Archive for January, 2017

Depression and its Antecedents

Today I will approach the problem of depression, but from a particular vantage point – that steeped in cognitive theory and informed by the work of Martin Seligman.

English: Abraham Lincoln, the sixteenth Presid...

English: Abraham Lincoln, the sixteenth President of the United States. Latviešu: Abrahams Linkolns, sešpadsmitais ASV prezidents. ?????? / Srpski: ??????? ???????, ????????? ?????????? ?????????? ????????? ??????. (Photo credit: Wikipedia)

There have been other views about depression- a psychoanalytical one whereby depression was deemed as rage turning upon inwards and directed towards the self; and a biomedical one whereby depression is considered a disease of the brain/body- imbalances in neurotransmitters etc. . Seligman rejects both models and considers depression (even clinically defined) as just the other extreme of response to loss etc. This is important to note as unipolar depression, clinically defined, is usually considered a  type rather than a degree phenomena, i.e. people in depressive phase are qualitatively different from those who are not clinically depressed as per the prevalent model.However, note that even Seligman considers the mild form of depression as distinct from sadness.

The theory of depression that Seligman and colleagues came up with is based on his famous experiments with dogs whereby experimental dogs were subjected to uncontrollable mild shocks while the control dogs either received no shocks or shocks that they could stop and control. When the dogs who were subjected to uncontrollable shocks were placed in anew chamber whereby they could escape shocks by climbing over a  low barrier, they sat passively. They had learned or internalized that nothing they do with respect to shocks makes the shocks go away and had even generalized it to new situations when things were actually under their control. Also the feelings of helplessness reflected in many diverse behaviors like less aggressiveness or exploration etc and was sort of generalized across situations too.  So not only the experimental dogs made permanent attributions about their lack of control, but also pervasive attributions and thus became depressed.

Seligman and colleagues designed and executed similar experiments with rats and also humans. Using these experiments they were able to create a model of depression. That model of depression requires different things to come together, but typically as its called learned helplessness model of depression, the focus has been on the learned helplessness following a loss of control.

The different components of the model, when explicated, have different implications for treatment/ prevention. To start with before the process can start one has to have loss of control – if our environments provided more opportunity for control over our experiences and in general if people learned to feel more in control of their life, despite losses and all, then the chain stops at its beginning itself. While some losses are inevitable, say loss of loved one, other losses like pink slips can be minimized and then no matter what the loss is , one can choose one’s own attitude towards the loss – the last of human freedom’s as per Frankl.

Once loss/ dejection/rejection/ loss of control has happened, almost all of us will temporarily become helpless. However, becoming helpless is not same as becoming mildly depressed too. For some of us who have a habitual pessimistic explanatory style, in terms of seeing the negative events in our lives as being permanent and pervasive, the learned helplessness turns into momentary , mild depression. We have sad affect, disturbed sleeping, eating etc. However, for those who have optimistic explanatory styles, we re-bounce from the learned helpless and do not become depressed. So changing the habitual explanatory style is another intervention opportunity.

Finally, the mild and momentary depression become full-fledged clinical unipolar depression, when the symptoms continue for 2 weeks or more and as per Seligman this happens when one adds a ruminating thinking style to the mix. Thus a person who has a pessimistic style and also keeps thinking about his own thoughts is more likely to get clinically depressed. Again , if we can prevent or reduce rumination we can prevent the clinical variant.

Cognitive behavioral therapy , which has been found to be quite effective for depression, has been shown to work on some of these aspects  increasing optimistic explanatory style and challenging negative automatic thoughts  but probably can be augmented by focusing on preventing rumination and story-editing techniques to re-frame issues of loss and control.

In the end, in my view depression has complex roots – some steeped in biology and temperament, while others due to environmental stressors and our reactions to them. A clearer understanding of the learned helplessness model of depression is likely to aid in therapy.

Stress causes negative emotions – are you NUTS?

Stress has been defined in many ways – one conceptualization that I find powerful and useful is the NUTS framework developed by Dr. Sonia Lupien. As per it, stress results when one or more of the following four ingredients are present in a situation.

NOVELTY Something new you have not experienced before
UNPREDICTABILITY Something you had no way of knowing it would occur
THREAT TO THE EGO Your competence as a person is called into question
SENSE OF CONTROL You feel you have little or no control over the situation
English: Emotions Q-sort

English: Emotions Q-sort (Photo credit: Wikipedia)

These conditions need not be aversive for the situation or event to feel stressful. For example, a person who is recently promoted may feel stress because of the new responsibilities that are novel and maybe he has no real option of declining the promotion, so he has little control too in the matter. Or consider the birth of a new born. So both positive and negative life events may lead to stress and maybe its more about how you are appraising stressful event.

If you are appraising a Novel event as a disruption of schedule/ comfort you will probably feel disgust; if you are appraising the same event as an opportunity to explore new stuff, you will most probably feel surprise / wonder. Its also conceivable that those high in the personality trait of Openness to experience may have more positive appraisals.

