Inspirational quote of the day: “Believe in yourself.” The first step towards success is optimism and confidence—even when it comes to optimizing your physical health. In fact, a positive attitude can benefit your bodily health more than you may think. A 30-year study by the Mayo Clinic found that optimists have 50 percent lower risk of early death than pessimists. Conclusion: “the mind and body are linked” while “attitude has an impact on the final outcome—death.” Creating positive expectations can add years to your life, and make all the difference when it comes to health and healing.
In this Article:
- The Science Behind It
- A Man Who Laughed His Way Back to Life
- A Note on the Placebo Effect
- Does optimism always lead to positive effects?
- Benefits of Specific Expectancies
Believe in yourself: the notoriously overused Inspirational Quote-of-the-Day. But did you know this little piece of advice has a scientific basis? In fact, numerous studies have shown optimism to be associated with positive health consequences, including lower blood pressure2 and slower disease progression for HIV and certain cancer patients3,4. The more positive you expect your future to be, the better your ability to adapt to trying situations, including college transition.
Dispositional optimism, or generalized positive expectations, predicts a healthier psychological mindset. The Journal of Personality and Social Psychology published that people with optimistic expectations report better physical health, although this may be due to a positive bias. Nevertheless, a positive attitude can benefit your body more than you may think. The Mayo Clinic says optimists have 50 percent lower risk of early death than pessimists1. Creating positive expectations can add years to your life, and make all the difference when it comes to health and healing.
A relatively new science is devoted to studying brain-body interactions and examines how psychological well-being affects the rest of the body. Psychoneuroimmunology (PNI) is an interdisciplinary field of how our thoughts and feelings (psych) influence our brain and nervous system (neuro), which temper the body's disease-fighting mechanisms (immunology).
Amongst other mind-body relations, PNI explores the health outcomes of dispositional optimism. In general, optimists tend to engage in positive health practices including higher levels of exercise, reduced levels of smoking, and healthier diet5. Emerging evidence also indicates that optimists are physically better off due to their ability to moderate the negative impacts of stress. In 1998, a study by former UCLA psychologist Suzanne Sergerstrom, PhD. hit findings that tied optimism to better mood, coping, and immune response to stress6.
The American Psychological Association explains this with the "immune-brain loop:" the brain communicates our thoughts and emotions with the body’s systems, and vice versa7. Communication between the brain and immune system occurs via two major pathways--one of which is the hypothalamic-pituitary-adrenal axis (HPA axis), the body's primary stress management system. The HPA axis allows us to respond to physical and mental challenges by stimulating activity in immune cells such as T cells and natural killer cells (NK cells), which are regulated by cytokine messenger molecules such as interleukin-6 (IL-6).
High levels of immune cells and cytokines indicate inflammation in our bodies, which is a natural immune response in order to deal with daily stressors in our lives. The ability for inflammation signals a healthy, responsive immune system, however prolonged inflammation is never a good thing. For example, the drawn-out, heightened immune response to constant stress ultimately damages a good deal of body tissue.
A 2007 study in Brain, Behavior and Immunity found increased circulating IL-6 to be correlated with psychological stress8. More notably, a more recent 2009 study in Brain, Behavior and Immunity found that subjects with high levels of dispositional optimism had smaller IL-6 responses in stressful situations, demonstrating the impact of a positive mindset on acute stress9.
Optimism can protect your physical and mental health. Though the exact pathways mediating optimism and stress-induced immune changes are unclear, a number of studies found positive correlations between optimism and positive health consequences.
Q: How do you measure optimism? Dispositional optimism can be assessed using questionnaires, such as the Life Orientation Test, which evaluates generalized expectations of positive and negative outcomes.
Q: How do you measure the immune response in relation to optimism? Many studies monitor and analyze levels of T cells, natural killer cells (NKCC), cytokines (such as interleukin-6), and cortisol (the stress hormone) to indicate the present strength and activation of the immune system.
