Jeff Tirengel with Bill and Carleen at the International Glasser Conference in New York City, 2006.

Jeff Tirengel with Bill and Carleen at the International Glasser Conference in New York City, 2006.

The response to the video of Jeff Tirengel’s talk regarding his cancer journey, posted in the last blog, has been very positive. The video is almost an hour long, yet some of you were able to watch it right away and let me know how much the talk meant to you. Some of you related to Jeff’s message on a deeply personal level.

Last summer Jeff wrote an article for The Los Angeles Psychologist magazine that I have been thinking about ever since. Choice theory was never mentioned in the article, yet I have come to see it as full of the highest kind of freedom and love that we can give to another person, especially a loved one or friend engaged with cancer. It was titled “Cancer Survival and the Tyranny of Positivity,” two phrases that at first glance would not seen to go together. Check out the following excerpts from the article and reflect on how you relate to the tyranny of positivity. As you do I believe your concept of choice theory will be deepened

Cancer Survival and the Tyranny of Positivity
by Jeff Tirengel, Psy.D., MPH

I was diagnosed and hospitalized with an aggressive form of lymphoma, a type of blood cancer, in December 2009. While still in the hospital I began to hear from family members, friends, and colleagues, including fellow psychologists, that I was the kind of individual who was likely to do well under these circumstances. After all, they said, you are generally a positive and optimistic person, and you have the fighting spirit that characterizes those who are most resilient when dealing with cancer.

Although I fully understood that these messages were intended to be caring and supportive, it was clear to me immediately that they reflected a particular cultural viewpoint, “the triumph of character and attitude over biology” (Coyne and Tennen, 2010, p. 17). As I continued to hear similar sentiments expressed by physicians, nurses, and even other cancer patients, I began to sense the shadow side of these same messages, i.e., they discouraged open communication about the uncertainty, distress, and pessimism that were part of my actual mix of thoughts and feelings. I also wondered whether others might blame me for not being positive enough, or as psychologically resilient as they had believed me to be, if the cancer eluded effective treatment.

Jeff wrote about his career-long commitment to understand why people become ill, how they respond to treatment, and how people stay healthy in the first place, yet he admitted he knew relatively little about studies that had to do with cancer and cancer survival. As a result of his research, he listed a number of articles that addressed positivity and cancer, some pro, some con. The articles agreed that –

. . . there is concern about the seemingly relentless emphasis on mandating optimism, individual happiness, and personal growth no matter the circumstances, and a related concern that the general public may come to believe that one can conquer cancer by thinking positively and that if one is not getting a good response, one is not thinking positively enough, not laughing enough, or not being spiritual enough. Indeed, the explicit blame of people with serious illness for their failure to cure themselves in best-selling popular treatments of positive thinking is shocking and reprehensible (Aspinwall and Tedeschi, 2010, p.10).

Such views help us to see that there can be a kind of tyranny in positivity. Jeff’s conclusion helped me a great deal and taught me something very important about choice theory. He finished with –

My conclusion from my own experience with cancer and the tyranny of positivity is similar to a perspective that I have heard expressed by others, including Ehrenreich, who has herself been an oncology patient: Somewhere between “positive thinking and feeling” and “negative thinking and feeling” there is a space available for “realistic thinking and feeling.” In this “realistic” space, there is room for optimism and pessimism, hope and despair, gratitude and anger, courage and fear, gain and loss, certainty and uncertainty, etc. As I suspected when I was first diagnosed, the most evidence-based practice for supporting family members, friends, and colleagues with cancer is to allow them to express a full range of thoughts and feelings rather than require them, explicitly or implicitly, to be positive, deny their distress, or engage in particular behaviors for which there is no empirical evidence.

In this short article Jeff helped me to understand better that people with cancer, people in distress in general, need the freedom to express a full range of thoughts and feelings, rather than being somehow required to be positive or deny their feelings. Choice theory reminds us to give others this kind of space for realism, yet that doesn’t mean we can’t try to influence a loved one’s or friend’s outlook on the situation. Choice theory also reminds us that how we go about trying to influence is important. The following kinds of questions, for instance, would be important to a choice theorist –

Is my relationship in place with the person I am trying to support?

Have I received “permission” from the person to engage in supporting them?

Am I verbally and non-verbally allowing the person to express a full range of their thoughts and feelings?

Is our relationship staying connected even as we may disagree about the thoughts and feelings being expressed?

There are no easy answers when it comes to being a cancer patient ourselves or when it comes to supporting a loved one or friend who is a cancer patient, however Jeff’s article reminds us of the importance of a human being’s basic need for freedom. Maybe cancer patients are especially sensitive to this need.


Jeff Tirengel, PsyD, MPH is a Professor of Psychology at the California School of Professional Psychology at Alliant International University. He also directs psychological services for the Preventive and Rehabilitative Cardiac Center, Cedars-Sinai Heart Institute. Dr. Tirengel began his career in Washington, DC, serving public and private organizations including the U.S. Office of Disease Prevention and Health Promotion and the National Association of Community Health Centers.


Soul Shapers 1, scheduled for June 16-19, is just around the corner. For more information or to sign up for the class, call Debra Murphy at (707) 965-6642. Those of you who have taken Soul Shapers 1, this is a good time to invite colleagues to consider taking the class. It really helps when there are several teachers from the same school who are on the choice theory journey together.

Soul Shapers 2 is scheduled for June 23-26. Remember that this class can be re-taken as a choice theory re-charger each summer.