One-Minute Book Reviews

October 27, 2009

‘Smile or Die’ – Barbara Ehrenreich’s ‘Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America’

Taking aim at the “prosperity gospel,” “positive psychology” courses, and teddy bears designed for breast-cancer patients

Bright-sided: How the Relentless Promotion of Positive Thinking Has Undermined America. By Barbara Ehrenreich. Holt/Metropolitan, 235 pp., $23.

By Janice Harayda

When I was a book editor, I often had to reassure freelancers that they had the right to give negative reviews. Critics never apologized for praising books, but they did apologize for panning them – even when they had done so brilliantly.

At first, I thought freelancers were worried that they would get fewer assignments if they wrote unfavorable reviews, because some editors do prefer to publish praise. But many seemed reluctant to criticize books even after I had explained that I didn’t care whether reviews were positive or negative: I cared whether they were fair, honest and well written.

Barbara Ehrenreich suggests a possible explanation for the reluctance in Bright-sided, a spirited broadside against enforced optimism in medicine, psychology, business, religion and other fields. She argues that faith in “positive thinking” has become so ingrained in American society “that ‘positive’ seems to us not only normal but normative – the way you should be.”

Ehrenreich found when she was diagnosed with breast cancer that a cult of optimism pervaded articles and books about the disease that made her feel isolated instead of supported. “No one among the bloggers and book writers seemed to share my sense of outrage over the disease and the available treatments,” she writes in a chapter ironically called “Smile or Die: The Bright Side of Cancer.” “What causes it and why is it so common, especially in industrialized societies? Why don’t we have treatments that distinguish between different forms of breast cancer or between cancer cells and normal dividing cells?”

Instead of finding answers, Ehrenreich kept coming across articles by women who claimed that they owed their survival to a “positive attitude” – even though the death rate from breast cancer has changed little since the 1930s and there is no consistent evidence that staying upbeat extends the life of those who have the disease, though it may have many other benefits. She also found that “positive thinking” can exact a terrible price in self-blame if a cancer defies treatment. As the oncology nurse Cynthia Rittenberg has written, the pressure to think positively is “an additional burden to an already devastated patient.”

“Smile or Die” recycles some of the material from Ehrenreich’s award-winning essay, “Welcome to Cancerland,” but is still the strongest chapter in Bright-sided. Other sections of the book describe the wholesale effects of “positive thinking” better than they show their retail cost to ordinary Americans. Ehrenreich argues cogently that the emerging field of “positive psychology” is based heavily on bad or no science. But the same is also true of some older forms of therapy that apply similar principles, as the Robyn Dawes documented in his superb indictment of the betrayal of scientific standards in psychotherapy, House of Cards (Free Press, 1996). So why focus on “positive psychology” when other types of therapy have done more damage, if only because they are more widely used? Ehrenreich describes an unflattering interview with the high priest of “positive psychology,” the psychologist Martin Seligman. But she seems to have talked to no one burned by his teachings – which shouldn’t have been hard to do, given that more than 200 schools and colleges offer courses in his field.

In a chapter called “God Wants You to Be Rich,” Ehrenreich faults the so-called “prosperity gospel” preached by superstar pastors like Joel Osteen, whose churches offer “services that might, in more generous nations, be provided by the secular welfare state,” such as pre- and after-school programs. Certainly those ministries may foster self-blame. (If God wants you to be rich and you’re not, you don’t have enough faith.) But if the churches that promote the “prosperity gospel” are offering low- or no-cost day care that enables parents to seek prosperity by holding jobs, doesn’t that count for something? You sense that such programs are exactly kind of thing that Ehrenreich might love, if only they weren’t endorsed by pastors who wear too much gel in their mullets.

No less important: A blurred line exists between innate optimism – which may be genetic — and the enforced optimism of disciplines like “positive psychology” and the “prosperity gospel.” To what extent are advocates of “positive thinking” creating an attitude and to what extent are tapping or reinforcing one that’s already there? Ehrenreich sidesteps the question. But if optimism is in our genes, it may do little good to argue as she does that we need replace “positive thinking” with a “vigilant realism.” Joseph Hallinan takes a less extensive but more practical approach to the subject in his Why We Make Mistakes (Broadway, 2009), which deals in part with the research on errors based on overconfidence – a trait often indistinguishable from “positive thinking.”

