Live Long and Well with Dr. Bobby

#51 Can Thinking Positively Cure Disease?

• Dr. Bobby Dubois • Season 1 • Episode 51

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Can a positive mindset truly improve your health—or even help you beat disease? In this episode, Dr. Bobby and guest Sean McDevitt explore the evidence behind optimism, visualization, and prayer to uncover what really works.

In today’s episode of Live Long and Well, Dr. Bobby is joined by fitness and life coach Sean McDevitt to explore whether positive thinking can influence health outcomes. They dive into both anecdotal and clinical evidence, starting with sports psychology and then navigating the science behind mindset and disease. 

The conversation opens with laughter and smiles—literally. Inspired by Norman Cousins’ Anatomy of an Illness, Dr. Bobby references a meta-analysis showing genuine smiling does, in fact, temporarily boost happiness, while artificial smiling (like holding a pen in your mouth) doesn’t.

They begin with sports, where 86 studies show that visualizing athletic success can improve performance in agility, strength, and game-specific skills. Next, they ask a deeper question: does having a positive attitude affect the progression of serious disease? 

A meta-analysis of 26 studies on life satisfaction and longevity suggests happy people may live longer—especially when it comes to heart health. Optimism, for instance, was linked to a 35% reduction in cardiovascular events and a 15% decrease in all-cause mortality.

However, when it comes to cancer, the picture gets murkier. A review of 165 studies links stress to poorer survival, but a separate meta-analysis on coping styles found no consistent impact on recurrence or survival. One influential study on breast cancer patients even found that while helplessness predicted worse outcomes, having a “fighting spirit” made no significant difference (source). As Dr. Bobby notes, it’s important not to burden patients with guilt if they can’t “stay positive.”

The critical question becomes: if you're not naturally optimistic, can you cultivate positivity—and will it help? Encouragingly, several intervention studies suggest it might. One trial showed cardiac markers improved after optimism training, and a meta-analysis of 56 RCTs found a 15% boost in immune function after psychological interventions. A small MS study linked mindfulness to better walking ability, and a large RCT on breast cancer showed a 45% drop in recurrence with stress-reduction and mood-enhancing strategies.

Finally, the episode touches on spirituality. While many find comfort in prayer, evidence from an RCT of 800 ICU patients and a [meta-analysis] shows no significant impac

SPEAKER_00:

Can you laugh your way to better health? Does praying for others make a difference? Will a positive attitude help fight cancer? We all want to know, both to help our loved ones who might be ill or ourselves. As always, what does the evidence tell us? Let's look at a fair and balanced way, and you can decide. There's something here for everyone. Hi, I'm Dr. Bobby Du Bois, and welcome to Live Long and Well, a podcast where we will talk about what you can do to live as long as possible and with as much energy and vigor that you wish. Together we will explore what practical and evidence-supported steps you can take. Come join me on this very important journey, and I hope that you feel empowered along the way. I'm a physician, Iron Man, triathlete, and have published several hundred scientific studies. I'm honored to be your guide. Can thinking positively cure disease? Last episode I shared my dear wife Gail's cancer journey. And we've heard many very lovely words shared with us. Things like, I'll pray for you to Gail. Your positive spirit will beat the cancer. Now, this sounds really good. But as you might guess, I asked the question, is there any evidence? And that's the topic we're going to explore today. Gail has a remarkably positive attitude. Is she more likely to win her cancer battle? What does the evidence say? And that's what we're going to explore today. Also, today I am trying something new and I need your feedback whether this is something you want me to continue to do. You may recall back in episode 25, I had an interview with Sean McDevitt. And we discussed taking what we know works. So what does the evidence say about exercise or nutrition? And then how do you actually motivate people to do it? So summarizing the evidence is one thing, but actually getting people to do it is another, and that's an area of expertise for him. Sean is a fitness and a life coach. He also has an MBA and now works in the tech world and was kind enough to join me today. And I thought it would be fun to have two voices for this episode. Again, let me know whether this format works for you or not. And should I do more episodes like this? They are likely to be a bit longer than that 20 to 25 minute uh length that I typically shoot for. But again, you can tell me the trade-off and whether that's something you enjoy or not. So, welcome, Sean, to Live Long and Well.

