Positive Psychotherapy

1. Positive Psychotherapy Slides created by Barbara A. Cubic, Ph.D.Professor Eastern Virginia Medical School To accompany Current Psychotherapies 10

2. Learning Objectives • This presentation will focus on: • Overview of positive psychotherapy • History of positive psychology • Applications of positive psychotherapy • Empirical evidence supporting positive psychotherapy

3. Basic Concepts

4. Flourishing • Traditional psychotherapies focus on the negatives. • Positive psychotherapy (PPT) is built on the principles of positive psychology. • Flourishing is a state characterized by positive emotions, a strong sense of personal meaning, good work, and positive relationships.

5. Positive Psychotherapy (PPT) • Name does not suggest other psychotherapies are negative. • PPT not intended to replace traditional therapeutic approaches. • PPT is an approach that seeks to balance the attention given to negative and positive life events in psychotherapy.

6. PPT • PPT focuses on the reorientation to a build-what’s-strong model that supplements the traditional fix-what’s-wrong approach.

7. Comparing Positive Psychotherapy to Other Therapies

8. Comparing PPT to Other Approaches

9. Psychoanalytic View • Arthur Schopenhauer and Sigmund Freud felt the best humans could ever achieve was minimizing their own misery. • Freud posited that negatives were an indispensable element of human existence. • Assumed defenses built to repress these conflicts and manage the unbearable anxiety they cause.

10. Psychotherapy Has Hit a Dead End

11. 65% Barrier • Treatment of depression • CBT and Pharmacotherapy both hit a ceiling at 65%. • Placebo may account for 45-55% of this effect. • More valid and realistic the placebo, the greater the placebo response.

12. Why a 65% Barrier? • Behavioral change is difficult. • People lack motivation, have co-morbid issues, or live in unhealthy environments that are not amenable to change. • Easier to continue to behave in maladaptive ways.

13. Other Challenges Facing Psychotherapy • About 40% of clients terminate therapy prematurely. • Clients only make superficial changes as a result of therapy. • Traditional psychotherapy takes a palliative approach. • Has stopped looking for a cure. • Psychotherapy largely a science of victimology.

14. How PPT Challenges Traditions • Focuses on learning to function well in face of psychological distress. • Trying to break the 65% barrier. • Builds on research. • Presence of character strengths shown to make a significant incremental contribution toward recovery from depression. • Gratitude leads to lower levels of stress and depression.

15. History of Positive Psychotherapy

16. Self-Actualization Self Esteem Love and Belonging Safety Physiological Maslow’s Hierarchy of Needs “Psychology has been far more successful on the negative than on the positive side … It has revealed to us little about his potentiates, his virtues, his achievable aspirations … It is as if psychology has voluntarily restricted itself to only half its rightful jurisdiction, and that, the darker, meaner half.” Maslow

17. Early Beginnings of PPT • Jahoda’s (1958) Current Concepts of Positive Mental Health argued well-being should be appreciated in its own right. • Frankl (1963) noted that the primary human drive was not pleasure, but the pursuit of meaning.

18. Psychological Abstracts(since 1887)14-1 Negative to Positive Ratio

19. Limited Attention to Positives • Handbook of Psychotherapy and Change by Bergin and Garfield does not include well-being or happiness in the subject index. (Lambert, 2013) • Diagnostic Statistical Manuals have catalogued hundreds of psychiatric symptoms for disorders, but not a single and coherent classification of strengths until 2004.

20. Examples of Therapies Incorporating Positives • Fordyce (1983) focused on increasing happiness for college students through 14 strategies. • Well-being therapy (WBT) integrates CBT and well-being. • Is effective in treating affective and anxiety disorders. • Frisch’s quality-of-life therapy (QOLT) integrates CT with positive psychology and has been shown effective with depressed clients.

21. Positive Interventions Making Progress • Journal of Clinical Psychology (2009) focused exclusively on positive interventions for clinical disorders. • Positive psychology interventions are being explored in clinical settings. • Interventions focusing on one or two positive attributes have been conducted.

22. As APA President, Marty Seligman Urged • Psychology to supplement this historical goal with a new goal. • Exploring what makes life worth living and building the enabling conditions of a life worth living.

23. Current Status of PPT • 2000-2010 — More than a 1000 articles related to positive psychology published in peer-reviewed journals. • Peer-reviewed journals include the Journal of Positive Psychology, Journal of Happiness Studies, International Journal of Well-being and Applied Psychology: Health & Wellbeing.

24. Current Status of PPT • Positive psychology taught internationally. • Programs on positive psychology developed in the United States. • Online positive psychology resources are available: • www.authentichappiness.com • www.ppc.com • www.viacharacter.org • www.positivepsychologynews.com

25. Current Status of PPT • Grants for Positive Psychology Center to explore longitudinal indicators of positive health, positive neuroscience, the mechanisms of self-regulation, and retention among college students. • International Positive Psychology Association founded in 2007.

26. Current Status of PPT • International level scientific gatherings on positive psychology. • Positive psychology exercises under the Comprehensive Soldier Fitness Program are now being taught within the U.S. Army. • Considerable popular press attention towards positive psychology.

