But rather than providing emotional sustenance, the sugar-coating of cancer can exact a dreadful cost. First, it requires the denial of understandable feelings of anger and fear, all of which must be buried under a cosmetic layer of cheer. This is a great convenience for health workers and even friends of the afflicted, who might prefer fake cheer to complaining, but it is not so easy on the afflicted. Two researchers on benefit finding report that the breast cancer patients they have worked with “have mentioned repeatedly that they view even well-intentioned efforts to encourage benefit-finding as insensitive and inept. They are almost always interpreted as an unwelcome attempt to minimize the unique burdens and challenges that need to be overcome.” 22 One 2004 study even found, in complete contradiction to the tenets of positive thinking, that women who perceive more benefits from their cancer “tend to face a poorer quality of life—including worse mental functioning—compared with women who do not perceive benefits from their diagnoses.” 23
Besides, it takes effort to maintain the upbeat demeanor expected by others—effort that can no longer be justified as a contribution to long-term survival. Consider the woman who wrote to Deepak Chopra that her breast cancer had spread to the bones and lungs:
Even though I follow the treatments, have come a long way in unburdening myself of toxic feelings, have forgiven everyone, changed my lifestyle to include meditation, prayer, proper diet, exercise, and supplements, the cancer keeps coming back.
Am I missing a lesson here that it keeps reoccurring? I am positive I am going to beat it, yet it does get harder with each diagnosis to keep a positive attitude.
She was working as hard as she could—meditating, praying, forgiving—but apparently not hard enough. Chopra’s response: “As far as I can tell, you are doing all the right things to recover. You just have to continue doing them until the cancer is gone for good. I know it is discouraging to make great progress only to have it come back again, but sometimes cancer is simply very pernicious and requires the utmost diligence and persistence to eventually overcome it.” 24
But others in the cancer care business have begun to speak out against what one has called “the tyranny of positive thinking.” When a 2004 study found no survival benefits for optimism among lung cancer patients, its lead author, Penelope Schofield, wrote: “We should question whether it is valuable to encourage optimism if it results in the patient concealing his or her distress in the misguided belief that this will afford survival benefits. . . . If a patient feels generally pessimistic . . . it is important to acknowledge these feelings as valid and acceptable.” 25
Whether repressed feelings are themselves harmful, as many psychologists claim, I’m not so sure, but without question there is a problem when positive thinking “fails” and the cancer spreads or eludes treatment. Then the patient can only blame herself: she is not being positive enough; possibly it was her negative attitude that brought on the disease in the first place. At this point, the exhortation to think positively is “an additional burden to an already devastated patient,” as oncology nurse Cynthia Rittenberg has written. 26 Jimmie Holland, a psychiatrist at Memorial Sloan-Kettering Cancer Center in New York, writes that cancer patients experience a kind of victim blaming:
It began to be clear to me about ten years ago that society was placing another undue and inappropriate burden on patients that seemed to come out of the popular beliefs about the mind-body connection. I would find patients coming in with stories of being told by well-meaning friends, “I’ve read all about this—if you got cancer, you must have wanted it. . . .” Even more distressing was the person who said, “I know I have to be positive all the time and that is the only way to cope with cancer—but it’s so hard to do. I know that if I get sad, or scared or upset, I am making my tumor grow faster and I will have shortened my life.” 27
Clearly, the failure to think positively can weigh on a cancer patient like a second disease.
I, at least, was saved from this additional burden by my persistent anger—which would have been even stronger if I had suspected, as I do now, that my cancer was iatrogenic, that is, caused by the medical profession. When I was diagnosed I had been taking hormone replacement therapy for almost eight years, prescribed by doctors who avowed it would prevent heart disease, dementia, and bone loss. Further studies revealed in 2002 that HRT increases the risk of breast cancer, and, as the number of women taking it dropped sharply in the wake of this news, so did the incidence of breast cancer. So bad science may have produced the cancer in the first place, just as the bad science of positive thinking plagued me throughout my illness.
Breast cancer, I can now report, did not make me prettier or stronger, more feminine or spiritual. What it gave me, if you want to call this a “gift,” was a very personal, agonizing encounter with an ideological force in American culture that I had not been aware of before—one that encourages us to deny reality, submit cheerfully to misfortune, and blame only ourselves for our fate.
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* “Bad” genes of the inherited variety are thought to account for less than 10 percent of breast cancers, and only 30 percent of women diagnosed with breast cancer have any known risk factor (such as delaying childbearing or the late onset of menopause) at all. Bad lifestyle choices like a fatty diet have, after brief popularity with the medical profession, been largely ruled out. Hence, groups like Breast Cancer Action argue, suspicion should focus on environmental carcinogens, such as plastics, pesticides (DDT and PCBs, for example, though banned in this country, are still used in many Third World sources of the produce we eat), and the industrial runoff in our ground water. No carcinogen has been linked definitely to human breast cancer yet, but many carcinogens have been found to cause the disease in mice, and the inexorable increase of the disease in industrialized nations—about 1 percent a year between the 1950s and the 1990s—further hints at environmental factors, as does the fact that women migrants to industrialized countries quickly develop the same breast cancer rates as those who are native-born.
