1. “Positive Psychology” Anita R. Webb, PhD JPS Family Medicine Residency Fort Worth, Texas

2. Goals of Presentation Introduce an emerging field of psychology Review “happiness” research Explain an alternate focus in psychotherapy Apply this knowledge to benefit –Yourself –Your patients –(and others)

3. Key Points Intent of Positive Psychology (P 2 ) –To lastingly increase happiness P 2 is research based. Focus of research –Interventions that build happiness –Happiness can be cultivated

4. PREMISE Definition: “What makes life most worth living” Universality of human morals “The virtues which humans most value appear to be ubiquitously cross cultural.” Basic aspects of human nature which promote happiness can be identified through research.

5. P 2 Research Agenda Identify through research –Positive Emotions –Positive Character –Positive Institutions (foster positivity) Identify ways to lastingly increase all of these

6. Research (continued) To Understand –Suffering and happiness –As well as their interaction To develop validated interventions which – Relieve suffering –And also increase happiness

7. Classification Manual Character Strengths and Virtues: A Handbook and Classification Manual [CSV] –“Describes and classifies strengths and virtues that enable human thriving” –(Peterson C & Seligman MEP. New York: Oxford Press, 2004) “Sunnyside-Up” version of DSM-IV –To catalog what is already known –To stimulate research

8. Research: Example Six overarching “virtues” that almost every culture across the world endorses: –Wisdom –Courage –Humanity –Justice –Temperance –Transcendence (Park N et al. Character strengths in forty nations and fifty states. Unpublished manuscript. 2005)

9. Research (continued): 24 “Character Strengths” Most commonly endorsed “Most like me” Kindness Fairness Authenticity Gratitude Open-mindedness Least endorsed “Not like me” Prudence Modesty Self-regulation

10. Strengths (cont.): “Heart Strengths” –Zest –Gratitude –Hope –Love “Cerebral Strengths” –Curiosity –Love of learning [Heart Strengths are more robustly associated with life satisfaction.]

11. Happiness Routes Some researchers define Happiness by “routes”. Three independent routes to happiness –1. Positive emotion: the Pleasant Life –2. Engagement: the Engaged Life –3. Meaning: the Meaningful Life

12. Happiness Routes Which happiness route is the most successful? –i.e. produces the most satisfied people Two routes carried the most weight –The engaged life –The meaningful life But the most satisfied people pursued all 3 routes Pleasure, engagement and meaning (Peterson et al. Orientations to happiness and life satisfaction. J Happiness Studies 2005;6:25-41)

13. Happiness Correlates Happy people are: –Healthier, live longer –More successful/productive –More socially engaged –More cognitively creative –More flexible –(Hershberger P. Prescribing happiness: Positive psychology and family medicine. Fam Med 2005;37(9):630-4. Direction of causality?

14. Example: Health “Positive kids grow up to be healthier adults.” Research tracked 569 children age 7 for 30 years. Children with more positive outlook (and superior attention span) reported better general health, fewer illnesses as adults. Effects were greater for females. –(Kubzansky LD. Health Psychology 2009;28(3):364-72.)

15. Research: Interventions Research Question: “Can positive psychology interventions make people lastingly happier?” –One month open recruiting on-line –Pretest with repeated post-tests over 6 months N = 577 at pretest, 411 at final posttest –(Seligman MEP. Positive interventions: more evidence of effectiveness. Authentic Happiness Newsletter, Sept 2004. www.authentichappiness.org/news/news10.html.)

16. Interventions Five experimental groups –Four intervention groups, one placebo group –Participants were randomly assigned –All completed a brief depression pre-test Instructed to practice assigned task for one week –Follow-up x 5 over 6 months

17. RESULTS Criteria for success: Tasks that lastingly –Increased self-reported happiness –AND decreased depressive symptoms –At 6 month follow-up Two successful tasks were identified –Use your top 5 strengths in a new way –List 3 good things that happened today Report on-line daily Include causal explanation

18. Surprise Outcome Many participants spontaneously continued successful task beyond the one week requirement. Why? –They reported that the tasks were fun. –Self-reinforcing = Self-maintaining –The majority in the 2 successful groups had continued the tasks on their own.

19. Long Term Outcome Six-month follow-up Positive results were most pronounced for –Participants who voluntarily continued beyond the one-week requirement

20. Psychotherapy Research Even larger effect sizes when these two successful interventions were used in psychotherapy. –Due to therapeutic alliance? Positive interventions can supplement traditional interventions (which focus on relief of suffering). Suggestion for psychotherapist: –Bundle multiple tasks into a treatment package

21. [Clinical Aside] Current movements in psychotherapy –Resilience: ability to overcome adversity –Wellness –Life Coaching Future Focus: Growth –How to enhance a person’s strengths

22. “Practical Optimists” People who recognize the negatives of life –But choose optimism as their habituated state (“Habituate”: accustom self to certain conditions through constant use/repetition, as in “habit”) Default attitude and approach to life Learned Optimism can be achieved through mindfulness and practice.

23. Optimism Quotient (O.Q.) As in I.Q. (Intelligence Quotient) Ways to increase your O.Q. –Internal dialogue (self-talk) –Reasonable expectations –Feel worthy –Read selected “positive” materials –Be happy for others’ success –Learn from setbacks

24. Increase O.Q. (continued) Internal dialogue –Observe your self-talk : Is it negative? –Replace with positive, supportive self-talk Read inspirational, motivational works –Emulate positive role models Feel worthy of a positive fulfilling life (continued)

25. Examples (continued) Choose/decide to be happy for others’ success Nurture reasonable expectations –Choose realistic goals –Acknowledge incremental progress Learn from setbacks –It is our choice how we metabolize setbacks. –Look for the lessons in them.

26. Cultivate an Attitude of Gratitude “It’s the best way to achieve happiness.” Book: Curious? Discover the missing ingredient to a fulfilling life (2009) College courses: The Science of Happiness –Todd Kashdan PhD, Director –Laboratory for the Study of Social Anxiety, Character Strengths, and Related Phenomena –George Mason University

27. Positive Psychology and Family Medicine “Practice” happiness for your patients, yourself –Assign simple positivity tasks to your patients –Contributes to physician well-being [Hershberger PJ. Prescribing happiness. Fam Med 2005;37(9):630-4] Reassess the limitations of the “illness” model [Steinert Y. On prescribing happiness. Fam Med 2005;37(9):663-4]

28. Summary The goal of P 2 is to lastingly increase happiness. The virtues and strengths which humans most value appear to be “ubiquitously cross cultural”. Happiness interventions can be successfully used by individuals, on their own. These interventions are even more powerful when used in psychotherapy.

29. Additional Resources www.authentichappiness.org www.ReflectiveHappiness.com Seligman E.P. Learned Optimism (2005) Seligman E.P. et al. “Positive Psychology Progress.” American Psychologist (2005) 60(5):410-421.

30. The End