What’s so Positive about Positive Psychology

Chances are, if you are reading this then you are at least passingly familiar with the emerging field of positive psychology. Although every religious and philosophical tradition through antiquity has offered insight into the “good life” it is only in the last couple decades that we have truly been able to turn scientific attention to this important topic in a sophisticated way. Modern scientists have used careful research designs, validated assessments and rich theory to produce new and sometimes counter-intuitive ideas about age-old topics such as happiness, resilience, and hope. Among the set-pieces of this modern movement are so-called “positive psychology interventions.” These are, more or less, simple behaviors in which a person can engage to improve her own well-being. The most famous of these is the “gratitude exercise.” In this exercise people are instructed to jot down “three things” for which they are grateful. The list might include a reliable automobile, a sunny afternoon, or a healthy child. The list will change from person to person and from time to time. The results are in, however: the gratitude exercise appears to boost individual happiness and buffer people from the deleterious effects of depression. This finding has been replicated and most famously so with a randomized controlled study conducted by positive psychology founder Martin Seligman and his colleagues.

Since that initial study appeared in 2005 there have been other positive psychology interventions that have been tested and have shown—at least in a preliminary way—evidence for small boosts in happiness. One of these is the “counting kindnesses” intervention conducted by Keiko Otake and her colleagues. As the name implies people who kept a tally of their daily kindnesses felt a little spring in their step as a result. The publication of the counting kindnesses intervention set me to wondering what the causal mechanisms were that might form the foundation of positive psychology interventions. Could it be, for instance, that the gratitude exercise actually boosts appreciation and this improved mindfulness translates to a better mood? Or might it be that gratitude works primarily by reminding people to appreciate things they overlook, and in this ways functions primarily by acting as an antidote to the natural human tendency to adapt.

Privately, I have been worried by what I see as the uncritical acceptance of these intervention techniques by some coaches and other human service professionals. It’s nice to know that these techniques work—for the most part—but isn’t it even nicer to understand how they work? For months I harbored a sneaking suspicion that positive psychology interventions such as counting kindnesses and the gratitude exercise were simply “listing interventions.” That is, I was curious to know if we might find the same rise in happiness if we had people simply list anything positive. Imagine having people keep a daily “courage diary” in which they listed three ways they didn’t let discomfort hold them back. Or picture a scenario in which people tally hopes, such as “three things that are likely to happen in the next two weeks that you are eagerly looking forward to.” Could it be that any instance of pen, paper and positivity constitutes an effective positive psychology intervention?

Interestingly, this exact premise was tested in a study that appeared in the Journal of Clinical Psychology. The researchers replicated the classic Seligman study using a sample of nearly 1,500 adults ranging in age from 18 to 72. They included the gratitude exercise, a “positive placebo” in which they had participants write for 10 minutes each evening about a positive memory, and a control placebo in which they had participants wrote for 10 minutes each evening about an early life memory (not necessarily a positive one). Using the same happiness assessment employed by Seligman in the original study, the researchers discovered that the positive memory exercise performed roughly in the same way that the gratitude exercise did: both boosted happiness and did so over three and six month follow-ups. Now, on the one hand, it would seem that the researchers have created yet another positive psychology intervention. Hooray! We can now add the “positive memory exercise” to the stable of happiness boosting activities.

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In the end, however, the researchers draw much the same conclusion I do: there is some common factor that acts as the therapeutic mechanism for many of these “listing interventions.” According to the researchers, engaging in any activity that makes positive self-information more accessible is likely to have a tonic effect on people. This does not mean that we should dismiss positive psychology exercises as somehow “fake.” It does mean that we should not rush to mental closure on their effectiveness or the ways in which we use them. This is an important study because it opens the door to exciting new research questions: are there different types of positive psychology interventions? Will some types work better with certain people than with others? Are there people for whom these activities are contra-indicated? Is salient positive self-information as powerful as positive information about loved ones? How might these interventions be modified to be more effective across cultural boundaries? We are just scratching the surface of these tools.

Mongrain, M. & Anselmo-Matthews, T. (2012). Do positive psychology exercises work? A replication of Seligman et al. (2005). Journal of Clinical Psychology, 68, 382-389

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What Influences Our Happiness the Most?

I have two friends, Seth and Michael, and one of them is a lot happier than the other.

Seth is chronically unhappy. He is often glum, frequently irritable, and sometimes hopeless, though he has never been clinically depressed. By contrast, Michael is a remarkable happy person. Although he has his low moments and periodic stress, he manages to find joy in his days and is quite content with the way his life is going. To understand why these two men are so different, let me tell you a little bit about them.

Both are in their early 40s and doing well in their careers. Seth is a professor of psychology at a prestigious university, who has reasonably bright students, a fair amount of autonomy in his work, and many opportunities for travel. His research program has been successful, garnering attention from all over the U.S. Michael is a deputy city attorney in a small but beautiful city right on the Pacific Ocean. He specializes in landlord-tenant disputes and other civil matters, and his success as a litigator has led to occasional media appearances, in which he is asked to speak about his latest cases. He gets a kick out of doing that.

