Empirically Supported Self-Help? - Hiram College...Although there are several empirically-based...
Transcript of Empirically Supported Self-Help? - Hiram College...Although there are several empirically-based...
Increasing Happiness in The General Population:
Empirically Supported Self-Help?
Acacia C. Parks1, Stephen M. Schueller2 & Arber Tasimi1
1University of Pennsylvania, 2University of California, San Francisco
Keywords: positive interventions, positive psychotherapy, self-help, increasing
happiness, subsyndromal depression
Self-help is a burgeoning industry, and with good reason. Subthreshold depressive
symptoms (often referred to as the “blues”) are more than a nuisance; they are a serious
public health issue. In addition to being at least as prevalent as Major Depressive
Disorder (MDD), subthreshold depressive symptoms lead to substantial functional
impairment, and are a risk factor for the future development of MDD (Flett, Vredenburg
& Krames, 1997; Judd, Akiskal & Paulus, 1997; Cuijpers & Smit, 2004). However, the
existence of subthreshold depressive symptoms goes largely unaddressed by medicine
and clinical psychology. For individuals whose lives are impaired by subthreshold
depression, the dearth of other options often leads them to turn to self-help for relief.
Although there are several empirically-based self-help books that target
depression (Burns, 1999; Lewinsohn, Muñoz, Youngren & Zeiss, 1992) these typically
draw from the literature on Cognitive-Behavioral Therapy (CBT; A. Beck, Rush, Shaw,
& Emery, 1979; J. Beck, 1995). Problem-focused therapies such as CBT have reliably
demonstrated efficacy as a treatment for MDD (DeRubeis et al., 2005), as have CBT-
based self-help books (Cuijpers, 1997). However, it is not clear that a cognitive-
behavioral approach is ideal for populations with subclinical depressive symptoms.
Whereas CBT for major depression often produces robust effect sizes in symptom
reduction, an 8-week CBT-based program for individuals with subthreshold symptoms
only led to small reductions in symptoms and prevention of future disorders (Seligman,
Schulman, & Tryon, 2007).
A growing area of research and practice involves the promotion of mental well-
being and happiness as a complement to previous approaches that primarily targeted the
the prevention and treatment of psychiatric disorders (National Research Council and
Institute of Medicine, 2009). We believe that this is particularly appropriate for
individuals with subthreshold depressive symptoms for three reasons.
First, it is theoretically plausible that increasing happiness will be effective
against depression. Depression is characterized by a deficit in positive emotions (Forbes
& Dahl, 2005; Seligman, Rashid, & Parks, 2006) and laboratory studies have
demonstrated that positive emotions can both alleviate negative mood states and
counteract the physical stress (e.g. cardiovascular reactivity) resulting from negative
emotions (Fredrickson, Mancuso, Branigan & Tugade, 2000). Indeed, interventions
targeting happiness counteract existing depressive symptoms with moderate to large
effect sizes (Seligman, Rashid, & Parks, 2006; Seligman, Steen, Park, & Peterson, 2004).
As subthreshold depressive symptoms are a risk factor for MDD, reducing these may
result in a decreased probability of future episodes of MDD (Seligman, Schulman, &
Tryon, 2007). Thus, we have reason to believe that interventions targeting happiness are a
reasonable approach to reducing depressive symptoms in nonclinical populations.
Second, there is preliminary evidence that happiness-focused approaches may be
more acceptable to consumers than are problem-focused approaches, and as a result, may
lead to better rates of adherence (Haidt, 2002; Seligman, Rashid, & Parks, 2006). Even if
happiness-focused and problem-focused programs are equally efficacious when followed,
if participants are more likely to participate in happiness-focused programs, they might
be more effective than problem-focused programs if both are available for consumers.
This is a particularly important consideration for nonclinical samples, where the need for
change (and subsequent follow-through on treatment) is often less than for individuals
with a mental disorder. So, in addition to being effective against depressive symptoms,
happiness-focused interventions may have greater potential than problem-focused
approaches for being used in the long-term.
