In Search of Good Health? Try a Bad Attitude.

By HENRY FOUNTAIN

ot to sound too negative about it, but there's yet more evidence that this power-of-positive-thinking idea may not be all it's cracked up to be.

Survey findings released last week at a meeting of the European Society of Medical Oncology show that cancer support groups do not help patients live longer. Edzard Ernst, a professor of medicine at the University of Exeter in Britain, and colleagues reviewed earlier studies on the issue and found no evidence for the belief, held by some doctors and patients, that the good vibrations gleaned from talking with others who are in the same boat can do as much to prolong life as any physical treatment.

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The researchers were quick to point out that they have no doubt that positive thinking helps patients feel better and improves the quality of their lives. It just doesn't add days to them.

That may be a bitter pill for those who urge the grouchy and grumpy among us to cheer up. Norman Vincent Peale, who convinced millions that worry, doubt and defeatism can be overcome, might be overcome himself were he alive to hear the news.

All in all, this hasn't been a bull market for positive thinkers. Two decades ago, in the Reagan era, it might have been morning in America, but now, with terrorism, snipers, threats of war and economic anemia, it's the middle of the night. We're tossing and turning, anxious and angry thoughts racing through our heads, while somewhere a faucet goes drip, drip, drip.

Do we really need to look on the bright side?

Barbara S. Held, a psychologist and professor at Bowdoin College, argues that it's time to end what she calls the "tyranny of the positive attitude in America."

"It's gotten worse since 9/11," she said. "There's less tolerance for the expression of negativity. You're labeled unpatriotic, as if you've somehow given in to the enemy."

Negativity is not such a bad thing for some people, Dr. Held said, from the rude curmudgeon who wallows in it to the normally upbeat person having the occasional bad day. "Insisting that they smile and look on the bright side may backfire and make them feel even worse," she said.

(Want proof that negativity works? Look no further than Jimmy Carter, the man who preceded Mr. Reagan and whose 1979 "malaise" speech is perhaps the most public display of negativity in recent memory. He was just awarded the Nobel Peace Prize.)

"There's much to be gained from appreciating our negative thoughts and feelings," said Gerald Amada, a psychologist and the former director of the mental health program at the City College of San Francisco. It is important to acknowledge that negative thoughts can serve a purpose. "We need to take a morally neutral position with respect to angry emotions, not always see them as destructive and all-consuming," said Dr. Amada, the author of "The Power of Negative Thinking" (Madison Books, 1999).

Even when it seems that negative thoughts should dissipate — as with the apparent resolution last week of the sniper case in the Washington area — there are those who will stay gloomy, angry or anxious.

"Some people might say, ‘What are you angry about — he's been caught,' " said Dr. Held, whose book "Stop Smiling, Start Kvetching" was published last year by St Martin's Press. "But now there's a whole new dimension to life. There may be more snipers. Life is more unstable than we ever conceived of."

But perpetually anxious people have their own form of bulletproofing. Their Kevlar consists of setting expectations low, preparing for the worst possible outcome and precisely planning how to prevent it from happening.

Julie K. Norem, a psychologist and professor at Wellesley College, calls this defensive pessimism. "This focuses them on things they can do, and away from the anxiety," she said. "An awful lot of people do learn how to do it for themselves in a concrete way."

Anger can help some people manage anxiety, too. "One of the things that makes anxiety so awful is that you feel out of control," said Dr. Norem, the author of "The Positive Power of Negative Thinking" (Basic Books, 2001). "Anger is an energizing emotion. With anger you feel more in control."

Whether venting anger or maintaining a generally glum attitude has actual health benefits, however, is an open question, Dr. Norem said, although she pointed to one study that showed a correlation between cheerfulness in men and earlier mortality.

"You don't want to make too much of it," she said. "But for cranks like me, it was encouraging."