Remaining hopeful amid all the violence of war is an increasing challenge. But as a well-known psychiatrist often repeats, it may not be necessary to jump out of bed every day with joy and embrace the world while yodelling. Sometimes life and the world are just miserable. Or much worse. Acting forcibly optimistic and expecting the same from others can actually have negative effects, as research has even shown.
Because then you suppress everything that is not exclusively positive and that is not exactly psychologically healthy. It can isolate you and lead to shame or make dealing with what is really negative extra difficult. One study even shows that people who suppressed their negative feelings and agreed with statements like “I try to be nice so that others don’t get upset” were more likely to die from any cause, including cancer, during the study period .
And yet there is also science that advocates optimism. The Dutch Erik Scherder, clinical neuropsychologist, and cardiologist Leonard Hofstra, for example, serve in their book Hope for heart and brain the most relevant recent studies on how hope literally makes you live. Optimism makes people live longer and increases chances of recovery and humor has a pain-relieving effect, among other things.
An example: “In Utrecht, where I have my clinic, there are two neighborhoods that are close to each other: the residents of Overvecht have a low social profile, and middle-class people live in Tuindorp,” says Hofstra. “The geographical distance is minimal – barely a hundred meters – but in healthy years the distance is twelve years. The people in Overvecht therefore become ill on average twelve years earlier than the residents of Tuindorp. That is an immense difference. That also means that the ‘soft’ side of health – is there hope, optimism, stress, bad news, fear, financial worries, security in our lives? − has an immense impact on our physical well-being.”
The most optimistic people even appear to have a 50 percent lower risk of a heart attack, partly because they take better care of themselves and surround themselves better socially.
But Hofstra and Scherder do emphasize that all this “absolutely does not” mean that people who do not recover from illness or die were ‘not positive enough’. “Hope does not heal, that is what we say in the book,” says Scherder. Optimism can make or keep you healthier, but it does not protect you from illness or death. That is an important nuance. Certainly also for patients, who are sometimes bombarded with ‘shut up, you have to fight’, while it has never been established that combative and positive thoughts actually cause cancer cells to shrivel. That is why oncologist Siddhartha Mukherjee (Columbia University), who won the Pulitzer Prize in 2011 with The emperor of all diseases: a biography of cancerthe idea that you have to fight against cancer is consistently ‘dirty’, because you feed the already overwhelmed patient with the idea that healing depends on him or her, which if you look at the science, is a myth.
As an example of how emotions have an impact on our health, Hofstra and Scherder also mention broken heart syndrome. “If someone is under immense stress, they can suffer from the Takotsubo effect: due to a huge adrenaline peak, part of the heart stops completely. These people arrive at the hospital with chest pain, the ECG shows a very abnormal heart graph. We usually think of a heart attack, but when we look at the coronary arteries with a catheter, they appear to be completely clear. Yet part of their hearts is literally broken.”
It is equally remarkable that it is almost only women over fifty who have to deal with this phenomenon. Another top doctor, cardiologist Pedro Brugada, explains this. The passionate expert complains, among other things, that far too few people, including doctors, realize that more women than men die from cardiovascular disease and that women’s hearts also run other risks and develop other diseases. In addition, the symptoms of a heart attack in women may be different from the well-known ‘chest pain’. But women with heart problems receive less good help because these issues are not sufficiently known and because doctors are more likely to think that women’s complaints are related to their emotions.
“Several studies show that women with heart complaints are systematically less likely to receive the right care. A woman with heart problems is supposedly emotional, a man who clutches his chest immediately receives the right help. I find that really unimaginable,” says Brugada.
He would like to teach as many people as possible about the heart, especially because that knowledge can make a big difference. Some heart diseases are hereditary, but “everyone should realize that you can do a lot more for your heart than you think,” says the cardiologist. For example, exercising more, keeping an eye on your blood pressure and, above all, quitting smoking can make a huge difference. “Research on Vietnam veterans has shown that atherosclerosis (buildup of plaque in the arteries, which can endanger the heart) starts to build up as early as the age of 20. So start taking care of your heart early. This means that in your twenties you already have your blood pressure and sugar levels measured.”
This doctor also comes with an optimistic message: the insight that you can ensure good heart health yourself. It is in line with the many health advice that eagerly receives attention from the online reader. What we should eat, how much we should exercise and sleep, what we can do to prevent aging: many people are very interested in this.
‘Eight advice from scientists to slow down the aging process’, ‘Are you really healthy? These new tests offer you the ultimate check up’, ‘Why a Mediterranean diet is good for your skin’ and ‘What impact does age have on what you should eat?’ are all newspaper articles that are devoured. On the website of the popular science magazine New Scientist it is also noticeable at the moment: three of the first nine articles you see are about how you can boost your health. As if sophisticated care for our own body, so that we at least try to keep ourselves as intact as possible, gives us a much-needed positive sense of action and control in a world full of misery over which we have increasingly less control.
What we can classify as junk are all nutritional supplements, probiotics, detoxes and other treatments, says Danny De Looze (UZ Ghent), also a top doctor and official gastrointestinal and liver doctor. In his new book he sings about the ‘beauty of our intestines’. His answer to the question of what we can do ourselves for the health of our intestines can also be summarized in the evergreen ‘eating healthy and exercising more’. “You actually don’t have to do much for your intestines: it is a system that maintains itself,” says De Looze. “The only thing that really helps – unless you have irritable bowel syndrome – is eating fiber. This is not only food for your microbiome, fiber also ensures better transit. In addition, you are much less likely to be obese, which ultimately leads to fewer cancers and cardiovascular problems. Exercise is also an underestimated tip. This activates your intestines and it would also be good for your microbiome. I know, I’m kicking open doors here. Ultimately, we all know what is good for us, we just don’t always find it easy.”
That last sentence is telling: health advice usually comes down to those well-known recipes of healthy eating and sufficient exercise and not sitting still too much. You can then supplement that with personal dadas. Those who care about animals and sustainability avoid chicken meat because industrial chickens lead a miserable life, the mega stables threaten public health and it is not efficient food production. This is explained by historian Dirk-Jan Verdonk in De Explofte Kip.
More difficult to estimate are the many reports about all kinds of risks to our health. Or, in the words of colleague Katrin Swartenbroux: “Do we really get cancer from everything?” The science editors recommend that anyone who is concerned about ‘possibly carcinogenic’ deodorants, meat products, varnish, woks or soft drinks read her essay on how to interpret such messages. “Because what does that really mean: possibly carcinogenic? That not all toothpastes with fluoride cause cancer? Or that not all people who use toothpaste with fluoride will get cancer? And what exactly does science want me to do with all that information about “possible carcinogens”? Embrace my morning breath? No longer letting my smartphone sleep in my bed? Never drink Diet Coke again?”
An important instinct, as we often notice here, is the confusion about absolute and relative risk percentages. Things still go wrong there regularly, including in press releases and newspaper articles. “When you read that ‘eating processed meat daily increases the risk of colon cancer by 18 percent’, this can quickly be interpreted as: if I eat a Bifi sausage daily, I have an 18 percent chance of developing colon cancer. While that 18 percent must of course be associated with your absolute risk of colon cancer, which depends on other factors such as your age or genetic makeup. And if your risk of a certain cancer is very small, then even a doubling of that risk is still very small,” Swartenbroux summarizes.
In other words, there is at least one type of news that we can tell you that usually makes you unnecessarily more pessimistic, anxious or desperate than necessary: news about health risks of all kinds where only those relative risks (’18 percent greater risk of colon cancer!’) to be mentioned.
The science editors