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Hope is not a strategy: A pause for thought for Health Psychology

This sentence popped up in my Spanish Duolingo practice yesterday (that is another story). As first I whole-heartedly agreed with the sentiment. I am a woman of action. But as I thought about it, I started to think that I would need to modify it to ‘Hope is not always a strategy.’ Initially it was the word ‘strategy’ that caused me to think. Oxford Dictionaries on-line define it as ‘A plan of action designed to achieve a long-term or overall aim’. Following that I looked up ‘hope’: ‘A feeling of expectation and desire for a particular thing to happen’ or ‘A person or thing that may help or save someone.’ As I pondered on this sentence more I started to put it in the context of health psychology. I started to reflect on situations in which a strategy of hope would be effective. The true story of Lorenzo’s oil came into my mind. Without a strategy of hope would the parents have embarked on their quest for a means of improving their son’s condition? Similar stories are in the media and pop up regularly on my Facebook page. The story of Ashya King, whose parents took him out of Southampton Hospital as they wanted him to have access to further treatment. A quick internet search found a number of such stories. Similarly the story of Diane Pretty, who wanted to die with dignity in her home assisted by her husband, but didn’t want him prosecuted for assisting her suicide. For these people hope was certainly a strategy, all-be-it with different intended outcomes. We acknowledge the power of the human psyche and how it can use hope as a means of improving someone’s condition. One of the reasons for double-blind randomised control tests is an attempt to mitigate against the possibility of hope of a cure/improvement in the condition rather than the drug being tested providing the basis for the trial’s results. In Australian Aboriginal culture, and among other indigenous cultures, otherwise healthy individuals are executed by having a bone pointed at them. The psychosomatic properties resulting from the belief that death is inevitable in such circumstances perhaps is the result of a lack of hope that anything can be done. Increasingly there has been acknowledgement among health care professionals about the power of a positive attitude when dealing with illness or in changing addictive behaviours. Later in the day, I listened to ‘Crossing Contents: Addiction in Suburbia’. One of the participants was entering his fourth rehabilitation effort. During the interview he mentioned that he needed to continue to hope that he would remain drug free in the long-term. There has been a similar reaction to the news of a possible more effective drug to treat Alzheimer’s. Perhaps what we need to do as health psychologists is to harness this human tendency to use hope as a strategy to work with individuals and help them visualise their hopes happening. It seems to me that the opposite of hope is despair. Perhaps we need to focus on how to turn Hope into an effective strategy linked to action to achieve the desired outcome.

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