No great hope

A few years ago, social historian and author Barbara Ehrenreich was diagnosed with breast cancer. She wrote about the incessant go-girl, pink-ribbon culture that greeted her upon diagnosis, a heal-thyself community in which she was told to "fight back," as if cancer were confrontable: a schoolyard bully, a bad neighbour. For her, there was little comfort in thinking positively, wearing a pink T-shirt and speed-walking for research dollars. "Fight back" was the wrong thing to say.

But what is the right thing to say to a friend in crisis? I remember when my close friend K. watched the dizzy, hopeful months of pregnancy turn grim, ending in a complicated C-section and a severely premature baby. As I listened to K. on the phone from her hospital room, three months before she should have been there, I feebly scrambled for pen and paper, looking for something tangible: I'll Google this. I'll gather information. I'll make food. And I bit my tongue not to say what I wanted to be true: It's going to be all right.

The very real possibility hovered that it might not be all right. As my friend went through weeks and months agonizing over her child's health, and advocating for her with inspiring fierceness, she grew frustrated at the stream of well-intentioned people who told her to "think positive." Her miasma of guilt and confusion – Did I cause this? Am I a bad mother? What will our future look like? – couldn't be conquered by a sunny outlook. Good thoughts don't close a hole in a one-pound baby's heart.

Yes, some studies have shown that stressed-out people are more susceptible to colds and flu, and a multi-million dollar self-help industry is based on the idea that thinking positively actually improves health and happiness. But much of this research relies on self-reporting from subjects, and your idea of happiness might be quite different from mine. In fact, a 2002 study found that mildly depressed women actually live longer than non-depressed or more severely depressed women. Now some mental-health professionals are suggesting that exhorting people in crisis to adopt a silver-lining attitude dumps another kind of burden on their half-broken backs. Barbara Held, professor of psychology at Bowdoin College, calls this "the tyranny of the positive attitude": The 24-hour sleep-deprived, breastfeeding, doctor-fighting, all-consuming care you're providing for your sick baby is okay, but a sunny outlook would really increase her chances of survival. On the other side of this seemingly benign advice is a hiss of blame: If you don't creak out that smile, and she gets sicker, whose fault is that, hmm?

Giving in to sadness is looked upon as weakness, and weakness is uncomfortably close to death. Ehrenreich wondered what the breast-cancer culture (which she called a cult) said about those who succumbed to illness: "Did we who live 'fight' harder than those who've died? Can we claim to be 'braver,' better, people than the dead? And why is there no room in this cult for some gracious acceptance of death, when the time comes, which it surely will?"

Our fear of joining the dead – the pitiable, defeated dead? – rouses us to think positively. Of course, we need optimism to live, and at heart, most of us believe the world is good and babies will be healthy. We believe these things because usually, they're true. But not always. Do-it-yourself happiness is a pastime of those who are well and, as such, can control their futures to some degree. When I think of my impulse to tell K., "Everything will be fine," I realize the phrase would only comfort me, confirming that my ordered life and healthy kids would remain in this world, untouched, while my friend was somewhere else, just outside the living.

That premature baby is now a hilarious, healthy toddler who does a mean duck impression. When I ask K. what she would have liked to have heard during those early days of illness, she says the words that comforted her were "How unfair." Accepting the idea that some events are uncontrollable isn't weakness. Perhaps recognizing the injustice of tragedy actually produces a will to go on. "How unfair" may not spur a friend to rail against the great wrong, but it may help her to wake up every morning. Maybe that's not positive thinking, but sometimes, it's enough.