As if I needed another reason to love Barbara Ehrenreich

Writing for HuffPo, Charlottesville’s own Barbara Ehrenreich takes on positive psychology. I have to remember to drop by sometime with a cake and welcome her to the city, even if it is a year too late.

She addresses something very annoying about the belief that positive thinking is a universal good (and provides a backhanded slap to Depeak Chopra and “the Secret”), that there isn’t much proof that it really works – at least not in situations of ongoing stress. Further, a more insidious aspect of the emphasis on positive thinking is a blame-the-victim mentality inherent in its proponents.

The perennial temptation to blame disease on sin or at least some grave moral failing just took another hit. A major new study shows that women on a virtuous low fat diet with an extraordinary abundance of fruits and veggies were no less likely to die of breast cancer than women who grazed more freely. Media around the world have picked up on the finding, cautioning, prudishly, that you can’t beat breast cancer with cheeseburgers and beer.

Another “null result” in cancer studies — i.e., one showing that a suspected correlation isn’t there — has received a lot less attention. In the May issue of Psychological Bulletin, James Coyne and his colleagues at the University of Pennsylvania reported that “there is no compelling evidence linking psychotherapy or support groups with survival among cancer patients.” This flies in the face of the received wisdom that any sufficiently sunny-tempered person can beat cancer simply with a “positive attitude.”

Then, Chopra gets a snub:

So far no one appears to have read Coyne’s study. On June 30, a month after its publication, all-purpose guru Deepak Chopra assured Sanjay Gupta on CNN that the mind can control the body: “…You know, of course, the … study where women who supported each other in a loving environment with breast cancer the survival doubled.” Gupta, last sighted seeking to discredit Michael Moore’s SiCKO with his “fact-checking,” simply nodded, although the study Chopra was referring to was discredited years before Coyne’s research came out.

For the last decade or so, adherents of the new discipline of “positive psychology” have been insisting that not just cancer, but almost any health setback, can be conquered with optimism or a “positive attitude.” But as Coyne and other critics point out, the science here is shaky at best. Even the theoretical linch-pin of the supposed happy-mind-healthy-body connection — that a positive outlook strengthens the immune system — took a kick in the teeth two years ago when Suzanne Segerstrom at the University of Kentucky found, to her own apparent surprise, that optimism can have a negative effect on the immune system when the stressors are intense, as in the case of serious disease.

Quite true. Segerstrom’s review on the topic is interesting. It suggests mixed benefits to optimism, in some situations it helps, sometimes it appears to be detrimental. In particular, optimists seem to do well with temporary stresses, lasting a week, but if a stress is prolonged, they do worse – possibly due to circumstances creating a big conflict with their personality. Segerstrom’s “engagement” hypothesis is that in the face of an ongoing stressor, the optimist doesn’t give up early enough, which would allow to accept their fate and decrease engagement with stressors. I recommend reading the paper if you’ve got a subscription, it’s really very interesting.

The only point on which I disagree with Ehrenreich’s is her characterization of HRT being “pushed” as something negative. One of the problems with science is that you work with the data that you have. HRT did have many positive and beneficial effects and earlier studies didn’t show the breast cancer risk.

TheWomen’s Health Initiative study came along and showed that along with those benefits came a small but significant increased risk of breast cancer and stroke with one type of HRT (with reductions in risks of some other diseases and no difference in overall mortality). I’d say there is still room for debate over the positive and negative aspects of HRT and there always is the possibility one day we’ll develop a specific estrogen that has the benefits of HRT without increasing other risk factors. Also, there is a benefit for certain women for whom the relative risks don’t outweigh the benefits. The Relative Risk was 1.26, or and incidence of breast cancer 26% more than one would expect, another example of a RR less than 2 that is important because of the power of the study.

Anyway, back to the point. Barbara Ehrenreich rocks.