"I thought I should always be positive with my patients – until I found out how damaging that can be", article by palliative care doctor

"In my early years as a doctor, I thought it was my role to be positive, sometimes overly positive, with patients and their next of kin, reassuring them of a low likelihood of my worst suspicions being confirmed. Yet I started to find myself regretting what I had said, especially when a hunch became a reality. “I wish you’d told us this might happen so we could prepare,” was one of the comments that would come back."


"There is a lot of pressure to be positive these days. Some people even regard it as a form of wellness treatment in itself and warn of the potential dangers of “allowing negativity into their lives”. But such enforced optimism ignores the realities of our existence. Some patients seem to think negativity will shorten their lives. But researchers in different studies have tested the hypothesis that optimism can impact survival in cancer patients and have found that it does not have an impact. In one of these studies, there was a suggestion that encouraging patients to be positive perhaps even represents an additional burden.

Whether you have terminal cancer or not, believing everything must stay positive just isn’t sustainable. It needs to be balanced with realism. An expectation that outcomes will and must always conclude well can in itself create disappointment and anxiety – because, at some level, we know that we cannot guarantee those wishes will come true."

More at https://www.theguardian.com/commentisfree/2023/jun/19/positive-patients-damaging-upbeat-honesty

 

Relentless positivity is as bad as relentless negativity, in any context. What I want from doctors is honesty, not something fake.

 

It took three years before I got a diagnosis of ME/CFS. Doctors I met before that often tried to reassure me with comments such as "don't worry" and "I wouldn't worry if I were you". I think it is cruel to give the patient the impression that everything will be fine and instead let the patient slowly realize that the doctors were not telling the truth and that the conditions for the rest of their lives have changed. The doctors are looking for an easy way out so they don't have to be confronted with the patient's worry and sadness in a difficult situation. Not to mention the phony ideas that patients may recover by having a positive attitude. These are all examples of toxic positivity and are not helpful for patients in any way.

 

And THAT is why we have BPS medicine: to give providers a way to not have to deal with the discomfort that comes when they can't actually do much for their patients (which, unfortunately, is more often than we'd like to think it is). Instead of teaching providers how to manage those very real, legitimate emotions, BPS medicine allows them to fob patients off into highly structured programs of gaslighting to ostensibly help the patients with their "emotional distress."