Dr. Peter Harvey's paper has been updated

Hello all

A few years ago I drew your attention to this gentleman’s insightful article.

It has been updated, extended and broken down into sub topics:


I hope this is helpful.

Brilliant Dahlia, when I get a minute tomorrow I will have a good look at this. I have passed copies of the original on to quite a few people now, all have said how helpful they have found it. A few have told me they read it again when they are struggling with the way they are feeling as it helps them cope with things better.

Thanks so much for posting that link.

Thanks Dahila, I’m feeling very low only got 3 more Herceptins left and I am starting to panic. Any info is great to read, thanks for the link… looks helpful x

This link is excellent. i have just spent a while reading it and have saved the site to my favourites.Thanks Dahlia.


Thank you so much Dahlia. Just had a quick look and when my visitors have gone I’m going to sit down and read it all. I think this is going to be a big help.

Jan x

Morning all

Very glad I passed this on, thank you for your appreciation.

Have you all got access to his article - The Perils and Pitfalls of Positive Thinking?


Hi Dahlia

I haven’t seen the article about ‘perils and pitfalls of positive thining’ but definately want to! (is it ‘googlable’) Sounds very interesting and thanks from me also for posting the article above - very useful reading.

Lots of love. Cathy x

Hi Dahlia

Thanks for posting this do you have a link for Pearls and Pitfalls of Positive Thinking? I have goodled it but can’t seem to find the article in full.

Anne xx

Re the Perils and Pitfalls of Positive Thinking…if this is of any help, it’s from the Northumberland cancer support group…it’s easier to read than the PDF google first shows in results…Belinda. Thanks for highlighting this excellent article again Dahlia!

The Perils and Pitfalls of Positive Thinking
Dr. Peter Harvey is a clinical psychologist and was one of the speakers at the National Conference of Cancer Self Help Groups in June 1999. We have tried to summarise his talk “The Perils and Pitfalls of Positive Thinking” as the full transcript is quite lengthy. However, where quotation marks are used, we have quoted verbatim from the transcript.

As a clinical psychologist, his expertise is in the area of human behaviour; how and why people think, act, feel and behave in the ways they do, unlike psychiatrists who look for mental illness. He tries to make use of psychological knowledge about a huge range of ‘normal’ behaviour to understand and try to alleviate distress.

His experience over five years or so has been in working with people living with cancer, patients, relatives and staff.

“You too have experience and expertise. You know more about your life, your thoughts and your feelings than any psychologist could ever divine. You are the only person in the known universe that really knows about you. Sometimes as professionals we have a tendency to overlook this simple and obvious fact”.

He stated that much of what he was going to say was based on psychological knowledge but even more was based on what people had talked about with him and he hoped that his expertise enhanced by the experience of others, would complement our expertise and experience.

He explained that he had very carefully chosen a deliberately provocative title, grounded in what people had told him when describing their experiences e.g. being exhorted to think/feel/be positive as being the way to beat cancer, at times when they felt at their most vulnerable. This caused him concern and he asks what we mean by ‘being positive’.

He used an overhead projector to show examples of greetings cards which sent the message that being positive was being cheerful and then asked the question – can we equate being positive with happiness.

Words are important and two of them are often confused for positivity.

Optimism – is a fairly stable disposition i.e. it varies between different individuals but is fairly constant within people. “The optimist proclaims that we live in the best of all possible worlds; and the pessimist fears this is so” – James Cabell. Optimists are not happy all the time any more than pessimists never smile. Optimists generally view that ‘things will probably turn out for the best’ whereas pessimists view that ‘things will probably turn out for the worst’.

Happiness – often desired, often unfortunately short-lived and transient emotional state. Few of us are happy all the time. It could be rather tiring and faintly annoying for those around us! We can be happy without being optimistic.

Positivity: Stephen Greer and Maggie Watson and colleagues, looking at how people cope with cancer, came up with one coping style which they called ‘Fighting Spirit’.

“This is characterised by an outlook which aims to try and beat the cancer, to confront it head on, to acknowledge its existence as a part of life but not to let it predominate, to be an active participant in decisions about treatment. Not a word about happiness or sadness. Being positive is not about being happy. It is not about not crying or not being sad. It is very different from, and much more complicated than these transient emotional states. My discomfort with the phrase is to do with the experience that people have when they are as good as told off for not doing well enough, scolded for expressing how they really feel”.

Peter Harvey said that the characteristics that we might call positivity, he would prefer to call ‘Constructive Coping’. He pointed out that ‘coping’ is a much misunderstood word

and that people often set themselves targets that are unachievable. Coping is not a single process, but is multi-stranded, employing a variety of strategies to deal with a variety of challenges. There is no one, right way of coping. Coping is not an all-or-nothing event; it requires effort and energy. It can be tiring, uncomfortable and very difficult and we cannot expect ourselves to be able to cope easily without some cost. “Too often people tick themselves off for not coping well enough, when sometimes they should be congratulating themselves on coping at all”.

Elements of coping: The first is confronting the issues. Once we know what the threat is, then we can mobilise our inner resources to deal with it. Cancer is obviously a major threat both physically and psychologically. Part of the process of dealing with the physical threat is to have treatment. A complementary and equally necessary process is to mobilise psychological resources. We need to keep the ever-changing threat under constant review. We must harvest and preserve our internal resources so that we can concentrate on dealing with what can be changed.

