When managing a chronic health condition — pain, inflammation, hypothyroidism, an autoimmune disease — it’s easy to get caught up in the nuts and bolts of care. Strategies such as an anti-inflammatory diet, supplements, medications, sleep hygiene, exercise, and other functional medicine protocols can consume your thoughts and Google searches. Don’t get me wrong, these are extremely important tools that can help you successfully manage your condition and get your life back.
But one tool that many doctors and their patients overlook is the effect of attending to deeper, less tangible areas of your life.
For instance, do you feel you have a support network and are loved by friends and family? Were you supported and cared for as a child, or did you begin life in a stressful survival mode you still operate in today? Do you socialize regularly or are you a hermit?
Do you make time for fun, playful activities on a regular basis or do you spend all your free time watching TV?
Do you see most people as good and life as positive and fulfilling, or does the world seem like a dark place filled with evil people? Are you spiritual or do you have a meaningful view of life beyond ordinary existence?
Are you in a loving, supportive relationship, or is your marriage or partnership toxic and chronically stressful? Do you have a sense of purpose in your career life, or does going to work fill you with dread?
Lastly, do you believe you deserve to feel good and get better? And do you truly want to?
Sometimes a person has been feeling awful for so much of their life and has become so accustomed to so much negativity and unhappiness, that getting better can feel like a threat to their identity and way of life. On an unconscious survival level, you may actually fight against change and improved health because the human body and mind are wired to maintain homeostasis — an avoidance of rocking the boat.
Perhaps the people in your life, such as your spouse or family members, will also unconsciously resist or demean your work toward improvement. It may strike them as abandonment or a message that suddenly they’re not good enough for you.
Their resistance can also come from feeling threatened by your motivation and improvement because it challenges them to work to improve, which is daunting.
These are all issues that profoundly affect your immune health and your success on a functional medicine protocol. I and many other practitioners have seen it over and over — patients who have a positive outlook, healthy relationships, and support from their loved ones typically experience better outcomes.
But the good news is you don’t have to be a naturally happy person to get better. Science has shown us we simply have to practice small, doable strategies on a regular basis to benefit from the anti-inflammatory effects of positivity.
And please take note: Although the science of positivity, gratitude, healthy socialization and so forth is fascinating, life happens. Happy people still get cancer and grumpy people live past 100. There are no absolutes, but if your attitudes, belief systems, or social circumstances are a chronic source of stress for you, I invite you to view them as doorways into feeling and functioning better.
Mind as medicine: How your inner world affects your health
Your inner world deeply affects all aspects of your physical health, including function of the immune system, brain, hormones, and so on. Simply put, positivity makes for better health. And even if a positive outlook doesn’t directly improve health, research suggests it still helps you cope better with your condition and follow your protocols. A 2012 study found people who thought of something that made them feel good each morning and used self-affirmation techniques when encountering obstacles were better about complying with their treatment plan.1 2
I know for many people struggling with autoimmunity, being told to “be positive,” can be infuriating. It sounds dismissive and belittling when every waking moment is a struggle, when fear and anxiety about your health are constant, and when fatigue has you barely functioning, much less thinking positive. I have heard autoimmune patients say if one more person told them to think positive they were going to punch them in the face.
I’m not saying you have to become all rainbows and sunshine or reject or suppress your emotions. While naturally happy people have been shown to live longer and enjoy better health in general, all of us can cultivate a positivity habit—even just a few minutes a day of positive thinking can improve your health.3 Learning to have a positive attitude is like learning tennis or piano. It’s not something at which you immediately excel. Instead, you spend a little time every day practicing for gradual improvement. For instance, you can spend a little bit of time every day thinking of a memory or experience that makes you feel good, or of someone you love and who loves you.
One of the most reliable paths to positivity is gratitude. You can develop a more positive outlook thinking of things in your life for which you are grateful.4 A grateful attitude has been linked to less anxiety and depression, sounder sleep, kinder behavior, and overall better health.5 One study showed participants who wrote down five things for which they were grateful only once a week were happier, more optimistic, reported fewer physical problems, and exercised more compared to the control group. Similar results were reported in polio survivors who kept a gratitude journal.
By keeping a gratitude journal or cultivating some other regular gratitude practice, you can build more pathways in your brain for positivity so that it increasingly becomes a habit. It’s like speaker Zig Ziglar once said, “People often say that motivation doesn’t last. Well, neither does bathing—that’s why we recommend it daily.” Your positivity practice can be like brushing your teeth, showering, or taking a walk—something you do out of habit because you know it’s good for you. This in turn will better support your health, or at the very least, your coping abilities and compliance.
