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July 16, 2019

When Serious Illness Strikes: Effective Ways To Ease Anxiety

By American Psychosomatic Society

Contact: Christopher Celano, MD

For Release: Immediately

It’s understandable that serious medical problems and anxiety often go hand-in-hand.  Now there’s good news from the first thorough review of scientific research testing whether “positive psychology” exercises designed to improve well-being can reduce this anxiety for patients grappling with illness.  The techniques—portable, easy to learn and practice on your own—are effective for lowering anxiety in seriously ill people.  The new report, published ahead of print, will appear in a forthcoming issue of Psychosomatic Medicine, journal of the American Psychosomatic Society.

“Anxiety can be a normal reaction to serious illness,” notes Christopher Celano, MD, Associate Director of the Cardiac Psychiatry Research Program at Massachusetts General Hospital and Assistant Professor of Psychiatry at Harvard Medical School.  He is coauthor of the review with colleagues Lydia Brown, PhD, and Jeff Huffman, MD.

Most patients in the studies did not have an anxiety disorder– they were anxious but still in the normal range after receiving their diagnoses.  Among their medical problems: cancer, heart disease, multiple sclerosis, chronic pain and infertility.  The review covered 12 studies with 1,131 people randomly assigned to treatment with the positive psychology exercises or to a control group that didn’t use these techniques.  The exercises included an array of practices found to improve overall well-being in healthy people.  Some of them were:

  • Writing a letter of gratitude to a person who did something for you.
  • Recalling three positive things in your day and writing them down.
  • Identifying your personal strengths and thinking about how you can use them in new ways.
  • Setting aside time in your day to do something enjoyable.
  • Identifying those things that are most meaningful for you in life.
  • Writing about your best possible future despite pain or other medical problems.

In some studies patients were told to do specific exercises on their own, in some they used an instruction manual or followed an Internet program.  Other studies provided a clinician to guide the patients.

Those given the positive psychology exercises had greater reductions in anxiety than patients in the control groups.  And the more sessions their program included, the more they benefitted compared to the controls.  Clinician-led programs were somewhat more effective than the others.  Control participants were given treatments such as supportive therapy, massage and health education.  A follow-up averaging eight weeks after the studies ended showed that the benefits in lowered anxiety were maintained.  A smaller review of 11 additional studies with 300 ill adults who weren’t randomly assigned to groups also found anxiety-reducing benefits after the positive psychology exercises.

Research on how to reduce anxiety usually focuses on the most anxious—those with a bona fide disorder.  Since these anxious patients were typically still within the normal range, it’s striking that deploying such simple techniques could produce a statistically significant benefit, says Celano.  “This is hard to do because these individuals’ anxiety could not decrease that much, since it was not very high to begin with.  Sometimes interventions like these show bigger effects when people are experiencing higher levels of symptoms and therefore have more room to improve.” Also, maintaining improvements a couple of months after the formal studies ended suggests that people were using the strategies going forward, he adds.

“A lot of these skills translate well into everyday life, so once people learn them, they can use them even after these programs are over,” says Celano.  Serious illness tends to catapult us down into a vortex of negative thoughts.  “Instead of focusing so much on the negative, positive psychology exercises help people to focus on the all the positive things still occurring in their lives,” he says.  This counteracts dwelling too much on the illness.  “It helps you to put things in perspective and to be less anxious.”


Study Link: http://doi.org/10.1097/PSY.0000000000000722
Faculty Page: https://www.massgeneral.org/psychiatry/research/researchlab.aspx?id=1829

The American Psychosomatic Society (APS) (www.psychosomatic.org), founded in 1943, is an international multidisciplinary academic society that organizes an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the APS is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”

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