Happiness and Health
The central claim of positive psychology, as of positive thinking generally, is that happiness—or optimism, positive emotions, positive affect, or positive
something
—is not only desirable in and of itself but actually useful, leading to better health and
greater success. One book on positive psychology states that “happiness . . . is more than pleasant, it is beneficial,” and Seligman begins
Authentic Happiness
by summarizing a few studies showing that happy (or positive) people live longer than unhappy ones.
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In other words, you should make an effort to be happy, if only because the consequences of unhappiness may include poor health and lower achievement. Would happiness stop being an appealing goal if it turned out to be associated with illness and failure? Isn’t it possible to imagine being gloriously contented with a life spent indulging unhealthy habits, like the proverbially happy “pigs in shit”? Nothing underscores the lingering Calvinism of positive psychology more than this need to put happiness to work—as a means to health and achievement, or what the positive thinkers call “success.”
Happy, or positive, people—however that is measured—do seem to be more successful at work. They are more likely to get a second interview while job hunting, get positive evaluations from superiors, resist burnout, and advance up the career ladder. But this probably reflects little more than the corporate bias in favor of a positive attitude and against “negative” people. A widely cited review article entitled “The Benefits of Frequent Positive Affect: Does Happiness Lead to Success?,” coauthored by Ed Diener, makes no mention of this bias and hence appears to do little more than to confirm it.
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When it comes to the proposed health benefits of a positive outlook, the positive psychologists would seem to be on firmer ground. As we have seen, a positive outlook cannot cure cancer, but in the case of more common complaints, we tend to suspect that people who are melancholy, who complain a lot, or who ruminate obsessively about every fleeting symptom may in fact be making themselves sick. Recall the miraculous cures worked on
chronic invalids by Phineas Quimby and others in the nineteenth century, simply by encouraging them to get up out of bed and start thinking of themselves as healthy people. We don’t have “neurasthenics” today, but there are plenty of ills with a psychosomatic component, some of which may indeed yield to a “mind over matter” approach. When John E. Sarno, a professor of rehabilitation medicine, published a book proposing that lower back pain was caused by repressed anger rather than a physical abnormality and that it was curable by mental exercises, thousands testified that they were helped, including the well-known health guru Andrew Weil.
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In contrast to the flimsy research linking attitude to cancer survival, there are scores of studies showing that happy or optimistic people are likely to be healthier than those who are sour-tempered and pessimistic. Most of these studies, however, only establish correlations and tell us nothing about causality: Are people healthy because they’re happy or happy because they’re healthy? To sort out which comes first, you need longitudinal studies carried out over time. Three such studies are cited frequently by positive psychologists, and none is exactly airtight.
One, the 2001 “nun study,” which Seligman calls “the most remarkable study of happiness and longevity ever done,” purports to show that happier nuns live longer than less happy ones—into their nineties as opposed to their seventies or eighties.
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The questionable thing here is the measure of happiness. In the early 1930s, when the nuns were about twenty-two years old, they had written brief sketches of their lives and commitment to the religious life. Some of these sketches contained a high “positive emotional content,” as judged by the researchers, with statements such as “I look forward with eager joy to receiving the Holy Habit of Our Lady and to a life of union with Love Divine.” As it turned out, the nuns who registered high in positive emotional content outlived the
ones who had written such matter-of-fact statements as “with God’s grace, I intend to do my best for our Order, for the spread of religion and for my personal sanctification.” But since not everyone is capable of expressing their emotions vividly in writing, there’s a leap between “positive emotional content” and subjective happiness. One might just as well conclude that the key to longevity lies in good writing, and an earlier study by one of the authors seemed to suggest just that: nuns who, in their youth, wrote complex sentences with high “idea density” turned out to be less likely to succumb to Alzheimer’s disease in old age.