Both have close-knit families. Seth is married to Allison, whom he met while on sabbatical in the Netherlands, and they have 5-year old twin boys. Michael is married to Holly. They started dating in law school, and now have a boy (age 6) and a girl (age 3).

Both men own homes in the suburbs of a major metropolitan area, about half an hour from the city and their jobs.

So, why is Michael happier than Seth? Was he simply lucky to be born with a sunnier disposition? Or, is he more fortunate with regard to the events and circumstances of his life?

Knowing them, I would be hard-pressed to assert that the life situation of one is clearly superior to the other. On balance, neither seems to have the better job, wife, kids, house, or car. Furthermore, scientific research has shown that prosperity, health, and physical attractiveness are only minimally related to one’s overall happiness. For example, a study by Ed Diener from the University of Illinois demonstrated that the richest Americans – those earning more than $10 million annually – report levels of personal happiness only slightly greater than the people who work for them. So, even if Seth had fewer of life’s “goods,” this shortfall wouldn’t explain his acute unhappiness.

What about genetics? Growing research done with identical and fraternal twins suggests that each person is born with a particular “happiness set point” – that is, a baseline or potential for happiness to which he or she is bound to return, even after major setbacks or triumphs. The set point for happiness is similar to the set point for weight. Some people are blessed with a “skinny disposition.” Even when they’re not trying, they easily maintain their weight. By contrast, others have to work extraordinarily hard to keep their weight at a desirable level and the moment they slack off even a bit, the pounds creep back on. So, Michael may simply possess a higher set point for happiness, a higher potential for well-being. He doesn’t have to work hard at it – he just is happy.

So if Michael’s happiness is due to genetics, what is left for Seth to do? Are we all doomed to obey the directives of our genes?

The answer is “no.” I am an experimental social psychologist who has conducted the first controlled experimental intervention studies to increase and maintain a person’s happiness level over and above his or her set point. In broadest terms, this research suggests that sustainable happiness is attainable regardless of genetics, if one is prepared to do the work. Much like permanent weight loss and fitness, becoming lastingly happier demands making some permanent changes, requiring effort and commitment every day of one’s life.

My two colleagues – Ken Sheldon at the University of Missouri and David Schkade at UC San Diego – and I developed a theory that describes the most important factors determining happiness. (This theory lies at the heart of my book, The How of Happiness.) In sum, we argue that the set point determines just 50% of happiness, while a mere 10% can be attributed to differences in people’s life circumstances – that is, whether they are rich or poor, healthy or unhealthy, married or divorced, etc. This leaves a surprising 40% of our capacity for happiness within our power to change. This means that Seth can be a great deal happier and Michael could be even happier too.

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Beyond Happiness: The Upside of Feeling Down

Negative emotions do us a great favor: They save us from ourselves. They’re signals urging us to change what we’re doing—and they’re actually necessary for feeling good

No one questions the value of feeling good. In fact, it seems that for the past 20 years, everyone in America has been on a relentless quest for a blue-sky state of mind, in pursuit of permanent residence on the spectrum between contentment and ecstasy.

Feeling bad is another matter entirely. Emotions that generate unpleasant feelings have been called sins (wrath, envy), shunned in polite interaction (jealousy, frustration), or identified as unhealthy (sadness, shame). We suppress them, medicate them, and berate ourselves for feeling them.

Because such feelings are aversive, they are often called “negative” emotions, although “negative” is a misnomer. Emotions are not inherently positive or negative. They are distinguished by much more than whether they feel good or bad. Beneath the surface, every emotion orchestrates a complex suite of changes in motivation, physiology, attention, perception, beliefs, and behaviors: sweating, laughing, desiring revenge, becoming optimistic, summoning specific memories. Each component of every emotion has a critical job to do—whether it’s preparing us to move toward what we want (anger), urging us to improve our standing (envy), or allowing us to undo a social gaffe (embarrassment).

We have the wrong idea about emotions. They’re very rational; they’re means to help us achieve goals important to us, tools carved by eons of human experience that work beyond conscious awareness to direct us where we need to go. They identify trouble or opportunity and suggest methods of repair or gain. They are instruments of survival; in fact, we would have vanished long ago without them.

Negative emotions are not only crucial to our existence but also—ironically—to feeling good. To live optimally in the world and endure its challenges, it’s necessary to engage the full range of psychological states we’ve inherited as humans.

Smudged up smiley face
“The science of well-being has forgotten that the world is an uncertain, complex place filled with people who often are annoying and obnoxious,” says Todd Kashdan, a psychologist at George Mason University and coauthor, with Robert Biswas-Diener, of The Upside of Your Dark Side. Knowing when and how to deploy all our emotions, we can better live with ourselves and with each other.

 

Anger

An ex-girlfriend once told me she didn’t know how much I cared about her until I yelled at her. That succinctly summarizes a decade or two of research on what may be our most misunderstood emotion. Anger results when we feel undervalued. It prompts us to reassert the importance of our welfare by threatening to harm others or withhold benefits if others don’t recalibrate our worth. This explanation clarifies why you might get angry when people needlessly try to be helpful; they haven’t shown malicious intent, but they’ve underestimated you.

