'Bright-Sided': When Happiness Doesn't Help When author Barbara Ehrenreich was diagnosed with breast cancer, she was bombarded with wildly optimistic, inspirational phrases. But a cheerful outlook, she argues, does not cure cancer. In her new book, Bright-Sided, Ehrenreich explores the negative effects of positive thinking.

'Bright-Sided': When Happiness Doesn't Help

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This is TALK OF THE NATION. I'm Neal Conan in Washington.

Barbara Ehrenreich is likely to upset a lot of people with her new book. It won't be the first time. She raised hackles a couple of years ago after a commencement speech at Haverford College called "The Apocalypse is Yours Now." And for her book "Nickel and Dimed," she went undercover to attack the belief that Americans can get by on a minimum-wage job. Her new book takes on, among other subjects, the cheerily optimistic world she entered after she was diagnosed with breast cancer in 2000, a world festooned with pink ribbons and teddy bears, where she writes: The overall tone is almost universally upbeat, and cheerfulness is required; dissent, a kind of treason.

This systematic optimism permeates American culture, she argues, and contributes to a kind of collective self-delusion. We're going to focus today on her story about cancer, and yours. What advice did you get about positive thinking after your diagnosis? Did it help or hurt? Our phone number: 800-989-8255. Email us: talk@npr.org. You can also join the conversation on our Web site. That's at npr.org; click on TALK OF THE NATION.

Later in the program, the brutal murder of a high school student in Chicago and the author of an op-ed titled "Snitch and You're a Dead Man." But first, Barbara Ehrenreich's latest, "Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America." The author joins us from our bureau in New York. Nice to have you back on TALK OF THE NATION.

Ms. BARBARA EHRENREICH (Author): Good to be with you, Neal.

CONAN: At one point, you write that you made an entry on a blog under the header called Angry, where you complained about the effects of the chemo, impossible insurance companies, environmental carcinogens and most daringly, you write, sappy pink ribbons. What kind of response did you get?

(Soundbite of laughter)

Ms. EHRENREICH: Well, see, I was really reaching out for support. I was looking for other people, other women in the same kind of situation and naturally, you would reach out and say, there's something wrong here, you know, what's the cause of this disease? How come so many people have it? I didn't go into a lengthy rant. I just said that much and I said, why are the treatments so barbaric, etc.? And I got back responses - well, a typical one said, Barb, you should run, not walk, to the nearest therapist. There's something, you know, really wrong with you.

(Soundbite of laughter)

Ms. EHRENREICH: And that's when I began to understand that the idea was that you will not recover from cancer unless you are cheerful and have a positive attitude about it. And this applies very heavily to breast cancer, but I think it's pretty ubiquitous in - you know, it can - it's been said about prostate cancer, too. So it's not only women here.

CONAN: And you say, in fact, after your diagnosis, you describe it as being recruited into positive thinking.

Ms. EHRENREICH: Well, you feel that way because it's everywhere you turn in the pink-ribbon breast cancer world, that, you know, be positive, this is - all right, this isn't so great, but pretty soon you're going to be a quote, survivor, and that'll be wonderful. And that you should, in fact, embrace this disease as something that will make you a better person, more evolved, more spiritual, more - I don't know - remember all the things it was supposed to do for me. So this - you know, actually, I recoiled. I was angry. I was not happy. I was not embracing the disease. And I have since learned that this is, you know, everywhere in our culture.

We're supposed to greet unemployment or a layoff as a wonderful, life-changing, growth opportunity. We're supposed to, you know, quickly recover from bereavement, etc., and think positively, move on to the next thing.

CONAN: Hmm-hmm. At one point, you say the most extreme form of this - and again, getting back to the cancer - is that the disease is a gift.

Ms. EHRENREICH: Yes. And you know, all I could think was, if that's your idea of a gift, get me off your Christmas list…

(Soundbite of laughter)

Ms. EHRENREICH: …you know, this is…

(Soundbite of laughter)

Ms. EHRENREICH: But that is very much said. It's been said about prostate cancer too, that - all with a good intention, that you will get better if you have this positive attitude.