Lastly, increasing happiness is an endeavor that is both worthwhile in its own
right (see Lyubomirsky, King, & Diener, 2005), and practically feasible. It is on these
two points that we will focus for the remainder of the chapter.
Self-help books and websites that target happiness – with a few recent exceptions
(Emmons, 2007; Kashdan, 2009; Lyubomirsky, 2007; Seligman, 2002) – lack an
empirical basis. Yet there remains a constant demand for self-help materials such as
books or websites. Therefore, we argue that research-based materials must be more
accessible to the public. Just as clinical psychology has sought to meet the demand for
therapy with the Empirically Supported Therapies movement (Chambless & Hollon,
1998), the goal of this chapter is to outline the beginnings of what will hopefully one day
become a field that establishes techniques of Empirically Supported Self-Help (ESS-H)
for increasing happiness.
In order to pursue such an enterprise, however, we must demonstrate that our
efforts are based on a solid underlying science of happiness. To that end, we address two
questions in this chapter: First, what is the theoretical basis of psychological interventions
designed to increase happiness, and second, what positive interventions exist and what
evidence supports their effectiveness? We conclude with some thoughts about what
remains to be addressed in this line of research, suggesting some important future
directions.
Theoretical Framework: By What Means Can Happiness be Increased?
Duckworth, Steen, and Seligman (2005) define positive interventions as
techniques that build happiness through one or more of three routes: pleasure,
engagement, and meaning.
“Pleasure” deals with positive emotions such as joy, contentment, or gratitude.
Drawing on broaden-and-build theory (Frederickson, 2001), positive emotions broaden
an individual’s thought-action repertoire. In other words, positive emotional states
expand the number of thoughts available to an individual, and subsequently, the number
of actions they are willing to engage in, at a given moment. The broadening of an
individual’s momentary thought-action repertoire, in turn, results in increases in
intellectual resources (faster learning performance; Bryan & Bryan, 1991), social
resources (stronger social relationships; Lee, 1983), physical resources (cardiovascular
recovery; Frederickson & Levenson, 1998), and psychological resources (resilience;
Tugade & Fredrickson, 2004).
“Engagement” is marked by absorption, social engagement, and, in particular,
flow. Flow refers to the state of complete absorption in a single activity that is
challenging yet appropriate for one’s level of skill (Csikszentmihalyi, 1975; Moneta &
Csikszentmihalyi, 1996). When experiencing flow, an individual is living fully and
optimally (Nakamura & Csikszentmihalyi, 2002). While many situations and activities
can be conducive to flow, including hobbies, work, and social interactions, Seligman
(2002) argued that one is most likely to experience flow when engaging in activities that
make use of one’s character strengths.
“Meaning” entails the connection to positive institutions, such as families,
schools, communities, and societies (Peterson, 2006). Since meaning is created from a
sense of belonging or attachment to something larger than oneself such as a group
(family, work) or spiritual purpose or being, it is posited that positive institutions will
engender a meaningful life. Meaning in life provides clear goals and values for one to
pursue and imbues actions with purpose (McKnight & Kashdan, 2009).
Peterson, Park, and Seligman (2005) provided initial empirical support for the
idea that happiness is comprised of these three separate, but not mutually exclusive,
components. In a sample of 845 adults who responded to online surveys, Peterson and his
colleagues found that although the three domains of happiness are distinguishable – that
is, each is independently predictive of life satisfaction – one can pursue all three
simultaneously. Furthermore, individuals who reported pursuing all three were more
satisfied than would be expected based on the predicted influence of each domain
individually. In short, pleasure, engagement, and meaning each appear to contribute to
life satisfaction on their own, but they also interact synergistically to produce even more
life satisfaction when pursued in combination.