In his research, psychologist Aaron Sell has shown that strong men and pretty women—those who, over the course of evolution, have had the most power to cause harm or withhold benefits—are angered more easily than their peers. “The primary benefit of anger for an individual,” Sell says, “is preventing oneself from being exploited.”

If you know what you deserve, and someone else sees things differently, anger arises. Your heart rate increases, you start to sweat, you think about all the things you could do to set the other party straight. Safety, civility, practicality—such concerns evaporate. When really enraged, you can’t contain your physical energy. Across cultures, people use metaphors for anger related to hot fluids in containers: You’re a tea kettle or a volcano, ready to erupt.

Anger can seem like the ultimate loss-of-control emotion, perhaps because it triggers actions so against our norms of care and courtesy. But “any emotion, when it’s really intense, takes over,” observes Maya Tamir, a psychologist at the Hebrew University in Jerusalem.

In fact, the frustration of devaluation that leads to anger quite often gets you what you want. It is a reliable tool for obtaining the upper hand in negotiations. Sure, anger that progresses to rage can exacerbate a situation, but swallowing the pain of devaluation can lead to depression and health problems. And by acting as a threat of further aggression, anger can forestall escalation. I yell, you back down, we’re good.

Anger motivates an individual to take action. While most “negative” emotions encourage us to avoid situations—think of fear—anger typically stimulates approach. Anger boosts confidence, optimism, and risk-taking, necessary when the alternative is losing something important to you. Anger has reputational value, too; it signals to others that you have strength of resources and resolve. In fact, those who display anger are seen as higher in status, more competent, and more credible.

Expressing anger varies widely across cultures. Tamir recalls an incident shortly after she moved back to Israel after studying in the U.S. She waited and waited in line to have her picture taken for her new driver’s license. Finally someone asked what she was still doing there, and she told him. “He said, ‘Well why didn’t you come and shout?!'” Do not try this in Japan.

Anger does not merely benefit the individual. It also fuels social progress. It stimulated the civil rights and gender equality movements. It can bring about fairness, justice, boldness, and clarity. Without it the downtrodden might never be heard. If you always muzzle your frustration when your partner does something you don’t like, your problem may never come to light, which can corrode the relationship from within.
Shame, Guilt, Embarrassment

Several years ago, Ilona de Hooge had a job as an assistant professor of psychology. “I really thought I was doing very well,” she says, “but in the end I was failing completely, and I was sacked.” For a month, she berated herself. “It felt as if I couldn’t do anything right, that I was completely worthless. Although I failed at just one aspect of my life, it felt like, ‘OK, now I’m failing at everything.'” But after a few weeks, the experience “motivated me to start looking for a different type of job where I could succeed.” And that worked out very well. De Hooge is now a marketing professor at Erasmus University, where she studies shame, guilt, and embarrassment.

Humans would not be so successful—indeed, would not have survived—without social cohesion. Living among others requires all to adhere to agreed-upon social and moral norms: Don’t fart in public. Don’t sext constituents. Don’t sock people in the nose. When we violate a norm, we need a way to pull ourselves back toward appropriate behavior. Enter shame, guilt, embarrassment to heap self-consciousness upon us.

First, they make us feel crummy. De Hooge says she felt thoroughly worthless after her firing, a feature of shame. Embarrassment, by contrast, doesn’t taint so broadly. When de Hooge once crashed her bicycle and broke her hand, she says, “it felt like, ‘Ah, I did something really stupid and everybody’s looking at me now.'” She didn’t feel all-encompassing degradation, but she definitely felt dumb for making such a mistake. After uttering an insensitive remark, you vow never to make the same mistake again. The experience and anticipation of future psychic pain act as a deterrent to foolish or hurtful behavior.

The discomfort of embarrassment, and especially of shame, turns you inward to examine what led to such a state and what you need to fix within yourself. “People can learn from their mistakes only when they acknowledge that something went wrong,” she says.

The emotions also motivate you to make amends. When feeling embarrassment, guilt, or shame, you try to repair what you damaged, by saving face or by offering help to others. You become more generous and cooperative, even with strangers, researchers find. Criminals who feel guilt are less likely to end up back in jail. Patients who feel shame during a doctor’s visit improve their health behavior. Husbands who know what they did wrong buy flowers.

Involuntarily, you blush when embarrassed; you slump with shame. Such built-in displays signal vulnerability and deference and serve a positive end: They endear you to others, reports University of California, Berkeley psychologist Dacher Keltner. After a misstep, expressing embarrassment or guilt or shame makes people like you better. They see you as more ethical, empathize more with you, and offer greater help. Remaining unemotional signals either that you don’t understand that you broke a norm or that you don’t care. Either message will not win you a popularity contest. Blushing with embarrassment “acts as a nonverbal apology,” Keltner says, “reducing the likelihood of harsh judgment and aggression.” It’s a hard-to-fake giveaway, unique to humans, that evolved to broadcast our essentially good character.

