HEALTHY THINKING IS NOT ALWAYS POSITIVE THINKING
WHY REPEATING POSITIVE STATEMENTS HELPS SOME PEOPLE AND MAKES OTHERS FEEL WORSE, AND WHAT TO DO WHEN YOUR BODY KEEPS REACTING AFTER A TRAUMA
By: Joy Stephenson-Laws, JD, Founder and President
Updated September 2026
FEEL.
You have worked hard on how you think. When a negative thought comes, you notice it and replace it with a better one. Coaches and wellness writers give this advice all the time, with lines like "Change your thoughts and you'll change your life." But your heart still races when the phone rings. Your shoulders tighten when someone touches your arm. You feel sick to your stomach before you speak in a meeting, and you notice you have been holding your breath. Things you used to enjoy feel flat. You know you are safe, but your body is acting as if you are not.
PAUSE.
Forcing yourself to think positively and understanding what you are experiencing are two different approaches. Forcing means repeating statements you do not believe, hiding the signs of what you feel, or making yourself look happy because others expect it. Understanding means noticing what you feel, checking your thoughts against the facts, and letting unpleasant feelings be there while you decide what to do. Healthy thinking is understanding what you are experiencing and then responding in a way that fits it.
Repeating positive statements can backfire. In one experiment, college students with low self-esteem repeated "I am a lovable person" 16 times over four minutes. Afterward, they were in a worse mood than other students with low self-esteem who did not repeat it. Students with high self-esteem who repeated the statement felt only slightly better. Both groups had their mood measured a few minutes after the exercise.
Researchers have also tested messages about whether sadness is acceptable. In an experiment with Australian university students, some students read that society accepts sadness. After they wrote about a painful experience, their unpleasant emotions showed no significant increase. Students who read that society does not accept sadness, or who read an article about something else, felt more unpleasant emotion after writing.
Hiding the outward signs of your feelings is linked to problems too. In studies of college students, people who usually kept their feelings from showing reported fewer pleasant emotions, more unpleasant ones, less support from others, and more signs of depression than people who did so less often. These studies measured people's habits at one point in time, so they cannot show that one thing caused another.
Other approaches were linked to better results. In the same studies of college students, people who usually rethought upsetting situations, which researchers call reappraisal, reported more pleasant emotions, closer relationships, and fewer signs of depression. Reappraisal often aims at feeling better. The difference is in the method: the person changes how they understand the situation instead of covering up how they feel about it.
A second experiment with "I am a lovable person" tested a different approach. Students with low self-esteem who were allowed to think about ways it might be true and ways it might not be ended up in a better mood than students with low self-esteem who were told to think only about ways it was true.
A later study followed 222 adults for six months. People who accepted their unpleasant feelings, instead of judging them as bad, felt less upset during everyday stress. That, in turn, predicted better mental health six months later. This study followed people over time but did not assign anyone to practice acceptance, so it also cannot prove cause and effect. Accepting a hard situation itself, as opposed to accepting your feelings about it, was mostly not linked to mental health.
These approaches differ, and each was studied on its own. What they have in common is that the person starts from what they think and feel.
The studies above looked at students and other adults in everyday life, not at people with PTSD. The PTSD research that follows studied people with PTSD.
Understanding what you are experiencing includes finding out what is causing it. A racing heart, tight shoulders, and an upset stomach have many possible causes, including medical ones. The symptoms alone do not tell you the cause. If you have physical symptoms no one has explained, ask for a medical checkup. When symptoms like these follow a traumatic event, PTSD is one possibility worth checking.
To diagnose PTSD, clinicians use a specific definition of a traumatic event. It is an event in which someone dies or could have died, is badly hurt or could have been, or suffers sexual violence. A person can go through the event, see it happen, or learn that it happened to someone close to them. If that person died, the death must have been violent or an accident. Police officers and first responders can also be affected by seeing the details of such events over and over at work.
About 7 in 10 U.S. adults go through a traumatic event at some point in their lives. About 6 in 100 develop PTSD during their lifetime. Most short-term stress reactions go away quickly with reassurance, rest, and safety.
Two of the signs clinicians use to diagnose PTSD resemble reactions described at the start of this article. One is a strong physical reaction to things that remind a person of the trauma. The other is being unable, for a long time, to feel pleasant emotions such as happiness, satisfaction, or love.
In PTSD, the body's fight-or-flight response can start when there is no danger. The VA's National Center for PTSD explains that this response is useful when danger is present. PTSD can cause a person to use it too widely, so something harmless, like a car backfiring, sets it off.
Scientists have also studied how PTSD affects pleasant feelings in the brain. A 2018 review by Gregory Fonzo describes fewer and weaker feelings of happiness, interest, and closeness as a core part of PTSD. The most consistent finding in the brain-scan studies he reviewed was a weaker response to receiving a reward in the ventral striatum, a part of the brain involved in reward. He warns that these studies were small and did not always agree.
ACT.
Responding in a way that fits starts with describing what is happening. Write down the reactions you notice, when they happen, how long they have been going on, and how they affect your work, sleep, and relationships. Bring that list to your doctor or a mental health professional.
If the reactions are very upsetting or are getting in the way of daily life, ask for help. The VA's National Center for PTSD says that whether or not you have PTSD, if thoughts and feelings from a trauma are bothering you, treatment can help. You do not have to wait a month, which is the shortest time symptoms must last for a PTSD diagnosis. For people diagnosed with acute stress disorder in the first month after a trauma, the VA/DoD guideline suggests a talk therapy that focuses on the trauma.
