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Positive psychology Rather than parading as a specialised discipline, positive therapy offers a way of working where happiness is a goal to head for. By Clare Pointon Happiness is one of the most highly prized goals in our society today. And guidance on how to get it is in demand. It's not only a media preoccupation, as reflected in the recent six-part BBC TV series, The Happiness Formula. The call for help on how to be happy is also loud and clear within the psychological world. Currently, the most popular course at Harvard University in the States is a positive psychology class by Israeli psychologist Tal Ben-Shahar, reportedly drawing around 900 students. And in Britain, one public school in Berkshire – Wellington College – has decided to timetable positive psychology and happiness lessons as part of its core curriculum. So what is positive psychology and what are its implications for our practice of counselling and psychotherapy? For Alex Linley, psychology lecturer at Leicester University and founding member of the European Network for Positive Psychology, it is 'the science of optimal functioning'. Linley has just co-authored with Stephen Joseph, Professor of Psychology, Health and Social care at Nottingham University, a book on the applications of positive psychology for counselling and therapy: Positive Therapy: A Meta theory for Positive Psychological Practice1. He says its main thrust is to redress the traditional tilt towards psychopathology in the psychological world: 'Positive psychology is about rebalancing our interests to highlight the fact that we also need to study the plus side of the equation – what is right as well as what is wrong, performance as well as vulnerability.' Why the bias? His American counterpart, Martin Seligman, one of the biggest positive psychology proponents in the US and beyond, argues that there has historically been a belief that virtue and happiness are inauthentic, that they ultimately come back to negative traits and states: 'This "rotten-to-the-core" view pervades Western thought,' says Seligman. 'And if there is any doctrine positive psychology seeks to overthrow it is this one. Its original manifestation is the doctrine of original sin. In secular form, Freud dragged this doctrine into 20th-century psychology where it remains fashionably entrenched in academia today. For Freud, all of civilisation is just an elaborate defence against basic conflicts over infantile sexuality and aggression.'2 But according to Linley, there are also historic political and economic reasons for psychology's bias. Following the Second World War, the US Government gave massive funding to two American organisations – the Veterans' Administration and the National Institute of Mental Health – for research into psychological disorders including traumatic stress, anxiety and schizophrenia. This, he argues, meant that psychologists were at that time able to get research grants and make a good living from work in these areas. Thus the medical model – also embraced by clinical psychology which was supervised by psychiatry – became entrenched. Change came with the advent of humanistic psychology and the Human Potential Movement in the US of the 1960s, to which Linley believes positive psychology owes some of its heritage. But he points out that this movement never penetrated the academic institutions and thus government funding sources; it was seen as focused on subjective experience, rather than research. Then came the cognitive revolution, and the humanists became further marginalised from the established mainstream. A frame of mind Research is a point on which positive psychology has always been sharp. Those who practise in this domain may be academic, clinical, forensic, organisational or counselling psychologists, but they are all trained psychologists with a grounding in science and research. Apart from one course in the United States (Martin Seligman's Masters in Applied Positive Psychology in Pennsylvania) there is no training for practitioners in positive psychology, nor is there any system of regulation. The unifying identity, says Alex Linley, is these psychologists' frame of mind: 'You could say that any psychologist is practising as a positive psychologist if they are adopting an approach that looks at what works well, as well as what doesn't work. I don't see it as a specialised discipline within psychology. It's more an approach to how we practise psychology.' At the heart of this, Linley believes, are the values of Carl Rogers – belief in the actualising tendency and the importance of an internal locus of evaluation3 or in positive psychology terms 'intrinsic motivation'4. So, when applied to therapy – also known as Positive Therapy – the practitioner's role crystallises as that of helping the client find her inner voice in the belief that it's this that will lead her to the greatest fulfilment and happiness. For the central goal of positive psychology is to increase a person's happiness which, research shows, is associated with stronger physical health, less psychopathology, better coping skills and even longer life5,6. But this philosophy posits two definitions of happiness. The first, Linley describes as the balance between a person's positive and negative affects; the second, as engagement with the existential challenges of life, including a sense of meaning, relationships, autonomy, personal growth and mastery of one's environment. Positive psychologists argue that it is the pursuit of the second which is the most likely to lead to lasting happiness and make the greatest contribution to the wider community: 'The actualising tendency guides us all to ever more development, fulfilment, and integration, and …this is explicitly a socially constructive force, rather than a selfish, destructive one. It is important to be clear … that in talking