Magical Thinking Works For You? That’s Great. It Doesn’t For Me.

People with disabilities and illnesses constantly run into what I refer to as ‘magical thinking,’ the idea that they just need to ‘think themselves well.’ These attitudes are embedded in everything from pamphlets at the doctor’s office to well-meaning advice from friends. The ‘power of positive thinking’ is touted left and right as people are told they need to be cheerful, upbeat, think about the positives. They should look for the silver lining, and all the other adages people like to repeat to someone who is having a hard time.

These reminders to remain positive are also an object lesson; people are told that they should remain cheerful and calm for the people around them, if not for themselves. The kind of energy they put out, they are told, is the kind of energy they will receive in return. In a sense, this becomes a form of mood policing, as people are effectively ordered to be cheerful or else. But, more than that, they’re told that not being cheerful will make them more sick, or will decrease the chance of a positive outcome.

Some research absolutely does support claims that moods can have an effect on patient outcomes. Depression, for instance, can make it harder to recover from surgery. Notably, this research on patient attitudes often concludes with an indication that patients need to receive better support from the people around them; that a breast cancer patient struggling with the aftermath of a mastectomy, for example, cannot magically think the bad thoughts away. That patient needs friendly support from caregivers, friends, and family to address the depression, because mood changes are not within your personal control.

Studies indicating that people tend to be healthier when they are happier are, unfortunately, twisted to make people with disabilities and patients feel bad when they are unhappy. They are told by the people around them that they need to think more positively, and in some cases they are outright lied to with claims that thinking positively will cure them or generate a radical improvement in their condition. It’s a disservice to the patient as well as to the basic science of how the body and mind work.

For some people, magical thinking works really well. Some really do feel empowered by it, find it a useful framework for viewing their lives and treatment. They feel like thinking positive has been a force for change in their lives and helps them manage their conditions more successfully and effectively. I am very thankful for this, because I think there are lots of ways to approach the management and treatment of health conditions and disabilities, and that patients need to find the method that works best for them, and need to be supported in their choices. If guided visualisation helps someone cope with cancer, for example, I’m all for making sure that patient gets access to that treatment.

Some patients feel like they are taking control of their illness by using positive thinking as a tool for life management. They may feel like so much in their lives has been taken away, and that being able to control even a small element of their surroundings is a victory. For these people, maintaining an upbeat attitude can be part of the way they cope with their conditions. There is certainly nothing inherently wrong with wanting to stay positive about your life, or searching for good things among the bad, if you have the kind of personality that benefits from this approach.

All personalities are not the same, though, and what works for one person may not work for another. For some people, positive thinking is just not possible, no matter how hard they try, and even if they really want to engage in it. Moods are not something that can be adjusted by sheer force of will, and that includes attitudes toward disability or illness. Sometimes you hate your body. Sometimes life sucks. Sometimes you are tired of social attitudes around you that make it hard for you to engage with the world. Sometimes you are bitter or angry or frustrated and all the positive thinking in the world can’t save you.

For some, the idea of positive thinking is not at all helpful, and may in fact be actively damaging, because they don’t feel like thinking positively. And because they experience constant pressure to do just that. They are effectively ordered to think positive, and shamed for not doing so; told they must not really want to get better if they’re going to be such sourpusses, or informed that they must enjoy playing the victim.

This is where the element of magical thinking comes in, as people insist that if you just try harder to think positively, if you just concentrate a little more on ‘improving your attitude,’ you will feel better. The result can be a sort of rebound effect, as irritation with being told how to manage your condition makes you feel less positive, not more, and the growing pressure only increases your irritability and frustration. You are blamed when you don’t ‘get better’ (including from disabilities that are, uh, permanent in nature) and told it’s all your fault.

It is not for others to tell you how to think, behave, and manage your conditions. It is also not for others to tell you how to feel about them, and that’s effectively what’s going on with magical thinking, where the social pressure comes not just from friends and family, but also fellow patients. People with disabilities who subscribe to the magical thinking approach unfortunately often force it on others, insisting that they need to ‘make the best of what they have’ and pointing to themselves as success stories. Despite the fact that experiences of disability are not universal, some people seem to believe they’ve cornered the market on the ‘correct’ attitude about disability, illness, and chronic conditions.

Sadly, those people are the ones society tends to listen to, which means that people who don’t believe in magical thinking and don’t find it helpful are constantly hassled for it.