The power of optimism and positive thinking are well documented, particularly when it comes to pursuing goals. But until now, researchers knew little about how best to nurture optimism in someone facing a serious challenge, such as a health crisis.

Thanks to a series of six studies conducted at Stanford, they now better understand the interplay between optimism and physical health, recognize the importance of words in shaping a patient’s outlook toward the future, and know that considering a patient’s cultural and ethnic background can improve the chances of a successful recovery.

"Our work shows that the mindset an individual adopts when tackling a challenge can significantly impact how easily they can imagine recovering, and also affect physiological outcomes like physical strength and endurance," says Jennifer Aaker, the General Atlantic Professor of Marketing at Stanford GSB and a coauthor of the paper to be published this December in the Journal of Consumer Research. Her coauthors are Donnel Briley of the University of Sydney and Melanie Rudd of the University of Houston.

"Prior research has shown the best way to achieve a goal is to focus less on the outcome and more on the process, and that that applies across all cultures," says Rudd, whose mother’s breast cancer diagnosis during the project helped the researchers focus on the reality of the challenge to cultivate optimism in the face of life-threatening illnesses and on developing interventions that would be useful for health care professionals. "But that’s where the research left us. We wanted to give people actionable tools they could use."

The paper, titled "Cultivating Optimism: How to Frame Your Future During a Health Challenge," involved studies using more than 1,300 subjects, including flood victims and patients battling cancer, across different cultures. The results show that optimism can be best nurtured by understanding how a patient thinks about his or her health challenge, and framing that challenge for the patient in a way that increases their chances of being hopeful about the outcome.

A key way to help a patient clearly see a path to recovery is to understand how they view the world. "Are they an ‘initiator,’ the kind of person who focuses on how they will act regardless of the situation, or a ‘responder,’ the kind of person who focuses on how they’ll react to situations they encounter?" Briley says.

Personal characteristics like that often are shaped by the patient’s culture or ethnicity. Those from cultures that value the independent self, such as the U.S. and Europe, tend to be more optimistic if they approach the crisis as an initiator. Those who typically see themselves as interdependent, such as people from East Asian cultures, tend to be more optimistic if they approach the crisis as a responder.

"These results serve a fresh reminder that something subtle, something we often don’t think about, can be so important," Rudd says. "You can have a big impact simply by framing how you visualize your recovery process, and by using the right language. It’s about the power of vivid imagination."

So how to steer patients toward the mindsets that will benefit them most?

Rudd thinks of it as "priming" the patient. "You have the default cultural preference that comes from the patient, but then there’s an opportunity for the health care professional or family member to influence which mindset they adopt," she says.

For example, a doctor whose patient is an initiator personality might frame a discussion about recovery as, "What are you going to do?" But with a responder personality, the doctor might frame the same conversation by saying, "How are you going to respond?"

It’s a subtle but critical difference, Briley says, adding that words matter much more than we realize.

"We didn’t just ask subjects their prospects for recovery, we also looked at physiological outcomes," Briley adds. In one study, the researchers included a handgrip test and found that optimistic people squeezed more vigorously. They ran another study immediately after a flood in Texas, and found that optimistic people were more willing to use a vaccine to protect them from waterborne diseases.

"We were confident our studies would show that increased optimism prompts better health decisions," Briley says. "But it was less obvious that optimism would result in physiological effects, such as physical endurance and strength. So this was a significant finding."

Adds Briley: "Ultimately these studies show that imagination is a powerful force that can cultivate optimism and, consequently, move those who face health challenges to better health."

Aaker says the power of imagination is often unleashed when people envision themselves effectively addressing their health issues, and when such images are clear and concrete in their minds. "Everyone has the ability to imagine their future," she says. "We show how to leverage imagination so that an optimistic outlook takes hold."