Similarly, an unpredictable situation may result in sadness if the unpredictability of rewards/ stimuli is attributed to deficits in self. If however, the unpredictability of situation is attributed to luck or external circumstances one may be more at ease and feel joy or happiness (note that ‘hap’ means luck). Its likely that those who are more Extraverted have a more positive appraisal.

A threat to ego or self may lead to feelings of fear and anxiety if the threat is considered unmanageable. On the other hand if the threat is considered manageable, it will result in the emotion of courage and facing the issue rather than running away. Those high in emotional stability (vs Neuroticism) are likely to show more positive appraisals.

Lastly, when one is in a situation that provides little options of control, one may feel anger if one is in a dominating frame of mind and needs control. On the other hand, one may feel love or compassion if one is ready to voluntarily give up control and submit oneself in the service of other. Agreeableness may mediate the relation with positive appraisals.

So as Kelly McGonigal has pointed out stress by itself is not bad; its how you appraise stressful circumstances that may be the key to suffering and wilting or rejoicing and flourishing.

The different shades of Hope

Hope is one of the 24 character strengths as identified by VIA.  Its also known as optimism, future-mindedness and future orientation. It is defined by VIA as ‘expecting the best in the future and working to achieve it; believing that a good future is something that can be brought about.’

There are three variants of this strength, as found in the psychological literature:

Is the glass half empty or half full? The pess...

Is the glass half empty or half full? The pessimist would pick half empty, while the optimist would choose half full. (Photo credit: Wikipedia)

(dispositional) Optimism is a general feeling that good things will happen to oneself. It’s a generalized expectancy about the future and is not tied to any specific task or goal in particular. It is a general feeling of confidence and is related to the outcome expectancy that energizes behavior while pursuing a challenge or solving a problem and results in persistence. Pessimists on the other hand are doubtful and hesitant in goal pursuit and this gets exacerbated in times of adversity. While optimists are confident of their ability to handle adversity one way or the other, pessimists tend to catastrophize.

Optimists are more likely to feel excitement and eagerness when confronted with adversity and have overall positive affect; while pessimists are more likely to feel negative emotions like guilt, despair, anger, anxiety and sadness when confronted with adversity.Optimists are confident in their ability to handle adversity and thus expend effort and energy in facing the adversity, while pessimists may indulge in wishful thinking – that getting distracted perhaps or closing their eyes – will make the adversity disappear and may stop expending effort.

Optimists are likely to use problem-focused coping (aimed at doing something about the stressor itself to blunt its impact) when in control; and use positive reframing, or accept the reality of situation, when not in control. Even in situations not under control, optimists use emotion focused coping (aimed at soothing distress) like seeing the silver lining in the cloud and learning from the bad situation. Pessimists are likely to use denial or distance themselves from the situation or use substance abuse as a means of escape.  Optimists engage with the situations while pessimist try to avoid the situations/ stressors.

Optimism has many psychological health benefits too; for eg. it helps you fight postpartum depression, and leads to lowered distress in wide ranging health conditions from lowering of pre and postoperative coronary surgery distress, to less suffering from cancer, or less distress in a caregiver caring for a person with cancer.Pessimism or hopelessness, on the other hand, rather than depression, is a stronger predictor of suicide.

Optimism is also related to behaviors that lead to more health promoting behaviors and that reduce health risks. Optimists also have better physical health and immunity and even longevity. Optimists are more likeable and thus have better social circles and networks as they use a positive problem focused approach to relationships too.

Optimism is moderately inheritable (25%), especially given its association with inheritable traits like neuroticism and extraversion, and is thus prtly in your genes. Also, it has been suggested that optimism develops as a result of early childhood experiences be it a secure attachment or development of ‘basic trust’ as per Erikson’s stages. However, optimism can be developed. Cognitive behavioral therapies intend to do so by changing the underlying thought patterns.

And that brings us to optimistic explanatory styles. While dispositional optimism is all about expectancies for the future, optimistic explanatory style grounds those expectancies into how we habitually interpret past success and failures.

One has an optimistic explanatory style when one makes stable, personal and global attributions for good events and learns to make temporary and specific attributions for negative past experiences. Pessimistic explanatory style on the other hand is when one makes stable and global, personal attributions for negative past events and experiences. Optimists have a flexible explanatory style, while that of pessimists is more rigid.

I will do a separate post on learned optimism and CBT which is related to this concept of optimistic and pessimistic explanatory styles. bI will focus more on dispositional optimism and Hope.

Hope as per the framework used by Snyder has three components: the goals that are clearly conceptualized, important to self and direct one’s future orientation;  agency or a belief in one’s ability to  take the first step and reach the goals despite inevitable obstacles, and pathways or the ability to come up with alternate paths and strategies to achieve the goal, if obstacles are encountered.

Hopeful people have learning goals and are mastery oriented, while those low in hope have performance goals and have a helpless orientation. Having hope means that one can think of many alternate paths to achieve the goal and is thus focussed on success and having learning goals. High hope also entails much enthusiasm and energy while pursuing goals and leads to positive affectivity; while being low in hope correlates with negative affectivity characterized by worry, negative thoughts and dissatisfaction with self.

