Staying positive may be a brain drain when you're in pain

The commonly held belief that staying positive when facing a health problem will help you through it might not always be the best message for people who are experiencing high levels of chronic pain, according to a psychology researcher.

People who reported being in a positive mood despite suffering high levels of pain from rheumatoid arthritis demonstrated lower levels of “executive functioning,” which includes working memory, inhibition, planning, decision making and cognitive control, said Chris Abeare, an assistant professor in clinical neuropsychology.

“Staying positive and happy is a message that is reinforced all throughout the popular press, and with good reason, but there are some caveats,” said Dr. Abeare, who along with several other researchers published results from their study of 157 arthritis patients in The Clinical Journal of Pain.

Abeare’s team put subjects through a battery of tests to measure pain levels, moods, selective attention, inhibition and working memory. Among the most important findings was an inverse relationship between pain and executive functioning among those with high levels of positive affect. In other words, subjects in a lot of pain who reported being in a positive mood were more likely to have lower levels of certain types of cognitive functioning. Subjects with high pain who reported being in a negative mood demonstrated little or no effect in functioning.

Abeare suspects that people in pain are trying to concentrate on staying positive, which could be a drain on their brain’s ability.

“We have a limited amount of cognitive resources,” he said. “If we’re devoting a lot of attention to maintaining a positive attitude, we might not have enough left over to focus on handling the world.”

Abeare said the findings are important for physicians, therapists and other health care providers planning treatments for patients suffering from chronic pain.

“Intact cognitive functioning is crucial for performing many key daily activities, including adhering to medical regimens, planning activities based upon one’s current physical condition, and changing plans should pain worsen unexpectedly,” he said.