The Cousins Center for Psychoneuroimmunology at UCLA was founded by a man who laughed in the face of death. Literally. American journalist and medical professor Norman Cousins applied his own research on the biochemistry of human emotions to his own battle against a heart attack, heart disease, and Ankylosing Spondylitis, a life-threatening collagen illness involving deteriorating connective tissue in the spine10. Doctors speculated his chance of survival to be 1 in 500, with only a few months to live.
Faced with impending death, Cousins chose a treatment process simply unheard of: (1) an abundant supply of Vitamin C with (2) a check-out from the hospital and into a hotel room and (3) funny films to provide him with massive doses of positive attitude and laughter. The result? Cousins survived to a ripe old age of 75—10 years past his heart attack, 16 of his collagen illness, and 26 years after being diagnosed with heart disease. The remarkable survival of Cousins is but one case supporting this holistic approach to health and recovery, demonstrating how optimism and a positive attitude can strengthen the body's ability to counteract disease.
"The more serious the illness, the more important it is for you to fight back, mobilizing all your resources — spiritual, emotional, intellectual, physical." --Cousins, Anatomy of an Illness
The power of positivity is perhaps most convincingly portrayed when examining the role of optimism on the placebo effect. The “placebo effect” is an all-too-familiar concept in which an inactive treatment produces an actual physiological or psychological reaction, such as symptom relief or analgesia (decreased pain perception). It turns out that dispositional optimism can actually predict placebo responding.
A 2010 Journal of Pain study applied a placebo hand cream on subjects, who then immersed their hand in ice for 2 minutes11. Half of the subjects were told the hand cream would block pain (analgesic) from the cold presser task while the other half were told the cream was just a cleanser. Of the participants who believed the cream was analgesic, those who scored higher on dispositional optimism reported less pain. Interestingly enough, without the optimism variable, subjects with the same optimism level reported the same level of pain—regardless of whether they were told the hand cream prevented pain or not.
The implications of this study are huge. According to these results, the placebo effect may be due—at least in part—to positive expectation effects. We are likely to experience something along the lines of what we believe will happen, especially if we are optimistic about it. The take home message: thinking optimistically about your body’s defense mechanisms, or any therapy or medication taken, can make a difference in its actual effects.
It is important to note that the relationship between optimism and immunity is far from simple, and the exact mechanisms have yet to be defined. Despite findings that indicate optimism to be positively related to cell immunity when stressors are easy, some experiments have shown optimism to be negatively related when stressors are particularly difficult, complex, persistent or uncontrollable. The 2004 Psychology & Health reported optimism to be associated with lower HIV viral load among HIV+ gay men, but only at moderate levels—high levels of optimism did not confer any additional benefit12.
According to Sergerstrom, there may be a couple reasons for this13:
(1) The Disappointment Hypothesis: It’s the same concept as an over-hyped movie. Optimists are more likely to set themselves up for disappointment whenever the positive envisioned future doesn’t pull through. A 1999 study at the University of San Francisco measured higher T cell and NK cell levels in optimists facing brief stressors, but a decline in immune cells when stressors were prolonged. Likewise, another 1992 Yale study found optimists exposed to loud noise stressors had higher NK cell levels when they believed they were able to control the noise offset. When optimists can’t terminate persistent and uncontrollable stressors, their positive expectations are violated, leading to distress and decrements in the immune system.
(2) The Engagement Hypothesis: Knowing when to stop trying is important. In a difficult situation, optimists are more likely to remain struggling whereas pessimists would give up. Though “giving up” is commonly frowned upon in today’s goal-driven society, it can be physiologically protective by minimizing stress exposure. When circumstances are easy or straightforward, keeping engaged can lead to problem-solving and ultimately terminate the stressor. When the situation is difficult or complex, however, to keep trying means keeping yourself exposed to ongoing persistent stressors. Sergerstrom’s 2005 study found optimists more likely to work longer in attempt to solve difficult anagrams, raising levels of cortisol (the stress hormone).