Positive Interventions: Empirically Supported Techniques for Increasing
Happiness
Positive interventions are cognitive or behavioral strategies that attempt to build
well-being through psychological processes. According to meta-analyses, positive
interventions yield average increases in happiness ranging from small to moderate (r =
.29, Sin & Lyubomirsky, 2008) and decreases in depressive symptoms ranging from
small to large (r = .31, Sin & Lyubomirsky, 2008). Below we provide an overview of
existing techniques for increasing happiness divided into the three pathways defined by
Seligman (2002); at the same time, however, we want to be clear that this distinction is
more theoretical than empirical, and additional research is necessary to determine the
extent to which the pleasure/engagement/meaning distinction is warranted.
Building Pleasure
Whilst there are several techniques that seek to cultivate, amplify, and prolong
positive emotional experiences in the present, three approaches have proven to be
particularly reliable for inducing positive emotion: savoring, loving-kindness meditation,
and gratitude.
Savoring
Savoring involves bringing conscious awareness to pleasurable momentary
experiences, along with the attempt to make these experiences last (Peterson, 2006).
Savoring is enabled by three preconditions: eliminating one’s own concerns, attending to
the present, and being aware of the positive aspects of the experience (Bryant & Veroff,
2006). In order to make savoring more likely, Bryant and Veroff (2006) recommend: 1)
taking time out from everyday activity to savor, 2) becoming more open to experiences
that could potentially be savored, and 3) attempting to narrow one’s focus to the positive,
pleasurable aspects of life. Peterson (2006) provides several specific techniques that can
be used while savoring, including self-congratulation (focusing on the details of a
personal victory, prolonging it), absorption (focusing completely on the experience),
memory building (making efforts to remember positive experiences, i.e. taking
photographs or keeping a journal), and sharpening perceptions (focusing on each distinct
aspect of an experience in turn, i.e. paying attention to the temperature, texture, and
different taste components of a dessert).
Compared to other happiness-increasing activities, relatively few research studies
have focused exclusively on savoring; instead, savoring generally appears as one of
several techniques taught in a sequence. Savoring exercises typically involve taking a few
moments, several times per day, to truly focus on and enjoy an experience such as taking
a warm shower or sipping a warm cup of coffee (Seligman et al., 2006). Individuals who
consistently savor are more optimistic, less depressed, and more satisfied with life
(Bryant, 2003; Wood, Heimpel, & Michela, 2003). Recognizing the fleeting nature of the
present moment can furthermore increase one’s well-being (Kurtz, 2008).
Loving-Kindness Meditation
In loving-kindness meditation (LKM), individuals practice directing their
attention towards generating warm and tender feelings and extending those feelings
towards others (Salzberg, 1995). In LKM, individuals are first directed to think of a
person that they already hold positive and compassionate feelings towards. The
meditative practice then guides participants to extend those feelings first towards
themselves and then towards others radiating first to those closely connected to them and
moving out towards all people. This can be accomplished through imagery (i.e.,
imagining oneself or the other smiling) or phrases (i.e., “I am warm”, “I am safe”, “I am
uplifted”). Frederickson et al. (2008) have proposed LKM as a way of experimentally
inducing positive emotion in a way that is more substantial and long-lasting than the
short-term mood induction techniques typically used in the laboratory. After teaching
LKM to 139 working adults, Frederickson and colleagues found that participants
experienced increases in positive emotion over time. In line with broaden-and-build
theory (Frederickson, 2001), these increases were associated with greater levels of social
support and purpose in life, as well as decreased illness symptoms.
Gratitude
Gratitude is the feeling that something good has happened to oneself combined
with the acknowledgement that an outside source is responsible (Solomon, 1977). Given
the substantial benefits of naturally-occurring gratitude (Emmons & McCullough, 2003),
several techniques have been employed to teach gratitude to individuals. Emmons and
McCullough (2003), for instance, studied gratitude journaling and its effect on well-
being. Gratitude journaling refers to the practice of writing down things, both big and
small, that one is thankful for. Participants who completed weekly entries in a gratitude
journal experienced higher levels of positive affect. Interestingly, gratitude also led to
fewer physical symptoms, greater propensity to exercise, and higher sleep quality in
participants. Lyubomirsky et al. (2005) experimented with different “doses” of gratitude
and found that people benefitted more when they made one weekly entry into a gratitude
journal compared with more frequent entries. This study suggests that to be effective, an
intervention must represent a substantial enough change in one’s life to feel different to
an individual.