TWO
The Years of
Magical Thinking
Exhortations to think positively—to see the glass half full, even when it lies shattered on the floor—are not restricted to the pink ribbon culture of breast cancer. A few years after my treatment, I ventured out into another realm of personal calamity—the world of laid-off white-collar workers. At the networking groups, boot camps, and motivational sessions available to the unemployed, I found unanimous advice to abjure anger and “negativity” in favor of an upbeat, even grateful approach to one’s immediate crisis. People who had been laid off from their jobs and were spiraling down toward poverty were told to see their condition as an “opportunity” to be embraced, just as breast cancer is often depicted as a “gift.” Here, too, the promised outcome was a kind of “cure”: by being positive, a person might not only feel better during his or her job search, but actually bring it to a faster, happier, conclusion.
In fact, there is no kind of problem or obstacle for which positive thinking or a positive attitude has not been proposed as a cure. Trying to lose weight? “Once you have made up your mind to lose weight,” a site devoted to “The Positive Weight Loss Approach” tells us, “you should make that commitment and go into it with a positive attitude. . . . Think like a winner, and not a loser.” Having trouble finding a mate? Nothing is more attractive to potential suitors than a positive attitude or more repellant than a negative one. A Web site devoted to dating tips (one of many) advises people engaged in Internet dating: “Write a profile or message with a negative attitude and you are bound to send potential suitors packing. A positive attitude on the other hand is attractive to virtually everyone.” Similarly, “the best blind date tips boil down to two basic pieces of advice,” we learn from another Web site. “Have a positive attitude, and keep an open mind.” Women in particular should radiate positivity, not mentioning, for example, that their last boyfriend was a jerk or that they’re dissatisfied with the
ir weight. “You should remain positive at all times,” counsels yet another site. “You should avoid complaining too much, seeing the negative in things, and allowing all this negativity to show. While it is important that you are yourself, and should remain true to that, being negative is never a way to go when it comes to socialization [meaning, perhaps, socializing].”
Need money? Wealth is one of the principal goals of positive thinking, and something we will return to again and again in this book. There are hundreds of self-help books expounding on how positive thinking can “attract” money—a method supposedly so reliable that you are encouraged to begin spending it now. Why has wealth eluded you so far? Practical problems like low wages, unemployment, and medical bills are mentioned only as potential “excuses.” The real obstacle lies in your mind, which may harbor a subconscious revulsion for “filthy lucre” or a deeply buried resentment of the rich. A friend of mine, a chronically underemployed photographer, once engaged a “life coach” to improve his finances and was told to overcome his negative feelings about wealth and to always carry a twenty-dollar bill in his wallet “to attract more money.”
Positive thoughts are even solicited for others, much like prayers. On an Internet site for teachers, a woman asks colleagues to “please think positive thoughts for my son-in-law,” who had just been diagnosed with Stage IV brain cancer. Appearing on CNN, the father of a soldier missing in action in Iraq told viewers: “I would wish everybody out there to give your positive thoughts on this issue and to help us through this. And if everybody gives us their prayers and their positive thoughts, this stuff is doable. . . . I know the military are doing all they can to do whatever they can, and the positive thoughts are very important right now.” 1 Positive thoughts notwithstanding, the soldier’s body was found in the Euphrates River one week later.
Like a perpetually flashing neon sign in the background, like an inescapable jingle, the injunction to be positive is so ubiquitous that it’s impossible to identify a single source. Oprah routinely trumpets the triumph of attitude over circumstance. A Google search for “positive thinking” turns up 1.92 million entries. At the Learning Annex, which offers how-to classes in cities like New York and Los Angeles, you’ll find a smorgasbord of workshops on how to succeed in life by overcoming pessimism, accessing your inner powers, and harnessing the power of thought. A whole coaching industry has grown up since the mid-1990s, heavily marketed on the Internet, to help people improve their attitudes and hence, supposedly, their lives. For a fee on a par with what a therapist might receive, an unlicensed career or life coach can help you defeat the “negative self-talk”—that is, pessimistic thoughts—that impedes your progress.
