Thrill of a Gain

A platitude is precisely what is left of a truth

after it has been drained of all emotion. 

–Michael Pollan, How to Change Your Mind, P. 251

Positive thinking experts turn me off. Really off. As in, “If you mention a gratitude journal one more time I’m going to snap your head clean off.” All you need to do to get me to leave an event is to tell me a motivational speaker is on the night’s bill. Even if I’ve paid good money to be there.

Why? First of all, because it’s exhausting for an introvert like me to be rah-rah, even for a short while. Second of all, because it’s a big fat lie. No one can maintain a positive attitude forever–not unless they’ve been hit with Joker’s gas and laugh themselves to death on the streets of Gotham. And third, because all those positive thinking exhortations aren’t being honest about how my brain actually works.

I’ve smacked headfirst into this fact my entire life: the moment someone tells me I can’t or shouldn’t do something, what do I do? Try it. Every time. Like I’m a recalcitrant four year old instead of an (ostensible) adult. And being told I could die young (even if I do manage to perfect a bunch of behaviors!) has made me dig my heels in even harder on some of my worst habits. The depression, anxiety, and mental/spiritual exhaustion of carrying the cancer “glass of water” for the last two years has simply driven that spike in even harder, though for different reasons (deathwish, anyone?).

And as it turns out, I’m not the only one who acts like that when change is necessary. It’s all of us.

TED Tali Sharot

Go ahead, watch it. I’ll be here when you get back.


Let me tell you, a cancer diagnosis and a 72% chance for a later potential metastasis makes that “poop hitting the fan in slow motion” visual from Dr. Sharot’s talk really darkly funny.

In cancer “support” circles, the notion of positive thinking as the best weapon against cancer has been turned into a platitude, a truth that has been drained of all emotion. It’s not a real bulwark or action plan that recognizes the mental realities of dealing with a scary diagnosis. It’s a shorthand bludgeon that many doctors and nurses use to interrupt a moment of real emotion happening in front of them so they can move on to their other patients.

Instead of smacking cancer patients upside the head with “have a positive attitude/lose weight/eat right or you’re gonna die”–which is essentially nothing more than a fear statement, which science has proven doesn’t work for most people in the long term–why don’t doctors use Dr. Sharot’s work?

Dr. Sharot’s TED is all about working with my own most unfortunate tendencies–the tendency to bury my head in the sand, to get evil and do worse things to myself because I can’t afford to. Now that’s honesty–recognizing the faults built into my mental systems so that I can work with them, and succeed despite them. And (hopefully) not pass my nasty mental buck on to everyone else later.

So what would such honesty look like in a clinical setting?

Over the last two years, I’ve learned I have to stage my answers to the ubiquitous question, “How are you doing?” (If I’m talking to an acquaintance, “Hanging in there” is both honest enough not to make my heart hurt, but bland enough to allow said acquaintance to comfortably start nattering on about themselves instead. My assumed physical or mental discomfort should never be the subject of anyone else’s prurient interest. If they’re genuinely concerned not just for themselves but for me–if they want to find out in order to better help and protect themselves and their loved ones by knowing, and I’m among those loved ones–then okay, I’m willing to talk real cancer turkey with you.)

But when a doctor asks the same question, the type of doctor he/she is gets revealed pretty quickly. A frankly bad doc just wants a list–a general, dispassionate discussion of physical symptoms. I’ll know what I’m dealing with if the doc takes that list and runs (literally away) with it. And I’m happy to let them do so. But if the doc then asks, “How are you doing emotionally,” I’ve learned to be honest in my answers…even if they’re not prepared to hear them. Because otherwise they’re not going to get better as doctors, and I’m not going to get better as a patient. (And by better, I don’t necessarily mean physically. That’s pretty much out of my hands at this point. I’m talking about getting and keeping my heart and head solid–honest–with the state of my body and soul to the very end, whether that end happens when I’m 80 or 49.)

The problem is that, up until now, even the best doctors have had no answer for me about how to get physically/emotionally more skillful. (The absolutely best ones have at least been honest in their emotional reaction to my answers. They’ve been genuinely sorry to hear them. I appreciate the hell out of that. But even for the best doctors, that’s as far as their repertoire goes.) Their only answers have been the platitudes–exercise/eat right/positive thinking–with no emotion or honesty behind it. And those platitudes–what dozens of doctors and nurses and cancer patients (!) have flung at me in response to my honest statements, like, “I’m not doing too well emotionally. Anxiety is trying to eat my lunch. What would you recommend?”–are essentially no different than fear.

“Exercise/eat right/positive thinking.” That’s not truly positive, skillful thinking. That’s nothing but a dressed up fear statement. It’s not “here’s what you do.” It’s “do these things or else.”

As Dr. Sharot put it, “The thrill of a gain induces action. Fear induces inaction.” That’s neuroscience. That’s the way my brain (and everyone else’s) is physically built. Why in God’s name are doctors still trying to use fear statements to motivate their patients? Dr. Sharot’s power company does a better job of motivating their customers than oncologists do.

So, when a doc asks me how I’m doing, I might finally be able to answer him or her honestly. “I haven’t been doing terribly well. But I think I may have a plan for how to do better.” Any doc should nod and say, “Good!” But a good one will hopefully ask, “Oh? How?”

My reply might now be, “The thrill of a gain.”

It sounds so…motivational. [shudder]

When cancer takes so much away, it’s important to plan for what’s left. The way the conversation between doctors and patients is currently constructed, it’s as if the honesty–cancer takes a bunch away from you, permanently–is omitted. That lack of honesty then impedes my ability to recognize the facts quickly and begin to plan for what’s left. I spent so much time with the agony over what was gone (and the fear of what might be coming) that I wasn’t looking at what was still available to me. I’ve been paralyzed into inaction by the fear.

I can’t guarantee that I’ll make big things of this new thought process. It’s, well, new, and coming hard on the heels of a long period of bad times. And as I mentioned before, I can only be motivated so far or so long by any tactic, even well-recognized, positive, motivational [shudder] tactics.

But I must admit…it’s really fragging nice to think about a gain for the first time in two years.


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