A few studies that investigated how we employ positive thinking came up with some interesting results. They found you obtain more mileage out of constructive, purposeful visualization versus just fantasizing. For instance, in one study, participants who spent a few minutes each day visualizing what it felt like to get a good grade on a test scored lower than those who visualized when, where, and how they were going to study. The same held true for tennis and golf players.6 Those who visualized practicing performed better than those who visualized winning. Regular visualization of performance is well known in the sports world for improving scores. So, although visualizing how good it will feel to be healthy may help you, don’t forget to also mentally rehearse things like planning, shopping, and cooking for your anti-inflammatory diet, physical activity, socializing, staying calm in a stressful situation, going to bed on time, and other strategies to manage your autoimmunity.
Sometimes the deeper issues causing stress can seem too insurmountable or scary to broach. It is not always possible to suddenly leave an ailing marriage or dead-end job, to confront childhood traumas, or to pick up and move to a place you like better (although if you are in an abusive relationship you need to take urgent action to get out as soon as possible). But simply identifying the issue and its effect on your health is a monumental part of the process. You may not be able to arrange a major life change in the next few weeks, but by acknowledging issues that play a role in your inflammatory or autoimmune condition, you can begin to envision and gradually move toward a more rewarding life experience.
The effect of other people on your autoimmunity
While your own positivity is important for your health, so is the attitude of the people you surround yourself with, including your own doctor. Research shows a positive and supportive practitioner is going to help twice as many patients get better compared to a grumpy, negative practitioner who discounts or disregards what you say about your symptoms and experience in your own body.7
The people you surround yourself with outside of the doctor’s office also influence your health. First of all, do you even surround yourself with people? Social interaction seems to take a back seat to an online life for many people these days, but an online social life is not the same thing.
Being in the presence of another living human being, hearing inflections in the voice, reading body language and facial expressions, handshakes and hugs, eye contact, and just picking up on another person’s vibe are all part of the human experience. In-person socialization leads to deeper conversations and feeds our well-being. In fact, social isolation is so detrimental that it has been found to carry the same health risks as smoking, obesity, and lack of physical activity, while regular social activity can improve your odds of survival by 50 percent.8
Studies also have linked a healthy social life with better heart health and the prevention of depression and memory loss.9 10 11Socializing online is great for finding your tribe. Facebook groups and online forums are a great way to find others with a condition like yours working to get better. But go one step beyond and look for groups such as on meetup.com that bring those tribes into “real life.” If you don’t find one that matches your interest, start one!
The exception to this benefit is if those relationships are unhealthy. It is better to be alone than to subject yourself to negative relationships, which increase stress and depression.12 Negative relationships can be with spouses, partners, coworkers, bosses, or toxic friends or family. I’ve known a number of people who, after deciding to prioritize their health and wellness, find negative relationships in their life fall away to be replaced by healthier ones. Although we can’t always choose our family or coworkers, by developing self-worth and positivity we attract positive people into our lives while the negative ones no longer stick around.
1 Positive Attitude Can Benefit Patients with Chronic Disease. Teachers College Columbia University. Volume XVII, No. 4. Jan. 30, 2012. http://www.tc.columbia.edu/news.htm?articleID=8368&pub=6&issue=287
2 3 Diener, E. & Chan, M. Y. (2011). Happy people live longer: Subjective well-being contributes to health and longevity. Applied Psychology: Health and Well-Being.
4 Emmons RA, McCullough ME. Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. J Pers Soc Psychol. 2003 Feb;84(2):377-89.
5 A serving of Gratitude May Save the Day. John Tierney. New York Times. Nov. 21, 2011.
6 Taylor, S.E., Pham, L.B., Rivkin, I.D., & Armor, D.A. (1998). Harnessing the imagination: Mental simulation, self-regulation, and coping. American Psychologist, 53, 429-439.
7 K. B. Thomas, “General Practice Consultations: Is There Any Point in Being Positive?” British Medical Journal 294, no. 6581 (May 9, 1987): 1200– 1202.
8 Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010 Jul 27;7(7):e1000316. doi: 10.1371/journal.pmed.1000316. Review.
9 Yang YC, McClintock MK, Kozloski M, Li T. Social isolation and adult mortality: the role of chronic inflammation and sex differences. J Health Soc Behav. 2013 Jun;54(2):183-203.
10 Sheridan A., O’Callaghan E., Drennan J., Coughlan B., O’Keeffe D., Nee J., Frazer K. and Kemple M. (2012) Enabling Recovery: The Benefits of Supporting Socialisation. Report of a Randomised Controlled Trial. University College Dublin, Dublin
11 Shankar A, Hamer M, McMunn A, Steptoe A. Social isolation and loneliness: relationships with cognitive function during 4 years of follow-up in the English Longitudinal Study of Ageing. Psychosom Med. 2013 Feb;75(2):161-70.
12 Teo AR, Choi H, Valenstein M (2013) Social Relationships and Depression: Ten-Year Follow-Up from a Nationally Representative Study. PLoS ONE 8(4): e62396. doi:10.1371/journal.pone.0062396