Thursday, June 22, 2006

An Unwanted Journey: Day 0211 - Cognitive Adaptation

May we continue reflecting on optimism and cancer for just a little longer?

It wouldn't take a genius to infer that I like to read thematically, picking up one book or article and then searching for similar material to corroborate or challenge the thesis of the original. I also like to "write down" my thoughts in a blog format (or other) while they are current, not just to communicate with others, but to organize and articulate my own germinating thoughts arising from the seeds of my reading.

And so it is with optimism and cancer. I am still reading Seligman's Authentic Happiness, but I am concurrently reading another book by another psychologist, Daniel Gilbert, on happiness called Stumbling on Happiness. The latter made reference to an essay, a copy of which I found online, called Cognitive adaptation: a comparision of cancer patients and healthy references.

The theory of cognitive adaptation suggests that people hold unrealistic positive views of themselves in order to feel better about themselves. For cancer patients, diagnosis threatens optimism, control, and self-esteem. And the sun rises in the east and sets in the west - somewhat obvious, right?

But what is not so intuitive is that cancer patients, when compared with a healthy control group, hold distorted views as positive as those in the control group along all three dimensions (optimism, control, self-esteem). Even when facts intrude to challenge (side effects continuing, for instance), positive cognitive adaptations continue for cancer patients.

The study took a longitudinal approach (examining all three variables over time using specific assessment points). At each assessment, cancer patients had significantly higher optimism and self-esteem than the healthy control group. Control did not differ significantly between both groups.

So what does this mean? For one thing, I am not alone. We cancer patients, it seems, tend to use both our diagnosis and treatment as a lever to ratchet up our overall sense of optimism and self-esteem not just over time but above and beyond the levels of the general population.

How can that be? One possibility is that we tend to compare ourselves with those even less fortunate than we are. One other possibility is that the studies of cancer patients thus far have only included patients with a relatively good prognosis and did not extend in time beyond three months after the end of treatment. Yet another is that we don't yet know whether all cancer patients cognitively adapt (depending on tumour site, stage, etc). Perhaps it is only specific types of cancer and stages that result in so positive adaptations.
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