Toxic positivity chronic illness

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Toxic positivity: a black and white of a person lying down on their back with they arms folded on top of their head. The person is looking directly at the camera.

Toxic positivity and chronic Illness: accepting the reality of not getting bette

Accept that not every illness can be cured.

“Are you not getting better?”

“Hey, you’re better!”

“You look better!”

“Are you getting better?”

“But you’re going to get better, right?”

“Don’t think like that, you can get better.”

“You won’t get better if you don’t believe it.”

“Look on the bright side. Be positive.”

Better (adj.) – partly or fully recovered from illness, injury, or mental stress.

So much weight of expectation in two syllables and six letters.

Of course, being better is a good thing, whether the recovery is partial or full. My legs are better when I can walk than on the days I zoom around like a Dalek. Medication makes my migraines better. If I resemble a functional human, it is probably safe to assume I feel better than when I stumble about looking like something scraped out the bottom of a crypt. I have my better times, and I would absolutely love – love, adore, appreciate, sell my grandmother’s grave (she wouldn’t mind) – to be fully, permanently, better.

The problem is, it’s unlikely to happen. That’s not pessimism; it’s the reality.

"Telling people with a chronic illness to be positive – to wish themselves better – is toxic positivity. Accept that not every illness can be cured."

What is toxic positivity

In the context of having a chronic illness, what is toxic positivity? It is telling me to “get better” when I can’t. You see, I have Ehlers-Danlos Syndrome with (probably) some co-morbid bells and whistles. This is (probably) caused by a (probably) complex set of genetic mutations that (probably) screw up my collagen and (probably) interfere with various other bodily functions. It’s (probably) not going to get cured without major medical breakthroughs on the cause and potential cures.

Major medical advances take time. While I’m not in Methuselah territory, I’m no spring chicken, so it is a reasonable working assumption that I’ve got this for life.

Some people see that conclusion as a sign of defeat. I’ve lost count of the times I’ve been told I need to “believe I can get better” by people all-embracing of our positivity culture. Worse still, some people take it as a sign of “wanting” to be ill (a hazard of popular opinion many people with an ME diagnosis will be familiar with). After all, surely, if you want to get better, you’ll focus everything you’ve got on it, right? If you want to be better, you won’t “give in.”

Don’t get me wrong; positivity can be powerful. But can positivity be toxic? You bet it can.

Positivity isn’t always the best way to help people who have a chronic illness. Telling me to be positive, and to “look on the bright side of life,” is not going to cure me of Ehlers-Danlos Syndrome. This is not positivity: it is toxic positivity.

Fighting isn’t helpful if you are punching a mirage

It’s not that simple. It’s not getting better. Fighting isn’t helpful if you are punching a mirage; you win nothing but exhaustion. The phrase “pick your battles” applies.

I do fight, daily, to maintain physical fitness, and manage my condition constructively. That’s a good fight; it can be painful and tiring, but it’s real, positive, and influences my quality of life. It makes my health the best it can be. It doesn’t make me well.

Belief in a cure might be a helpful coping mechanism for some people – it all depends on individual psychology – so I don’t want to take that away from others. However, for me believing I’ll get better when there is no practical, evidence-based way to achieve it is no more beneficial than believing in Santa Claus.

At least Santa’s parental stand-ins brought presents. Belief can’t make my collagen less wonky, or my pain and fatigue levels normal. For me, false hope has proved far more damaging than acceptance. I am not getting better.

"Toxic positivity chronic illness: Ignoring the storm of reality and drowning in false hope."

In early 2010, I got better, sort of. I had a near-perfect patch of health and started to believe that I’d done it (I didn’t know I had EDS at the time, and part of ME/CFS treatment was being drilled with the idea that recovery was conditional on believing it would happen). I started to think I was better. I started to act like I was better, which turned out to be a major mistake when my health crashed horribly. That physical health crash took my mental health with it. Believing I had recovered and discovering I hadn’t was devastating, far more so than adjusting to life with a chronic illness.

Guess what? My chronic illness is not getting better

That wasn’t the only downside to this idea of getting better as the holy grail. If “getting better” is a matter of what you believe and how hard you fight, then failure to recover becomes just that – a failure. Personal. Guilt-inducing. In reality, of course, that’s rubbish. While it’s a good idea for anyone to take responsibility for the management of their health, some medical conditions simply can’t be fully cured. And it is time the positivity police understood that.

I felt, and still do feel, guilt for the effect of my illness and disability on the people I love. Carrying the additional weight of expectation that I would get better if I believed the right things or fought harder was crushing. So, I don’t deal in “getting better,” I deal in, “it’s not getting better.” I deal in living well, in managing my condition to the best of my ability, and in keeping my health as good as it can be (which is sometimes pretty bad).

Every day has symptoms, and that’s ok. Some days are worse than others, and that’s ok too. At the coal face of living with chronic illness, I accept reality and make the best of it. It’s really helpful when the people around me do too. So please, enough with the toxic positivity.

"Embracing toxic positivity in the face of chronic illness is like expecting sunshine during a hurricane – it ignores the reality and leaves us drowning in false hope."

Article by
Aphra Pell

Aphra Pell, the author of "Toxic Positivity Chronic Illness," was born slightly too long ago in the UK, to a family with a dilapidated cottage, dogs and cats, and a lot of books.


It's not getting better. I am not getting better. I would like to get better. But the problem is, it's unlikely to happen. Why can't people accept this? Why the toxic positivity? | ©Das FleischProjekt / Behance Creative Commons