CONAN: And you say that, in fact, there is a culture that focuses around the color pink and the race for the cure and other things, and teddy bears, which you describe as infantilizing. Nevertheless, what harm can it do? Positive thought can't hurt.

Ms. EHRENREICH: Well, I think my feeling at the time was I was angry, I was upset, and I didn't want to deny those feelings. I wanted to find other people who were sharing those feelings because that, you know, I think that's a natural human impulse to reach out. But when - if you're - if you reach out and all you're told is, oh, don't whine, there's nothing - you know, this is really a wonderful experience, put on a happy face, that hurts. I found it very hurtful. And I wrote about it, the experience at the time, and I did get a lot of feedback from women saying, thank God, you know, I had that too. Nobody - nobody wanted to hear anything about, you know, what I was going through. It's just, you know, smile and get over it.

CONAN: And the words we always hear about cancer are, you know, fighting a long battle against cancer. And you write, well, you know, some days you're not. You're just feeling terrible.

Ms. EHRENREICH: Well, I don't know exactly what you do to fight it. See, that's, you know, why it's sort of understandable that some people would get into this ideology of positive thinking through their disease. If you - you want to feel like you're doing something, and you're not doing much. Stuff is done to you, horrible stuff, but there's not much you can do. So I don't - I don't like to use that language of battling. And I don't call myself a survivor, either, because that seems to put down all the people who don't survive. And I just, you know, I'm a little luckier, that's all, or I had better treatment or something.

CONAN: So in some sense, those who die from the disease - which can be very, very, very bad - those who die are somehow failures.

Ms. EHRENREICH: That's what you - I would - I think is the implication of kind of glorifying the survivor. And I don't feel at all comfortable with that. Some wonderful people and brave women and - have died of breast cancer.

CONAN: We are talking with Barbara Ehrenreich, the writer and social critic, about her new book, "Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America," a world that she entered first after she got her diagnose of breast - diagnosis of breast cancer back in 2000. 800-989-8255, email us talk@npr.org. And Alan is on the line, calling from Fairfield in Iowa.

ALAN (Caller): Yes. I would like to agree with you on the point that it's ridiculous to have a positive mental attitude towards a low-success procedure. And for example, there are lots of things that are not in the standard medical armamentarium of treatments for cancer which work extremely well. And if a person wants to have a positive attitude, it would be very useful to have a positive attitude about finding something that is better than the standard treatment. That's…

(Soundbite of laughter)

ALAN: That's a good use for positive mental attitude. But if you're going to be, you know, cheerful and kind of marching to the tune of everybody else who is getting the standard stuff that doesn't work very well, that certainly is in line with, I think, what you're saying, is that it's dumb.


Ms. EHRENREICH: Well, but Alan…

ALAN: I'll give one example, very quick. There is research that was done at the University of Miami in Florida which shows that the ordinary antioxidant Coenzyme Q10, when applied with a topical penetrant to the breast or prostate, was effective in curing breast cancer and prostate cancer. Just a penetrant and Coenzyme Q10, which is an antioxidant, which eliminates a lot of the toxicity that was causing the cancer. I'm not aware that this is, you know, being widely adopted but this was, you know, very well-done research at the University of Miami, perfectly scientific.

Ms. EHRENREICH: Well, I'd like to see that research. See, I will not, you know, agree with you. We need to look at every possible form of approach to this disease, but why are you saying, then let's bring a positive mental attitude to that? I'd rather bring a critical mental spirit to that. I want to see the results on those Coenzyme Q studies, just as I should have looked closer at the results in chemotherapy.

ALAN: Oh, absolutely.

Ms. EHRENREICH: Yeah, that's all I'm saying.

ALAN: Yeah, well, the reason I mentioned it was because it was, so far as I know, very good-quality scientific research and, you know, it produced an alternative approach, which…

CONAN: Well, Alan, I think you'd also have to agree, though, that a lot of alternative, quote-unquote, approaches are, well, nonsense.

ALAN: Certainly, there's a lot of nonsense that is promoted. But that doesn't mean that everything alternative is nonsense. You have to be intelligent about it and look and see what does make sense, what is proven, what does produce results and what doesn't.

