Why You Need Hope
“Is there hope?” is a question I hear often. One of my patients struggling with a low back injury recently mentioned that doctors keep telling her that there is no hope. The look on her face told me how upsetting this was for her, and she asked me, “What do you think?”
Before I tell you my answer, I first want to be clear about why both the question and the answer matter.
Broadly defined, hope is a feeling or expectation for a desired outcome. Using standardized tests like the Hope Scale, a number of different studies looking at the impact of hope on chronic disease suggests that it is associated with improved outcomes. Higher levels of hope often correlate with increased life satisfaction scores, better lifestyle habits, and lower levels of depression and anxiety. Cardiovascular problems seem to recover more favorably in patients that are more hopeful.
When it comes to chronic pain conditions, whether it be back pain, fibromyalgia, or migraines, experiencing constant pain can easily squeeze hope out. You want to stay optimistic and have a positive outlook, but the more you hurt, the more you start to question whether or not good times can lie ahead. Behavioral health researchers sometimes refer to this as emotional conflict, meaning all of this worrying about your future starts to take a toll.
Interestingly, a certain part of the brain, known as the rostral anterior cingulate cortex, seems to play an important role in boosting hope. In theory, the right thoughts or mindset generated from there help trigger a surge in more positive feelings or emotions in the brain’s emotional processing center called the amygdala, and this, in turn, activates behavior changes that eventually lead to accomplishing desired goals. The key step is mustering the right outlook to set this reaction in motion, and this is where folks can get stuck. If you start off with the notion that “This condition is chronic and won’t go away, and therefore, there is no hope,” then this plane will never get off the ground.
Having a rosy outlook when things are going well is one thing, but seeing a glimmer of light when things seem to be at their darkest can pose a bigger challenge. The first step is finding that all-important spark that can rekindle hope, and then you can build your path forward based on the hope, not the pain.