This is my last website article until September. As I have expressed in previous June articles, I am very appreciative of the many thoughtful e-mail messages I have received from my readers in response to my monthly columns. I always welcome your feedback, questions, and insights as well as suggestions for future topics. Your responses are very meaningful to me. One of my primary goals in writing these articles is not only to share information and ideas but to have the information and ideas serve as a catalyst for self-reflection and self-change.
Given the response I received to my May article about “regrets,” it certainly seems to have achieved the goal of eliciting much thought. A number of readers wrote that the article prompted them to identify regrets they currently have and, most importantly, to consider what steps they might take to remedy these regrets. Others shared regrets they held in the past but subsequently addressed and in the process felt emotionally healthier for doing so.
Several mentioned that they read and re-read the final paragraph of the May article in which I asked readers to imagine that they were one of Bronnie Ware’s patients. Ware is the Australian nurse who devoted several years working in palliative care with patients in the last 12 weeks of their lives and wrote a blog and book about the five main regrets her patients expressed about their lives as they faced imminent death (please see last month’s article for a discussion of these five regrets).
In my final paragraph, I asked how each of us would respond if we were a patient of Ware’s and she asked, “What, if any, regrets do you have about the life you have led?” I emphasized that our answer could serve as a catalyst and guidepost for the behaviors we adopt in the future. I observed that regrets are part of the human experience, but if we are burdened by too many of them, there is a lessening of joy and satisfaction. Consequently, it may be beneficial to embrace and apply the wisdom shared by dying patients to our own lives.
To Practice “Personal Control”
Regrets may be seen, in part, as unresolved issues that are within our control to address but for which we fail to take corrective action. Instead, too many people adopt a passive role in the face of regrets. They wait for others to change first. The following are examples of this attitude that I have heard from patients in my clinical practice or participants at my workshops:
“Why should I compliment my wife? She doesn’t compliment me very often.”
“I would spend more time with my teenage kids, but they don’t seem very interested in spending time with me.”
“I don’t make an effort to keep in touch with some friends since they don’t make an effort to keep in touch with me.”
“People at work rarely smile or have good things to say. It’s a depressing place.” When I asked, “Do you ever smile or say positive things to your colleagues?” this woman replied, “What good what that do?”
“I love to paint, but I don’t have the time to do so.”
The problem with these comments is what Ware discovered with her dying patients, namely, years later people have genuine regrets for not having made more of an effort to maintain a close relationship with friends or family or to follow one’s interests and passions or to live life in concert with one’s values. The key to lessening regrets is to come to the honest conclusion that we did what was within our power to do, even if the outcome of our actions was not always positive.
As an illustration, if we make an effort to maintain ties with certain people and they do not reciprocate, we should not be surprised if we feel a sense of hurt and rejection. However, in my experience this pain will diminish and we will eventually feel better knowing that we did what we could to maintain the relationship; we accept that for reasons we may never know or understand, these seeming friends made a decision not to stay in touch and that was their choice not ours. In such a scenario, feelings of regrets will be attenuated since we did what was within our control to do, demonstrating what I call “personal control.”
As many of my readers are aware I have devoted a number of my website articles to the theme of personal control, including last month’s focus on regrets and this past November and December articles about therapeutic lifestyle changes. It is little wonder that I was attracted to a recent article in The Boston Globe by Deborah Kotz with the heading “How to rewire your brain to be more optimistic.”
In the first paragraph Kotz quotes Winston Churchill who defined success as the “ability to go from failure to failure without losing your enthusiasm.” Kotz observes that Churchill “might have been more than a little prescient because researchers have since found that optimism plays a key role in achievement in life—as well as increasing our odds of living longer and healthier.” She continues, “The latest research suggests that genes play only a 30 to 40 percent role in our outlook and that with a little training, our brains have the ability to shift over time from a negative outlook to a more positive one.”
Kotz supports this assertion by citing a new book authored by cognitive neuroscientist Elaine Fox titled Rainy Brain, Sunny Brain. Fox asserts, “It’s not just positive thinking but positive actions. . . . Optimists literally don’t give up easily and this links to greater success in life.” Describing Fox’s philosophy, Kotz captures the notion of personal control when she writes, “Persistence is key: Rather than sitting and passively waiting for life to happen, optimistic people take steps to implement their goals.”
The benefits of an optimistic outlook were also reported in an article by Marjorie Dwyer, “Protecting the heart with optimism,” that appeared in Harvard Science. In a review of more than 200 published studies, Julia Boehm, research fellow, and Laura Kubzansky, associate professor, both of whom are in the Department of Society, Human Development, and Health at the Harvard School of Public Health, “found that there are psychological assets, such as optimism and positive emotion, that afford protection against cardiovascular disease. It also appears that these factors slow the progression of disease.”
Boehm and Kubzansky closely examined the behaviors associated with cardiovascular health. “They found that individuals with a sense of well-being engaged in healthier behaviors such as exercising, eating a balanced diet, and getting sufficient sleep.” Kubzansky concludes, “These findings suggest that an emphasis on bolstering psychological strengths rather than simply mitigating psychological deficits may improve cardiovascular health.”
