Daniel Carlat, MD. Vice Chair, Community and Public Sector Psychiatry, Tufts University School of Medicine. Publisher, Carlat Publishing.
Dr. Carlat has no financial relationships with companies related to this material.
Learning Objectives:
In this article, you will learn to:
Positive psychology is a relatively new branch of psychology that is focused on the traits and features that contribute to a robust sense of happiness, resilience in the face of trauma and stress, and a sense of purpose and well-being.
Positive psychologists look at what is right (ie, a strength-focused approach), not what is wrong (ie, a symptom-focused approach). It is meant to complement, rather than supplant, existing psychotherapy practices. Let’s take a look at some principles of positive psychology, followed by suggestions for incorporating these approaches into your psychotherapy practice.
The Three Domains of Positive Psychology
Positive psychology is aimed at increasing satisfaction, facilitating contentment and joy, strengthening inborn virtues, and moving beyond a narrow focus on weaknesses and deficits. It holds that positive emotions are possible and exist regardless of psychological burden and that well-being is more than the reversal or absence of negative emotions (Duckworth AL et al, Annu Rev Clin Psychol 2005;1:629-651). Positive psychologists identify three domains of happiness: the pleasant life, the engaged life, and the meaningful life.
The Pleasant Life
The first domain is the pleasant life, which concerns positive feelings about the past, present, and future. Positive emotions that may be associated with the pleasant life, and that positive psychologists believe foster happiness, include the following:
Although this domain does concern pleasant sensations and experiences, it is not to be confused with what your clients may typically associate with “the good life” (in other words, fancy clothes, shiny cars, and lots of cash). This road to happiness is not paved in diamonds. It is independent of material goods.
Assessment of subjective well-being and quality of life will help you better understand your client’s standing in this domain. In most clinical practices, degrees of pathology are often assessed with symptom checklists and questionnaires. But these might miss an understanding of your client’s general feelings and thoughts about his or her life, capacity to experience momentary pleasure and joy, or hopes for the future.
A practical place to start is to assess your clients’ sense of well-being. For example, ask about the following:
Certainly, this process may be more difficult for your clients suffering from hopelessness in the face of a severe depressive episode, or with generalized anxiety disorder who feel terrified about the uncertain future. You should empathically acknowledge such fears and negative emotions; positive psychology techniques should not interfere with rapport building and trust and may not be appropriate during episodes of severe symptoms.
However, if you focus exclusively on pathology, you will overlook the things that have gone right for your client. Most people—even those suffering from depression—can identify a time in their lives associated with a positive emotional state, and feelings of joy and laughter. With guidance, they may also be able to verbalize how they made the best of less-than-ideal circumstances and identify how their efforts in school or work have contributed to feeling competent and pleased.
Satisfaction With Life Scale: A Therapeutic Tool
The Satisfaction With Life Scale (SWLS) can be a useful tool for therapists to assess their clients' subjective well-being and life satisfaction (Pavot W et al, J Pers Assess 1991;57(1):149-161). Here are some guidelines for how you might use the SWLS: Explain the purpose of the SWLS: It is used to assess their level of life satisfaction in order to help guide psychotherapeutic work. Administer the SWLS: The SWLS is completed by your client, and consists of five items, each rated on a 7-point scale ranging from 1 (strongly disagree) to 7 (strongly agree): 1. In most ways my life is close to my ideal. 2. The conditions of my life are excellent. 3. I am satisfied with my life. 4. So far I have gotten the important things I want in life. 5. If I could live my life over, I would change almost nothing. Use the results to guide therapy: Depending on the client's score on the SWLS, you may choose to focus your therapeutic work on issues related to life satisfaction, happiness, and well-being. Follow-up: Consider re-administering the SWLS periodically throughout therapy to track changes in the client's life satisfaction over time. |
The Engaged Life
The second path to happiness is the engaged life, which means using positive character strengths to enhance your life. Strengths of character include honesty, integrity, diligence, and creativity, among others.
Assessing clients’ core strengths allows them to understand their abilities so that they can leverage them to accomplish meaningful tasks. There are free tools available through the Positive Psychology Center at the University of Pennsylvania (here) with which clients can assess their character strengths. You can then use these results in the course of therapy. One suggestion is to ask clients to use one of their character strengths in a new way every day for one week (described in Seligman, MEP et al, Am Psychol 2005;60(5):410–421). For example, if you have clients whose top character strength is creativity, they might try looking for a new solution to a problem at work. For other clients whose top strength is social intelligence, they might try to actively engage with new parents while picking their child up from daycare.
The Meaningful Life
The third domain is the meaningful life, consisting of affiliation with, and contribution to, positive organizations or groups. This domain highlights the fact that involvement in something beyond oneself—a cause larger than one’s own concerns and needs—provides a sense of meaning and purpose. Examples of potentially positive institutions include family, peers, academic settings, politics, religion, and local and national communities. How might you collaborate with your clients to enhance their sense of purpose and connection? What groups or people might help your clients grow and flourish? Decisions about where to live and work, and who to spend time with, are a natural part of the discourse of psychotherapy. If you adopt and encourage a stance of enhancing meaning, rather than one focused purely on minimizing symptoms or avoiding a bad outcome, you can help clients find happiness via the meaningful life.
CARLAT TAKE: While the importance of focusing on “the positive” is nothing new in the practice of psychotherapy, the introduction (in the late 1990s) of positive psychology has offered practitioners new perspectives on how to identify and develop emotional strengths. Incorporating positive psychology into our psychotherapy approaches presents us with a framework for focusing on these strengths.
References in the order of appearance in this article:
Pavot, W., Diener, E., Colvin, C. R., & Sandvik, E. (1991). Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures. Journal of personality assessment, 57(1), 149–161. https://doi.org/10.1207/s15327752jpa5701_17
Seligman, M. E., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: empirical validation of interventions. The American psychologist, 60(5), 410–421. https://doi.org/10.1037/0003-066X.60.5.410
Duckworth, A. L., Steen, T. A., & Seligman, M. E. (2005). Positive psychology in clinical practice. Annual review of clinical psychology, 1, 629–651. https://doi.org/10.1146/annurev.clinpsy.1.102803.144154
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