimistic people may have a lower risk for developing cancer. I conclude that healthy people who have good psychological well-being are at less risk for death from all causes.”

As you might’ve guessed, Seligman was involved in the one randomized, controlled experiment to find a causal connection between optimism and health in humans.

The experiment was conducted at the University of Pennsylvania where Dr. Seligman has taught for many years. Seligman and colleague Gregory Buchanan sent the entire freshman class a questionnaire designed to find the optimists and the pessimists. They then contacted the most pessimistic quarter of the freshman, “at risk for depression on the basis of their very pessimistic explanatory scores,” and randomly invited them into one of two groups: an eight-week “stress management seminar” to teach them to be more optimistic—or a control group which did nothing to change their pessimistic mindset.

“We found that the seminar raised optimism markedly and lowered depression and anxiety over the next thirty months, as we predicted,” Seligman relates. They also monitored the physical health of all participants over that period.

Participants in the seminar group had better physical health than did the controls, with fewer self-reported symptoms of physical illness, fewer doctor visits, and fewer illness-related visits to the student health center. The seminar group was also more likely to visit doctors for preventive checkups, and its members had healthier diets and exercise regimens.

“This lone experiment suggests that it is the change in optimism itself that improved health, since random assignment to intervention versus control eliminates unknown third variables,” Seligman writes. “One cheer, so far, for causality,” he summarizes.

The observational studies referenced earlier controlled for obvious variables, such as smoking, hypertension, everything logical confounder, but there is always the possibility that an “unknown third variable” is making the difference.

In this experiment, Seligman and Buchanan created the variables—optimism training or no intervention—and measured the results. As the students learned to be more optimistic they also became healthier; their change in mindset and better health went hand in hand.

Why are optimists less vulnerable and pessimists more vulnerable to disease? Seligman suggests three possibilities; two are logical and ring true, while the last category is what I would call med-tech. They are all educated guesses yet to be tested. Seligman suggests testing along the line of what he and Buchanan did at the University of Pennsylvania.

Let's touch on the three categories and end with Dr. Seligman’s plans for testing the causal connection between psychological and physical well-being. 

1) Optimists take action and pessimists believe they are helpless. Those mindsets play out in many ways. Optimists act on medical advice and pessimists don’t; for example, it’s the optimists who give up smoking, not the pessimists.

More generally, people with high life satisfaction are more likely to eat healthy and exercise. Not only do optimists follow medical advice, they also avoid high risk activities; for example, they heed tornado warnings and take shelter. Pessimists are more inclined to be fatalists; what will be will be.

2) Optimists are more likely to have social support. The more friends and the more love in your life, the less illness. Lonely people are less healthy than social people. Happy people have richer social networks than unhappy people, and social connectedness contributes to lack of disability as we age. Misery may love company, but company does not love misery, and loneliness may be a path to illness.

3) Biological mechanisms may also be involved. Seligman lists a variety of plausible paths, which favor optimists over pessimists. One is the immune system. Seligman and a colleague compared the blood of optimists and pessimists, and found more infection-fighting white blood cells in optimists. Another possibility is common genetics: optimists and happy people might have genes that ward off diseases. There are more, but you get the idea.

Again, these mechanisms are supposition, not well tested. They are simply reasonable hypotheses.

Seligman has plans—obvious and expensive—to change that.

“The gold standard for finding out if optimism is causal and how it works is the optimism intervention experiment….We take a large group of people vulnerable to cardiovascular disease, randomly assign half to optimism training and half to a placebo, monitor their action, social, and biological variables, and see if optimism training is lifesaving.”

Seligman begins the book by telling about a philanthropic foundation that financed his efforts early on. Their philatelic approach was somewhat unusual: “We pick winners, and you are a winner. We’d like to know what research and scholarship you want to do. We don’t micromanage. We should warn you at the outset, however, that if you reveal our identity, any funding we give you will stop.” Sounds like something made for TV, but it was real.

The offers of support began modestly, at $120,000, and grew. The second project was for something called positive psychology, which garnered funding of $1.5 million. Two years later, the foundation trustees offered $20 million for a project (not positive psy) which was ultimately voted down by the board for political reasons. It was just as well. The foundation came along at just the right time, but Seligman didn’t need any more enigmatic funding; positive psychology had become self supporting.  

In due course, this brought Seligman to the time depicted in Flourish.

A representative of the Robert Wood Johnson Foundation visited and, after a long discussion, told Seligman: “We want to invite you to send us two proposals, one exploring the very concept of positive health, and the second proposing an optimism intervention to prevent CVD deaths.”

Dr. Seligman’s next book will no doubt contain the results of both proposals—and what’s next for positive psychology.

*  *  *

As readers of my columns and books know, I’m a believer in positive psychology. It tells the story of my life.

Picking up my dad’s barbell for the first time in the fifth grade set the pattern for my life. Over time, lifting taught me that hard, purposeful work would give me the power to shape the course of my life. It gave me a sense of control. It made me an optimist.

After starting a little behind the curve, I built a pretty good body by the time I was in middle school. In high school, I won the state pentathlon championship as a junior and the city Olympic lifting championship as a senior. Those successes gave me the confidence to go to college. The same approach—hard, purposeful work—allowed me to graduate second in my class from a law school that flunked 8 out of 10 incoming students.

The rest is well known.

At 75, most people have given up any thought of improving their body. My success in bodybuilding has taught me not to worry about my age. I keep training hard—and intelligently—and challenging myself.  

Experience tells me to work hard and expect the best—in training and in life. I take care of my body and it takes care of me.

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