To a Point

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Volume 17, Number 4

Optimism has been associated with better health outcomes in numerous studies, whether the optimism is dispositional (a personality trait) or learned (a way of thinking, such as a growth mindset). But as is the case with most aspects of human behavior, too much of a positive characteristic can become a negative. Optimism is beneficial, to a point, and is best mixed with a dose of realism.

Unrealistic optimism certainly can be problematic. If one is unrealistic about their invulnerability to health problems or injury, they may ignore behaviors that reduce risk. This might include avoidance of recommended screening tests, drinking without making arrangements for a designated driver, stopping prescribed medications prematurely, or not wearing a bicycle helmet. Certainly there have been casualties of COVID-19 whose unrealistic optimism resulted in behavior that cost them their lives.

Being unrealistically optimistic about the potential benefits of a medical or surgical intervention can lead to disappointment. In the pain management realm, a pain level of 2 on a scale of 0-10 will be disappointing to a patient whose expectation was 0, but viewed as successful to the patient whose expectation was to be able to function more effectively. Optimistic outlooks on aging have been associated with better quality of life and living longer, but expecting that one’s older years will be identical to one’s younger years is a recipe for discouragement and discontentment. And while not necessarily life-threatening, unrealistic optimism about expected positive outcomes in other life domains paradoxically results in more negative emotion due to dashed hope, disappointment, and loss.

On the whole, human beings tend toward having an optimism bias, and there is evidence that self-serving biases may be a contributor to mental health — to a point. Living with a degree of expectation of positive outcomes, and behaving in a manner that contributes to such outcomes, is the type of optimism that has been associated with better health. A benefit of realistic optimism is that occasionally there may be outcomes that are even better than expected, and these experiences contribute to joy in life.

 It is accurate to say that optimism is health-enhancing, to a point. The point is that a dose of realism is an essential ingredient. Realistic optimism is the goal.     

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