On positive thinking and recovery and its significance in present days is as important for persons with mental health problems as with anyone else. Actually, more so, as persons with mental health problems have to face other unique challenges as stigma and discrimination from the society and system, and low self-esteem, lack of confidence, stress and many other personal, emotional and psychological reactions. Many motivation and inspiration leaders, and spiritual gurus talk about positive thinking and attitude and its significance in life and living.

What is positive thinking? Though we all understand what it implies, it is a difficult concept to define in words and there may be differences of opinions among experts, but one could consider that these are thoughts which make you feel good, give a sense of well-being, or satisfaction and achieving something—a feel-good factor.

What’s positive about positive thinking itself has different connotations in different circumstances about what is actually positive–it is relatively relative. For example, when we think of what we faced over the last few years, if someone is tested and turns up to be Covid-19 positive or HIV positive, is it really a positive news? On the contrary, when a test for cancer comes out negative, is it not positive! Further, there can be occasions when a negative event can appear to be positive, for example a person with an advanced painful disease dies, that ends his misery or suffering and it is a relief for the family. Or when positive thinking or hope can be negative–the person with severe advanced and painful disease is saved and survives, but the suffering increases for self, the family, and others.

Positive thinking has numerous good effects [feels good, nice, happy and satisfying], some side effects [wants more of it, at any cost, too good and addictive, need more and more positivity], certain adverse effects [jealousy and envy, animosity from others, does not feel good any longer] or no effects [develops tolerance to the positivity, if it continues for too long or too much]. Positive thinking can be toxic, with a desire to get it at any cost, or addictive, that a person misses it (withdrawal effect) and cannot live without it.

Positive thinking can indeed be lifesaving, in a person who views a positivity in stress, anxiety or depression. Depression gives a break and rest to the person, slows down, and conserves energy, or for those with suicidal thoughts such thoughts show alternatives, provide hope and a light, or for those who are suffering such thoughts provide a search for meaning of the suffering.

In the light of the above discussion, a typology of positive thinking can be proposed:

  1. i.

    Positive thinking which is positive: think positive, get positive, radiate positivity. Everyone craves for this. This type is full of optimism.

  2. ii.

    Positive thinking which in fact has negative effects–wish that the person with an advanced disease live longer/ survive, but would be miserable and suffer, brings great trauma and suffering.

  3. iii.

    Negative thinking which is positive in the end– makes a person resilient and stronger to face stresses of life.

  4. iv.

    Negative thinking which is negative–this pulls the person down, and makes him depressed and suicidal, hopeless, frustrated and worthless

  5. v.

    Varying between positive and negative; positive becomes negative and reverts back.

  6. vi.

    Neutral thinking–lots of thinking, but neither positive nor negative

Negative thinking may not always be bad, but can lead to poor prognosis or outcome or lead to alternative outcomes; When there are negative events and obstacles in the way, these divert your direction to your destiny. People at times try paradoxical intention, i.e., think negative to get positive, one of the methods used at times, intentionally or unintentionally.

If there was a Positive thinking index or quotient of a ratio between positive and negative or between negative and positive, how positive or negative a person is, can be an indicator to predict clinical outcomes. Once this concept picks up, and becomes popular, people may consider computing this index or quotient, like intelligence quotient or emotional quotient as a positivity quotient.

Certain popular types of positive thoughts, are taught and used by motivation leaders and spiritual gurus. These informal or quasi formal positive thoughts may be religious, spiritual, inspirational, motivational, purposeful–for a purpose to achieve, karma related or acceptance related. Some leaders encourage having no expectations, and hoping that whatever is achieved is positive. Formal psychotherapeutic methods and therapy like Cognitive Behavioral Therapies remove automatic negative thoughts; assertive training, social skills training and many others inculcate positive thinking, and help cope with or deal with negative thinking. In the end, to think or not to think positive is one’s choice for one to decide.!

In this issue, we feature a couple of articles on alcohol and substance use, an editorial on Recovery and Rehabilitation from Alcohol, Substance Use and Related Disorders in Nepal: Call for Paradigm Shift, and another one from New Zealand entitled A Realist Evaluation of Residential Treatment of Adults with Substance use Disorder: Development of an Initial Programme Theory. Two articles related to Covid and mental illness are included, one on the Consequences of Discontinuing a Home Care Service for Patients with Severe Mental Illness After the COVID-19 Pandemic, from Teheran, Iran, and another one on the Impact of Covid-19 Restrictions on Individual Placement and Support Service Delivery in Northern Norway, from Norway. Two interesting articles from Canada, one on Daily Living Functioning in Men with Borderline Personality Disorders: A Scoping Review and another on the Support Provided Through Sport: An Evaluation of an Intervention for People Experiencing Homelessness, Canada. The article on Setting up a Recovery College: Exploring the Experiences of Mental Health Service-Users, Staff, Carers and Volunteers, from Birmingham United Kingdom, User-Led Mental Health Service Evaluation: The Contribution of User-Focused Monitoring to Recovery-Oriented Quality Development, from Sweden and Family Intervention in Severe Mental Disorder: An Online Intervention Format in Psychosocial Rehabilitation Centers, from Spain. Other interesting papers in this issue are on the Impact of Supportive Factors on the Academic Reintegration of Students with Mental Illness: A Qualitative Study and Mortality among Treatment Non-Adherent Persons with Mental Illness – Findings from the Community Mental Health Centre in India. There is also a description of a popular organisation, the Medico-Pastoral Association, Bangalore: Beyond Rehabilitation. Lastly, there is a book review, written by Neeta Pant, an English teacher from Delhi, on Mental toughness for champions–transform from no one to stardom, which gives nine sure shot ways to increase resilience, forge an invincible mindset, and succeed in competitive sport and beyond. The book has been written by a physician Niranjan Tachamo born in Nepal and trained in the United States, and working in Vrindavan, India. Overall, this issue has a wide spectrum of research and articles and a book review which encourages positivity.