SPEAKER_01:

Thank you so much, Bobby. I really appreciate you having me back. And I know this is going to be a very powerful episode because so much of what we're talking about is very near and dear to my heart. That said, I'm excited to get into the data and find out what is actually efficacious and that we can use in our lives backed by science.

SPEAKER_00:

And maybe some of it will surprise you, some of it might depress you, and some of it might just befuddle you. So hopefully that will be true also for our listeners. Now, as I was thinking about the power of positive thinking, I was thinking back on my marathon and Iron Man Triathlon career and the positive thoughts that the spectators send my way as I'm biking past or I'm trudging past on my marathon at the end of all of this. Now, I have to admit, some of the words didn't really help me. So in a marathon, when somebody says, you're almost there, and you're only at mile 15, you got another 11 miles to go, that doesn't necessarily help me. Or you look great. And I know I'm dying, so I know I don't look great. So these words didn't cheer me up or improve my running speed. So there's a question of power of positive thinking. Of course, it was their positive thinking, not necessarily mine. But as I reflected, I realized there were some words I really enjoyed and actually pumped me up and got me happy for at least a period of time. One of them is hey, naked spectators ahead. Well, that got some images and took me out of my pain place. Beer at the next water stop, or little kids giving me high fives. This really works. So there was some positive aspects for me, although temporary. So, Sean, you were a competitive swimmer in high school and college. And what thoughts helped you? What did not? Where was the power of positive thinking for you?

SPEAKER_01:

I appreciate this question so much, Bobby, and for your listeners. I swam for the University of Georgia, Go Dogs, very proud of that accomplishment. As you mentioned during your marathons and triathlons, you heard a litany of different comments from the Peanut Gallery, so to speak, whether they were positive, negative, or just funny. Unfortunately, being under the water, I did not hear beer in the next lap. I did not hear, you know, naked spectators in the pool. However, what I did hear that was helpful were more of the tactical specific strategies for swimming specifically. And so if I had a coach or my father or a friend tease out something that they actually saw that I could thoughtfully fix or remedy for that next race, I really appreciated that. The hey go win or swim fast. It was like, okay, I I got it. Yes, that's the plan. And that wasn't very helpful. I like you. You know, I appreciated the positivity. I'd much rather have someone say, hey, you're gonna do great, right? But what I found is that expectators, others in the audience will sort of apply what they think worked for them. It may not work for the individual that's competing, and that's why I liked more of the technical expertise or actionable things that I could actually focus on during a race.

SPEAKER_00:

That's great. And yes, being under the water makes it a little difficult to hear, so I can uh I can understand that. But the thought of naked spectators in the in the pool, that might get me excited and interested. So in the 60s, Norman Cousins, who's an author, developed a degenerative disease of his back, and he created his own approach to get healthy. And his theory or his approach was if stress can hurt you and make you ill, then perhaps the opposite, laughter, can help. And so he wrote a book, The Anatomy of an Illness. In essence, he was saying you can laugh your way to health. And so he watched funny movies. And his goal in watching these funny movies was to have about 10 minutes of true belly laughing, you know, uncontrolled laughing. And his condition got better. Now, he attributed it to, well, the laughing and such releases endorphins, maybe your cortisol stress hormones go down, maybe it helps your immune system. So this goes back 60 years where he was really promoting this. And as I was putting stuff together for today, I looked at the literature on not laughter, because there's not a whole lot on laughter, but there is on smiling. And there is a meta-analysis or a summary of many, many studies. And they asked the question: did the act of smiling, meaning pulling your kind of the corners of your mouth up and maybe squinting your eyes, does it actually change your brain? And temporarily do you feel happier? And the answer was, yes, it really did. And if you try this at home for my listeners, you will find it's hard to be kind of sad if you stick your mouth in a smiling position. Now, some very industrious researchers said, well, yeah, maybe, maybe, but they were going to imitate smiling by putting a pen in people's mouth, not sticking it down their throat sideways. And so it kind of forces your lips upwards. And that was sort of imitating a smile. What they found ultimately was that didn't work. But a true smile initiated by you did seem to make people happier.