Confronting the issue is often very painful and distressing; one reason why it’s better to do it a bit at a time. Confronting can result in emotional trauma and part of the coping response is being open to feelings, good or bad, constructive and destructive. Coping is often characterised by being stiff upper lipped, stoical and accepting. Feelings can veer from one powerful emotion to another like some horrendous roller coaster. Some of the threats that cancer brings with it are about our very existence. It would be an abnormal reaction not to be upset.

Dr. Harvey says “In situations when people are berating themselves for being upset, or for not coping, a phrase that I sometimes use – stolen, I freely admit from Michael Stewart and Peter Hodgkinson – is ‘You seem to be experiencing expected reactions to extraordinary events.’”

When you feel tearful, frightened or despondent, don’t give yourself a hard time and tell yourself that you are not coping. “True courage comes in the face of fear, not pretending that fear is not there”.

One of the coping strategies he recommends is privacy. Someone diagnosed with cancer can suddenly become “public property”. Telling the same story over and over again does not necessarily get easier.

Secondly, some people who ask how you are don’t really want to know. You may be feeling awful after chemotherapy but look quite well and you know that when someone asks “How are you?” they want to hear “Just fine, thank you.” So you pretend, to protect the feelings of others.

It is possible to set up effective communication networks that protect privacy but still ensure that those who genuinely want to help and need to know are properly informed.

Information is more readily available for patients these days, so the next element of constructive coping is informing yourself. This can and must be within your own control. The key to this is selecting the amount of information you need at the time you decide and presented in a manner that suits you. If people thrust books and press articles at you, you can choose not to read them.

Next, is finding and developing constructive social networks. Some peoples’ attempts to be helpful “clatter hobnail boots through carefully woven support structures” with horror stories about other people or gloom-laden sympathy. Just as bad, are the people who try to cheer you up with “Look on the bright side – after all you could be in Kosovo”. It’s not always helpful to be reminded that there will always be people worse off than yourself.

Another problem can be over-protectiveness. You may actually want to go and make a cup of tea for yourself. It’s interesting that people rarely offer to do some horrid job like cleaning the loo! The best kind of support is that which asks you what you want and is prepared to do it, but will not be offended if you say “Thank you very much for the offer but I need to do this for myself”.

In other words the sort of support that is an active contribution to your well-being and not an additional burden.

A very important part of coping is with fun and laughter, grinning, giggling and gallivanting but also….

Grieving: Cancer can bring many losses – independence, self confidence, sense of self; these are real and acknowledging their loss may be an important part of being able to move on and face the future. Dr. Harvey has been struck by how people feel they are being vain and self-centred when they are devastated by the loss of a breast, loss of hair, loss of masculinity or femininity etc. they feel they should be grateful. You are allowed to feel sad and sorry that you have lost something valuable. Allow yourself to acknowledge that the self you present to the world has been changed – in ways that you do not like and have not chosen.

What can carers do? Constructive caring: From health professionals, patients experience only clinical touch during investigation, intervention, treatment etc. Non-professional carers can give the warm, supportive loving touch that professionals cannot. The professionals may be able to comfort with a squeeze of the hand or a gentle touch on the shoulder but they are limited. Loved ones can support with the hugging and holding which says more than words. Even if someone is too fragile for a big bear hug, a gentle caress can provide a concrete symbol of care and concern.

Encouragement: A tightrope to be trod with great care. Over-encouraging can be oppressive and hurtful; under-encouraging can look like lack of interest. Encouragement is not about ordering you not to worry, telling you not to be silly and not allowing you to show your feelings. It’s about helping you to get the balance right. This may be reminding you of something helpful that the consultant said, it may be crying with you. Whatever it is, it must be in partnership with you.

The easiest way to know how to do this is by listening. Listening to distress and fears as well as hopes and aspirations. None of us likes to hear and feel the pain of a loved one. It’s not easy but persistence pays. Sometimes the desire not to hurt or upset each other builds walls rather than bridges.

In listening we also learn of the need to protect. You can ensure that the contact that is wanted is encouraged and the unwanted contact is discouraged, when the party gets too tiring you can make sure leaving early is done subtly and so on. But this can only be done by openness and agreement. Sadly, over-protective partners can become domineering and controlling in their desire to protect and some would be devastated to hear what their loved-ones say about this.

It can be incredibly distressing to watch someone you love and care for suffer. You may feel powerless and helpless despite the fact that you may be able to offer more than anyone else. There is the feeling that you don’t deserve the time or care as you are not the one with cancer. The carer needs support and help too so that they can help the patient. Unburdening is a key element of constructive care. We will be better carers if we allow ourselves to be properly cared for.

Summary: Being positive is something more than being happy. David Speigel who did a study of women with breast cancer has warned against making positive thinking a prison – by which he means behaviour that denies people the opportunity to feel low, to feel bad, to weep and rail and rage as well as to be constructive, happy and optimistic.

“What I have tried to do today is to move away from a narrow constraining view of positive thinking towards one that liberates, one that becomes a source of energy to support, enable and empower those who are living with cancer”.

Excellent Belinda - thank you.

Anne xx

Thank you Belinda for the precie and Dahlia for bringing it up.

Found it very usefull, the overal summery I thought was spot on.

Also the bit about overprotective people struck a cord.

A friend who gets the support, advice whatever spot on was criticised harshly by others for some of the things she’s done or said but which were from my point of view just what I required. Fortunately she’s strong enough to cope but I’ve asked her to tell them to 's*d off.

Thanks again ladies and I will be looking at that updated thread as I found the last one very helpfull and have read it several times.