It’s Time to Do More Attending and Less Pretending

“Toxic positivity is positivity given in the wrong way, in the wrong dose, at the wrong time.”  David Kessler, author of “Finding Meaning: The Sixth Stage of Grief.”

“We just need to be more positive!”  These words from a healthcare executive in the midst of a discussion about the sobering results of a physician well-being survey still haunt me.  In this case, it felt much more like a disingenuous denial of reality rather than a misguided attempt at encouragement.  The impact was a “poisoning” of the conversation and shutting down of any meaningful dialogue.  In other words, it felt toxic.

In the midst of our demanding work, positivity is often seen as a beacon of hope guiding both clinicians and patients through the darkest of times.  Yet, there exists a shadow, a phenomenon known as "toxic positivity," which can undermine the very essence of genuine support and understanding.  Toxic positivity is the belief that one should have a positive mindset and express only positive emotions and thoughts at all times, particularly when things are difficult.   It often comes disguised as a simplistic attempt to circumvent a challenging circumstance, using phrases such as “No worries,” “It’s all good,” or “It could be worse.”  Although perhaps well-intentioned, it has the effect of discounting, dismissing, or even denying emotions that are not positive. 

Hopeful optimism is a process of anticipating positive circumstances and desirable outcomes without denying present reality and is a constructive coping strategy.  Forced optimism or toxic positivity, on the other hand, encourages us to deny any “negative” emotions we might be experiencing, even if they seem appropriate to the circumstances.  In healthcare, where emotional and physical stakes are high the resulting damage can be quite real, including the erosion of trust, emotional harm by devaluing a cry for help, and the suppression of vital dialogue or glossing over adverse circumstances that need to be addressed. Research has shown that acknowledging a range of emotions can lead to better coping strategies, resilience, and support networks in medical settings, and that imagining the future in a hopefully optimistic way can help promote thriving and sustain us during challenging times. 

How do we emphasize the positive without denying or suppressing the negative so we can break this all too pervasive tendency toward toxicity?  By practicing!  I found this wonderful resource on the website positivepsychology.com called “Harmful to Helpful Toxic Positivity Phrases” that provides a starting point for reframing some of the well-intended but often harmful reflexively used “just be positive” phrases.

This upcoming week, be aware of any tendencies you might have to dismiss or minimize the struggles of those around you (and your own!) and note when “positivity phrases” might be inappropriately used by yourself or others.  It’s likely not “all good” right now.  Far from it.  Pretending isn’t fooling anyone.  But there is good news.  You don’t have to navigate any “this is hard for me” alone.  The antidotes to our regular challenges are hopeful optimism and positive connection.  Let’s remember to use them generously and frequently to ensure that no one cares alone …. not now, not ever.