Seligman, Steen, Park, and Peterson (2005) piloted two different gratitude
exercises: “Three Good Things,” in which the individual keeps a nightly journal of
positive events and speculates as to their cause, and “The Gratitude Visit,” in which the
individual writes a letter to someone they wish to thank detailing their gratitude, and
reads the letter out loud to the recipient. They compared these two exercises’ effects on
happiness and depressive symptoms with those of a placebo exercise and found that the
Gratitude Visit resulted in large, immediate increases in self-reported happiness and
decreases in self-reported depressive symptoms that did not last over time, while Three
Good Things led to a smaller, but more long-lasting increase that occurred with a time
delay, one month after participants began using the exercise.
Grateful processing of events also promotes positive emotions and decreases
negative emotions (Watkins, Woodward, Stone, & Kolts, 2003). Findings in studies with
youth samples mirror those found in adult samples. For instance, in a study of middle
school students, reflecting on what one is thankful for led to significant increases in
gratitude, optimism, life satisfaction, and school satisfaction (Froh, Sefick, & Emmons,
2008). The benefits of this intervention on positive emotions, however, may be most
pronounced with lower initial levels of positive affect (Froh, Kashdan, Ozimkowski, &
Miller; 2008). This could be due to a ceiling effect limiting individuals high in positive
affect from receiving additional benefits from this exercise. Another possibility is that
individuals lower in positive affect were less grateful to begin with which would be
consistent with the conclusion drawn by Lyubomirsky and colleagues (2005) that
interventions need to be a significant enough shift from one’s daily life to boost one’s
well-being.
Increasing gratitude through reflecting on good things throughout the day has
gained considerable attention as a quick, simple, and easily disseminated positive
intervention. In fact several Internet groups and web sites, such as Momentary.org,
provide opportunities for individuals to journal about good things online and allow others
to view one’s journal. One study examined the use of a Facebook application to promote
connection with others in one’s social network using the three good things exercise
(Munson, Lauterback, Newman, & Resnick, 2010). Although the application – which
contained features such as automated reminders, privacy settings (e.g. the ability to make
some posts private and others public), the ability to export postings to their Facebook
feeds, where friends can comment, and a way of tracking how often various topics show
up in the user’s own postings – was not evaluated in terms of its efficacy, it did improve
adherence. Compared to users who were part of a simple Facebook group (distinct from
an application in that it is merely a place where people can post, with no features), people
using the application posted roughly twice as often. Integrating this exercise into an
already widely used social networking site provides a promising example of the
widespread dissemination of positive interventions.
Building Engagement
Using Signature Strengths
Signature strengths are positive traits that an individual possesses, celebrates, and
continually displays (Peterson, 2006). Peterson and Seligman (2004) identified 24
strengths, or positive traits, based on a list of criteria that requires strengths to be
ubiquitous, morally valued, fulfilling, distinct, trait-like, and measurable, among other
factors. These criteria were selected to identify strengths that are agreed-upon across
cultures, and that can provide reasonable targets for study and intervention (Dahlsgaard,
Seligman, & Peterson, 2005). These strengths are divided into six virtues (wisdom,
courage, humanity, justice, temperance, and transcendence) and include such
characteristics as creativity, honesty, leadership, forgiveness, kindness, and humor. To
measure these characteristics Peterson and Seligman designed an online strengths
assessment that provides instant feedback about an individual’s top strengths. Since
Seligman’s (2002) theory posits that strengths are a logical path to achieving flow, it has
been hypothesized that providing individuals with feedback on their strengths and
encouraging them to use them more regularly should lead to enhance engagement.
