Research Summaries: Positive Psychology in Clinical Practice
Review articles are themselves supposed to be a summary of a field of inquiry, so it appeared queer summarizing a review article; but here I go. This post summarizes a 2005 review article appearing in Annual Review of Clinical Psychology. As it is more than a decade since the publication of this article by Martin Seligman, Angela Duckworth and Tracy Steen, I think it is appropriate to see how far the field has come since then and what still remains to be done.
- Positive psychology (PP), in this article, is seen through the triple lens of focusing on subjective well-being or pleasure; flow, engagement, and strengths; and meaning in life. This is as contrasted with the traditional deficit focus of clinical psychology whereby one looks at diathesis (genetic vulnerability for disorders) and stress (environment acute events like death of a loved one and chronic conditions like poverty) to figure out causes of diseases and suffering. While not denying the importance of ‘fix-what’s-wrong’ , positive psychology takes a ‘build-what’s-strong’ approach.
- Antecedents of positive psychology can be seen in most earlier movements within psychology. For e.g., if one were to focus on Psychoanalysis, Freud’s pleasure principle, Adler’s ‘healthy’ strivings motivated by social interest and Fromm’s productive orientation, all relate to some aspects of the new positive psychology paradigm. However, Humanistic psychologists, like Rollo May are more closely and directly related to the positive psychology movement, with conditions for self-actualization (Maslow) or fully functioning person (Carl Roegrs) laying the groundwork for PP.
- Its usually insinuated that humanistic psychology was not empirical or evidence based, however research showing that people grow most when they live an authentic life aligned with their values; or the co-opting of Jahoda’s six processes that lead to mental health by Carol Ryff et al in their wells-substantiated measure of Psychological well-being suggests that humanistic psychology had enough teeth.
- PP tenet no. 1: positive states and emotions and factors are not merely the lack of or inverse of negative states or emotions or factors. Thus, mental health and mental illness are two separate though correlated entities. Reducing your anger will not make you automatically more loving and caring; getting out of depression will not necessarily make you flourishing and happy.
- The authors try to fit their new framework of the Pleasant life, the Engaged Life and the Meaningful life into the earlier conceptualization of PP as consisting of a focus on positive states, traits and institutions. Please note that this framework has been subsequently extended to include the Accomplished life and the Connected (relationships) life in the newest PERMA model.
- In therapy, its important to note the buffers and resources a person has and measures of well-being can indicate the actual or potential positive functioning. They can also elucidate differential predictors. For e.g. positive satisfaction with life predicts less acting out in youth when stressed.
- Self-report measures like Satisfaction with Life scale, need to be conjunct with informant reports, experience sampling methods (ESM) etc to get a more cohesive picture. VIA survey can be used for identifying character strengths that can be useful in therapeutic context by providing therapists an insight into what strengths can be used for planning and executing interventions.
- Flow or engagement states can be identified using ESM and semi-structured interviews etc. However measuring the degree of flow is challenging to this day, I believe. However identifying the activities that lead to flow experiences may aid in therapy by making the client move towards more of such experiences.
- To discern how meaningful or purposeful one finds life, one can use narrative techniques like asking the client to treat his or her life as a book and give chapter titles, main characters and future possible plots to that life-as-book. Existential traditions do focus on meaning as a way to diagnose and treat and their marriage with PP leading to PP2.0 is the newest thing in town.
- PP makes sense in therapy as positive emotions or events undo the effects of negative emotions or events. No mention is made of the (in)famous 3:1 ratio (3 positive for each negative event or interaction) required for the same! Resilient people also typically experience more positive emotions, hence PP in clinical practice makes sense.
- Many therapists are already using PP stuff like instilling hope, courage, authenticity in clients and these are perhaps the non-specific factors that ensure that any therapy works better than placebo.
- Active PP interventions can also help in therapy. Some of the interventions reviewed were the early Fordyce’s ‘Act like happy people’ intervention, the ‘3 good things’ or gratitude journal based interventions (which have proven to be one of the most effective interventions), writing about intense positive experiences (which nobody talks about nowadays) , the random acts of kindness interventions, Gratitude visits, At your best write-ups, bibliotherapy and using strengths in a new way everyday. Results show that while most interventions lead to short term gains in happiness, (even placebo do), for long term gains, interventions that can become habits like counting 3 good things daily or deploying strengths in a new way daily, work better.
The promise of positive psychotherapy is still to be fulfilled, though progress is being made in that direction. If you are a therapist planning to include PP approaches in therapy or a mental health service user or caregiver, you probably should read a bit about this new filed. For others too, if the paper seemed exciting check it out here.
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- To Have or to Do? To Be or to Become?
- Research Summaries: Can Adolescents Learn Self-control? Delay of Gratification in the Development of Control over Risk Taking
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