The disappointment and engagement hypotheses are the case for general positive expectations. Specific positive expectations, however, can reduce the stress impact on your immunity. Law students with specific expectancies about school predicted higher immune cell levels, increasing self-efficacy to successfully achieve their academic goals14. In addition, positive HIV-specific expectancies were correlated with later symptom onset and longer survival after AIDS diagnosis15.
Ties between optimism, immunity, and health vary case-by-case. One the one hand, dispositional optimism and specific expectancies can effectively buffer the immune system. Sometimes, however, optimists pay a physiological cost for opting to overcome particularly difficult and persistent situations.
This only means higher stress for the short-term, however. In the long run, optimism can definitely lead to better outcomes. Whereas optimists solve problems to the best of their ability, pessimists choose to temporarily avoid persistent problems in their lives.
As Sergerstrom puts it, “it is clear that to the question of whether optimism is good or bad for immunity: the answer is ‘yes.’”
 Maruta, T., Colligan, R. C., Malinchoc, M., and Offord, K. P. Optimists vs. pessimists: survival rate among medical patients over a 30-year period. Mayo Clin Proc. 2000; 75:140-143.
 Räikkönen, K., Matthews, K. A., Flory, J. D., Owens, J. F., and Gump, B. B. Effects of optimism, pessimism, and trait anxiety on ambulatory blood pressure and mood during everyday life. J Pers Soc Psychol. 1999; 76(1):104-13.
 Ironson, G., and Hayward, H. Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med. 2008; 70(5):546-54.
 Allison, P. J., Guichard, C., Fung, K., and Gilain, L. Dispositional optimism predicts survival status 1 year after diagnosis in head and neck cancer patients. J Clin Oncol. 2003; 21(3):543-8.
 Taylor, S. E., Kemeny, M. E., Aspinwall, L. G., Schneider, S. G., Rodriguez, R., and Herbert, M. Optimism, coping, psychological distress and high-risk sexual behavior among men at risk for acquired immunodeficiency syndrome (AIDS). J Pers Soc Psychol. 1992; 63(3):460-73.
 Sergerstrom, S. C., Taylor, S. E., Kemeny, M. E., and Fahey, J. L. Optimism is associated with mood, coping, and immune change in response to stress. J pers Soc Psychol. 1998; 74(6):1646-55.
 Azar, B. A new take on psychoneuroimmunology. American Psychological Association. 2001; 32(11):34.
 Sergerstrom, S. C., Schipper, L. J., and Greenberg, R. N. Caregiving, repetitive thought, and immune response to vaccination in older adults. Brain Behav Immun. 2008; 22(5):744-52.
 Brydon, L., Walker, C., Wawrzyniak, A. J., Chart, H., and Steptoe, A. Dispositional optimism and stress-induced changes in immunity and negative mood. Brain Behav Immun. 2009; 23(6):810-6.
 Cousins Center for Psychoneuroimmunology. History. Accessed on November 17, 2011.
 Geers, A. L., Wellman, J. A., Fowler, S. L., Helfer, S. G., and France, C. R. Dispositional optimism predicts placebo analgesia. J Pain. 2010; 11(11):1165-71.
 Milam, J. E., Richardson, J. L., Marks, G., Kemper, C.A., and McCutchan, A.J. The roles of dispositional optimism and pessimism in HIV disease progression. Psychol Health. 2004;19:167–181.
 Sergerstrom, S. C. Optimism and immunity: Do positive thoughts always lead to positive effects? Brain Behav Immun. 2005; 19(3):195-200.
 Sergerstrom, S. C. Stress, Energy and Immunity: An ecological view. Curr Dir Psychol Sci. 2007; 16(6): 326-330.
 Reed, G. M., Kemeny, M. E., Taylor, S. E., and Visscher, B. R. Negative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men. Health Psychol. 1999; 18(4):354-63.
Click here to view the original article published in the Winter 2011 issue of Total Wellness Magazine.
By Grace Lee, B.S., Psychobiology, University of California, Los Angeles
M.P.H., Health Promotion Research & Practice, Mailman School of Public Health, Columbia University
Total Wellness Assistant Director, 2011