Indeed, Seligman et al (2005) found that asking people to utilize their “signature”
strengths in a new way every day for a week resulted in decreased depressive symptoms
and increased happiness (compared to a placebo exercise). These improvements were
maintained at a 6-month follow-up.
Engaging in Social Connections
Engagement and relationships often go hand in hand. Individuals often report that
relationships are a primary source of engagement in their lives, and experiencing
engagement with others is a predictor of relationship satisfaction (Duckworth, Steen, &
Seligman, 2005). One exercise designed to build social engagement is Active-
Constructive Responding. Gable, Reis, Impett, and Asher (2004) proposed that
individuals could respond to good news in either an active or passive and constructive or
destructive manner. Table 1 provides an example of each style of responding to a
hypothetical positive event of a job promotion. Couples that use more active-constructive
responding, according to Gable, Gonzaga, and Strachman (2006), are more satisfied with
their relationships and are less likely to break-up two months later.
Insert Table 1 about here
Although teaching individuals to respond more actively and constructively has not
yet been tested in isolation, Seligman, Rashid and Parks (2006) included such an exercise
as part of a 6-week program (see below, “Positive Psychotherapy”). Specifically, their
exercise asked participants to keep track of how they respond to good news, and to make
an effort to respond actively and constructively when possible. Seligman and colleagues
expected this exercise to result in increased life satisfaction, as the experimental data
suggest that by responding actively and constructively, conversations are lengthened,
partners become more engaged, and relationships are strengthened (Peterson, 2006).
Another technique for increasing social engagement is “Acts of Kindness”, which
consists of helping others (close friends or strangers) in ways that can range from
relatively brief, simple acts (e.g. putting change in someone’s parking meter or helping to
fix someone’s computer) to more time consuming acts (e.g. coordinating a fundraiser or
spending the day helping a friend move). Lyubomirsky, Sheldon and Schkade (2005)
asked participants to perform acts of kindness, either in a concentrated period of time
once a week (five acts in one day) or spread out over the week, for six weeks, and found
that participants who did several acts of kindness at once reported higher levels of
happiness and lower levels of negative affect and stress, whereas the group in which
participants spread out their acts of kindness did not report any significant benefits as
compared to the control group. In a further study, participants who varied the acts of
kindness performed over an 8-week period received larger boosts in well-being compared
to a group that repeated the same kind acts each week (Tkach, 2006). Similar to reflecting
on things one is grateful for, simply keeping track of one’s kind acts produces
psychological benefits as well (Otake et al., 2006).
Flow and Mastery
As the concept of engagement is closely tied to flow states, one would expect that
interventions aimed at increasing flow would be an obvious way to increase engagement.
Indeed, enhancing flow has been suggested as a possible intervention for increasing
happiness as higher levels of engagement in life are correlated with higher levels of
happiness (Schueller & Seligman, 2010). Unfortunately, no empirical investigations to
date have directly tested an intervention aimed at increasing flow. However, because a
key criterion for the experience of flow is a balance of challenge and skill, it is reasonable
to extrapolate that flow consists, in part, of feelings of mastery – and there exist several
interventions that target this related construct. Such interventions, referred to in the
literature as behavioral activation, aim to increase engagement in rewarding activities. A
recent meta-analysis of 20 studies and 1,353 participants found that behavioral activation
in both clinical and non-clinical samples led to reliable boosts in well-being compared to
control conditions (g = .52, Mazzucchelli, Kane, & Rees, 2010).
Building Meaning
Expressive Writing
Writing has many different benefits for health, well-being, and emotional
adjustment (Frattaroli, 2005; Smyth, 1998). The cognitive change theory of expressive
writing posits that these benefits come from the creation of coherent and meaningful
narratives of the event (Pennebaker & Seagal, 1999). Indeed, writing a narrative about an
event induces analytic processing which might support the construction of meaning
(Lyubomirsky, Sousa, & Dickerhoof, 2006). Humans show a tendency to explain
ambiguous events and the meaning imbued can have powerful effects on emotions and
behaviors (Abramson, Seligman, & Teasdale, 1978; Wilson & Gilbert, 2008).