But we don’t have to do anything wrong to feel embarrassment. It surfaces when we’re flirting with a crush, meeting a rock idol, or receiving a round of “Happy Birthday.” The attention we receive or the lack of a social script to go by may provoke blushing so as to invite a generous judgment from others or signal lack of threat.

There’s a lot of shame about feeling shame, and embarrassment about feeling embarrassed (blushing feeds on itself), but these emotions enable us to live side by side. Without them we would not be able to trust each other—or ourselves.
Envy and Jealousy

Niels van de Ven still thinks back to playing baseball as a kid. “A teammate—whom I quite liked—was always the better hitter,” he says, “which is especially frustrating in a sport like baseball, where it’s nicely quantified in a batting average how much better the other person is.” He was bothered that his friend had something he didn’t have, but he didn’t want to take that ability away from him. So he practiced more, a lot more. He rehearsed his swing in his bedroom when he should have been sleeping. “I once accidentally hit my bed so hard that part of the headboard broke off,” he says. He improved.

Much of our success—financial, romantic, reputational—depends on our relative status and resources within a group, as it has throughout human history. You don’t need to outrun the bear, just your friend. Happiness is greatly influenced by our comparison of ourselves to others. You don’t need to be the smartest or richest, just smarter and richer than your neighbors. The discomfort of being worse off than those around you can present as a combination of hostility, shame, and resentment—a medley packaged as envy.

Envy can have destructive consequences. But it also has benefits. To reduce or reverse inferiority, envy moves us to increase our own standing or decrease the standing of others. One invariable way to increase our own standing is to become more successful. Van de Ven, now a research psychologist at Tilburg University, found that inducing envy enhanced subjects’ persistence and performance on a creative task—even more than admiration did. Admiration sure feels better in the moment, but the sting of envy ignites ambition to achieve future success. We can also become more successful by emulating the person we envy. Envy increases attention to and memory for others of our gender.

What Van de Ven felt was a kind of benign envy: He recognized that his friend was legitimately better, and he focused on what it took to reach that point. But when someone has something you don’t think they deserve, you experience malignant envy, a “seething discontent that involves animosity toward the person you’re envious of, while also feeling inferiority in oneself,” says psychologist Gerrod Parrott of Georgetown University, editor of the compendium The Positive Side of Negative Emotion. Unpleasant indeed. You sense injustice and want to take the rival down.

While benevolent envy is essentially a creative force, malignant envy is destructive—although it, too, can be good if an unworthy blowhard needs destroying. The increased attention to a competitor that allows you to learn from him might also enable you to take down someone who achieved success unfairly, by noticing his flaws and misdeeds and capitalizing on them.

Envy is often confused with jealousy, but the two are psychologically distinct. Envy is a longing for what another person has. Jealousy arises when a third party threatens a valued relationship. Like envy, jealousy can be destructive, but in response to a real infidelity it promotes survival. Stemming from the pain of feeling excluded and the fear of abandonment, it forces couples to examine and repair their relationship, the most protective envelope we have for raising children and perpetuating the species.
Fear and Anxiety

One night around 10 o’clock, 30-year-old Samantha (not her real name) was walking home by herself when she passed a park and a man on a bench called out to her. As she drew near, he yanked her down, put a knife to her throat, and yelled, “I’m going to cut you, bitch!” She recounted to a researcher that, instead of panicking, she calmly looked into his eyes and commented on the choir music coming from a nearby church. “If you’re going to kill me,” she said, “you’re gonna have to go through my god’s angels first.” He let her go.

Samantha lives with a rare disorder that has destroyed the amygdala in her brain, eliminating her ability to feel fear. As a result, she’s strolled through numerous life-threatening situations with similar aplomb, so it would appear that her fearlessness has kept her alive—until you consider that it may be what got her into those situations to begin with.

Fear is our defender, an appropriate response to signs of threat, heightening awareness and preparing the body to escape danger. Occasionally people are overcome with fear and become frantic or paralyzed, but more often fear is initially marked by widened eyes and nostrils, acutely tuned to collecting sensory information. No wonder subjects in one study chose to listen to scary music while playing video games in which they had to avoid enemies and aliens.

Fear stimulates vivid pictures of what’s about to go wrong—and how to get out of the situation. Flee? Fight? Feign death? Your focus narrows, your heart races, your senses perk up. Everything unrelated to your safety fades.

While the fear response is automatic, originates deep in the brain, and has been conserved in species throughout evolution, many specific fears are learned. Children, for example, must be taught not to get friendly with electrical sockets.

Not all threats are deadly; some will merely kill your reputation. Fears of social repercussions are also good to have, which is why we’re so concerned with morals and manners. You don’t want to anger a superior or embarrass yourself. If you’ve never dreamt about going to school naked, you might not be on speaking terms with the human condition.