SPEAKER_01:

Well, I love that smiling study, Bobby. And it reminds me of the power of positive thinking, quote unquote. And it seems like, based on the studies, if we're very genuine in our smiling, there are some benefits. How might we approach this generic topic, whether positive thinking can affect our health?

SPEAKER_00:

Yeah, that's really the crux of the issue. We're gonna just take a f a couple of minutes, talk about sports, because in sports, there are studies and belief that if you imagine hitting the baseball, imagine hitting that serve and it goes it exactly where you want that it might actually make a difference. Then we're gonna turn to the next two health areas. So the first is are people who have a positive attitude when a disease hits, are they likely to get a better outcome versus somebody who is very down in the dumps, has a very negative view. So it's a correlation between happiness and the outcome of the illness. Then the third part, which I think in many respects is the most critical one, is well, maybe you don't generally have a positive attitude, or maybe, you know, with this illness that just beset you, you're not feeling very upbeat. So now the question is if there was a way to change your attitude, get you in a more positive space, would that change the outcome of your disease? And that's really, really critical. As I said earlier, there's something for everyone here. There are some studies that support it and some studies that are not supportive. So let's jump into sports.

SPEAKER_01:

I appreciate you mentioning the sports component, Bobby, because as you can imagine, in my high school and collegiate swimming careers, I've been around many athletes who visualize success. For me, it's something to do versus being nervous before the race. And it was something that my dad actually recommended that I start doing for that reason, because as an eight, nine-year-old, I started making these big meets, and all of a sudden I got a little bit more nervous. And so my dad encouraged me to visualize the race, and I found that anecdotally it helped me calm my nerves. Um so it seems to help folks. I'm curious if there are any studies to support this.

SPEAKER_00:

So when when you were swimming, did you ever like envision your stroke or envision that perfect flip turn? Was that something that maybe you pre-gamed to get yourself ready? And did it make a difference?

SPEAKER_01:

I actually used to do this all the time, Bobby, in and out of the actual meet. And so if I had a big competition coming up, I would actually visualize the races in bed or my favorite races, the nights leading up to the meet. And so, for instance, if the meet started on a Thursday, I might start on Monday visualizing it at night as I'm going to bed. And then as my pre-race ritual, I would visualize a little bit more and just bring that back up. I cannot tell you because no one was in my head watching what I was visualizing if I was actually able to execute on that. But I did feel more prepared because it felt like I had swum the race already or I had done the meet already. And so it did help calm my nerves in that way. And anecdotally, as a placebo effect, it was helpful for lowering the stress and lowering the anxiety around the actual That's great.

SPEAKER_00:

So let's turn to the evidence. What do we know in the area of sports? So this isn't health. We'll get to that in a second. So the studies typically looked at imaging, meaning people were envisioning how that perfect high jump would go or that perfect golf swing and exactly where the ball would go that you wanted to go. So they had these imagery practices and some psychological skills training that basically helped people feel positive about what they were about to do. And there were 86 studies. There was a lot of studies. And what they found was there were benefits in muscle strength, tennis and soccer performance, and agility. And what they found was that 10 minutes of visualizing three times a week for a hundred days seemed to really help people. So I found that really interesting. Of course, we could have this whole discussion about sports, but that's not what our main topic is for today.

SPEAKER_01:

I do wish I could go back in time using this data and increase my visualizing even more.

SPEAKER_00:

So one of the examples of these types of studies, and again, there's been a lot of studies that look at some of this, the thing about do happy people live longer? And is there a relationship between how satisfied you are and optimistic you are, and what happens long term? Are you going to live longer? And there was a review of about 26 studies, and they did seem to show a relationship. I'll just give you, give my listeners a glimpse of one of them. Again, we're not talking about health per se, but it's looking at people who are happy and whether they tend to live longer. So this was a study that they looked at 196 professional baseball players in 1952. Now they had pictures of them, and they rated the pictures as to how happy they looked. And then they figured out how long they were going to live. And they controlled for baseline health and whatever it was. And what they found was there was a relationship. The happy baseball players and the fees lived longer. Now it was most pronounced for heart disease. It didn't correlate as strongly for cancer or some other things, but for heart disease. And we're going to come back to that. Now, obviously, that's not causality, but that's at least a kind of a hint on where we're we may be going.