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A second longitudinal study, also cited by Seligman at the beginning of
Authentic Happiness
, does not even bear directly on the proposition that happiness leads to better health. In this case, happiness was measured by the apparent authenticity of smiles. Poring over the class photos in two mid-twentieth-century yearbooks for Mills College, a private liberal arts school for women, the researchers found that about half the young women smiled “authentically,” with eyes crinkled and the corners of their mouths turned up, and that decades later these happy smilers reported being more happily married and generally satisfied with their lives. Whatever the relevance of this finding, it could not be replicated in a similar study of high school yearbook pictures from Wisconsin.
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For the less elite population in the high school photos, happy smiles did not predict happy lives.
Finally, the positive psychologists like to cite a study of older Mexican Americans—sixty-five and up—that found that people who reported being happy were likely to live longer and experience less frailty than those who did not.
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In
Authentic Happiness
, Seligman writes that this study, combined with the nun and Mills College studies, creates “an unambiguous picture of happiness as a prolonger of life and improver of health.”
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But even here, a question can be raised. The study controlled for income, education,
weight, smoking, and drinking but not for physical activity, which is a known predictor of health and strength in old age. It could be that the happier Mexican Americans were healthier simply because they were more likely to walk, dance, exercise, or engage in physical labor—a possibility that one of the authors of the study tells me they are now looking into.
Adding further ambiguity to the “picture of happiness as a prolonger of life and improver of health” are a number of studies showing that happiness or other positive emotional states may have no effect on one’s health. As we saw in chapter 1, an improved mental outlook—generated in support groups or through psychotherapy—does not extend the lives of breast cancer patients, and the same has been found for those suffering from throat and neck cancer. Nor, it turns out, does optimism add to the longevity of lung cancer patients.
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The evidence that positive emotions can protect against coronary heart disease seems sturdier, although I am not in a position to evaluate it. At least a list of articles on heart disease and emotional states compiled for me by Seligman included a number of studies finding that optimism and other positive states can both protect against heart disease and hasten recovery from it.
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But others on Seligman’s list were more equivocal, and one study cited by Barbara Held found that people high in “trait negative affect” do more complaining about angina but are at no greater risk of pathology than cheerful people.
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Some of the studies Held has reviewed even conclude that negative traits like pessimism can be healthier in the long run than optimism and happiness.
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For example, a 2002 study found that women who are mildly depressed are more likely to live longer than nondepressed or very depressed women. Somewhat alarmingly, a longitudinal study of more than a thousand California schoolchildren concluded that optimism was likely to lead to an earlier death in middle or old age, possibly because the optimistic
people took more risks. Another, more recent, study found that preteenagers who were realistic about their standing among their peers were less likely to become depressed than those who held positive illusions about their popularity.
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But the most surprising case for pessimism comes from a 2001 study coauthored by Seligman himself, finding that, among older people, pessimists were less likely to fall into depression following a negative life event such as the death of a family member.
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This study goes unmentioned in
Authentic Happiness
, but at the time it led Seligman to comment to the
New York Times
that “it’s important that optimism not be footless [probably meaning “footloose”] and unwarranted.”
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So realism has its uses after all.
But the results that go out to the public through the media tend to be spun toward the positive effects of positive emotions on health. Partly, this represents a long-standing media bias away from “null results”: a study finding, for example, that there is no sex difference in the ability to sprint or solve quadratic equations is likely to be judged less newsworthy than a study reporting that one sex left the other in the dust. In the case of positive psychology, a 2002
New York Times
article cited two studies linking optimism to longevity—and four studies tracing longevity to such other traits as “conscientiousness,” calmness, pessimism, and even cantankerousness. Yet the article was headlined “Power of Positive Thinking Extends, It Seems, to Aging.”
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Some positive psychologists acknowledge the pressure to feed the media positive-sounding results, with the editors of the
Handbook of Positive Psychology
warning that:
In the excitement that may be associated with this new and invigorating approach [positive psychology], it may be tempting to overextrapolate so as to convey a sense of the progress that is being made. This can be
even more possible when a person from the news media is almost putting words in our mouths about the supposed discoveries and advances that already have occurred.