Without fear, we become uncritical risk takers. There are some situations that, by themselves, dull our ability to assess risk—being intoxicated, being in a position of power, being a teenager. Unnecessary risk taking can lead to anything from unprotected sex to economic collapse. Sometimes we don’t fear things, such as climate change, enough because the outcomes are not sufficiently concrete.

When we are afraid but can’t directly address the threat—or possibly even identify it—fear becomes anxiety. By stimulating information gathering, anxiety actually improves the performance of highly intelligent people (who have the power to process it), whether at work or at school. It makes people energetic and vigilant. Researchers believe that anxiety not only preserves life, it is essential in all kinds of situations that require caution and self-discipline.

Anxiety about how we’re living our lives can point to ways in which we’re not being true to ourselves, ways in which our actions don’t align with our deepest values. Anxiety can serve a corrective purpose, bringing us back to authenticity.
Regret and Disappointment

Ted Ligety went to Vancouver in 2010 favored to win an Olympic medal in giant slalom skiing. He came away empty-handed. “I knew after the race that I left speed on the hill,” he said later. “That was a really disappointing feeling, but it also helped me change my mentality.” He pushed himself harder, and four years later he won gold.

Regret emerges when we think about what could have been, if only we’d done something differently. It relies on counterfactual thinking—pondering alternate realities. Counterfactual thinking allows us to analyze the past and the future and to understand causality: If I hadn’t done A, B would have happened; If I do X, Y will happen. It boosts learning and planning.

Because making a mistake is such an excellent learning opportunity, our emotions highlight our mistakes for us, adding regret to injury. “How could I have done that?” you wonder. “I was such a schmuck! If only I’d known then what I know now.” We evolved to see the errors of our ways and to make note, often in cringe-worthy detail. There’s a reason we kick ourselves while we’re down: Research shows that by making our errors more painful, regret renders them more memorable and more effectively induces us to change our ways. It might be the most common negative emotion, shadowing every situation from our choice of mate to our choice of checkout line.

Todd Kashdan still reflects on his chance to take a class with Carl Sagan in college. He’d scheduled an interview with the astronomer to be admitted, but was too intimidated to show up. “I’m embarrassed that I let my anxiety override such a beautiful experience,” he says. “And it’s a great touchstone for every time I’m faced with the fear of making a decision because of how I might present myself.”

Regret has a trusty sidekick keeping us out of trouble: anticipated regret. When it’s not paralyzing us, this fear of future self-loathing makes us wear condoms, drink less, and eat better, studies show.

Regret also motivates us to fix whatever mess we’ve caused, whether that means returning an impulse purchase or apologizing to a friend. The reparative element distinguishes regret from disappointment, which motivates us to abandon a goal rather than persist. Regret arises when an outcome is worse than if we’d acted differently, implicating personal responsibility; disappointment arises when an outcome is worse than we expected it to be, highlighting powerlessness. Although unpleasant, disappointment also has its uses—putting us off an unachievable goal, for instance. It also attracts sympathy and support. As a result, others become more helpful toward us.

Voicing regret has benefits, too—it brings people together. Sharing personal regrets can make you seem more humble (we all make mistakes) or more vulnerable. And it shows that you care about the repercussions of your actions.

Psychologists Laura King and Joshua Hicks believe that regret is necessary for ego development. People who elaborate on lost possible selves—who they could have been—inhabit more mature, complex personalities: They tolerate ambiguity and see life in a more nuanced way, they’re more empathic and open to new experience, and they form stronger relationships. Only by recognizing what you’ve lost can you absorb a lesson, not to mention disengage from your old goals and pursue new ones. In the long run, regret may actually enable a newer, more fulfilling type of happiness, one that is more resilient and more complex.
Confusion, Frustration, Boredom

When Sidney D’Mello, a psychologist at Notre Dame, was learning to program computers, he’d frequently compose a program, run it, and get an immediate error message. Everything looked fine, but something wasn’t working. Encountering new information that doesn’t fit with the old—an error message when you’re not expecting one—elicits surprise, and if the mismatch persists, you become confused. The world becomes an unsettling, uncanny place, where perception and logic are no longer reliable. The universe feels broken.

But confusion can be productive; it can force you to methodically piece the universe back together. D’Mello created a mental model of his program and ran test after test to determine which output every input begat. “That entire rich process, the abstract thinking, the testing, and seeing how a complex system works,” D’Mello says, “that’s the essence of deep learning.”

D’Mello now researches how students learn scientific reasoning. The emotional discomfort of confusion drives problem solving. Education researchers talk about “desirable difficulties,” which force students to engage with material and process information deeply. Teachers’ goals, D’Mello writes, should be to find “zones of optimal confusion.”

When confusion persists, you become frustrated—angry, even. Significantly, confusion, frustration, and anger all produce a furrowed brow, the indicator of a blocked goal. Frustration motivates you to push harder, churn those mental cogs, fight to resolve the incongruities.

If you keep churning and get nowhere, boredom ensues. Boredom nudges you to search for more interesting problems. The state is so aversive that people will give themselves electric shocks to avoid spending 15 minutes with their own thoughts. If you don’t happen to have a battery on hand, you might take to daydreams or new challenges. Great ideas may emerge.

