Glass half empty patient? New language, reframing can change ‘sticky’ negative thoughts

INDIANAPOLIS — The human mind often gravitates toward negative information and holds onto it, making it difficult for patients focus on positive thoughts and achieve health goals, according to a speaker here.

The good news, said Alison Ledgerwood, PhD, associate professor of psychology at the University of California Davis, is that the human brain can be retrained to think in a more positive way, improving health outcomes and general wellbeing for patients. Diabetes educators and other care team professionals can also have greater impact by changing the language they use in their interactions with patients — even using a patient’s “glass half empty” attitude to their advantage.

“Diabetes educators can help motivate patients to engage in important health behaviors by using language that fits a given patient’s style of thinking,” Ledgerwood told Endocrine Today before her presentation at the American Association of Diabetes Educators annual meeting. “Thinking about things in a positive way takes practice, but it’s something we can train our brain to do if we put some effort into it.”

How the ‘glass’ is presented

There are two classic ways of thinking about events: the proverbial glass, Ledgerwood said, can be looked at as half empty or as half full.

However, research also shows that the way the glass is described to others influences how they feel about the glass. Ledgerwood described a recent experiment in which two groups of participants were presented with ground beef. One group was told the beef was 75% lean; the other group was told the beef contained 25% fat.

Those in the “lean” group not only considered the beef healthier than did those in the “fat” group, they even reported that it tasted better, Ledgerwood said.

Similarly designed experiments that evaluated responses to work projects, surgical procedures and even political candidates all had similar results, she noted.

“This general pattern has been studied across psychology, economics, political science, marketing, across a range of disciplines,” Ledgerwood said. “Taken together, you can think of this research as showing the extent to which people’s current judgements and behaviors are influenced by the way the information is currently described or framed.”

Reframing negative thinking

In the real world, information is often framed and reframed before people act on it, Ledgerwood said. A diabetes educator, for example, may tell his or her patient that their HbA1c is down, provoking a positive response. However, that patient’s partner may be quick to remind him or her that same day that the HbA1c is still higher than it was last year, disappointing the patient.

“So, the good news gets reframed as bad news,” Ledgerwood said.

There is reason to believe that some “mental labels,” like the idea of having a “bad” HbA1c, can be sticky, resisting subsequent attempts to change them, Ledgerwood said. That resistance, Ledgerwood said, stems from a primitive, adaptive human tendency to prioritize safety and negative thoughts.

In addition, experiments show that when people start out thinking negatively, but then have a situation reframed, they experience muted change when compared with those who start out thinking about a situation positively. In other words, Ledgerwood said, negative thoughts “linger longer.”

To make positive change that counteracts negative thoughts, Ledgerwood said, it is important to identify a patient’s thinking style. People generally tend to focus on either avoiding loss, referred to as “prevention focused,” or on approaching gains, referred to as “promotion focused.” These two types of patients will think about the world in different ways, and different language can be more motivating for one type vs. the other, Ledgerwood said.

“For some patients, describing health goals in terms of trying to avoid problems is going to be most motivating, whereas for other patients, describing those same health goals as finding new opportunities to boost health and wellness is going to be most motivating,” Ledgerwood said in an interview. “In other words, some patients will respond well to messages like ‘Avoid the cake!’ and ‘Exercise to prevent health problems.’ But others will respond better to ‘Find new healthy recipes’ and ‘Exercise to achieve new levels of fitness.’”

Breaking the cycle

Reframing language and thinking takes practice, Ledgerwood said, but cognitive behavioral science research shows that repeatedly reframing negative thinking can help to retrain the brain to accept more positive thoughts. Still, there are additional ways to improve a focus on the positive. Ledgerwood said patients should work to share any good news related to meeting positive goals, keep a weekly or even daily list of positive achievements and observations of gratitude, help others to foster feelings of wellbeing and even talk more to strangers.

“Buy a cup of coffee for the person standing behind you in line,” Ledgerwood said. “Give your umbrella away to a stranger in the rain. Do something to make somebody else’s day a little better, and suddenly, your day gets better, too.”

“Our minds may be built to look for negative information and to hold on to it once we find it,” Ledgerwood said. “And that may be very adaptive from an evolutionary perspective and not so great in the modern-day era when we are safe from tigers. But we can also retrain our brains if we start to think a little bit differently about our lives and the world around us.” – by Regina Schaffer

Reference:

Ledgerwood A. Why Negativity Sticks and What to Do About It. Presented at: American Association of Diabetes Educators; Aug. 4-7, 2017; Indianapolis.

Disclosures: Ledgerwood reports no relevant financial disclosures.