Within America today, a positive outlook is not always entirely voluntary: those who do not reach out to embrace the ideology of positive thinking may find it imposed on them. Workplaces make conscious efforts to instill a positive outlook, with employers bringing in motivational speakers or distributing free copies of self-help books like the 2001 paperback mega–best seller Who Moved My Cheese?, which counsels an uncomplaining response to layoffs. Nursing homes famously brim over with artificial cheerfulness. As one resident complained: “The diminutives! The endearments! The idotic we’s. Hello, dear, how are we doing today? What’s your name, dear? Eve? Shall we go into the dining room, Eve? Hi, hon, sorry to take so long. Don’t we look nice today!” 2 Even the academy, which one might think would be a safe haven for cranky misanthropes, is seeing the inroads of positive thinking. In early 2007, the administration of Southern Illinois University at Carbondale, alarmed by a marketing study finding the faculty “prideless,” brought in a motivational speaker to convince the glum professors that “a positive attitude is vital for improving customer satisfaction,” the “customers” being the students. It should be noted that only 10 percent of the faculty bothered to attend the session. 3
But positive thinking is not just a diffuse cultural consensus, spread by contagion. It has its ideologues, spokespeople, preachers, and salespersons—authors of self-help books, motivational speakers, coaches, and trainers. In 2007, I ventured into one of their great annual gatherings, a convention of the National Speakers Association, where members of the latter occupational groups came together for four days to share techniques, boast of their successes, and troll for new business opportunities. The setting, a waterfront hotel in downtown San Diego, was pleasantly touristic, the internal ambience engineered for a maximally positive effect. A plenary session in the main ballroom began with a ten-minute slide show of calendar-style photos—waterfalls, mountains, and wildflowers—accompanied by soothing music. Then a middle-aged blond woman in an Indian-type tunic came out and led the 1,700-member audience in “vocal toning.” “Aaaah,” she said, “aaah, aaah, aaah,” inviting us to stand and chant along with her. Everyone joined in, obediently but not enthusiastically, suggesting some prior experience with this sort of exercise.
It was New Age meets middle-American business culture. You could pick up some crystals at the exhibition booths or attend a session on how to market your Web site. You could hone your meditation skills or get tips on finding a speakers agency. You could delve into “ancient wisdom”—the Upanishads, the Kabala, Freemasonry, and so on—or you could purchase a wheeled suitcase personalized with your name and Web site in large letters, the better to market yourself while strolling through airports. There was nothing remotely cultlike about the crowd, no visible signs of fanaticism or inner derangement. Business casual prevailed and, among the men, shaved heads greatly outnumbered ponytails.
The irrational exuberance, such as it was, all came from the podium. First up, among the keynote speakers, was the slender, energetic Sue Morter, described in the program as the head of a “multi-disciplined wellness center in Indianapolis.” When the initial applause she receives “doesn’t do it” for her, she orders the audience to stand and engage in a few minutes of rhythmic clapping to music. Thus primed, we are treated to a fifty-minute discourse, delivered without notes, on the “infinite power” we can achieve by resonating in tune with the universe, which turns out to have a frequency of ten cycles per second. When we are out of resonance, “we tend to overanalyze, plan, and have negative thoughts.” The alternative to all this thinking and planning is to “be in the Yes!” When she comes to the end, Morter has the audience stand again. “Squeeze your hands together, think the thought Yes. Put your feet firmly on the planet. Think the thought Yes.”
Best known among the keynoters was Joe (“Mr. Fire”) Vitale, introduced as “the guru himself,” who claims doctorates in both metaphysical science and marketing. Vitale, who looks like a slightly elongated Danny DeVito, offers the theme of “inspired marketing,” and also love. “You are just incredible,” he begins. “I love all of you. You are fantastic.” He admits to being a “disciple of P. T. Barnum” and recounts some of the pranks he has used to gain attention—like a tongue-in-cheek press release accusing Britney Spears of plagiarizing his “hypnotic marketing” techniques. Love seems to be among these techniques, since he recommends increasing one’s business by looking over one’s mailing list and “loving each name.” He plugs his most recent book, Zero Limits: The Secret Hawaiian System for Wealth, Health, Power, and More, which explains how a doctor cured inmates in an asylum for the criminally insane without even seeing them, by simply studying their records and working to overcome his negative thoughts about them. Again, there is a jubilant finale: “Say ‘I love you’ in your head at all times so that we can heal all that needs to be healed.”
The audience absorbs all this soberly, taking notes, nodding occasionally, laughing at the expected points. As far as I can judge, most of the attendees have not published books or ever addressed an audience as large as the National Speakers Association provides. Random conversations suggest that the majority are only wannabe speakers—coaches or trainers who aspire to larger audiences and fees. Many come from health-related fields, especially of the “holistic” or alternative variety;
some are coaches for businesspeople, like the ones I had encountered instructing laid-off white-collar workers; a few are members of the clergy, seeking to expand their careers. Hence the predominance of workshops on nuts-and-bolts themes: how to work with speakers bureaus, acquire bookings, organize your office, market your “products” (DVDs and inspirational tapes). Not everyone will make it, as one workshop leader warns in her PowerPoint presentation, with a kind of realism that seems sorely out of place. Some, she says, will go into a “death spiral,” spending more and more to market their Web sites and their products, and “then—nothing.” But clearly there is money to be made. In one workshop, Chris Widener, a forty-one-year-old motivational speaker who began as a minister, tells the story of his unpromising youth—he had been “out of control” at the age of thirteen—culminating in his present affluence: “Three and a half years ago, I bought my dream house in the Cascade Mountains. It has a weight-lifting room, a wine cellar, and a steam bath. . . . My life is what I would consider the definition of success.”