When it comes to the positive aspects of life, writing and talking about one’s
goals can be particularly beneficial (Cheavens et al., 2006; Pham & Taylor, 1999; Rivkin
& Taylor, 1999). Writing about life goals brings greater clarity and awareness to those
goals, and in turn, having clear and valued goals is strongly related to positive
psychological functioning (Emmons, 1986; King, 2001). Writing about life goals reduces
goal conflict, which can result in reductions in risk for physical illness (Emmons & King,
1988; Pennebaker, 1998). Disclosive writing about goals has also been shown to improve
self-regulation, which can lead to imagined goal success (Pham & Taylor, 1999; Rivkin
& Taylor, 1999), and a greater sense of meaning about one’s life purpose (King, 2001).
Sheldon and Lyubomirsky (2006) implemented an exercise that focuses on
disclosive writing – “Best Possible Selves”. Adapted from King (2001), this exercise
required participants to visualize and write over a period of 4 weeks about their “ideal
future life”, in as much detail as possible. Participants experienced immediate reductions
in negative affect and increases in positive affect. Moreover, they displayed more interest
and higher degrees of motivation compared with the control group who merely wrote
about life details (Sheldon & Lyubomirsky, 2006). This could be attributed to the fact
that writing about one’s possible selves can illuminate one’s motivations, priorities, and
values (Emmons, 1986; Omodei & Wearing, 1990). In bringing greater awareness to
one’s experiences and possible future the exercise seems to facilitate the process of
meaning-making about one’s life (Lyubomirsky, Sousa, & Dickerhoof, 2006).
Reminiscing
Exercises that engage people in reminiscences about pleasant past memories (i.e.
recalling positive experiences in great detail) seems to lead to a variety of emotional
benefits, particularly among elderly individuals. Early research found that individuals
who intentionally practiced reminiscence reported higher levels of positive affect (Fallot,
1980; Hedgepath & Hale, 1983). More recently, Cook (1998) and Bryant et al. (2005)
reported similar results using a different outcome measure: compared to participants in
the control condition, people assigned to reminisce on a regular basis reported significant
increases in life satisfaction. Zauszniewski et al. (2004) reported that a 6-week group
reminiscing intervention reduced negative emotion (depressive and anxiety symptoms)
among elders in a retirement home. Interestingly, these effects seem to be especially
potent when individuals use cognitive aids such as vivid imagery as opposed to physical
reminders such as memorabilia or photographs (Cook, 1998).
In sum, there is a solid foundation for the science of sustainably increasing
happiness and a variety of reliable methods and techniques have been developed for this
purpose.
Building Pleasure, Engagement, and Meaning: Positive Psychotherapy
Earlier, we discussed the findings that pleasure, engagement, and meaning are not
mutually exclusive, that each pathway can independently lead to life satisfaction, and that
these pathways interact synergistically with individuals who pursue all three reporting
higher levels of life satisfaction than that expected by the independent contribution of
each (Peterson, Park & Seligman, 2005). While most of the studies discussed in this
chapter have employed standalone exercises, this is practically rather than theoretically
driven – in order to isolate the pattern of efficacy of each specific exercise. It is unlikely,
however, that the use of standalone exercises is reflective of (or feasible in) everyday
practice. Further, it is both possible and potentially more beneficial to target pleasure,
engagement, and meaning, rather than focusing on any one route in particular.
Group positive psychotherapy (PPT; Seligman, Rashid & Parks, 2006; Parks,
2010). Rashid (this volume) provides an example of a more integrated positive
intervention that addresses pleasure, engagement, and meaning. PPT contains exercises
that are the same as or similar to many of the individually validated and empirically
supported techniques already discussed. In both a pilot study and a replication, group
PPT outperformed a no-intervention control group on measures of life satisfaction and
depression in a sample of mild-to-moderately depressed undergraduates (Parks, 2010).
