Avoid Toxic Positivity to Help PF Patients

Charlene Marshall avatar

by Charlene Marshall |

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I began hearing the term “toxic positivity” this year, and the pandemic has illuminated the term’s meaning for me.

According to The Psychology Group in Fort Lauderdale, Florida, toxic positivity refers to “the excessive and ineffective overgeneralization of a happy, optimistic state across all situations.” Since the beginning of the pandemic, I’ve encountered people and phrases that fit this definition several times.

Upon further reflection, I can also apply this definition to various situations I’ve encountered since my idiopathic pulmonary fibrosis (IPF) diagnosis four years ago. Despite having good intentions, some people just don’t know how to respond to those with a chronic illness. These people are often guilty of toxic positivity.

I have met many patients who customize descriptions of their chronic illness depending on the person with whom they’re speaking. More specifically, I know patients who intentionally leave out the fact that their illness is fatal in new relationships.

I am guilty of this as well. In the majority of conversations, I neglect to tell others that IPF is fatal (without a lung transplant). I never know how people will react, and sometimes their responses are frustrating and upsetting.

Since my diagnosis, I have twice been asked, “What are some of the dumb assumptions people make or stupid things they say to you as a young adult living with IPF?”

I shared my answers with an amazing author friend, Kristan Higgins, who will be publishing a book about IPF in 2021. When people say dumb things, they are often well-intentioned, but some of the hardest comments to hear are those intertwined with toxic positivity.

The next time a friend, partner, or loved one shares something difficult, I challenge you to sit with them and absorb their pain. It will be uncomfortable and awkward. However, being present and not trying to fix the situation will be a welcome change from unrealistic, positive phrases about how things will get better. This is especially true if a situation won’t improve, such as life with a progressive illness.

When friends and family try to minimize the difficulties we face by verbal-vomiting various positive phrases, it can be harmful. Toxic positivity can be dangerous because it often invalidates a person’s struggle.

Instead of relying on comfortable and familiar phrases when helping someone through a difficult time, I challenge you to react differently. Be realistic, be honest, and don’t suppress the patient’s emotions. If you don’t know how to react to a loved one’s difficult news, an easy solution is to ask how you can help.

Following are some of the most common examples of toxic positivity. Do you have any ideas on what you could say instead? (Hint: You can find some great solutions online!)

‘Don’t worry. It will get better.’

Not only does telling a patient not to worry invalidate their struggle, but the second part of the statement simply isn’t true. Unfortunately, IPF is progressive, which means a patient’s health won’t get better and is likely to get worse.

‘It could be worse.’

This may be true, but I can assure you an IPF patient is thinking it could also be better. Being unable to breathe is one of the most difficult things to endure. Your lungs can never take a break, so no amount of rest alleviates the pain and difficulty of feeling short of breath.

‘Don’t think about it. Stay positive.’

It’s nearly impossible not to think about IPF, especially when the shortness of breath or chronic cough that patients experience is present everywhere they go. This also makes it difficult to stay positive.

‘Everything will work out.’

For IPF patients lucky enough to receive a lung transplant, things may work out in the short term. New lungs are unfortunately not a cure, but rather another chronic illness to deal with. While often welcomed, as they improve a patient’s ability to breathe, lung transplant is not without its challenges. Also, very few patients end up receiving a transplant, so there is often a sense of hopelessness that things won’t work out in the end.

Please share any other forms of toxic positivity you’ve experienced since your IPF/PF diagnosis in the comments below.

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Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.

Comments

Zach Adams avatar

Zach Adams

Thanks for that essay. I agree that it's hard to have people cheer you up with thoughtless or ignorant statements that they think might make you feel better. I do think however that you can be hopeful and positive. I've had IPF for almost five years and I'm going to be 69 years old in a couple of months. Realistically a cure or breakthrough in treatment for IPF may not come in time for me, but it will come and I don't think it's wrong or bad for you to cling to that hope.

Someone told me that the best advice is to prepare for the worst but hope for the best.

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Charlene Marshall avatar

Charlene Marshall

Hi Zach,

Thanks so much for reading my columns and reaching out via the comments. This was a tough topic to write about because everyone who shares "toxic positivity" is usually well-intended, but their comments don't often make us feel better. I do agree with you, that you can be hopeful and positive and actually, I'd argue that this way of thinking is actually what has helped me most over the years. Clinging to hope is so important! Good advice to think about too, thanks for sharing that. Take care and thanks for writing!
Char.

