False Optimism is Not Helpful
Self-serving belief systems only hurt people.
I have a serious bone to pick with two specific cultural aspects of certain subsets of the American population. The first is the tendency to confuse being nice with being good, and those are very different things. The second is a nearly fanatical devotion to the idea that positive thinking is, by itself, a powerful universal good. The Venn Diagram of people who are guilty of these two sins is almost, but not quite, a circle.
First, let me explain the difference between being nice and being good. Being good is doing the right thing, even at great personal cost. Being nice is making people feel good, even if it’s actually harmful to them. Allow me to illustrate this difference with an example. I once got a call in the middle of the night because the patient didn’t look well. The patient was the matriarch of a very large, very wealthy family. They were not happy with my explaining that the patient was going to die within hours, maybe less. This turned into a several-hour long visit with multiple calls to the family’s concierge doctor, repeated explanations that I couldn’t get IV fluids or IV medications in the middle of the night because there were no open pharmacies with those medications in stock, and the family eventually calling EMS while I was there to give the patient IV fluids. The paramedic told the family the same thing I did, but he dutifully started the IV fluids and started EKG monitoring. The family argued about taking the patient to the hospital (despite her advanced directive clearly saying that she did not want that) until I told the family that the patient was going to die within the next handful of minutes, and if they wanted time to say goodbye, there was no more time to argue. They did all get to say goodbye, and they got to hold her hand when she died. They were not even remotely happy with me and filed a complaint against me with my company because I hurt their feelings. I knew they were going to, and I was on the phone with my supervisor before I left their driveway. I did the right thing, and no one was happy about it.
Second, my issue with the “power of positive thinking” crowd: there are some issues that no amount of positive thinking is going to fix, and it’s cruel to demand that people blind themselves to harsh realities in order to make yourself feel like you’re helping them. This is the ultimate issue with the people who insist that they don’t want to give up and don’t want their dying family member to give up, so they oppose hospice at all or demand that the hospice staff lie either directly or by omission in terms of not telling the patient that we’re with hospice. Whether I tell the patient that I’m a hospice nurse or not, I’ve never met someone dying a natural death that did not know they were dying. I’ve met people who were deeply in denial to the point that they violently rejected the idea that they were dying, but even they knew on some level that they were going to die. Denying people the ability to talk about it, as I’ve mentioned before, only isolates them and denies them the comfort of their family and friends.
There is nothing more destructive to a healthy grieving process than false hope, but forced optimism is a close second. There is also a difference between denial and forced optimism. Denial is the inability to engage with reality because you’re coming to grips with a painful truth. It’s a normal part of grief. Forced optimism is the refusal to engage with reality because some belief in mind over matter makes people believe that they can change the structure of reality purely by believing hard enough. For the patients, it makes for a harder dying process and an inability to process their own grief. For the people left behind, though, it creates a feeling of personal responsibility for their loved one’s death because they obviously didn’t believe hard enough. It essentially makes you feel like a murderer despite the fact that you couldn’t have done anything to change the outcome of the situation.
This also applies to the people who cling to the power of prayer idea. Clinging to the idea of the power of prayer as a way to avoid engaging with impending death, your own or someone else’s, is even more destructive than the power of positive thinking idea. Not only do you feel responsible for the death, you also become isolated from your faith at the exact moment you most need that support. I am absolutely not, in any way, demeaning the importance of religion or the idea that prayer is both helpful and important. First of all, there is great comfort in religion for a lot of people. Second of all, I have firsthand experience with the utility of prayer in seeking comfort and wisdom.
I am a person of very deep Christian faith, and I am well-studied in most other religions as well. I have read almost everyone’s holy book or books, because I’d like at least a passing familiarity with other beliefs. For the purpose of illustrating my point, though, I am going to refer to The Lord’s Prayer, common to all variations of the Christian faith. The most important line in it, in my opinion, is Matthew 6:10, “Thy kingdom come, Thy will be done in earth, as it is in heaven.” This is the most important line because the person praying directly submits to the will of God as being more important than their own, which is also an admission that you will not always get what you want.
For another example, there is the most popular version of the Serenity Prayer, “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” God, by whatever name you prefer, is very big and has an unimaginably vast perspective. We humans are very small, and our perspectives are frequently too small to deal with each other easily, so it’s no surprise that we are unable to really grasp big and tenuous ideas like death. The thing that the Serenity Prayer expresses beautifully, in my opinion, is that submission to the will of the divine also means acknowledging that you are not responsible for things that fall within the realm of the divine.
Between people trying to be nice rather than good and people trying to demand that reality change itself to suit them, it can be very hard for people who are terminally ill and their families to properly engage with each other and their larger communities so that they can be properly supported in the grieving process. It is often very awkward for people who have accepted that they’re dying, or that a family member is dying, to engage with people who want to encourage them to think positively or pray for a miracle recovery. Usually, these bits of unwelcome and unhelpful advice come from a place of genuine desire to help. My advice is to thank people for wanting to help and just forget the entire conversation.
If you’re finding yourself wondering if you’re hurting someone, including yourself, by not believing (nor not believing hard enough) that a miracle will suddenly occur and prevent the death that you’re expecting, whether by prayer or positive thinking, I would like to offer an alternative perspective. Would you expect that someone would be able to change losing their job through prayer or positive thinking? No, you absolutely wouldn’t, because you know that their employer has more to do with that than they do. You might pray for them to find a new, maybe better job, or hope that they alter their perspective enough to try to make the best of the situation and find a new, maybe better, path forward, but you would understand that the situation is beyond their control. With that in mind, why would you expect that death can be denied by the same set of actions? You are not responsible for the structure of the universe.
Bad things can happen to anyone at any time. You can call it random chance, you can call it a trial, you can call it the will of God, or you can use whatever other explanation makes it easier for you to accept. As for me, I decided that it’s not any of my business why bad things outside my control happen to me. I am too busy dealing with the things I can control to worry about the ones I can’t. I have chosen to pick my battles, and that means accepting that I can’t fight reality.
If you have anything to add, or any questions, please feel free to hop in the comments or in the chat!
I enjoyed reading this posting. It is hard for people to let the dying process unfold naturally while being present for whatever good they may contribute. I have had hospice family members complain to my supervisors for what I felt was just being honest and truthful while they did not want to hear that but instead wanted me to join them in their limited beliefs. We hospice nurses who are present over and over with the dying understand and try to guide people with our compassion and experience. Keep up the good work.