Ms. EHRENREICH: I completely agree about that, Alan. I just think that when you're telling people who are ill or who have suffered through something like a layoff that they have to be positive and put on a smiley face about it, that's like adding an additional burden to their suffering.

ALAN: I would agree with you totally, and there is an awful lot of not good stuff going on in the economy right now, which we should not be Pollyanna about.

CONAN: Alan, thanks very much for the call, appreciate it.

ALAN: You're welcome.

CONAN: Here's an email we have from Mary(ph) in Portland, Oregon. I have avoided the pink-ribbon group, refusing to be part of runs for the cure, survivors meeting, etc. Yes, they do good. They are not what I need or needed. I refuse to buy anything pink. I gave at the operating room, and I have the scar to prove it. I stayed positive but not necessarily cheerful. I was in a fight, and cheeriness was not what was needed. I did not watch the funny movies, TV series, etc. I watched baseball, something I could see wins and losses, good plays and bad calls. So there's somebody who shares your attitude towards…

Ms. EHRENREICH: Oh, Mary, I wish I had found you when I was going through this.

(Soundbite of laughter)

Ms. EHRENREICH: Yeah, because all I can testify to is, well, I was angry. I was just angry all the time. And I wouldn't say that helped me or didn't help me. In fact, there's so much research now that shows that it doesn't make any difference, you know - that having a positive attitude does not mean that you're going to recover more quickly from breast cancer, lung cancer, prostate cancer, neck or throat cancer. It's been ruled out in studies of those things.

CONAN: We should point out you studied originally as an immunologist. So you know a little bit about this.

Ms. EHRENREICH: Cellular immunologist. Please, Neal.

(Soundbite of laughter)


CONAN: Barbara Ehrenreich is the author of "Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America." Give us a call, 800-989-8255. Email us: talk@npr.org. Stay with us. I'm Neal Conan.

It's the TALK OF THE NATION from NPR News.

(Soundbite of music)

CONAN: This is TALK OF THE NATION. I'm Neal Conan in Washington.

In her new book, "Bright-Sided," Barbara Ehrenreich writes: The sugar-coating of cancer can extract a dreadful cost. First, it requires the denial of understandable feelings of anger and fear, all of which must be buried under a cosmetic layer of cheer. This is a great convenience for health workers and even friends of the afflicted, who might prefer fake cheer to complaining, but it is not so easy on the afflicted. It takes effort to maintain the upbeat demeanor expected by others, effort that can no longer be justified as a contribution to long-term survival.

You can read more about how Americans came to be such positive thinkers in an excerpt from her book; that's at npr.org. Just click on TALK OF THE NATION. The book is titled "Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America."

We want to focus on Barbara Ehrenreich's experience with cancer, which delivered her to this world and yours. What advice did you get about positive thinking after your diagnosis? Did it help or hurt? 800-989-8255. Email is talk@npr.org. And let's go to Yasmine(ph), Yasmine with us from Atlanta.

YASMINE (Caller): Hi, well, I have to tell you, I got very excited when I started listening to you guys because - and Barbara, thank you for the book. I mean, I needed you two years ago. I am a relentlessly positive person, so much so that all my friends are very annoyed with me with my glass half full. But certainly, when you get the diagnosis of breast cancer, you do get mad. And what I found was that you weren't allowed to be mad - at all.

Ms. EHRENREICH: Exactly.

YASMINE: There's pressure to make everybody else feel better about it and hear their story and tell them it was going to be OK when on that day, you really didn't think it was going to be OK. It's unbelievable. And so, I think you're right on the money. And I think the pink revolution, I mean, God bless it, but it's put a pressure that is - I think sometimes makes the days much harder to get through.

(Unintelligible) for the color pink. I look good in pink, but now I can never wear it because there's always - there's a reason why you're wearing pink.

(Soundbite of laughter)

Ms. EHRENREICH: Right. That's a good point. No, I think that the awareness and the pink-ribbon culture is very good compared to what there was before, which was such a stigmatization of the disease, going back to the 1970s, that you could barely mention it. You know, obituaries would just say, died of a long illness. They would not…

YASMINE: Right. Listen, my mother passed away from cancer in the early '80s. So you can imagine. I mean, there is a huge difference, you know, from now and from then. But I think when you're saying this positiveness, it is really, it is a pressure that I think our friends and families don't realize that we get, that strain.

