Pessimists are also poor candidates for surviving challenging illnesses.

As a physician almost a quarter of a century beyond medical school, I've learned many important lessons from my patients. One that stands out prominently focuses on the relationship between attitude and outcome.

Clinical observation has demonstrated repeatedly that pessimism is a predictor of poor recovery. Despite numerous technological advances of our era, outcome and survival seem to be more than casually related to one's attitude. Yet as a scientist, I realize that well-controlled studies are required to transform clinical observations into fact.

A recent investigation documenting outcomes in 372 stroke victims adds substantial scientific support to my observations. According to Dr. S. C. Lewis of Western General Hospital in Edinburgh, Scotland, "Patients' attitudes toward their illness seem to be associated with survival after stroke."

In their study published in the July 2001 issue of Stroke: Journal of the American Heart Association, the researchers assessed the attitudes of each patient 6 months after a stroke. They discovered that the most fatalistic individuals were 79% more likely to succumb to stroke within 5 years than people who were positive.

While you might assume these results occurred without taking into account other important factors such as age, stroke severity and the presence of other diseases, think again. The researchers meticulously considered these variables in their final analysis.

Their data still held up to the rigors of exemplary scientific analysis.

Of particular interest is the fact that individuals with a pervasive sense of helplessness were also 58% more likely to die within 5 years than persons with hopeful attitudes. Yet factors such as anxiety, depression and the so-called, "fighting spirit" were not predictive of survival.

It's important to realize these findings are suggestive of what appears to be a strong correlation rather than an explanation of "cause and effect." While one can certainly speculate, we still do not understand the precise basis for these findings. From a purely behavioral perspective, perhaps optimistic people try harder, are more committed, or manifest greater engagement in their recovery. Another important consideration is the role attitude plays in biological terms as it affects neurological, endocrine and immune system function.

Frankly the contention that optimists live longer than pessimists isn't new. A study published in the Mayo Clinic Proceedings last year (2000) reviewed survival rates for 839 patients (124 optimists, 518 mixed and 197 pessimists) over a 30-year period. After adjustment for age, sex and 15-year estimated survival, it was shown that increased pessimism was clearly associated with increased mortality.

On an even more optimistic note (pardon the pun), researchers Taylor, Kemeny and Associates reported fascinating and seemingly surprising findings concerning men infected with HIV in the January 2000 edition of American Psychologist. Their research showed "even unrealistically optimistic beliefs about the future may be health protective. The ability to find meaning in the experience is also associated with a less rapid course of illness."

While these combined research findings are impressive, one should realize that attitude is not the only determining factor in survival. This is an important perspective to consider based upon the fact that some people tend to blame themselves unnecessarily for their disease or outcome. It's a fact that despite positive and unyielding attitudes, people still succumb to illnesses like cancer and strokes everyday. Heaven is filled with positive thinkers who adhered to healthy exercise and nutritional regimens throughout their lives.

Yet from a personal perspective, each of us should take time to explore and better understand the potential effect our attitude has on our health. While some may argue that a pessimist is always a pessimist, I challenge that stance.

Developing a healthy personal strategy can only be accomplished if there’s hope for a positive anticipated effect. Yet even with a meaningful outcome in sight, many of us tend to create numerous obstacles in our paths due to recurring negativity. That's where a change in heart has to take hold.

Perhaps the best way to proceed even in a sea of negativity is to practice positive affirmations. These are statements that clearly articulate a positive outcome. Every time a doubt surfaces, meet it head on and squelch it with a positive affirmation such as, "well-being is within my grasp." After a short time, you just might find those negative thoughts occurring far less frequently.

Remember it's your attitude alone that can fill your half-empty glass. There's also no better time to savor the glass that can become half-full once you put your mind to it. And perhaps that's where the real key lies - not in the outcome but rather in the positive anticipation of the journey. As Helen Keller implied, a healthy dose of optimism may just open a new doorway for your spirit - Mind Over Matter!