Although research on PPT is still in its infancy, it shows promise as an integrated positive
intervention that can be used with individuals with subthreshold depressive symptoms – a
population for which there are few empirically-supported interventions.
Concluding Remarks
From increases in positive emotion and greater life satisfaction to decreases in
depression, anxiety, and illness symptoms, positive interventions that build pleasure,
engagement, and meaning exhibit both short-term and long-lasting effects on well-being.
These techniques provide a solid foundation for the creation of Empirically Supported
Self-Help for increasing happiness – one in which techniques that have demonstrated
efficacy in research can be woven together in book or web format and disseminated to the
general public. However, there is much still to be done in the pursuit of a science of
promoting happiness. Below, we discuss several future directions for research.
Sustainability
Lyubomirsky, Sheldon, and Schkade (2005) argue that intentional activity is
necessary in order to increase happiness, yet evidence suggests that initial boosts require
continued effort to be sustained. Additional research is needed to assess patterns of use
that participants display with each of these exercises – what percentage of people keep
using each exercise naturally, and how can that percentage be maximized? To that end, it
is worth considering how exercises can be modified and integrated into everyday life.
Previous research has suggested that continued use is important, highlighting the need for
activities that can be integrated into the daily practices of individuals who use them; at
the same time, one must also find ways to keep activities novel in order to prevent
hedonic adaptation (Lyubomirsky et al., 2005). Therefore, an important task for the future
practice of these exercises is to find ways to address both objectives, promoting
continued use while also providing room for variation.
The Gratitude Visit, for example, which provides large and immediate effects on
happiness, is not designed, nor is it appropriate, for daily use. Furthermore, as described
above, gratitude exercises are subject to becoming “stale” if practiced too frequently, so
one must be careful when seeking to create a regular gratitude practice. However, there
are ways to practice elements of this exercise on a more regular basis without rendering
the practice vulnerable to hedonic adaptation. For example, an individual could make
daily additions to a gratitude list – a compilation of all the things about a given person for
which they are grateful – and then make monthly or yearly “gratitude reports” to that
person. This modifies features of the Gratitude Visit – a powerful, one-time gratitude
intervention – into a sustainable exercise that can be continuously practiced. Unlike the
Gratitude Visit, which focuses on broad gratitude towards a person, and is thus very
difficult to repeat, the “gratitude report” makes the content of the exercise variable (e.g.
based on the ongoing behavior of a gratitude recipient chosen by the individual), which
keeps the exercise “fresh,” minimizing the potential for adaptation. At the same time, this
new variation retains the power of the original Gratitude Visit – which comes from the
immediate and powerful effects of conveying gratitude to someone else in written form –
by having the regular “gratitude report” experiences.
Technology also provides a powerful tool to increase the sustainability of these
techniques. Indeed, research teams are currently utilizing mobile device applications for
the monitoring and enhancement of happiness (e.g. Gilbert’s
www.trackyourhappiness.org or Signal Pattern’s Live Happy iPhone application based on
Sonja Lyubomirsky’s work). Furthermore, as previously mentioned, pilot studies have
examined the feasibility and effectiveness of disseminating positive psychology exercises
through popular social networking sites (Munson, Lauterbach, Newman, & Resnick,
2010). Technology provides a powerful tool to increase the sustainability of these
techniques.
Person-Activity Fit
Taking personal preference or choice into consideration may maximize the
benefits of these happiness strategies. Sheldon and Lyubomirsky (2006) propose the idea
of “fit”; that is, assigning an exercise that is concordant with an individual’s personality,
values, interests, and goals. This idea could be accomplished by giving participants a list
of strategies and later asking them which strategy they think would work best. For
instance, an introvert assigned to complete the gratitude visit exercise may experience
short-term benefits, but feel more comfortable and thus more likely to continue using an
exercise more consistent with his introverted personality such as Three Good Things.
