Stop Being So Fucking Positive!

A 5-minute read on why being negative, worried, and even pessimistic isn't always a bad thing.

Somewhere, somehow, physios and many other healthcare professionals seem to have become overly obsessed with being positive and optimistic.

Don't get me wrong. I'm all for encouraging people and helping them see a brighter future… but… and this is a big fucking but… at the right time and place.

I think the relentless obsession that many healthcare professionals have with being positive all the time can actually be unhelpful, unrealistic, often downright annoying, frustrating, and even detrimental to some people's recovery.

Because, newsflash... it's perfectly normal to feel negative about a negative situation!

In fact, being negative, pessimistic, worried, frustrated, angry, and upset is completely reasonable, rational, and helpful right now.

My Reality Check

As some of you know, I've recently undergone surgery to correct a congenital obstruction in my right kidney.

After months of renal pain, hospital admissions, scans, stents, uncertainty, and various unpleasant experiences, I finally had the operation a few days ago to hopefully sort things out. 

But to add some extra fuckery to the whole process, they discovered my stent, inserted 6 months ago and designed to help with the kidney blockage, was also severely blocked and had developed a golf ball-sized deposit around its end that was rattling around my bladder and causing some problems getting it out. 

Apparently, my urinary tract had decided to start growing its own fucking quarry! 

Anyway, throughout this whole experience, I've had plenty of negative experiences, thoughts and emotions. 

I've been worried about the surgery, frustrated by the setbacks, pissed off about the pain, and concerned about the recovery. 

And the last thing I need during these times is some well-meaning, keen, positive, enthusiastic young physio or doctor cheerily telling me to… “look on the bright side” or to… “try to stay positive”… or that “everything will be fine”.

Annoying

Many physios and other healthcare professionals have this really annoying habit of trying to improve how someone feels, without first understanding and validating why someone feels that way! 

I know this because I see and hear it happening a lot. But also, because I used to do this. I don’t anymore.

When someone expresses to me negativity or pessimism about their current situation or future, I simply acknowledge it and leave it at that. 

If someone tells me they feel like shit and can’t be bothered about doing anything about it… I say… that’s ok, that’s perfectly understandable.

When life is feeling shit, people often need others to be understanding and to acknowledge that what they are going through is actually... pretty shit. 

What they don’t need is some happy clappy “its gonna be ok” positivity energiser bunny, telling them its going to be ok, and to look on the bright side.

In fact, that can fuck right off!!

Negativity and Pessimism aren't the Enemy! 

We often treat negative and pessimistic thinking as something that needs identifying, challenging, correcting, or eliminating. 

But negative thoughts and emotions aren't necessarily signs of psychological problems, barriers or dysfunctions. 

Sometimes they're just perfectly normal and appropriate responses to difficult circumstances. 

Fear can make us cautious.

Frustration can motivate change. 

Anger can help us recognise unacceptable situations. 

And pessimism can help us anticipate difficulties, prepare for setbacks, and develop contingency plans. 

In fact, there's even some research into something called defensive pessimism, showing that for some people, anticipating potential problems can help them manage anxiety and prepare more effectively (ref).

Now this is not to say pessimism is always helpful, or that catastrophising and endlessly dwelling on worst-case scenarios are good strategies. 

They're not. 

But neither is blindly assuming everything will be great, wonderful and rosy while ignoring genuine problems. 

There's a big fucking difference between being realistically pessimistic and being irrationally catastrophic! 

The Problem with Positivity!

Research also suggests that acknowledging and accepting negative thoughts and emotions, rather than constantly judging, resisting, or suppressing them, is associated with better psychological well-being (ref, ref)

Yet in rehabilitation, we can make patients feel that being worried, upset, or pessimistic is somehow wrong or detrimental. 

We tell them their attitudes are holding them back. 

That they need to change their mindset. 

That they need to believe they'll get better. 

And this can make people feel guilty or ashamed for having entirely normal, reasonable emotional reactions or for feeling negative and pessimistic. 

Essentially, we give them another problem to worry about… worrying about being worried! 

And that's not helpful 

What Good Rehab Should Do?

Good rehabilitation should help people recognise that negativity and pessimism are both normal and natural, and help people develop the capacity to deal with these emotions.

Not immediately try to change them, or worse, pretend they don't exist by ignoring them or sweeping them under the carpet. 

We should help people distinguish between normal, realistic concerns from exaggerated threats, and to continue to do meaningful things even when they're feeling unwilling, uncertain, or downright miserable. 

Sometimes this involves acknowledging that things are really shit, hard and difficult, and that their outcomes are not guaranteed, and their recovery will be long, frustrating, and unpredictable. 

Because people can be pessimistic and still be proactive. 

And people can feel negative and still make good progress. 

My Main Message!

To patients: You don't have to feel positive all the time. You're allowed to be fucked off, frustrated, angry, disappointed, and occasionally think everything is really shit. Because often it is. 

To clinicians: Stop treating every negative thought or emotion as something that needs fixing or correcting. Your job is not to turn everyone into a relentlessly optimistic, happy-clappy robot. 

Good rehabilitation isn't about making people feel better and positive all the time. 

It's about supporting and helping people when they feel less than positive, often just by acknowledging and validating it.

And that, in my opinion, is far more useful than any amount of motivational happy-clappy toxic positivity bullshit.

As always, thanks for reading...

Adam

Aka the grumpy, realistic, occasionally negative rehab curmudgeon!