In other words, the main impact of optimism on health is that it encourages health-promoting behaviors. For someone who is seriously ill, this might mean an extra push to drink some water and get out of bed. For someone facing a chronic condition like HIV, it might mean taking all those pills on time, cutting out alcohol, or seeing the best doctors one can possibly find. Optimists like Paul are generally better at coping with challenges in the short term, a trait that can help one through a medical emergency. For example, Paul’s successful battle with pneumonia when he was forty-two was seemingly aided by the optimistic belief that he would surely recover—which encouraged him to stick with the regimen his doctor recommended, including uncomfortable and tedious breathing exercises.
Furthermore, if patients feel reassured after getting a placebo treatment, they’re more likely to sleep and eat better. Their stress levels will be lower and their bodies will have a better shot at reestablishing inner balance. Even if poor nutrition or stress weren’t the root cause of the illness, an optimistic motivation could provide the needed impetus for corrective actions.
However, the long-term effects of high levels of optimism (and cheerfulness) are not necessarily beneficial. If you are facing serious surgery and a long recovery, then realistic optimism is good. It may enable you to get on your feet faster and go home from the hospital sooner. But too much optimism can leave you surprised, disappointed, and seriously frustrated with any unexpected long-term hardships. Moderate worriers would actually do better in such situations—more on that later.
Tinker Bell recovers, but unfortunately we see no good evidence for the pure and simple form of this approach—that if you and your supportive friends think good thoughts, you’ll thereby get better. There is some evidence for a more sophisticated version of this idea, though, in which people who are optimistic at the right times and to the right degree will remain healthier and live longer.
In a bit we’ll explain how we uncovered a helpful role for worrying.
Illusory Optimism and Those Most Senior of Citizens
A significant health downside to optimism involves overlooking or ignoring real threats—sometimes called illusory optimism. Optimistic people, like happy people, may underestimate risks to their health and thereby fail to take precautions or to follow medical advice. The same optimistic thoughts that may promote recovery from surgery (“I’m going to be just fine”) may prove deadly to a cigarette smoker, a hypertensive, or an overeater.
Or, optimistic people may be especially shocked when things turn out badly. So they experience additional stress in the face of a job loss, a death in the family, or the return of cancer. Not only that, but they may then resume life-threatening habits.19
But don’t the oldest of the old, in the most golden of the golden years, tend to have a positive outlook? Studies of centenarians do find that long-lived people are optimistic. But this line of research has a serious flaw: there’s no proper comparison group. People who live to be one hundred have an affirmative view on life, but compared to whom? Maybe it was the grouches at age fifty who, after thriving for another half century, became the centenarians with the positive outlook. In fact, who wouldn’t feel rosy in front of a birthday cake aglow with one hundred candles?
This flaw in the centenarian research helps explain why so many of the findings of past studies on the secrets to longevity rarely hold up. Eat all the yogurt you can stand, and you are still very unlikely to reach a hundred. In our analyses of the Terman participants, we do look at those who reached extreme old age, but we do so in the context of their full lives, from childhood on. And in fact, studies (by other scientists) on mood and aging find that as adults get older, they generally are happier and experience fewer negative emotions.20 The oldest among us are happy, but the happiness did not cause their long lives.
Would other research projects confirm this line of thinking? Aside from Dr. Terman’s project, there are only a few other excellent studies capable of looking at these matters of happiness and health in the proper way. One of the best is the Harvard Study of Adult Development, which has followed about 250 men since they were in college at Harvard in the 1930s. This study has found that men who coped with life’s challenges in a mature manner and maintained deep social relationships fared best. These men tended to have stable marriages and healthy habits (avoiding smoking and alcohol abuse and staying trim). Especially relevant to our own work on happiness and health is one of the most insightful conclusions by the head investigator of the Harvard study, Dr. George Vaillant, who contrasts the “Happy-Well” with the “Sad-Sick.”21 Some paths led the Harvard men to be happy and well while other paths led to being sad and sick. Happiness was not the cause of wellness. Sadness was not the cause of sickness. Instead, Vaillant concluded, happiness or sadness was an outcome, just as was wellness or sickness.
Dr. David Snowdon has been running another rare long-term study—the Nun Study—that has information on about seven hundred women across many decades. Needless to say, the nuns, of the School Sisters of Notre Dame, were not smokers, drinkers, or sexual adventurers. They had adequate housing, medical care, and social relations. Yet they did show individual differences.22 Those with higher verbal skills, more education, and positive emotions in young adulthood did better and lived longer. The young women who expressed more hope and gratitude in their diaries went on to live healthier lives than those revealing sadness and fear. But some nuns showed dips and declines in their moods, language, and health. Happiness and health often shifted in parallel. For example, those who would eventually develop Alzheimer’s disease articulated less and less positive emotion as their mental functions got worse and worse. Surely their poor moods were not causing their rapid mental decline.
We thus needed to understand much more about grumpiness, happiness, and anxiety across long periods of time. So we next turned our attention directly to issues of mood, worrying, and mental health across the decades.
Are Neurotic Individuals Unhealthy?
Fidgety Philip was moody, tense, and high-strung. Full of “tireless” energy, he was well liked by his schoolmates despite tending to seek the attention of others through his behaviors. Philip was not especially conscientious, applying himself diligently only to tasks that interested him. His mother noted that he was more nervous than the average child, prone to worry about many things including burglars and being alone. In 1922, the Terman subjects’ parents and teachers rated them on how moody they were. Were their moods very changeable—that is, often alternating between joy and sadness? Or were they more decidedly stable and permanent? Philip’s mother responded, “moods extremely changeable,” when describing her son. Dr. Terman thought that these reactions might be relevant to their later lives, and he turned out to be correct.
As we consistently found with our Terman studies, answers never wrapped up neatly. So while moodiness often had a negative impact on health and longevity, sometimes this worrying nature helped out later in life. In 1940, the Terman subjects were about thirty years old. Philip, it turns out, had grown up to be quite a worrier. Now married, he was the proud father of a daughter, but he remained moody and cared a good deal about what others thought of him. James, too, was rather anxious and uptight, but in a more focused way. A sensitive child, he’d become a sensitive adult, frequently keyed-up and restless, worrying about his financial planning and various other hassles of living through turbulent times. Although these characteristics were telling, we wanted to create a more formal measure of what scientists term neuroticism—the tendency to worry and be moody, tense, and at risk of rage or depression. We needed a scale that was reliable and valid, and so we sorted through dozens of Terman’s questionnaire items, scrutinized how they related to each other, and used advanced statistical analysis to extract items for a reliable scale. We then validated the scale against modern measures of neuroticism.
19
The average person tends to rate his or her risk as below average. For further discussion of related matters, see N. D. Weinstein, “Exploring the Links between Risk Perceptions and Preventive Health Behavior,” in
20
For a study of aging and positive feelings, see M. Mather and L. Carstensen, “Aging and Motivated Cognition: The Positivity Effect in Attention and Memory,”
21
You can read more about Dr. Vaillant’s study of the Harvard men in G. E. Vaillant,
22
For an overview of the Nun Study, see David Snowdon’s