Overall Bright-sided is much more theoretical than Nickled and Dimed, for which Ehrenreich took a series of low-wage jobs to show how corporations exploit blue-collar workers, or her more recent Bait and Switch. But it makes a needed assault on an idea that too often goes unchallenged in America: that “positive thinking” is always a good thing. Ehrenreich is right that a deep and unacknowledged anxiety often underlies efforts to block out unpleasant thoughts. “Positive thinking” requires a continual effort to deflect “negative” ideas, she notes, and it can be exhausting. “The truly self-confident, or those who have in some way made their peace with the world and their destiny within it, do not need to expend effort censoring or controlling their thoughts,” she writes. “Positive thinking may be a quintessentially American activity, associated in our minds with both individual and national success, but it is driven by a terrible insecurity.”

Best line: Ehrenreich notes that breast cancer has given rise to a highly commercialized industry of products for patients, including “infantilizing” teddy bears: “Certainly men diagnosed with prostate cancer do not receive gifts of Matchbox cars.”

Worst line: “All the motivators and gurus of positivity agree that it is a mistake to watch the news.” How does Ehrenreich know? Has she talked to them all? In my experience the self-styled motivators, with a few exceptions including Rhonda Byrne (The Secret), urge people to limit – not eliminate – exposure to bad news.

Editor: Sara Bershtel

Published: October 2009

Read an excerpt (the first pages) from Bright-sided or listen to an audio excerpt.

Furthermore: For more on optimism and illness, see the post “‘The Tyranny of Positive Thinking’ and Cancer Patients — A Physician-Author Says That It’s Not Always Best to Tell People to ‘Be Optimistic’.”

© 2009 Janice Harayda. All rights reserved.


  1. Thanks for this review. I really liked “Nickel and Dimed” and I put “Bright- Sided” on hold at the library immediately after seeing Ehrenreich on The Daily Show. Reading your take on the book has only made me more excited to read it!

    Comment by sarahsk — October 27, 2009 @ 9:16 pm | Reply

    • You’re very welcome, Sarah. Would love to know what you think of it after you’ve read it. Bright-sided could be a great book-club book, because people are likely to have strong opinions one way or the other.

      Comment by 1minutebookreviewswordpresscom — October 28, 2009 @ 11:19 am | Reply

  2. Thanks for this review. I stumbled across this in the bookstore and was intrigued. If I remember correctly, a number of years ago she wrote an essay that was titled “F–k Hope.” Is that included? It seems like it would fit with the theme.

    BTW, Best Line: “You sense that such programs are exactly kind of thing that Ehrenreich might love, if only they weren’t endorsed by pastors who wear too much gel in their mullets.” 🙂

    Comment by Jon — October 28, 2009 @ 9:32 am | Reply

    • I’d missed that essay, but it sounds as though it would fit in well with the theme of this one. Bright-sided seems to me to be an important book, if only because Ehrenreich is the first author with a big “platform” (the new favorite word of publishers) to challenge much of the conventional wisdom about positive thinking. But I wish she’d projected fewer of her biases (about religion, for example) onto her arguments.

      By the way, I did get Mitch Albom’s book a few days ago and will review it soon :). I wonder what it says about reading tastes that I had to wait longer for Have a Little Faith than for The Lost Symbol …

      Comment by 1minutebookreviewswordpresscom — October 28, 2009 @ 11:39 am | Reply

      • I found it on her site. It originally appeared in in Harper’s. Here’s a link (though the background color makes it almost unreadable):

        I finished Have a Little Faith. I think I know what you’ll say… 😉

        Comment by Jon — October 28, 2009 @ 11:55 am

      • That’s a great essay for anyone who wants to learn more about Bright-sided, because it lays out more broadly than “Welcome to Cancerland” the themes of the book. It also contains a lot of material that found its way, in different form, into Bright-sided. Thank you for the link!

        Interestingly, Ehrenreich seems to have toned down some of the ideas in the “against hope” essay for Bright-sided. I don’t recall that she used the phrase “truly sinister” for the cheerleaders for positivity in the book (though I’ve returned it to the library and couldn’t immediately check).

        Perhaps the most revealing quote in Ehrenreich’s essay on hope is:

        “A representative of the American Cancer Society rebuffed a researcher in the mid-Nineties by saying that the organization didn’t ‘want to be associated with a book on death. We want to emphasize the positive aspects of cancer only.'” Isn’t there a difference between talking about the positive aspects of life with or after cancer and the “positive aspects of cancer” itself? If so, you don’t see it in the ACS quote.

        Comment by 1minutebookreviewswordpresscom — October 28, 2009 @ 12:25 pm

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