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Sarah Malik 4 January 2019

Balancing optimism with reality when planning for our future

Whilst we like to think of ourselves as logical, rational beings, many of us are affected by optimism bias, and it deeply impacts our decision making
Our thoughts Advance care planning

If, like me, you’re a parent it’s pretty likely that you’ve found yourself thinking from time to time that your children are (just a little bit) above average. Their chances of success in the future is highly probable in our eyes. You may also believe yourself to be a better and safer driver than the average person you encounter out on the road.

These are some of the most commonly used examples of the optimism bias and the more I have been thinking about it lately, the more I see how connected it is to the way many of us approach our health.

Optimism bias is the personal belief that we are more likely to experience good outcomes and less likely to experience bad outcomes.

So whilst we like to think of ourselves as logical, rational beings, many of us are affected by optimism bias, and it deeply impacts our decision making.

Why this is important to me

I was out with friends recently and, intermittently, the same old few made their way outside to smoke. As I made one of my standard anti-smoking comments to the unfortunate friends who remained, the eyes rolled and the familiar looks of here she goes again were exchanged. These days, we all know that smoking is bad for you — so why do so many people still do it?

My aversion to smoking stems from my oncology nursing days, looking after people struggling for their final breaths in the most traumatic way imaginable. There was sometimes so little I could do to help them which felt almost unbearable at times.

I was used to looking after people who were dying — that’s not what was most difficult. I can remember so clearly almost every panic stricken face, gasping for breath from smoking related cancers. When people die with fear in their eyes it really stays with you.

My (long suffering) friends remind me that most people haven’t seen what I’ve seen. And, as I well know, most people — despite knowing all the facts — simply believe that ‘it’s never going to happen to me.’

This got me thinking — the ‘don’t do that’ approach just doesn’t work. Health care needs to shift away from its paternalistic ways, and what I was doing really wasn’t any different.

Taking a positive, motivational approach

For me, learning more about optimism bias has re-emphasised the benefits of applying a positive rather than a negative motivational approach when talking about health.

So, leaving the smokers to one side for now …

Studies consistently report that up to 80% of the population demonstrate a tendency for optimism bias. This leads many of us to naturally underestimate the likelihood of experiencing serious illness, and probably plays a part in why very few of us are planning ahead for our future treatment and care.

Planning ahead forces us to think about the sad and scary things we often try not to think about. However, in my experience, planning ahead doesn’t shatter the anticipation of a healthy future, in fact in many ways it supports it.

Optimism balanced with reality

Fortunately, acknowledging our optimism bias doesn’t have to eradicate our natural sense of hope. But, being open and — crucially — prepared for the reality that we may become unwell one day can offer peace of mind. Peace of mind that our wishes are recorded and will be followed, if ever the time comes.

So, for anyone who hasn’t already been motivated to plan ahead but are thinking about it — try not to worry. It doesn’t have to be morbid or depressing. Identifying what you want and documenting it in a legally binding way can help you balance all that natural optimism with a touch of realism.

At Compassion in Dying we have a free information line and wide range of resources to support you — please feel free to get in touch.

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