SPEAKER_01:

That's a fun study, Bobby. Things that make you go, hmm. Are there any studies that look at particular diseases?

SPEAKER_00:

Yeah, and I wanted to sort of break this down into areas. So in the heart, there's been a lot of studies, and they found that if you're optimistic at the beginning of the illness, it was associated with a 35% lower risk of cardiac events. It could have been a heart attack and such, and a 15% lower all-cause mortality. So in the area of heart, there's evidence that being happy at baseline made a difference. They also looked at people who were having bypass surgery, which is a big operation on your heart. And they asked the question who was calm and happy and optimistic and upbeat versus not, and who did better? And they looked at people at six months later, and their quality of life for those people who were in the happy place at the beginning was much better and their recovery went smoother. Now, you might ask, of course, and should ask, well, how can this occur? Can we actually believe this? Now, if you're a believer in the power of positive thinking, you may say, well, negative feelings may affect our hormone levels, like cortisol, some other things. And that could affect cardiovascular disease or other outcomes. Or you can take the cynical view. Perhaps the people that were positive felt more energetic and worked harder. So if they were supposed to get exercise after their heart attack and they were in a positive place, they were more likely to do it, perhaps. So again, this was an observational study, and that's what we learn. And for Hart, there is some promising evidence.

SPEAKER_01:

As we break down these particular diseases, Bobby, I imagine it's top of mind for your listeners given the last episode. I'm curious about cancer. Any information there?

SPEAKER_00:

Yes. And at the outset of this, I said, yes, well, Gail's got a positive attitude. Maybe that's going to make all the difference in the world, and I hope so. So it's a mixed picture in the area of cancer. There is a meta-analysis of 165 studies, and they looked at stressful life experiences. And people who had stressful life experiences had a lower cancer survival rate. But there's a lot of questions about the validity of some of the studies and all. So that one's not quite so clear. Another large summary of studies looked at coping styles and cancer survival. And here they said there's little consistent evidence that the coping style played an important part. Now, this is an interesting kind of double-edged sword. On the one hand, you'd like to think, well, if I adopt a positive attitude, I'm going to beat this cancer. But imagine you're so worn out from the disease and the chemotherapy and the radiation therapy, you just don't have that fighting spirit. And so you may feel guilty, like, well, if only I could be positive, I'd beat the cancer. So actually, by telling patients it may not make a difference, it takes some of the emotion and guilt out of the equation. There was an actual study that looked at early stage breast cancer about whether fighting spirit mattered. It didn't really make a difference. So again, a couple of things to give us pause. Now, why might people who have a positive attitude look to do better in some of these studies? Well, if you if you're financially more well off and you have social resources to support you, you may be in a more positive place in your life. And you may do better with the disease, but it might not do to the positive attitude. It might have to do with the financial resources and other kinds of things. So it's it's a little circular in reasoning, and so we really don't know ultimately the answer on this one.

SPEAKER_01:

Yeah, it seems like we have mixed reviews, and there's bad news and a good news story here for cancer specifically.

SPEAKER_00:

I think it is. Just to reaffirm that I think it's very positive to say to people, you're gonna fight this thing, and that's great if you're a fighter. But if you're not a fighter, take the guilt off because the studies don't say it makes a difference. If you're in a positive place, that's just fantastic. You'll feel better about the whole where you are in your life. But if you don't feel that fighting spirit, it's okay, and your outcome is likely to be just the same.

SPEAKER_01:

So it seems like if one has a positive attitude, they might be able to improve their disease outcomes. But if they don't necessarily have an extremely positive outlook, what do we do then? Can you do something to create that, to get that positive attitude? And would that actually help?