about happiness and wellbeing as desired outcomes of applied positive psychology and positive therapy, we are talking about psychological wellbeing, or growth and fulfilment, rather than transitory hits of sensual pleasure'1. According to Linley, psychologists now largely agree that around 50 per cent of our happiness is 'genetically determined', a phrase he uses to include the effects of early environment which, he argues, impacts on the expression of heredity, 10 per cent is down to circumstances and 40 per cent relies on the 'intentional activities' we pursue. If this is true, our margin for manoeuvre as practitioners is certainly great. Clinically, says Linley, what's important is that we don't confine our goals to helping people move on from uncomfortable states like depression, but that we think of how we can facilitate them – beyond this – to raise their levels of happiness. For, he points out, if someone comes for help when they rate themselves at minus three on a scale of minus 10 to plus 10 (where nought is the lowest level of happiness and plus 10 the greatest) and through our work with them they report that they now experience themselves at nought, what will happen if and when they relapse? They will be back in the minus. Whereas, if they are able to reach plus five, even with a relapse of three points, they will still be plus two – and therefore happy. Pinpointing strengths One seminal piece of work in the positive psychology field has been the evolution of the Values in Action (VIA) Classification of Strengths, a publication intended to complete the American Psychiatric Association's Diagnostic Statistical Manual (DSM)7. It follows the style of DSM, but, instead of focusing on problems and pathology, provides a matrix for identifying what is functioning well in a person. The VIA outlines some 24 character strengths which are seen to be the routes to displaying one or more of six virtues believed to be endorsed across many different cultures. They are: wisdom, courage, love, justice, temperance and transcendence. The idea is that any individual can complete the VIA Inventory of Strengths self-report 240-item questionnaire – either with a practitioner or on their own (download from www.authentichappiness.org) and identify what Seligman has named their 'signature strengths'. And, however high or low they score, they will emerge with a list of their top five strengths. 'Whilst there is no research yet on this, I have spoken to many people practising coaching who have found that doing this exercise with a client is a tremendously positive experience,' says Linley. 'Traditionally, we don't talk about our strengths, particularly in the UK. We tend to be modest and don't find it easy to focus on what we are good at and can celebrate.' There is now, however, research published in the American Psychologist linked to this, which highlights two specific interventions found to be effective in decreasing depression and increasing happiness. Where clients counted their blessings each day, reflecting on why each one had come about and also identified their signature strengths, using at least one of them in a new and different way each day, they reported feeling significantly better at a six-month follow-up. Whilst the interventions were introduced with the intention of pursuing them for a week, those who benefited appeared to have enjoyed and maintained the exercises for longer8. 'If we are able to develop a way of working with people so that they want to do these, then they can be very important in terms of preventing relapse,' says Linley. So what are the clinical implications for counsellors and psychotherapists of the findings to date of positive psychology? Alex Linley believes that – as in psychology – it's all about the approach: 'When we think about positive therapy or positive psychology applied to therapy, what we really mean is an approach where people hold the assumption that a person has a constructive developmental tendency. So what we should be doing is trying to facilitate that and if we are working from that basis, there are a number of different ways we might go about trying to do that.' In his view, this might be a person-centred orientation, but it might also be, for example, an existential, Gestalt, Transactional Analysis, psychodynamic or mindfulness-based model. A sense of the whole person One UK practitioner is Pam Gawler-Wright, a psychologist and psychotherapist who teaches 'Contemporary Psychotherapy', an approach in which she says she works with clients as people in process and updates her methods as research reveals new models of efficacy. For her, the starting point is that each person is resourceful and has the potential for greater wellness. In the early sessions with a client, she says she concentrates on building with them what she calls 'the safety raft'. This involves discussing – along with the issue that has brought them to therapy – where they are in their life, what they have achieved, what they like about themselves and the times when they are enjoying themselves, when they experience themselves as competent and in relationships that they find comfortable. 'The idea is to build a relationship between aspects of self, rather than isolating negative experiences,' she says. 