There is another conceptualization of hope especially in medical settings. Hope, as per Herth, has three components: The cognitive–temporal dimension taps into “the perception that the desired outcome is realistically probable,” whereas the affective–behavioral dimension refers to “a feeling of confidence with the initiation of plans” to achieve the desired goals.  Affiliative–contextual dimension refers to the “recognition of the interconnectedness between self and others and between self and spirit”. As such, this dimension can also be thought of as an interpersonal connectedness and spiritual dimension. Essentially, it contains items related to perceived social support, perceived spiritual support, and a sense of meaning and belongingness. Thus the concept of hope can be elaborated to include a social/ spiritual dimension too.

Hope is measured using Adult hope Scale, Life Orientation test , Herth Hope scale etc. Hope/Optimism as measured by these scales has been found to correlate with important life outcomes.

Optimism and pessimism, or hope and hopelessness, are moderately correlated, but different constructs. Thus someone high in optimism may not necessarily be low in pessimism; more practically, the correlates of life outcomes due to high optimism may not be same as those for low pessimism. Optimism is more strongly related to extraversion and positive affect and pessimism is more strongly related to neuroticism and negative affect.

Hope is correlated with perceived competence, self-esteem and perceived purpose in life; low hope is also correlated with depression and anxiety. The low hope anxiety relationship is mediated by inability to learn from failure and the non realization of utility of efforts/ new strategies to achieve valued outocmes. High hope is also related to higher creativity and problem solving abilities thus leading to higher academic performance.

Hope is also social; high hope people are socially competent,enjoy getting to know others, getting to know their interests, and more frequently interact with others. Low-Hope people on the other hand ruminate, get frustrated and are aggressive in their goal pursuit and struggle interpersonally.

Hope builds resilience. The agency component of hope buffers against future depression / anxiety symptoms.

Hope and perseverance are closely related and many interventions increase both; hope is correlated to perseverance as well as bravery in individuals.

Some of the interventions that have found emperical validity and have resonted with me are :

  • Best possible self
  • One door closes, another door opens
  • Hope letter
  • WOOP exercise

Hope this was useful!

The Strengths Workout: Hope for the new year

I have always wanted to write a book; however I am very irregular with even my blog posts and think that I lack the self-discipline to write regularly or write for a longer project. I want to test both these assumptions.

Moreover, I have been consciously moving away from theoretical stuff to more hands-on and applied issues. Writing a book typically appeared an intellectual pastime to me- where I could demonstrate my ostensibly expert/superior knowledge of a subject; lately however, I have started to veer more towards writing more of a book that is grounded in personal experience and uses theory as a guide to help other practitioners.

As you might be aware, I am deeply fascinated by strengths especially the VIA framework as developed by Peterson and Seligman. I am doing some work with school children around these strengths and hope to reach out to many more school children in this new year. While I apply the well tested interventions of positive psychology with these kids, I will also be experimenting with them myself and be on this collective strengths workout. I hope you join me on this journey.

Each fortnight I will be focusing on one of the 24 character strengths – reading books and articles related to that strength, digesting that and posting about that on my blogs- The Mouse Trap/ Flourish Mentoring; creating awareness about the strength on the social media; hopefully intervening with a larger group of school children around that strength, making that strength a focus of my life for the fortnight, making a collection of songs, movies, videos related to that strength and so on.

All this will also become rich material for a book that I will be writing in parallel, the book directed at positive psychology practitioners, especially people in school based settings who wish to work towards the socio-emotional development of children, but do not know where to start. If I am lucky enough to find a publisher, nothing like it; else I plan to release it myself (I still haven’t made a decision as to whether I will be releasing the book for free (and ebook) or it will be a very low priced paperback version).

If I manage to keep the average schedule of working on a strength per fortnight, then keeping aside 2 weeks of vacations too, I should have a book by the end of the year- however it will not be possible to have a useful book unless you all accompany me on this strengths workout. I would humbly request everyone to be generous with their time and suggestions- reading the posts and related material, thinking about the strength, experimenting with the interventions themselves and sharing their experiences with the world-at-large. Also dont forget to provide the moral support and encouragement.

For those of you who are new to the strengths framework, I strongly recommend that they take a free VIA adult/ youth survey be creating an account at viacharacter.org and reach out to me in case you need help with interpreting your free report. For starters focus on your top 5 strengths which are your signature strengths and try to see how you can enhance them even further and leverage them more in your daily life.

This VIA framework is quite a bit different from the Gallup’s Clifton Strengthsfinder 2.0 framework (please note that I am also a Gallup certified strengths coach) and both faremworks have their utilities, but for working with school children I am increasingly leaning towards VIA and will be focusing on that only for this project.

New year is a time for all round hope, so I have picked hope as the strength of the fortnight. More posts specifically on the topic of hope will follow. I truly hope that you are as excited about this project as I am and will joyfully accompany me on this strengths workout!

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