Ms. EHRENREICH: Yeah. And here's something that really horrified me that I learned recently and put in the book, is that some breast cancer support groups expel people who go into metastasis and who are clearly going to die. You can't be in the group because just your presence might bring other people down.


Ms. EHRENREICH: Now that kind of undermines the whole notion of a support group.

YASMINE: Unbelievable. Right. Well, I'm not a joiner, and I tried one group, and I knew right away it wasn't for me. But I'm very excited about your book. Thank you, and I can't wait until - I'm driving right now, but as soon as I get to a bookstore, I can't wait to get out there and grab it and start reading it. Thank you so much for doing that.

CONAN: Yasmine, please drive carefully.

YASMINE: OK, thank you very much.

(Soundbite of laughter)

CONAN: All right, bye-bye. Here's an email, this is from Edward in Milton, Massachusetts. I can't say I had a positive attitude immediately upon receiving my non-Hodgkin's lymphoma diagnosis on my wedding anniversary in 2002. My first thoughts were more along the lines of: It's been a great life of 44 years, I wouldn't change a thing.

Not long afterwards, however, I became intent upon surviving. I credit my positive attitude with contributing to my survival. I exercised and meditated. I didn't complain about pain or other discomforts associated with my many hospitalizations. My family and doctors think I'm crazy when I say I don't remember the chemo, radiation or bone marrow transplant as having been so bad.

I don't think you have to be positive. I just think it helps. The proof is I am still upbeat and positive and your guest, well, she's still angry.

Ms. EHRENREICH: Well, I'm still alive, though, too, I would point out to Edward, for ever how long that lasts. No, I think that's very good. I'm glad you are like that. I just think it's too much of a burden to put on everybody, to try to manufacture those feelings when you don't have them.

You know, when - I think that, for example, in the case of cancer, there are some real questions that we should ask and we should be angry about, like what causes it, what is causing the epidemic of breast cancer in our country? We don't know. We know it's, you know, a disease of industrialized countries, but we don't know what in the environment causes it.

That's something I feel a continuing anger about and desire to see something done about. But I'm not - don't ask me to just change my own attitude or my own mood.

CONAN: Let's go next to Jackie(ph), Jackie with us from Boston.

JACKIE (Caller): Hi. I'm really thrilled to hear about this book. I have lost several friends to breast cancer. I've not personally had it. But about a year ago, I lost one of my dearest friends to breast cancer, and I remember taking her into Mass Gen and her saying, I just came in to tell you all that I am not going to go through chemo anymore. I know it's not working - and the doctors coming in saying to her, it is working, and you need to have a positive attitude. And she was dead three months later.

And it really has left such a tremendous impact on me. I have to wonder. I mean, even in the medical establishment, this insistence that, you know, having a positive attitude when the woman clearly recognized that it wasn't working, and it was affecting her last days with her family.

CONAN: Jackie, so sorry for your loss.

JACKIE: Oh, thank you.

Ms. EHRENREICH: Oh, well, I think that happens all too often - is people being strung out to more and more chemotherapy, which may extend their lives marginally, but it also is, you know, it's a terrible life being on chemo. So I would not wish that on anybody.

I would just say, you know, in defense of the doctors and everything, although it's not a very strong defense, is that they have thought until recently that there was a scientific basis for this. That if you think positively, you boost your immune system and hence, you will get better from whatever illness.

The only problems with that is it's not true. I mean, we don't know that there's any scientific connection between mood and immune system unless - and we know in one extreme, if you're really stressed in terrible ways and tormented, your immune system will be compromised by that. But we don't know that just being in a good mood ups your immune system. But furthermore, we're not sure - there's no evidence that the immune system is fighting cancer whatsoever. So there's no basis to this. Doctors have thought there was; there isn't.