Paralleling this conclusion, Fox believes that there are steps one can take to increase optimism. “Research is encouraging. We know that we can change how the brain circuits function to change a person’s outlook, but a person needs to put a lot of effort into it.”
I would agree that effort is a major component in changing one’s outlook and actions, but it is important to remember that people will exert more effort if they believe that this effort will lead to positive outcomes. If they do not hold this belief, they are likely to give up, feeling “what’s the use of trying?” Thus, it is imperative that people experience at least some small success in the short term to reinforce their commitment to long-term actions. Even if we caution in advance that change takes time, it can be very discouraging to most individuals if they do not see within a short period some favorable results from their effort.
“Let People Experience Success”
George Everly, an associate professor of psychiatry at George Hopkins Bloomberg School of Public Health, contends in an article written by Karin Kiewra that appeared in Focus, a publication of Harvard Medical, Dental, and Public Health Schools, that resilience can be taught. Examining children and adults who have experienced war, natural disasters, and abuse, he found “the best predictor of immunity to stress is a social support network. Optimism (including faith in a higher cause or power), perseverance (work ethic), responsibility, and integrity also count.”
Everly advises “let people experience success” by providing encouragement, mentoring, and training. Very importantly, he emphasizes that we promote “self-efficacy—the belief that we are agents of change,” basically what I have called personal control. Everly warns that self-efficacy cannot be “given” but is based on realistic accomplishment when faced with challenge. It is genuine success that reinforces a belief in personal control.
How beset to maximize genuine success? In our book The Power of Resilience: Achieving Balance, Confidence, and Personal Strength in Your Life, my colleague and close friend Sam Goldstein and I offer realistic strategies for replacing scripts that involve negative thoughts, feelings, and actions with positive scripts. In a number of my website articles, including February, 2005 in which I outlined Sonja Lyubomirsky’s eight recommended actions for achieving happiness, I have attempted to highlight manageable initial steps we can take that can eventuate in long-term positive changes.
Four Suggestions for a More Optimistic Outlook
In her article Kotz lists four steps recommended by Fox—some of which parallel those offered by Lyubormirsky—that may result in a more optimistic outlook. She wisely writes that those with clinical depression most likely will require professional help to overcome their negative thoughts and behaviors, but those with “milder pessimistic tendencies” might benefit from the following actions without the assistance of a therapist:
Make a daily tally of negative and positive events. Fox recommends creating a list of the little and big things that go right and wrong during your day. She observes, “People prone to feeling depressed and down tend to be surprised at how many good things happened to them that day. Something as simple as making a list can help people gradually, over time, notice the good things when they happen.”
Aim for three positive experiences for every one negative one. I am always a little leery of quantifying how many positive actions are needed to offset negative ones since some positive or negative experiences are far more powerful than others. However, the main point to be taken from this recommendation is to make an active effort to engage on a daily or regular basis in those activities that provide satisfaction. I know that I am in a better mood when I start the day by doing physical exercise. At one of my presentations a man said that having a cup of coffee and reading the comics in the newspaper helped to begin his day on a positive note. Kotz writes, “The key is to build things into your day that you look forward to and to cut back on things, when possible, that you don’t.”
Exercise every day. I have advocated this activity in many of my writings. Psychiatrist John Ratey in his thoughtful book Spark: The Revolutionary New Science of Exercise and the Brain, provides ample evidence to demonstrate that regular exercise for both children and adults helps one to focus, deal more effectively with negative emotions such as depression, and feel happier. Unfortunately, all too often when someone is feeling down they are less likely to exercise or follow a sound diet, the very behaviors that can ameliorate their feelings of lethargy and sadness. Several of my patients have expressed the view that they didn’t have the energy to exercise. However, when with much encouragement they began a regular exercise regimen, their stamina increased as did their sense of satisfaction and accomplishment.
Engage in mindfulness meditation. It is beyond the scope of this article to describe training in mindfulness skills in the fields of mental and physical health. Mindfulness involves attending to the internal and external experiences transpiring at the present moment and is frequently taught through various meditation exercises. Kotz, referring to Fox’s position, notes, “Those who practice mindfulness tend to feel happier and more at ease in life simply from focusing their brains on the present rather than mulling over the past or fretting about the future.”
I believe there are other concrete behaviors we can adopt that will contribute to a more optimistic attitude, including one of my favorites, that of making a positive difference in the lives of others or what I call “contributory” or “charitable” activities. Fox might place this under “aim for three positive experiences for every one negative one,” but I believe it deserves separate mention. I am certain most of you can add other behaviors as well to the list of four.
The key message I hope you take from this article and several of my previous writings is that there are steps we can all take to reinforce feelings of optimism and create a more resilient lifestyle. While for some of us this will be a more difficult and lengthy task given our inborn temperament, our unique life experiences, and our strong doubts about being able to effect changes, we must keep in mind that all of us can gain from engaging in therapeutic lifestyle changes. Our initial short-term goals should be modest to maximize the probability of success, soon to be followed by more challenging long-term goals.
In ending, I hope that for all of you the next few months are filled with satisfaction and renewed emotional and physical well-being.