Published On October 21, 2021
For all the devastation brought by the pandemic, heart disease remains the leading cause of death for Americans. COVID-19 may, in fact, have made those numbers rise—the viral infection is suspected of affecting cardiac function, and even for those who haven’t been infected, the mayhem of the past 18 months has disrupted physician visits and added unhealthy levels of stress.
One response, unthinkable as it may seem, is to just be happy. Positive psychological states—happiness, optimism and resilience—can play a powerful role in improving heart health, according to a growing body of research. Driving many of those studies has been Jeff C. Huffman, director of the Cardiac Psychiatry Research Program at Massachusetts General Hospital, who is looking for ways to mend hearts by putting those positive mental states to work.
Q: How does one begin to look into the connection between positive feelings and heart health?
A: There are really two big questions in this field. One is: Does experiencing more well-being benefit cardiovascular health? Based on the evidence of the past decades, I think that answer is clearly yes. The related, bigger question is: Can you modify a person’s sense of well-being to provide this benefit? That is to say, if you’re a pessimist, are you forever a pessimist—or can we cultivate some of the habits of well-being to improve your cardiovascular health?
We’re looking into this second question and trying to determine whether we can develop a scalable, accessible program to benefit people’s mental health, and through that, their heart health. We don’t know whether it’s possible, but we are doing a lot of research to find out.
Q: Is it really possible to change a person’s outlook?
A: In considering someone’s well-being, there are probably three pieces to the pie: genetic predisposition, life events and temperament. Certainly, inherent personality plays a role in happiness, and life events have an influence. If you are in a war zone, it may be very hard to experience gratitude, optimism, or life satisfaction. At the same time, there is good research suggesting that a substantial proportion of one’s happinessis indeed amenable to change, independent of circumstances and genetics. It’s this modifiable element that we are working to target.
Q: What are the advantages of a positive psychiatry approach?
A: So much in psychiatry and in mental health treatment is focused on removing negative things. There’s a focus on “what is your source of stress?” and “what is your maladaptive way of handling it?” and “how can you fix that?” This makes sense, but it can be a challenge for someone to constantly focus on stress and weaknesses. In contrast, what we’re trying to do—strengths-focused well-being treatments—can help people think about a time when they were successful before and then get them to use those skills to tackle a new problem. Basically, “How are you awesome? Let’s help you expand how you are awesome!” It can be empowering and fun for people to participate in these programs.
Q: Can you describe some of your team’s research?
A: In one study, we worked with patients who had acute coronary syndrome—a heart attack or related event. The team measured patients’ levels of optimism two weeks after their coronary events, based on self-report. Six months later we measured how active the patients were and whetherthey had been readmitted to the hospital. We found that patients’ optimism and gratitude at the two-week mark predicted more physical activity at the six-month mark. The levels of optimism the patients felt at two weeks was also associated with lower rates of readmission over the next six months.
Q: And you’ve also been working on possible interventions?
A: Our team—and we’re not alone in this—has developed a series of programs focused on developing specific skills to boost one’s experience of optimism, happiness, and life purpose. For instance, we might invite participants to boost their openness to gratitude—which has a powerful correlation with life satisfaction and other positive emotions—by writing letters thanking important people in their lives, or by recalling three positive events from the past week.
We’ve started testing these programs in randomized controlled trials to see whether adding them to cardiac care leads patients to feel happier, and then to see whether this in turn helps them to exercise more, eat more healthily and be back in the hospital less. We’re on the verge of being able to answer some of those questions.
Q: Could these kinds of well-being treatments be scaled up for a broad range of people?
A: Some current psychological treatments are quite complicated. Undergoing cognitive behavioral therapy isn’t necessarily easy, and you may well need a certain level of education or psychological savvy to make the most of it. On the other hand, remembering positive life events, writing a letter of gratitude, doing kind things for others, using a personal strength—these things don’t require a lot of training or a certain level of education. Just about anybody can do these things, which makes them promising as part of the treatment for cardiac conditions that are so widespread.
Q: What would be the ideal outcome for your team?
A: The dream would be to create a program to improve well-being and show that it has concrete positive results, such as improving physical activity or reducing hospitalization rates, even beyond its effects on mood. We want something that would be accessible to a really diverse group of people—diverse in cultures and economic status but also diverse in the kind of heart disease they’re fighting. Developing that would really be the home run.
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