Hope is Healthy
You are about to go to the hospital for a routine surgical procedure. Which attitude is healthier?
A. "I'd better find out everything I can about this operation—you can never know too much. "
B. "Don't tell me the details. It's going to be fine. "
Answer B is supposed to be the wrong one. It's an example of what psychologists call "denial," a defence mechanism that minimizes uncomfortable information. Denial, they have argued, is stupid, self-defeating and ultimately dangerous.
But research is showing that answer B is a faster route to recovery. Denial—of a certain sort and at certain times—can be healthy. Of course, you do need to pay attention to some unpleasant facts. The trick is to know when it's helpful to worry and when it's counterproductive.
Out-and-out denial may be the best approach to surgery, according to Richard S. Lazarus, professor of psychology at the University of California at Berkeley. With Frances Cohen, Lazarus studied 61 patients about to undergo operations (all relatively common operations). In general, patients followed one of two mental strategies; "avoidance" or "vigilance. "
Typically, avoiders had not discussed their surgery in detail with anyone, didn't want to know about it and didn't dwell upon its risks.
In contrast, vigilant types were alert to every detail. Many sought out articles about their disorders. They wanted to know the risks of surgery, the risks if surgery was not performed, the surgical procedures, the potential complications and the likelihood of recurrence.
When Lazarus and Cohen compared the two groups after surgery, they found that avoiders got on much better. They had a lower incidence of postoperative complications such as nausea (恶心), headache, fever and infection. The net result: they were discharged sooner.
One reason may be that their denial make room for hope, or at least for a positive outlook, even under the grimmest of conditions. "Never deny the diagnosis, but do deny the negative opinion that may go with it," advises Norman Cousins, author of Anatomy of an Illness and The Healing Heart. Why? Because grim warnings about diseases come from statistics on the average case. Cousins believes that most patients, given hope and determination, have a good chance to transcend the averages.
Adds Dr. Hackett: "Deniers see the machines they're hooked up to as helping them to get well, not as a sign of a badly functioning heart. Those who feel most positive about their ability to get well tend to do better than those who fear and worry more. "
Of course, none of these researchers would conclude that denial is the best approach to all medical matters. A diabetic must monitor blood sugar; a kidney patient must keep track of dialysis (透析) ; a woman who finds a lump in her breast must not delay in having it diagnosed.
The question to ask yourself, Dr. Lazarus explains, is whether the information you gather will help you solve a problem, or whether there is little you can do to change things. In the first case, pay attention and act. In the second case, don't become preoccupied with the risks; anxiety can worsen your health.
Dr. Herbert Benson, associate professor of medicine at Harvard Medical School, points out that the overly vigilant patient's central nervous system becomes aroused into the fight-or-flight response. But since all the patient can do is lie there, his body suffers the classic damages of stress.
While studying people's reactions to medical stress, Temple University psychologist Suzanne Miller and University of Pennsylvania gynecologic oncologist (妇科肿瘤学 ) Charles E. Mangan placed 40 women about to undergo colposcopy (阴道镜检查) in two different groups, according to their coping style.
Miller's main interest was to see whether any of these women would cope better if they had extra information. She gave half of each group voluminous details about what would happen and how they would feel; she gave the rest only the basic facts. Overall, the results reinforced the benefits of avoidance. The women given minimal information felt more relaxed throughout the procedure than the women who knew more. (Oddly enough, the group desiring information complained that they would have liked even more. The very act of gathering details seemed to make them less anxious. )
Miller's research shows that different people react to news about their situations in very different ways. That means, she suggests, that people should seek as much or as little information as their individual coping style dictates.
Does the research on denial mean we should regress (倒退) to the days when physicians used to say, "Don't tell patients anything, because they don't really want to know?" Hardly. People have a right to know what is going to happen to them, and to take part in decisions about their treatment. But patients can get necessary information without learning a lot of nerve-racking details they don't need.
For example, a physician can say: "You have a suspicious Pap test. The next procedure is called colposcopy; it will take fifteen minutes. " The doctor doesn't need to describe everything a colposcope does, feels like or might find. Similarly, a woman should seek all the options if she has a suspicious Pap test, but once she makes a decision, she should not be obsessed about it.
You could summarize the research in a set of guidelines:
• In general, it is best to block out medical threats and worries when there is nothing you can do about them—say, after you've decided to undergo surgery. Don't dwell on all that could go wrong or visualize every fearful detail; concentrate instead on what is likely to go right.
• Be vigilant about matters that you can control, such as paying attention to signs of illness.
• Find out your personal disposition to avoid details or to acquire all information possible, and let your own inclination be your guide—but only up to a point. "Many of those who gather any and all facts are putting themselves through more stress than they need to," Miller says. She advises them to learn when their approach will only increase their anxiety. In those cases, they'd do better to turn off their radar. On the other hand, avoiders should recognize when it is valuable to gather more facts than they might like to.
The basic advice is clear: don't feel guilty if you decide to take the rosy view. Concentrating on the positive turns out to be medically sound.
1. It is suggested in the passage that if you were a vigilant patient, you should learn to adopt a new strategy of avoidance because it brings you less stress.
2. The doctors are discovering that the best medicine is often simply to deny the worst and expect the best.
3. Miller divided the women patients into two groups at will and provided each group with either detailed or basic information in order to find out who would get on better.
4. Based on the findings of the researches, doctors find it hard to decide whether they should tell patients anything about their illness.
5. Psychologists have changed their opinion that it is stupid and dangerous for people to deny uncomfortable information.
6. A tip for both deniers and vigilant patients is: avoid details or acquire much information following your own coping style, but only to a certain point.
7. It is unnecessary for patients to get information about their disorders because there is nothing they can do about their illness.
8. Patients generally fall into two groups: _______and_______.
9. "A diabetic must monitor blood sugar;" helps explain that_______to all cases.
10. All patients should pay attention to_______.
I. N 2. Y 3. N 4. N 5. NG 6. Y 7. N
8. avoiders, deniers 9. denial is not the best approach 10. signs of illness
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