On the importance of not always looking on the bright side of life

As someone with more personal experience than I'd like to have with watching (and listening to) people deal with cancer, I was rather interested in the excerpt from Barbara Ehrenreich's forthcoming Smile Or Die: How Positive Thinking Fooled America and the World published in the Guardian.

In it, she describes (and laments) what she refers to as the 'tyranny of positive thinking' that surrounds American cancer treatment and patient support (one to which, it seems, many patients actively contribute).

This extends to the view expressed by at least a few people that cancer might best be seen as a 'gift'.

Now, I'm thinking hard here, and to be honest I can't think of a single example of a person I know whose life has been improved by this particular experience, although I've seen a lot of impressive bravery and even dark humour emerge in response to the illness.

Facing the likelihood of reasonably imminent mortality can bring forth all kinds of complicated emotions, and I'd be the last person to tell others how they should react.

But I share Ehrenreich's doubts:

But rather than providing emotional sustenance, the sugar-coating of cancer can exact 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. One 2004 study even found, in complete contradiction to the tenets of positive thinking, that women who perceive more benefits from their cancer "tend to face a poorer quality of life – including worse mental functioning – compared with women who do not perceive benefits from their diagnoses."

I don't read Ehrenreich as arguing for meek, passive acceptance of cancer: quite the contrary. There are a lot of unpleasant and horrible things in life that have to be faced with grim determination or an active, even combative, spirit of resistance. Seeking encouragement of whatever kind, finding reasons to laugh and making plans beyond the disease is all to the good; however, there does seem to be something deeply imbalanced in the cancer-culture Ehrenreich describes:

Breast cancer, I can now report, did not make me prettier or stronger, more feminine or spiritual. What it gave me, if you want to call this a "gift", was a very personal, agonising encounter with an ideological force in American culture that I had not been aware of before – one that encourages us to deny reality, submit cheerfully to misfortune and blame only ourselves for our fate.

And that doesn't sound very positive at all.