“No one knows me better than I know myself.” Aside from an intimate partner who completes our sentences, this adage cannot be more true than when we are dealing with our own health. This statement probably doesn’t come as much of a surprise today, but as recently as the 1980s, attempts to explain health and illness in psychological terms were branded as “folklore” and further criticized for saddling patients with needless guilt. These days, health professionals and lay persons alike understand that no one can explain your own experiences but you. In an important way, this makes you an expert on your own health.

To learn the explanations for our health, someone has to ask us. According to Martin Seligman at the University of Pennsylvania, people have various ways of explaining their health or their illnesses. These explanations vary along three important dimensions and have been associated with more or less ill health, depending on the explanatory style. Explanations can range from internal to external, stable to unstable, and from global to specific attributions.

Internal explanations point to something about the self (for example, “It’s my fault” or “I can do it”) while external explanations indicate something outside the self is responsible. Stable explanations refer to long-lasting causes (for example, “It’s just the way things are”) and are apt to produce chronic difficulties in the wake of bad events. Unstable explanations refer to luck, flukes, or transitory things over which we have very little if any control.

Specific explanations suggest that “this situation doesn’t completely define who I am.” Global explanations indicate a pervasive factor that is thought to influence “everything I do”. Global explanations can become self-fulfilling and actually increase the likelihood that bad events will produce widespread problems. An internal, stable, and global explanation is the most debilitating account of bad events, whereas the external, unstable, and specific explanation is probably the healthiest.

In the 1980s, research was already showing that individuals with internal, stable, and global (i.e., pessimistic) explanations may become passive in the face of disease, neglect the basics of health care, and tend not to see that solutions are possible following uncontrollable events. They are also more likely to experience social withdrawal and loneliness, suffer from depression, and have less competent immune systems.

In the last two or three decades, research has focused more on the upside. In one study, physicians in more positive moods were able to make more accurate and quicker diagnoses, so clearly health service professionals can benefit from feeling better, just like the rest of us.

Across many studies over the last few decades, higher optimism ratings were associated with lower risk for life-threatening cardiovascular events and faster recovery rates after heart-attack. High optimism scores were also protective against stroke, progression of HIV, and general mortality in the elderly. In sum, subjective well-being and optimism, including a sense of control over health and confidence about one’s body and one’s future health, can protect us from physical illness. Needless to say, a positive attitude about one’s health correlates highly with positive mental health as well.

The mechanisms underlying these links are unclear, but they probably have something to do with the fact that our brains are closely linked to our immune systems. We should not, however, jump to the conclusion that thinking positively will eliminate illnesses. Nor should we imagine that we are the only experts able to help improve our health. But the very act of asking genuinely how another person is feeling recognizes that person as an expert on their health, because no one else can answer that question. That recognition can provide a boost in mood and self-confidence, enables us to notice how we are thinking about our health, and encourages consideration of change. And that is the beginning of healing.

For more information about positive psychology, pick up Martin Seligman’s book Authentic Happiness or visit www.ppc.sas.upenn.edu.

Kim Dawson is a psychologist in the Chilliwack Child and Youth Mental Health program, a part of the Ministry of Children and Family Development, Government of BC.