Pollyanna may have been right
Pollyanna’s philosophy of life centers on what she calls “The Glad Game”, an optimistic attitude she learned from her father. The game consists of finding something to be glad about in every situation. It originated in an incident one Christmas when Pollyanna, who was hoping for a doll in the missionary barrel, found only a pair of crutches inside. Making the game up on the spot, Pollyanna’s father taught her to look at the good side of things—in this case, to be glad about the crutches because “we don’t need ‘em!”.
Alez Zautra, Lisa Johnson and Mary Davis researched positive affect as a source of resilience in two groups of women experiencing chronic pain. One group had fibromyalgia and the other osteoarthritis, and both groups had weekly interviews over 10 – 12 weeks regarding pain, stress, negative affect, and positive affect.
As we know, stress and pain often go together, and in this study, elevated stress and pain tended to affect mood. The findings from this study found that women who were generally more positive reported lower levels of pain in the presence of stress, and this followed through even to the week after elevated stress and pain when for women with lower levels of positive affect, pain increased while for women with higher levels of positive affect, pain was less affected.
As the authors of this paper state ‘Fredrickson’s “broaden and build” model (Fredrickson & Joiner, 2002) predicted that people with more positive affect overall would adapt more readily during times of stress. The second model emphasized the dynamic quality of the relationships between positive and negative affect, predicting that during times of stress, higher positive affect would also be associated with less negative affect as a consequence of increasing bipolarity of these affective states.‘
The conclusion from this study was that ‘high positive affect characterized those participants who were more resilient in the face of both increased bodily pain and mounting interpersonal conflict.’ Happier people seem to cope better in the face of adversity. Maybe there is something in the ‘Glad game’.
At the same time, however, another conclusion can be drawn: ‘When positive affect is low at the same time that pain or stress are elevated, people are much more likely to experience negative affective states than with either condition alone.’ A double-whammy.
The authors point out ‘a model for understanding the development of chronic pain conditions should rely not only on sources of stress, but also on failures of resilience that may arise from a relative deficit of positive emotional resources.’
The search to be happy and remain positive has been a human holy grail forever! If looking for the positive in a situation can help build resilience, I wonder why it hasn’t been used clinically as often as it might.
During the treatment of one woman who was finding it really hard to keep persisting with self management, we decided to focus on building resilience through identifying good things. There were several activities we did together.
- The first was at the end of each day list five good experiences she had through the day. A sort of ‘count your blessings’ list.
- Then we built in at least one pleasurable activity each day – something to look forward to, and something that wasn’t a ‘chore’. So much of pain management is challenging, this was like a reward or a rest for her. These activities were things like spending five minutes appreciating something from nature, or putting nailpolish on her beautiful nails, or slowly sipping on a good coffee.
- Then during our therapy sessions we looked at the good things that she has as a result of having chronic pain. This was the most challenging part: that she could identify that by having to slow down because of her pain, she could spend more time acknowledging her own needs; that because she had chronic pain she had developed a good relationship with her doctor and took more care of her health; that because of her chronic pain she was much better at developing skills to set boundaries on other people – and so on.
The other component of working with this woman was using mindfulness to help her manage times when she felt either more pain than usual, or her mood started to dip, or when she was under more interpersonal stress. This helped her recognise that ‘she’ remains the same, and her emotions and thoughts ebb and flow without necessarily needing her to do anything with them.
This was also really challenging – we are so often taught that we ‘must’ control our feelings, that negative emotions are ‘bad’ and that we ‘must’ change our stinkin’ thinkin’. Actually, we can’t do a lot about our thoughts and emotions – what we can change are our actions. So we worked on developing her awareness of her ‘wise self’ that has an overview of what happens to and around her. This sense of a still pool in the swirling waters of life was an image that this woman has used in relaxation and imagery, as well as practically as she enjoys swimming.
Have you used this approach to building resilience? If you have yourself, or with patients, drop me a line – I’d love to hear. Tomorrow: more on resilience and chronic pain. Have a great day!
Zautra, A., Johnson, L., & Davis, M. (2005). Positive Affect as a Source of Resilience for Women in Chronic Pain. Journal of Consulting and Clinical Psychology, 73 (2), 212-220 DOI: 10.1037/0022-006X.73.2.212