JACKIE: Right, well, this was as recent as a year ago. So anyway, I wish she were around to hear this because I remember driving back with her from chemo and her, you know, just questioning herself and what she knew about her body and how the doctors and nurses were insisting that no, she was getting better when, in fact, she was right that she was getting worse. So anyway…

CONAN: Jackie, again, we're sorry.

JACKIE: Thank you.

CONAN: Bye-bye. Let's see if we can get another caller on this. Let's go to Laitha(ph), Laitha with us from San Francisco.

LAITHA (Caller): Yes, hi, thank you for taking my call. And Barbara, thank you so much for saying what might not be generally popular in our culture. I really appreciate your courage in doing that.

CONAN: She makes a habit of that.

(Soundbite of laughter)

LAITHA: Well, we are kindred spirits. So what I wanted to share was my almost reverse experience when I was diagnosed with a rare form of breast cancer three years ago. While I wasn't so much trying to be positive as determined and knowledgeable and wanting to take as much control of my situation and my body and my treatment as I could, what I actually found was people almost feeling sorry for me and, to some extent, encouraging me to feel all the negative feelings, the realistic negative feelings, and almost wanting me to wallow in what they said was such an unfortunate experience.

So I almost had the reverse experience. Where I was trying to be determined and take control, I found not so much that people were telling me to be positive, but that they were actually almost bringing me down by feeling sorry for me.

Ms. EHRENREICH: Mm-hmm, mm-hmm. Well, I guess I mostly ran into people who were trying to improve my spirits. And the worst of them, I remember, was a friend who said, oh, you're going to lose all your hair in chemotherapy, then we can see how beautiful your skull is.

LAITHA: Oh, my.

(Soundbite of laughter)

Ms. EHRENREICH: Well, he was losing his hair for other reasons, and I said, is that why you're doing it, too? I mean, I was just furious, and I found it easier not to even be around a lot of people.

LAITHA: I know, and my - actually the worst, emotionally, the worst time I had was when I lost my hair, which was very surprising to me, but I remember being in the shower and washing my hair and it all coming off, and I stood in the shower and sobbed for many minutes. So that was a very difficult time for me. I'm very thankful I'm overcoming things, and I'm healthy, still going through treatment and being healthy. And I wondered if this general sense of think positive in our culture is really rooted in another cultural belief, which is that pain and suffering and sorrow and discomfort are not supposed to be part of our lives.

Ms. EHRENREICH: I think so, to an extent. I am not somebody who would like, romanticize suffering and say it's good for us, or that it strengthens our character or something. I would like to eliminate suffering as much as possible.

LAITHA: Right.

Ms. EHRENREICH: But you know, there's this - an extent of denial which we've been through so much, which - you know, in my book, I highlight how it played in to the financial crash, because nobody wanted to believe that the housing was a bubble or that subprimes were, you know, going to collapse, or any of that. And people who were negative in the workplace were fired for bringing these - their doubts up or raising questions.

LAITHA: Yes. Well, thank you for taking my call. And once again, keep up the work of saying what is unpopular.

Ms. EHRENREICH: Thank you.

LAITHA: Thank you.

CONAN: Laitha, thank you very much for the call. We'll get one more call on cancer, then we're going to turn a corner with you, Barbara. Karen(ph) is with us. Karen, calling from Evanston.

KAREN (Caller): Hi. I am so delighted to be able to thank Barbara for the articles that she wrote earlier in the decades that I read in 2007, when I was diagnosed and treated for breast cancer. It was such a relief for me to be able to read those articles that other patients passed on to me, and to know that I wasn't crazy for not listening to the people who told me that I needed to be cheerful when I had - even a friend who had curable cancer told me it was my responsibility to stay positive.

Now, I was lucky, and my therapist knew then, that there wasn't scientific support for positive thinking in terms of getting better, surviving, living and not dying. So that was a great comfort to me.

And also, I really think - and I'd love to get your perspective on this - that when we don't allow ourselves to fully feel what's going on - for me, it was sadness and anger - then I think, you know, and this may be true of our society in general, that we suppress these feelings. And could that be a cause of the epidemic of depression? It's certainly deepened my depression that year.