Sadness and Grief

In 1995, Jane and Flicka Rodman were hiking the Pacific Crest Trail from Canada to Mexico. Two thousand miles into their trip, the young couple took a detour alongside a road to meet up with friends. A driver went off the road, killing them both. Flicka’s mom, Barbara Perry, channeled her overwhelming grief into two projects. She set up the Jane and Flicka Fund for the Pacific Crest Trail Association, and she organized an annual two-week backpacking trip, on which she and the couple’s friends hiked stretches of the trail. Each night around a campfire Barbara read from Flicka’s journal his account of the trail section just hiked. Tears and laughter flowed. Flicka, a medical student, loved to write about his poop.

Failure to experience grief and sadness (and anger) after such a tragedy would be unthinkable. It would also not have led Barbara to help the organization that had helped her son so much, and she would not have brought his friends together. “Particularly when there’s a senseless loss,” Barbara says, “there is such a need to make something positive come from it.”

Sadness comes in response to a real or potential loss and signals that restoration is needed. As a result, it motivates change, and different types of sadness stimulate different types of fix. In one study, subjects imagined losing a loved one to cancer, failing to achieve an important goal, or just going to the grocery store, and then listed all the things they’d like to do. Those who felt a relationship loss outlined the most social activities, and those who felt failure listed more work-related activities. We try to make right the cause of our anguish.

Sadness makes you more rational, your thinking more concrete. It reduces gullibility, forgetfulness, and susceptibility to stereotypes. It also makes you more sensitive to social norms, increasing politeness and fairness. By contrast, happiness can lead to superficial thinking, hubris, and risk taking. Accepting negative feelings such as sadness can, ironically, lower depression; it doesn’t compound the problem by making people feel bad for feeling bad.

Sadness also functions as a signal to others that we may need help. Crying, some scientists believe, makes the facial displays of sadness especially unambiguous. Depression—a state of prolonged sadness and hopelessness—is now widely seen as a disorder. But it can be a healthy response to difficult life situations. It may have evolved as a way for people to remove themselves from distracting activities (by eliminating their interest in them) and to ruminate on whatever complex problem is besetting them.

Whether avoiding sadness or anger, confusion or boredom, distancing ourselves from our negative feelings cripples everyday functioning and growth. It also alienates us from the full range of human experience. “While you never look for grief,” Barbara Perry says, “it’s one of the hugest growing experiences you’ll ever have. It deepens you as a human being.”

Recalling the desperation she felt after losing her son, she says, “You’ve got to find footholds wherever you can.” She laughs. “Sometimes holding onto the side of a fucking cliff.”

 

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Seasonal Affective Disorder

During the darker days of winter, more people report feeling depressed and tired. For many, it’s a normal response to less sunlight, but for others, it can be a clinical form of depression called seasonal affective disorder. To help understand the difference between the winter blues and SAD, APA asked psychologist and SAD expert Kelly Rohan, PhD, to explain the signs of the disorder and potential treatments.

Rohan is an associate professor of psychology at the University of Vermont. Her area of interest is adult mood disorders with specialization in cognitive-behavioral therapy and theory of depression and SAD. Her most recent project is a National Institutes of Mental Health-funded clinical trial comparing SAD patients who were treated with light therapy to those treated with cognitive-behavioral therapy.


APA: What is seasonal affective disorder and how is it different from winter blues or other types of depression?

Dr. Rohan: Seasonal affective disorder is a regular seasonal pattern of major depressive episodes during the fall and winter months with periods of full improvement in the spring and summer. The symptoms of SAD are exactly the same as non-seasonal depression symptoms, which can include a loss of interest or pleasure in normally enjoyed activities, excessive fatigue, difficulty concentrating, a significant change in sleep length and thoughts about death or suicide. The only difference with SAD is the seasonal pattern it follows. The most commonly reported SAD symptoms include significant fatigue, pervasively sad mood, loss of interest in activities, sleeping more than usual, craving and eating more starches and sweets, gaining at least 5 percent of body weight and difficulty concentrating. Most people experience SAD symptoms to a certain extent, especially at higher latitudes. These individuals who do not meet diagnostic criteria for depression during the fall/winter months, but who experience mild to moderate symptoms during fall or winter, are considered to have a milder form of this disorder also known as subsyndromal SAD or the “winter blues.”

APA: What are the types of treatments for this condition and when should people seek treatment?

Dr. Rohan: I strongly recommend against self-diagnosis and self-treatment because depression, including SAD, is a serious mental health problem. If you struggle with the changing seasons, experience some of the symptoms mentioned above, have difficulty functioning at school or work or if your symptoms interfere with your ability to interact with your family or others during the winter months, you should talk to your doctor about a referral to a psychologist or find a psychologist yourself.