SPEAKER_00:

Yeah, and that's really the crux of the issue is if we work with folks and help them to be more positive, could be cognitive behavioral therapy, it could be mantras, it could be journaling, it could be any of a number of things. The question is, if we did that and we help people along that path, would it make a difference? And there is some good news here. So in the heart area, which again, remember I mentioned that that in the heart area, having positive outlooks seemed to correlate with living longer and doing better. But when they actually intervened and taught people optimism training, many of their cardiac markers, blood markers, things about their heart got better. Well, now that's exciting. But what about immune function? Does a positive attitude help there? Again, there were 56 studies over 4,000 patients, and they looked at various blood markers, cell counts and inflammatory blood markers, and they found that those interventions that help people be positive, all of a sudden their inflammation markers did get better. And I'll have some of the links in the show notes because some of you may be wondering how is this possible for multiple sclerosis. It was a tiny study, there were only 35 people, but they did mindfulness and positive training. And what they found is the group that had that had an improvement in walking distance because MS patients find it sometimes very difficult to walk any length of time. In cancer, it's again, once more, it's a bit more mixed. But there was a study in breast cancer, and they had some strategies to help people reduce stress, improve their mood, and such. And the recurrence rate seemed to be lower in the people who underwent that training. So there it's a mixed message, but I'm you know cautiously optimistic. I'm gonna adopt a positive attitude about all of this.

SPEAKER_01:

I love it. I'm curious, Bobby, are there any other areas of the mind-body that maybe we should focus on and discuss?

SPEAKER_00:

So one of the things that I mentioned at the outset was all the wonderful people who said, I will pray for you. And it definitely felt good to know people cared and that they would be with us along this journey. But then the question is uh again, is there any evidence that prayer for someone else? And this isn't prayer for yourself, it's prayer for someone else, improved survival. So they took in this randomized trial 800 people that were in the ICU. And at discharge, they had half of the people get intercessory prayer. So that's prayer by somebody else. And there were five people that prayed for you on a weekly basis. So we're getting heavy duty prayer for you. And then there was the control group that didn't have the prayer, and they followed them for about six months. And they looked at death and hospital readmissions, need to go back to the emergency department, and there was no difference in outcome. Now, if people think you're praying for them, are you going to feel better about the whole thing? Sure, why not? But will it change the outcome of an illness? The data don't really support that. But I suspect if you enjoy prayer and it makes you and the other party feel better, then by all means that's the way to go. So, Sean, before I wrap up, any sort of points that you want to think about?

SPEAKER_01:

This was very informational, Bobby, and I'm excited to use some of this in my own life because much like yourself, I am often looking for cheat codes or strategies or hacks to be able to delay aging and live longer, live happier, live healthier, as I know that's your brand. And this was very helpful in terms of the smiling studies, the genuine smiling studies, and seeing what can actually, supported by science, make a difference in our lives for long-term health and holistically. So I really appreciate what you're doing overall, and I imagine your listeners appreciate it as well.

SPEAKER_00:

Well, thank you. It's been great to have you here. And by all means, let me know, my listeners, whether you like the back and forth approach and how whether we should continue to do this. Well, let's wrap up. The topic of power of positive thinking with respect to our health is really important because serious illness has a way of creeping up on all of us, whether it's in our loved ones or ourselves, and so it's an important topic. It does appear that if you do have a positive outlook, it is associated with doing better. The data are mixed, but I would say they're promising. The key question is whether becoming more positive will help. Now, the jury's out for some diseases, it appeared some of the blood markers got better, and for cancer and some of the others, maybe not so much. And on another day, we might talk about spirituality and cancer outcomes. Does in yourself, does going to church or synagogue or a mosque improve outcomes? So that may be a topic for another day. As always, I hope that you live long and well. And when you have a positive attitude, that's delightful. I know Gail has a positive outlook. I hope it helps her. It clearly brightens up everyone around here, hearer and me. Sean, thank you for joining us. And uh I look forward to more discussions together. Thank you so much for having me. Thanks so much for listening to Live Long and Well with Dr. Bobby. If you like this episode, please provide a review on Apple or Spotify or wherever you listen. If you want to continue this journey or want to receive my newsletter on practical and scientific ways to improve your health and longevity, please visit me at Dr. Bobby Livelong and Well. That's Dr. As N D R Bobby Live Long and Well.