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The positive spin on positive psychology cannot be blamed entirely on overeager reporters. Consider a 2005 review article entitled “Does Positive Affect Influence Health?,” the summary of which says in its entirety:
This review highlights consistent patterns in the literature associating positive affect (PA) and physical health. However, it also raises serious conceptual and methodological reservations. Evidence suggests an association of trait PA and lower morbidity and of state and trait PA and decreased symptoms and pain. Trait PA is also associated with increased longevity among older community-dwelling individuals. The literature on PA and surviving serious illness is inconsistent. Experimentally inducing intense bouts of activated state PA triggers short-term rises in physiological arousal and associated (potentially harmful) effects on immune, cardiovascular, and pulmonary function. However, arousing effects of state PA are not generally found in naturalistic ambulatory studies in which bouts of PA are typically less intense and often associated with health protective responses. A theoretical framework to guide further study is proposed.
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Yet when asked in an interview to “summarize the significance of your paper in layman’s terms,” the authors set aside all their “reservations”
and concerns about “inconsistent” literature and “potentially harmful” effects to respond cheerily that “the paper provides preliminary evidence that persons who more often experience positive emotions such as happiness, enthusiasm, and calmness, are less likely to develop a range of diseases, live longer, and experience fewer symptoms and less pain.”
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Another case of positive self-spinning is provided by Suzanne Segerstrom, a researcher at the University of Kentucky, who won the 2002 Templeton Foundation Award for Positive Psychology for her work on what may be the holy grail of positive psychology—the possible link between positive emotions and the immune system. Although the immune system plays no clear role in cancer, it is definitely important in fighting off colds and other infectious illnesses. Whether there is a link between positive emotions and the immune system is another matter. Martin Seligman asserts such a link, writing that “happy people” have “feistier immune systems than less happy people.” In a 1998 paper, Segerstrom reported that optimism was correlated with greater immune competence, as measured by levels of key immune cell types. But in a second study, published three years later, she found that “some contradictory findings have emerged” and that, in some circumstances, more optimistic people “fare worse immunologically” than pessimists.
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You would not know, however, that her results were negative or at best “mixed” from reading her newspaper accounts of her work. In a 2002 interview with the
New York Daily News
, she stated that the health benefits of optimism are “significant” and that not only do “optimists almost always have better emotional adjustments,” but “most optimists show higher immune responses to illness.”
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When I interviewed Segerstrom by phone in 2007, she insisted that she had been under no pressure from the media, or anyone else, to
downplay her negative results. But when I brought up her award a little later on in our talk, she told me, “To get the Templeton award . . . You don’t get anything for a null result.”
The Templeton Connection
The Templeton Foundation, which contributed $2.2 million to Seligman’s Positive Psychology Center in the first decade of the twenty-first century, as well as about $1.3 million to miscellaneous positive-psychology research projects on such matters as gratitude, humility, and connectedness, is probably best known for its efforts to put religion on an equal intellectual footing with science. Founded by billionaire investor Sir John Templeton in 1972, the foundation gives out an annual Templeton Prize for Progress in Religion, which was designed to fill a gap left by the Nobel prizes and pointedly pays more than they do. (In 2002, perhaps reflecting a certain lack of progress in religion, it was renamed the Templeton Prize for Progress toward Research or Discoveries about Spiritual Realities.) The foundation’s campaign to bring scientific legitimacy to religion has led to some dubious ventures, including funding in 1999 for a conference on intelligent design as an alternative to evolution. More cautiously, in recent years, the foundation has backed away from intelligent design and expressed its “spiritual” orientation through funding for research into the efficacy of prayer—another null result—as well as various abstract qualities like “character” and “humility.” Until his death in 2008, Sir John Templeton was fond of bringing scientists and theologians together with the aim of finding common ground in luxurious tropical resorts.