The most widely used and extensively investigated treatment for SAD is light therapy (i.e., daily exposure to bright artificial light during the symptomatic months). Light therapy devices rigorously tested in clinical trials for SAD emit a controlled amount of cool, white fluorescent or full spectrum light with a built-in screen to filter out harmful ultraviolet rays. Clinical practice guidelines for SAD recommend daily use of light therapy each year from onset of the first symptom until the time in the spring when SAD symptoms would naturally resolve on their own. Compliance and consistency with the daily regimen are very important for benefits. Light therapy devices are commercially available without a prescription. However, because of the possible side effects, such as headache, eye strain and feeling agitated, and because the dose of the light needs to be adjusted to each patient, it is best to use light therapy under the supervision of a mental health provider with expertise in light therapy. Ask your psychologist if he or she feels comfortable supervising your light therapy and side effects or if they can refer you to someone with that expertise. When light therapy fails, antidepressant medications are widely regarded as the second line of treatment for SAD.

APA: You’re researching the best ways to treat SAD, including some work on comparing the effectiveness of cognitive-behavioral therapy with light therapy. What have you learned?

Dr. Rohan: For the past 12 years, my laboratory has been developing and testing a novel cognitive-behavioral therapy for SAD, with promising results. CBT is a type of talk therapy used and researched extensively for non-seasonal depression since the 1960s, but we are the first group to apply the treatment to SAD. We previously published a clinical trial for SAD that compared standard light therapy, CBT and the combination of CBT and light therapy to a control group on a wait list for treatment. We found that CBT, light therapy and combination treatment all improved depression more than the control group and all three of these methods showed large and comparable improvements in SAD symptoms across the six weeks of treatment in the winter. A year later, patients who had been treated solely with CBT generally had better outcomes than those who had been treated with light therapy alone. In contrast, the combined treatment group did not fare any better than the light therapy only group the next winter. These results suggest that treating someone initially with just CBT may be more effective in the long term. My lab is completing a study to find out if these results hold in a larger, more definitive study funded by the National Institutes of Mental Health. In that study, we treated 153 adults with SAD with either CBT or light therapy and we are following them for two consecutive winters to measure future symptom severity and SAD recurrences after treatment ends. I am most interested in long-term outcomes, meaning how to keep people well over time.

APA: How can cognitive-behavioral therapy be tailored for SAD?

Dr. Rohan: The CBT for SAD treatment we have been testing includes 12 structured sessions, delivered two times per week over six weeks in the winter. The sessions focus on developing skills to improve coping with the seasons. The therapist works with the patient to foster two types of skills: behavioral (doing) skills and cognitive (thinking) skills. The behavioral skills involve identifying, scheduling and doing pleasurable, engaging activities every day in the winter. Over time, these proactive behaviors are meant to counteract the down, lethargic mood and the tendency to give in to “hibernation” urges that are so common in SAD. The cognitive skills involve learning to identify and challenge negative thoughts when experiencing SAD symptoms. In our CBT program, we encourage patients to aggressively apply the skills they learn in CBT before symptoms start, typically very early in the fall or around the end of daylight saving time, to manage their moods and prevent slipping back into old patterns that contribute to depression. This “tool box” of skills is assumed to be important for long-term benefits after formal CBT with the therapist ends.

APA: Can people be cured of this disorder?

Dr. Rohan: SAD can be effectively treated but the status of the research in the field is unfortunately not at the point where we can say we have a “cure” for SAD. The good news is that research in the field shows effective treatments are available, including light therapy, medications and CBT. So there are options for people affected by SAD. There is not a one-size-fits-all treatment approach. Different things work for different people. After finding a treatment or treatments that substantially improve acute SAD symptoms in the winter, it is important that the long-term treatment plan include specific steps to try to prevent the return of SAD, or lessen its impact in subsequent fall/winter seasons.

For more information, contact Dr. Rohan.

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Antipsychotics Don’t Ease Delirium in These People

These drugs won’t prevent or effectively treat the condition, review suggests

WebMD News from HealthDay
By Steven Reinberg

HealthDay Reporter

TUESDAY, March 29, 2016 (HealthDay News) — Antipsychotic medications, such as haloperidol (Haldol) or clozapine (Clozaril), aren’t appropriate for preventing or routinely treating delirium in hospitalized patients, a new study suggests.

The researchers reviewed past studies and found that antipsychotic drugs given before surgery didn’t prevent delirium. These drugs also didn’t make any difference in the course of delirium in medical or surgical patients, the study authors said.
“The American Geriatrics Society guidelines suggest avoiding using these medications as a part of routine care of a patient with delirium,” said lead researcher Dr. Karin Neufeld, clinical director of psychiatry at Johns Hopkins Bayview Medical Center in Baltimore.

Delirium causes confused thinking and diminished awareness of the environment, such as time and place. Delirium is often caused by physical or mental illness, such as drug abuse or an electrolyte imbalance. Delirium is usually temporary and reversible.

Antipsychotic drugs are routinely used to treat delirium. But the U.S. Food and Drug Administration hasn’t specifically approved their use for treating the condition.

However, antipsychotics can be used for limited periods for treating specific symptoms, such as distressing hallucinations, or “when the patient’s life or safety are at risk due to severe agitation,” Neufeld said.

Treating delirium without drugs has also been shown to be successful, she added.