Ms. EHRENREICH: Well, they say that yeah, depression as anger turned inwards. There maybe something to that, but I could only speculate. But thank you for telling you that what I wrote made you feel less crazy. I was very frightened when I first wrote about my experience and my response to all this cheerfulness - artificial cheerfulness. But mostly, you know, the responses have been from other women who were just silenced by it and intimidated by it.

CONAN: Karen, continued good luck.

KAREN: Thank you.

CONAN: Bye-bye. We're talking with Barbara Ehrenreich about her new book, "Bright-Sided." You're listening to TALK OF THE NATION from NPR News.

And this was an entrée, you say, for you into an ideology of positive thinking in this country?

Ms. EHRENREICH: Yeah. I guess I had never much thought about it. But as I, you know, researching for various reasons, I was interested in the corporate culture in the middle of this decade. And layoffs, the, you know, the way that corporations had begun sort of systematically, routinely laying off not only blue-collar people but white-collar people. And then to my shock, I found that people who are experiencing layoffs get the same kind of line. That they should be grateful for the layoff, it's a wonderful transition, that they need to think positively, that anything that happens to them is because of their attitude, and that's all that has to be changed and worked on.

And again, you know, don't worry about the world. Don't ask the question about where the cancer comes from. Don't ask why so many people are not employed, even in good times in our country. And it was the same sort of thing. And that's when I began to think hey, this kind of operates as a way of quelling discontent, quelling dissent, you know, when you can't say I'm mad about -whatever. You just have to swallow it and smile.

CONAN: And deal with an individual as opposed to, you know, an organizational level. But you also say it leads to a kind of group think where people who question things, as you mentioned earlier, that maybe investing in high- risk real estate loans - it might not be the brightest thing to do right now.

Ms. EHRENREICH: Yeah. Well, it is a piece of the dogma of the motivational speakers and the motivational books and so on, that you do not want to be around negative people. They will drag you down. And so it depends…

CONAN: Even in your family.

Ms. EHRENREICH: Well, now, see, I don't know how that would work. I mean, can you say, hey, I'm not going to go pick up the baby, who's being negative again and crying? You know, no. Or, I'm going to have nothing to do with that teenager, who's too surly? Of course not. You know, it's - of course we're with people who are going through various moods and phases. But that's the dogma in the workplace. And people were culled out for raising questions about the way corporate decision-making was going in the years up to the - leading up to the financial crisis. We haven't gotten over this mindset either, which is really scary.

CONAN: We just have a couple of minutes with you left, but surely you're not advocating that people be negative all the time. That does lead to depression.

Ms. EHRENREICH: No. But fortunately, the alternative to positive thinking isn't negative thinking. The alternative, which sounds kind of obvious when you say it, is realism. You know, what's really happening here, trying to see the world not totally colored by our own fears or wishes, and figuring out what the problems are and how we're going to deal with them.

CONAN: Here's an email we have from Sophie(ph) in Healdsburg, I think - it is in California. Thank you for this program and for Barbara's comments. I'm not dealing with cancer but recently went through a divorce and got similar attitude of lack of support and understanding of the anger, pain, grief such an event brings.

Your honesty about the anger and possible sense of loss one feels when going through disease, divorce or other life challenges is very important to acknowledge and be honest about. Pretending I am happy is the last thing I wanted to do.

Ms. EHRENREICH: Right, Sophie. I completely agree. And probably, it is the last thing you should do. I mean, divorce is a very, very difficult experience and you don't want to bury those feelings or stop analyzing why it happened so it doesn't happen again - in the case of relationships.

CONAN: Barbara Ehrenreich, thank you so much for your time today.

Ms. EHRENREICH: My pleasure.

CONAN: Barbara Ehrenreich is an author. Her most recent book is called "Bright-Sided: How The Relentless Promotion Of Positive Thinking Has Undermined America." She joined us today from our bureau in New York.

Stay with us, we're going to be talking with a journalism professor who grew up in a tough neighborhood in Chicago and says, of those people in his city who have declined to come forward to talk with police about the brutal murder of an honors high school student, well, maybe they're just protecting themselves.

Stay with us. I'm Neal Conan. It's the TALK OF THE NATION from NPR News.

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