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Denis Ryan avatar

Denis Ryan

Hi, my name is Denis Ryan and I live in Ireland. I am 79 years old & I was diagnosed with IPF nearly 2 years ago & given 3 to 5 years to live. I take OFEV @ 100 mg twice a day (decided by myself, as the consultant left it up to me to decide!) & have very little side-effects (small lack of appetite & shortage of energy).I play 9 holes of golf twice a week in a Buggy Cart as I cannot walk the distance any more.I've been told I cannot have a lung transplant as I am considered too old. I've never smoked and have always exercised regularly. With Coved 19 I am doing armchair exercises twice weekly via internet sites, golfing twice a week, walking or gardening other days. I am reasonably confident I can overcome the consultant's statement of 3-5 years & prove him wrong. I'm new to this Forum & find it interesting & beneficial.

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Charlene Marshall avatar

Charlene Marshall

Hi Denis,

Thanks so much for reading my columns and reaching out via the comments. Welcome!

I'm so glad to hear that you don't have many/have very little side-effects from the 100mg/2x daily Ofev dose. That is great news! I know a lot of people who really struggle with side effects from this drug. Kudos to you for keeping up with golf as well, that's great. There are a few other members on our forums who are avid golfers :) Keep up the great work with activity and exercises, along with the positive attitude for overcoming the consultant's prediction; that will take you far! Also, the data from the 3-5 year prognosis that doctor's usually rely on is very outdated. I know lots of people who have surpassed 3-5 years!
Take care and feel free to write anytime.
Charlene.

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Karen Martin avatar

Karen Martin

Another tough subject! You always handle them so well, Char. I sometimes find myself being the one with the glib remarks when I am talking to someone about my IPF. Saying some of these very things to them to discourage them from worrying about me! And then I feel sad and alone. I think it is hard to be honest about the difficult things, whichever side of the issue you are on.

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Charlene Marshall avatar

Charlene Marshall

Hi Karen,

Thanks so much for reading my columns and reaching out via the comments - as always, it is so nice to hear from you! I so appreciate your kind words and perspective on the glib remarks. I didn't think about it from that side of things, but I am also guilty of this: sharing (maybe unrealistically) positive things about how I'm doing, then as you say, I feel a bit sad and alone. Very much agree with you about it being hard to be honest about how we're doing, especially when both sides are usually well-intended. Take care and thanks for writing! Charlene.

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Denis Ryan avatar

Denis Ryan

I left some comments yesterday but you do not seem to have accepted them. What's the problem?

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Charlene Marshall avatar

Charlene Marshall

Hi Denis,

Thanks for your note. We/I get several comments to my email per day on my columns, which I'm very grateful for. Sometimes it takes me 24-48hrs to get through them all and approve the notes. I just approved yours, you're all set! Char :)

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Denis Ryan avatar

Denis Ryan

Thank you Charlene. My apologies. I'm afraid I thought my comments had got lost en route. It is very useful to have a support group for info,especially with a near total lockdown as we now have in Ireland re.the Virus. Keep up the great work that you do. Denis

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Charlene Marshall avatar

Charlene Marshall

No problem at all Denis! I'm glad you commented and shared some of your experience(s) with us. Glad to hear you're found support and help within the group, feel free to write anytime. I truly believe we're stronger together! Take good care, Char.

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Sarah avatar

Sarah

Hello, Everyone,
My sister-in-law was recently diagnosed with PF secondary to rheumatoid arthritis, so I'm looking for ways to support her, and found you. I find it helpful to both parties to focus on today...what are you planning for lunch or for supper? Or what are you working on today that brings you joy or satisfaction? Even without a chronic condition, all any of us have is this moment, right now. I feel grateful to connect with you, thank you!

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Charlene Marshall avatar

Charlene Marshall

Hi Sarah,

Thanks so much for reading my column and reaching out via the comments. I am really sorry however, to hear of your sister-in-law's new diagnosis of PF secondary to RA. So unfair! It sounds like she is very lucky to have you in her support circle, and please feel free to connect with us anytime. The PF forums: http://pulmonaryfibrosisnews.com/forums/ are filled with incredibly supportive patients and caregivers, so if it would be helpful please feel free to join, ask questions and read the discussion threads. I like your focus on the now, and I agree, it is very important.... after all, that is all any of us have! Please feel free to write any time, and know I'm thinking of you and your sister-in-law!
Kind regards,
Charlene.

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