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Author: Hilary Tindle, M.D., M.P.H.
Publisher: Hudson Street Press
Book Publication: 2013

Poet Khalil Gibran wrote, “Your living is determined not so much by what life brings to you as by the attitude you bring to life.” Dr. Hilary Tindle’s Up: How Positive Outlook Can Transform Our Health and Aging validates and expands upon this concept in this groundbreaking work. Dr. Tindle, a cardiologist and leading researcher on how outlook impacts health, uses compelling scientific studies, case histories and personal experiences to demonstrate how a positive attitude is good medicine that can substantially improve our health and longevity.

Results from her eight-year long outlook study on 100,000 American women provided the impetus for Up. Compiled data revealed that “middle-aged and older female optimists lived healthier and longer lives compared with pessimists (people who have a generally negative expectation of the future), exhibiting a 16% lower risk of a first heart attack and a 30% lower risk of death from heart disease by the end of the study” – sobering evidence of the detrimental physiological effects of negative emotions.

Tindle is quick to assure readers that the often facile and unrealistic bumper sticker mantras like “don’t worry, be happy” and “turn that frown upside down” have very little in common with true trait optimism. “People who score as optimists on the formal research scales show themselves to be proactive, expert copers… and are actually much closer to what many of us would refer to as realists.”

According to Tindle, optimism has many faces – each a little different in character – however, she believes there are five key components which can produce peak optimism experiences: confidence, resources (fin-ancial, social, education), keeping at least part of one’s attention on the positive, conviction, and endurance.

Through data from medical research, and “the crucible of [her] own experience as a physician and patient,” Tindle has formulated strategies she believes will help people optimize their outlook, and in turn their health span. She calls these the ‘7 Steps of Attitudinal Change’

The first step is to determine your current outlook tendencies, or what Tindle calls ‘attitude latitude’, which is your Point A. Three questionnaires are supplied to help you identify where this is. Once discovered, the next task is to form the intention to change. Tindle explains, “You may want to adopt an attitude that is more open, more optimistic, less angry, or otherwise different from your current perspective.”

Tindle, a self-proclaimed champion of self-examination, devotes an entire chapter to step three of the attitude change process – examining your outlook in action by learning to listen to your inner conversation. Tindle suggests it could be some of our inner conversations that are actually acting as barriers to healthy aging. She advises we approach our thoughts and beliefs as if they were “hypotheses to be proven or refuted, becoming the researcher of your own case study.” The recommended methods to achieve this are: cognitive behavioral therapy, mindfulness, contemplation, guided imagery and motivational interviewing. All of the techniques are clearly explained with examples of them working in real-world context.

Other steps toward attitude change include acknowledging accomplishments as concrete evidence that you really can make changes; engaging in regular exercise and getting sufficient sleep, which are crucial to a healthier attitude; reaching out for the benefits of social support when your attitude latitude has veered off course, and finally spending time in open green space as this has been linked to better health and longer life.

It is not always easy to be optimistic, but Up gives both hope and help. Dr. Tindle tackles the extensive research and complex issues of healthy aging with insight, wisdom and compassion, presenting it in a warm and engaging manner. As Up so clearly demonstrates, a healthier attitude begets healthier action or behaviours, which in turn begets a healthier attitude. With the seven steps for attitude change to guide us, we have the tools to get and stay on this upward spiral.

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