For PTSD, the 2023 VA/DoD guideline gives its strongest recommendation to three talk therapies that focus directly on the trauma: Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing (EMDR), and Prolonged Exposure. Cognitive Processing Therapy includes learning to examine whether the facts support your upsetting thoughts about the trauma. A trained clinician guides all three therapies. The guideline recommends these therapies over medicine for three reasons: studies found the therapies lead to bigger improvements that last longer, medicines are more likely to cause side effects, and the benefits of medicine are lost when people stop taking it. One study found no difference between Prolonged Exposure and the medicine sertraline.
Three medicines are also strongly recommended: paroxetine, sertraline, and venlafaxine. A clinician can help you choose among these options based on your preferences, your health, and what is available near you. The guideline was written for the care of military veterans and service members, and its authors say it can also be used for civilians.
Yoga, meditation, exercise, and time outdoors are popular, but the evidence that they treat PTSD is limited. The guideline did not recommend for or against them. For yoga, some studies reported improvement, but the guideline found the evidence low in quality and the programs too different from each other to judge. A 2026 review of studies in veterans found moderate-quality evidence that certain meditation programs reduced PTSD symptoms, though most of the studies had a high risk of bias, which means their design makes the results less reliable. The guideline says these activities may help overall well-being and that people who are interested should be supported in doing them.
Feel: Notice what your body does and when it happens: your heartbeat, your breathing, your shoulders, your stomach, and whether things you used to enjoy still feel good.
Pause: Ask what was happening when the reaction started and whether there is danger right now. Check your thoughts against the facts instead of covering them with statements you do not believe.
Act: Bring your notes to a doctor or mental health professional. If your reactions started after a traumatic event, ask about being screened for PTSD and about the three therapies above. If you enjoy walking, yoga, or dance, keep doing them alongside any treatment.
Healthy thinking starts with understanding what you are experiencing. Depending on what you find, the response that fits may be to rethink a situation, to let a feeling be there, or, when your body keeps reacting after a trauma, to get specific treatment from a trained clinician. Feel. Pause. Act.
Joy Stephenson-Laws, JD, is the founding and managing partner of Stephenson, Acquisto & Colman, a healthcare litigation firm, and the founder and president of Proactive Health Labs, a national nonprofit focused on evidence-based health literacy. A healthcare attorney for more than forty years and a certified holistic wellness coach, she writes about how people can partner with their doctors without surrendering their own judgment.
Her books include Your Labs Are Fine. You're Not., Advice on Trial: The Beliefs You Inherited but Never Examined, From Chains to Wings: A Poetry Revolution for Healing,Secrets That Sparkle (and Secrets That Sting), and Minerals - The Forgotten Nutrient: Your Secret Weapon for Getting and Staying Healthy.
(This article is for general education and is not medical advice. It is meant to help you ask better questions, not to replace evaluation by a qualified clinician).
RESOURCES & FURTHER READING
Ashoorion V, Cooley K, Le Scelleur H, Selvadurai S, Sud A. Complementary and integrative health interventions for PTSD in Veterans and family members: A rapid systematic review and meta-analysis. Journal of Military, Veteran and Family Health. 2026;12(2):12–43. https://doi.org/10.3138/jmvfh-2025-0068
Bastian B, Kuppens P, Hornsey MJ, Park J, Koval P, Uchida Y. Feeling bad about being sad: The role of social expectancies in amplifying negative mood. Emotion. 2012;12(1):69–80. https://doi.org/10.1037/a0024755
Fonzo GA. Diminished positive affect and traumatic stress: A biobehavioral review and commentary on trauma affective neuroscience. Neurobiology of Stress. 2018;9:214–230. https://doi.org/10.1016/j.ynstr.2018.10.002
Ford BQ, Lam P, John OP, Mauss IB. The psychological health benefits of accepting negative emotions and thoughts: Laboratory, diary, and longitudinal evidence. Journal of Personality and Social Psychology. 2018;115(6):1075–1092. https://doi.org/10.1037/pspp0000157
Goldstein RB, Smith SM, Chou SP, et al. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Social Psychiatry and Psychiatric Epidemiology. 2016;51(8):1137–1148. https://doi.org/10.1007/s00127-016-1208-5
Gross JJ, John OP. Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology. 2003;85(2):348–362. https://doi.org/10.1037/0022-3514.85.2.348
Schnurr PP, Hamblen JL, Wolf J, et al. The management of posttraumatic stress disorder and acute stress disorder: Synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline. Annals of Internal Medicine. Published online February 27, 2024. https://doi.org/10.7326/M23-2757
U.S. Department of Veterans Affairs, National Center for PTSD. Cognitive Processing Therapy for PTSD. Accessed September 25, 2026. https://www.ptsd.va.gov/understand_tx/cognitive_processing.asp
U.S. Department of Veterans Affairs, National Center for PTSD. Do I Have PTSD? Last updated October 7, 2025. https://www.ptsd.va.gov/understand/isitptsd/have_ptsd.asp
U.S. Department of Veterans Affairs, National Center for PTSD. What Is PTSD? Police Officer Toolkit. Last updated August 2, 2023. https://www.ptsd.va.gov/professional/treat/care/toolkits/police/policeworkWhatIsPtsd.asp
VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder, Version 4.0. Department of Veterans Affairs and Department of Defense; June 2023. https://www.healthquality.va.gov/HEALTHQUALITY/guidelines/MH/ptsd/VA-DoD-CPG-PTSD-Full-CPG-Edited-111624-V5-81825.pdf
Wood JV, Perunovic WQE, Lee JW. Positive self-statements: Power for some, peril for others. Psychological Science. 2009;20(7):860–866. https://doi.org/10.1111/j.1467-9280.2009.02370.x