27. Theory of Personality for Positive Psychology

28. Positive Psychology Asserts • Notion that childhood determines adult personality is false. • Genes have a tremendous influence on adult personality. • Heritability does not determine how unchangeable a trait will be. • Happiness is a personality trait that can be changed.

29. Formula for Happiness • H = S + C + V • H: Enduring level of happiness • S: Personal set range • C: Circumstances • V: Factors under personal volitional control

30. Psychotherapy Can Be a Venue for Strength Building • Fixing weaknesses yields remediation. • Nurturing strengths produces growth and more well-being. • Repairing or fixing weakness does not necessarily make clients stronger or happier. • Using strengths increases clients’ self-efficacy and confidence in ways focusing on weakness cannot.

31. Psychotherapy Can Be a Venue for Strength Building • Strengths offer ways to facilitate being good, being kind, humorous, industrious, curious, creative, and grateful. • Strengths essentially come from being good, not feeling good. • Six virtues with 24 character strengths identified.

32. The Six Virtues • Wisdom and Knowledge • Cognitive strengths that involve acquiring and using knowledge. • Courage • Exercise of will to accomplish goals in the face of opposition, whether external or internal. • Humanity • Interpersonal strengths that involve tending and befriending others.

33. The Six Virtues • Justice • Strengths that underlie healthy community life. • Temperance • Protection against excess and vices. • Transcendence • Strengths that forge connections to the larger universe and provide meaning.

34. Wisdom and Knowledge: Character Strengths • Creativity (ingenuity, originality) • Thinking of novel and productive ways to do things. • Curiosity (interest, novelty seeking, openness to experience) • Taking an interest in all of ongoing experience.

35. Wisdom and Knowledge: Character Strengths • Judgment (critical thinking) • Thinking things through and examining them from all sides. • Love of learning • Mastering new skills, topics, and bodies of knowledge. • Perspective (wisdom) • Providing wise counsel to others. • Taking the “big picture” view.

36. Courage: Character Strengths • Bravery (valor) • Facing threat, challenge, or pain. • Perseverance (persistence, industry, diligence) • Finishing what one starts.

37. Courage: Character Strengths • Honesty (authenticity and integrity) • Speaking the truth and presenting oneself in a genuine way. • Zest (vitality) • Approaching life with excitement and energy. • Not doing things halfway or halfheartedly. • Living life as an adventure. • Feeling alive and activated.

38. Humanity: Character Strengths • Love (capacity to give/receive) • Valuing close relations with others, in particular those reciprocated. • Kindness (compassion, altruism, generosity, care) • Doing favors/deeds for others. • Social intelligence • Awareness of the motives and feelings of self and others. • Knowing what to do to fit into different social situations. • Knowing what makes other people tick.

39. Justice: Character Strengths • Teamwork (citizenship, social responsibility, loyalty) • Working well as member of a group. • Fairness (equity) • Treating people the same according to notions of fairness and justice. • Leadership • Encouraging a group one is a member of to get things done while maintaining good relations within the group.

40. Temperance: Character Strengths • Forgiveness (mercy) • Forgiving wrongs of others. • Accepting other’s shortcomings. • Humility (modesty) • Letting one’s accomplishments speak for themselves. • Not regarding oneself as more special than one is.

41. Temperance: Character Strengths • Prudence • Carefulness about one’s choices. • Not taking undue risks. • Avoiding regrets • Self-regulation (self-control) • Regulating what one feels and does. • Being disciplined.

42. Transcendence: Character Strengths • Appreciation of beauty and excellence (awe, wonder, elevation) • Noticing and appreciating beauty, excellence, or skilled performance. • Gratitude • Awareness of and thankfulness for good things. • Hope (optimism, future-mindedness) • Expecting the best in the future and working to achieve it. • Believing in a good future.

43. Transcendence: Character Strengths • Humor (playfulness) • Liking to laugh and tease. • Spirituality (sense of purpose, faith, meaning, religiousness) • Knowing where one fits within the larger scheme. • Having coherent beliefs about the higher purpose and meaning of life that shape conduct and provide comfort.

44. Chris Peterson’s Model for Evaluating Disorders What psychological state or trait reflects absence of character strength? What state or trait signifies its opposite? What state or trait displays its exaggeration? A disorder may result from the absence of a given character strength, but it can also result from its presence in extreme forms.

45. Chris Peterson’s Model for Evaluating Disorders • If psychology as usual uses a lens of abnormality to view normality, “then why not use the lens of normality or even super normality to view abnormality?”

46. Example: Psychology Disorders and Dysregulation of Strengths

47. The Psychotherapy Process

48. PPT is Based on 3 Primary Assumptions • Psychopathology results when inherent capacities for growth, fulfillment, and happiness are thwarted by sociocultural factors. • Positive emotions/strengths are authentic and real. • Effective therapeutic relationships can be built on exploration and analysis of positive personal characteristics and experiences.

49. Seligman’s Conceptualization of Happiness and Well-being • PPT is primarily based on Seligman’s deconstruction of “happiness” into three scientifically measurable and manageable components: • Positive emotion (the pleasant life) • Engagement (the engaged life) • Meaning (the meaningful life)

50. The Pleasant Life • Dimension of human experience endorsed by hedonic theories of happiness. • Consists of experiencing positive emotions about the present, past, and future and learning new skills to amplify the intensity and duration of these emotions.