“Interventions, such as getting the patient out of bed and engaging in physical activity, can be first-line approaches to treating delirium,” Neufeld said. “These non-drug types of treatments have been shown to decrease delirium in hospitalized patients and we should incorporate them into our practices,” she suggested.

For the new study, Neufeld and colleagues reviewed data from 19 previously published studies. Seven of the studies looked specifically at preventing delirium after surgery. The studies compared antipsychotics with placebo pills or no treatment. The researchers found antipsychotics didn’t reduce the risk of delirium.

Pooling data from all 19 studies that included medical and surgical patients, Neufeld’s team found that antipsychotics didn’t alter how long patients suffered from delirium. The drugs also didn’t reduce the severity of delirium. And giving people antipsychotics didn’t change how long a patient stayed in the hospital, or if a patient died, the study authors reported.

continued…
“At this point we do not have any clear evidence that using antipsychotic medications can generally prevent or shorten the course of delirium,” Neufeld said.

The report findings were published online recently in the Journal of the American Geriatrics Society.

Dr. Eugene Grudnikoff, a psychiatrist at South Oaks Hospital in Amityville, N.Y., pointed out that delirium is not a disease. “It is a group of symptoms that may result from a number of conditions,” he explained.

It’s not surprising that antipsychotics didn’t work for patients who developed delirium after surgery or because of a medical condition that may have caused the delirium in the first place, Grudnikoff said. But that doesn’t mean that these drugs might not be effective in patients who have delirium due to drug abuse or mental illness, he said.

Grudnikoff said simple measures can be useful in helping patients regain their mental compass. These can include keeping a clock and calendar on the wall that the patient can see when waking up from surgery. It’s also helpful to keep the room dark at night and lit during the day. Having the same staff treat the patient throughout a hospitalization can also help, he suggested.
“These seem trivial and obvious, but they are important,” he added.

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Depression positive affirmations

Present Tense Affirmations
I find it easy to stay positive
I only focus on the positive things in my life
I am happy
I have a strong mind
I find it easy to think only positive thoughts
I am free from negative thoughts
I am happy with who I am
I am free of depression
I just naturally stay positive
I find it easy to stay happy

 

Future Tense Affirmations
I will beat depression
Each day I am finding myself more happy
I am finding myself less depressed
I am turning into someone who stays strong no matter what
I will be free of negativity
I will only focus on the best of life
I will only think positive thoughts
I am turning into a positive thinker
I will learn to love myself
I am turning into someone who enjoys life

 

Natural Affirmations
Being free of depression is my natural rite
I find thinking positively easy
Beating depression has made me a stronger person
I have overcome depression
I am nothing but happy
I constantly remind myself that life is great
I have and always will love who I am
People see me as someone who enjoys life
If there is one thing I enjoy it is life
Being free of depression is the greatest thing ever
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Relaxation positive affirmations

Present Tense Affirmations
I am relaxed
My mind is slowing down
My tension is melting away
I am letting go of all my worries
My body is relaxed and at peace
My mind is calm
I am centered and quiet
My muscles are relaxed
My thoughts are calming down
I release my concerns for the time being

 

Future Tense Affirmations
I will find time each day to relax
I am starting to relax
Each day I am more at peace
Relaxing is becoming easier and easier
I am transforming into someone who is always relaxed and centered
My life is beginning to feel more peaceful
Each moment I relax my body more and more
My mind is beginning to feel calmer
I am starting to feel more balanced and calm
Others are beginning to notice how relaxed I am becoming

 

Natural Affirmations
Being in a peaceful state is normal for me
I love relaxing
Slowing down feels good
Finding time each day to relax and unwind is important
I have a naturally peaceful mind
Relaxing my body is easy
People see me as someone who is balanced, calm, and centered
Letting go of the tension in my life is rejuvenating
I can effortlessly let go of any thoughts, concerns, or worries
I enjoy nurturing myself with deep relaxation
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Nearer the sky

Glad that I live am I
That the sky is blue
Glad for the country roads
And the fall of dew
After the sun the rain
After the rain the sun
This is the way of life
Til the work be done
All that we need to do
Be we low or high
Is to see that we grow nearer the sky.
JmaC
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Eternity

I sit here alone at night
Wondering g wat is wrong with me
Nobody ever cares nor they ever will
There’s a whole in my heart waiting to be filled
I fight back the tears hoping no one will notice
Why can’t they see me for me
And not sum rumor everyone believes
Do I need to change?
I use to think not
I’m not sure
They all run past acting like I don’t exist
Maybe I don’t allow myself to
Wat do I need to do to make u notice just once, one time.
I want to feel like I belong
My heart is empty and it waits for how long I ask
A year?
A month?
Tomorrow?
To me it’s like eternity!
JmaC
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Love Is

Love is wen 2 people touch each other’s soul.
Love is honesty and trust.
Love is about helping one another.
Love is respect.
Love means it can and will be worked out.
Love is reaching your dreams together.
Love is the connection of 2 hearts yours and mine.
JmaC
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