Schueller (2010) found that participants’ self-reported preferences for an exercise
predicted the number of days they engaged in the assigned exercise over a week period;
thus, participant preference may well be an important consideration for practitioners
using these techniques.
Along similar lines, an alternative model for accommodating individual
differences in preference and responsiveness to specific exercises is the approach taken
by Parks (2010). Each participant samples a variety of exercises, then in the time
following the intervention, chooses one or two to continue practicing. In this way,
participants are exposed to several techniques and have the opportunity to select what
they continue to practice, but do so having tried each one rather than relying on their
initial impressions of what may or may not be helpful for them.
In essence, flexibility is crucial for the success of each and every one of these
happiness-increasing strategies. The greater the extent to which researchers can find ways
to make these strategies more flexible, the greater the likelihood that people will benefit
from them and stay with the intervention.
Skepticism
Among the lay public, there exists a certain wariness of efforts to increase
happiness as some kind of push to create an oblivious, unrealistic, or otherwise
undesirable society (see Ehrenreich, 2009). A science of Empirically Supported Self-Help
can only thrive if it reaches the people for whom it is intended – and in order for
Empirically Supported Self-Help to have a broad audience, we must do what we can to
address suspicion and skepticism surrounding the idea of increasing happiness.
An important first step in this direction is to place our primary goal of increasing
happiness in a larger context that includes an important role for negative affective states
and experiences. Despite scientific evidence that positive and negative affect are
somewhat independent (Diener & Emmons, 1984), many members of the general public
equate becoming happier with eliminating distress, and assume that the goal of positive
psychology is to eradicate negative emotions altogether. However, it would be more
accurate to say that we aim to shift the balance so that one’s positive experiences
outweigh one’s negative experiences. Work by Fredrickson and colleagues suggest that a
ratio of between 3:1 and 13:1 positive emotions to negative emotions is necessary in
order to flourish psychologically (Fredrickson & Losada, 2005). Most notable about this
finding is that there is an upper limit, above which positive emotion is not adaptive
without sufficient negative emotion to anchor it. Thus, there is evidence that eliminating
negative emotion is an undesirable outcome – if doing so was truly the goal of positive
psychologists, the general public would be justified in being skeptical. Clearly
acknowledging the importance of negative emotion may go a long way in allaying
individuals’ concerns about the enterprise of increasing happiness.
Final Thoughts: Implications for Practice
In this chapter, we have provided an overview of exercises that target each of
three areas: pleasure, engagement, and meaning. As readers apply these exercises in
practice with clients, we make the following suggestions:
- Try to address pleasure, engagement, and meaning, as it appears that maximal
benefits occur when all three routes are pursued.
- Be flexible with which techniques that are selected and how they are applied,
taking into consideration client preference (to maximize adherence) and lifestyle
(to maximize sustainability).
- Explore and address any misconceptions or skepticism that clients might have
about the endeavor of increasing happiness, as such attitudes may interfere with
progress.
Lastly, we recommend that practitioners think ahead towards making these
techniques available to the general public in ways that break out of the standard 1-on-1
practitioner/patient model. Statistics demonstrate that this mode of dissemination has not
been effective for getting Empirically Supported Treatments to the general public – many
individuals do not have access to therapy, and even if they do, many practicing therapists
choose not to use ESTs (Hirschfeld et al., 1997; Stewart & Chambless, 2007). If
empirically-based happiness-increasing interventions are to be widely disseminated to the
general public, we must rely on some other means – it is for this reason that we believe
Empirically Supported Self-Help is the future of the dissemination of positive
interventions.
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Table 1. Example of Responding to Good News of a Job Promotion
Constructive Destructive
Active
“That is great news!
I am so happy for you! We
should go out to dinner to
celebrate the occasion!”),
“Does this mean that
you will have to put in extra
hours? I’m assuming this
promotion will be
burdensome.”),
Passive
“Good for you.” “Do you know what
the weather will be like
tomorrow?”