Bright Sided; By Barbara Ehrenreich A Review

Over this past week I had the chance to read the latest book by Barbara Ehrenreich; Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America. The book is well arranged in chapter headings that address every area of American society. The "Positive Thinking" movement, she believes, has taken hold and influenced American culture, from medicine, to politics, to business, to the world of religion, even shaping the way we practice psychology.

Ehrenreich traces the history of the Positive Thinking movement to late nineteenth and early twentieth-century writers like Phineas Parkhurst Quimby and Mary Baker Eddy and the "New Thought Movement." The New Thought Movement sought to challenge the older established ideas of Calvinism, which taught predestination set forth by a God who offered heaven to only a limited few. Calvinists were often depressed, fearful about their futures and consumed by thoughts of eternal hell and damnation. They valued hard work and spent their days laboring, toiling and contemplating their relationship with God the way a rejected suitor contemplates unrequited love--forever exiled from the source of their affection . The nineteenth century Calvinist suffered from chronic depression and a sense of powerlessness and hopelessness that must have made the New Thought Movement wildly appealing.

Bright Sided interested me for a number of reasons. Namely, it made me contemplate how cultural beliefs can impact our views about medicine, and possibly even lead to bias in medical research. For example, Ehrenreich suggests, in a position that would be challenged by many in the American medical community, that there is no scientific evidence that positive thinking can increase a cancer patient's survival time. In a meta-analysis conducted by James Coyne in 2007, Coyne concluded that a person's attitude had no significant effect on a patient's life expectancy. Furthermore, Ehrenreich points out the added burden on the patient to remain "positive" in the face of serious illness may place undo stress and burdens on people already riddled with more than enough challenges to face.

Positive thinking, as a dogma, also gives birth to the idea that our attitudes can impact our health, financial status, and quality of life--that a person who thinks positive thoughts is more likely to be successful in business and live a longer, healthier, and more productive life. However, this view also holds that people who are burdened with chronic disease, poverty, or a lack of nurturing relationships in their life have brought these burdens on themselves through their own "negativity". This dark side of the positive thinking movement has lead to victim blame, and, in some cases, to terminally ill patients being asked to leave cancer support groups when their conditions did not improve. The idea that personal circumstances are solely one's own fault could even be argued to have had an impact on how social policies are formed in Washington and on how business and even medicine is currently practiced in the United States. Certainly, America's fascination with Positive Thinking has made its way into the world of medical research and makes for an interesting conversation about cultural bias and how data is collected.

As a student of Anthropology at the University of Washington, I took a fascinating course on Medical Anthropology which examined how cultural biases can impact medicine . At one point in the course, we examined the American Psychiatric Association's Statistical Manual of Mental Disorders, referred to then as the DSM-III. After browsing the definition for depression, one student from Sri Lanka quipped, "according to this definition everyone in my country is clinically depressed." According to the DSM-III, in order to be diagnosed as clinically depressed, you must meet six out of eight symptoms criteria. Unfortunately for many American middle-aged women, many of those symptoms just also happen to be the same symptoms commonly found in menopausal women, such as problems with concentration, weight fluctuations, sleep disturbances ,and declining libido.

I can't help but notice that Prozac, which was released by the Eli Lily and Company in 1988, entered the pharmaceuticals market at the height of the Yuppie movement. Once released it quickly reached sales of several million prescriptions annually (currently, Americans account for 75% of all anti-depressants prescribed in the entire world--making anti-depressants the most widely prescribed drugs in America). Prozac was released on the heals of the Self Help craze in America and during the rise in America's love affair with Positive Thinking, and during a time when millionaires often claimed that it was their positive attitudes that had made them fabulously wealthy.

In 1988 Ronald Reagan was serving his final year in office, Trump had made the New York Times best seller list, Dallas was the top rated TV show, and Americans were learning that a hefty dose of thinking positive thoughts could not only make you rich, but made you more of an American as well. To be an American meant optimism and a "can do" attitude. If you deviated from that world view you could be fixed, albeit with pharmaceuticals, which allowed you to keep in step with America's positive world view. If you could not share that world view you were seen as 'negative", "depressed', and quite possibly in need of medications. Ehrenreich asks, "are Americans really happier, or is it the anti-depressant medications they are taking that is only making them think they are happier then everybody else?" She presents a strong case that we are a seriously ill nation, deeply troubled and depressed; that choices to ignore our deep-seated problems by sugar-coating them with forced optimism often lead to our detriment. In fact, when economists rate nations for health and quality of life in indices such as the Happy Planet Index, we are ranked a dismal 150. We are a nation riddled with high incarceration rates, economic disparities, inadequate health care, and a collapsing educational system.

Ehrenreich does not suggest America's future is hopeless. Rather, she argues that without hard work, and without steely-eyed realism about our current situation, things are likely to get steadily worse rather then better. She presents, I would argue, an adult view of the world, more in keeping with a European mind-set then an American one. But it is a view many Americans may finally be willing to embrace. Her book, perhaps in light of the current dismal economic environment, is likely to be her most successful to date.

Survivers of Child Abuse May Age Faster

The devastating and long term consequences of child abuse may extend beyond just emotional trauma. There is now evidence that survivors of child abuse may also be at greater risk of aging quickly. According to a recent report published by the BBC, people who experienced abuse in childhood may be at greater risk of high stress; which can be a contributing factor in aging.
http://news.bbc.co.uk/2/hi/health/8369919.stm

Names of the Dead

I have been very impressed of late by Congressman Alan Grayson of Florida's relentless efforts to see that the Public Health Care Bill is signed into law. For anyone interested in how they might help and or share their stories of friends and love ones who died due to lack of health care please go to the following pages.
http://namesofthedead.com/

Depression Linked to processed foods

A recent BBC article on the link between depression and processed food, points out an important correlation between poor nutrition and emotional well being. For Naturopathic doctors, this comes as no surprise. We understand that good nutrition is necessary for emotional and physical well being and the natural processes that allow for mental health. For example, in order for proper formation of neurotransmitters we need proper nutrition. We also need proper nutrition for blood sugar regulation. When our blood sugar is unsable, we can become anxious, tired and depressed.
It is sad that far too often when depression is treated in by physicians, important questions about diet and lifestyle are rarely addressed, and often the first suggestion is the use of pharmaceutical medications. In many of these cases, I have seen simple diet changes and nutritional support have remarkable impacts on mental health and well being.
http://news.bbc.co.uk/2/hi/health/8334353.stm