'So we start from a sense of the whole person, including the competent and functioning person who will have positive memories. When someone comes to therapy from a depressed or traumatised state, they are likely to remember other times when they felt the same. It can be hard for them to think about good things in their life, so the therapist needs to help them contact positive states.' One of tools that Gawler-Wright uses in this is body awareness work. She argues that it is very hard for someone to maintain a particular emotional state when they change their physiology, so she may invite a client to stand, and perhaps move around and sense the range of emotions that are a part of physical experience. From this position, she says, they will then have the chance to contact more of a sense of choice around their emotional state: 'This isn't a false happy-clappy state. It's about trusting the integrity of the body, seeing that even when our cognitive filters block out other more comfortable times that contradict our low view of ourselves, we can trust the body to remind us that other different emotions and experiences are possible.' She also facilitates clients to make what she calls authentic affirmations. When people are troubled, she says, they tend to speak mainly about what they don't want, as well as what they are not. Again, it's the skill of the therapist to help them find a way to articulate in positive terms – in words or writing – what they do want. This is where it's so important to facilitate a client to associate to a positive time. For someone who has lost a sense of self-esteem, this may involve recapturing through memory and reporting in the present tense the sensory details, for example, of the day they received their degree – the physical sense of how they are standing, what is going on in their body, how they feel about themselves. The memory can then serve as a bridge to feeling differently about themselves in the present context. Their affirmation may authentically reflect that they do not feel proud right now, but include the fact that they remember a time when they did. In this way, says Gawler-Wright, the client becomes increasingly aware of the physical processes engaged when they are in a positive emotional state. However, with clients who have for some time been more severely depressed, the task may require considerable patience and a sense of play. In this situation, she says she will spend some time helping them connect to a pleasurable internal world that they can access – perhaps inviting them to recall something that they like from each of the five senses. Likewise, where someone may feel anger, judgement or shame towards themselves for what they are feeling or what happened to them, she believes the work will be first about learning to cultivate a more compassionate stance. She may ask them to consider another person in a similar state to theirs and to explore whether they feel the same negative attitude towards them or find they feel more compassionate. If so, she will then invite them to visualise what it is like to be the recipient of that compassion. Using the negative A key theme of this approach, she argues is that what may sometimes be seen as negative emotions are not dismissed as undesirable and useless. For Gawler-Wright, they are keys towards greater self-understanding. What's needed, she argues, is to explore and discover their positive intention. For example, where someone is anxious about job security, she says it may be that they will discover in therpay that they feel they need to develop some specific skills that they don't currently have. And it's here that she draws on the concept of 'modelling' from Neuro-Linguistic Programming (NLP). The idea is that, even if a person doesn't know how to get a particular skill or embody a particular attribute (for example better planning and preparation skills), they are likely to know someone or be able to contact someone who does. So the work is to identify that person and ask them to explain about their own experience or alternatively to use the sensory imagination again to visualise themselves as that person – exploring how they might stand, breathe, what they might say to themselves. 'If we had good models when we were growing up, that's great, but often either we didn't or the models were less than productive,' says Gawler-Wright. 'Trying out another person's posture, for example, and noticing the difference between this and one's own is a very safe way to do things because we're playing. It's about getting into an early learning frame of mind.' She points out that neuroscientific research shows that doing new and unfamiliar movements in an exaggerated way – as children do when they learn by imitation – stimulates protein recipes that create new neural pathways9. But to what extent can all our clients benefit from this kind of positive psychological approach? Is it perhaps not more for those who might be seen as neurotic, the so-called 'worried well'? And to what extent is it helpful to tilt psychology's bias away from DSM and the concept of mental illness? Alex Linley is at pains to point out that he has no desire to bin psychiatry or the use of medication in cases where a problem is biologically based. What he does reject is the notion that there are any clients for whom this is the only option: 'One of the things DSM does which is damaging,' he says, 'is to categorically distinguish between people who are ill and people who are well. It says there is something fundamentally different between these two groups – and that on that basis we need to do something different with them.' Gawler-Wright agrees. She has worked therapeutically with clients who have chosen to see a psychiatrist concurrently to deal with a particular problem. And, whilst she says her approach is different from that of a psychiatrist, she does conceptualise mental and emotional processes as chemical processes. However, along with Alex Linley, she stresses that, in her view, chemistry isn't the only way to affect chemistry. What positive psychology has to offer is a greater understanding of the chemical part which emotional processes can play in the journey towards happiness and health.
Further information www.personalitystrengths.com – free
online questionnaires of personality, strengths and wellbeing www.enpp.org – European
Network for Positive Psychology Training in Contemporary Psychotherapy: www.beeleaf.com. References
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