Strengths: Not a Toy Hammer

Mental health practitioners who treat clinical populations can struggle with the relevance of positive psychology. It can sometimes be seen as a "don't worry, be happy" approach that ignores significant problems of living and the psychodynamics of dysfunction. As such, it is seen by some as superficial and potentially dangerous, just as miracle cures for cancer can keep patients from getting the proper tests and treatments available from mainstream medicine. A different perspective is needed to understand the role of positive psychology in treating the problems that clients present in the practitioner's office.

First, it needs to be clear that positive psychology has never been meant to supplant anything in the field, but instead, only to augment. Many therapists begin their initial sessions with the question, "What brings you here today?" Most times the reply describes one or more problems that are distressing to the client, with the accompanying statement that they hope to get help relieving their suffering. Positive psychology suggests that clients be asked to not only describe the problems from which they hope to get relief, but the aspirations they have for their life as well. For example, "If you were less depressed, how might your life become different?" Articulating aspirations can help boost motivation to change, and can broaden the explicit goals of treatment.

I remember well the many patients we discharged from an inpatient eating-disorder clinic where I worked, self-satisfied that they were leaving with much less of a disorder compared to when they arrived. While we all knew that they were about to encounter conditions on the outside that might cause relapse, we had our success data in hand and put the rest out of mind. I maintain that a positive psychology approach would have had us articulating aspirational goals, which we then would have worked into an outpatient treatment plan, in the end helping a person arrive at a life less bothered by disordered eating and fuller with engaging and meaningful activities that would help buffer against relapse.

Reflecting on my practice as a clinical psychologist, results from positive psychology fit neatly in a number of places. We know from experience and research studies that the strength of the therapeutic alliance is one of the most important predictors of positive outcome. While clients usually expect to be assessed early on in terms of their deficits, it can be an endearing surprise to find out that the therapist is interested in understanding the client's greatest strengths of character, talent, interest, and resources (e.g. financial and social)

Starting a relationship with the assessment that "You have a lot going for you; now let's look at how you can use your strengths to make your life more like the one you want," compares favorably with the more common articulation of deficits (e.g. "Your communication skills need improvement").

Positive psychology also suggests that in order for clients to function at their very best they should experience at least three times as many positive statements than negative ones. This positivity ratio has been shown to predict a variety of successful relationships, from marriages to business teams. I recall in an early internship when I was co-running a group, and I was surprised how much levity my co-therapist inserted into the group. She later told me, "Neal, if you're not having some fun, you're not doing something right." She intuitively understood the importance of the positivity ratio..

Further, just as the VIA Classification of Character Strengths is said to bring a language of strengths to the science of positive psychology, I think it also brings a language of strengths to the process of reframing. I have observed that reframing was one of the most powerful tools I possessed as a therapist. When I could reframe a woman's repeated errors in love relationships as reflecting her strengths of hope, persistence, and courage, I had a new platform from which to work. Her posture would straighten from its slump, and energy would fill her voice as we explored new ways she could use those strengths of character to get what she wanted in life. Until the VIA work, my vocabulary for reframing was less comprehensive and specific than now.

Positive psychology also provides scientific evidence for the utility of specific interventions. Seligman and colleagues' renowned double-blind, placebo-controlled, random-assignment study showed long lasting improvements in depression and happiness as a result of deliberate efforts to use signature strengths of character in new ways. Studies in mindfulness, loving-kindness meditation, flow, and other exercises have demonstrated positive benefits that are apropos to clinical and non-clinical populations alike. The field of positive psychology promises to yield more evidence-based interventions in the years to come.

Finally, one of the interesting frontiers of positive psychology is that of understanding disorders of living as deficits, exaggerations, or misapplications of character strengths. Chris Peterson began the unfolding of this work in his chapter in Czikszentmihalyi's book A Life Worth Living (2006). In it he offers for each of the 24 VIA strengths, words to describe what the character strength may look like when it is absent, exaggerated, or in its opposite form.

For example, critical thinking exaggerated may be cynicism, persistence may be obsessiveness, and exaggerated hope may be Pollyannaism. How many presenting problems in clinical settings may have components of obsessiveness, Pollyannaism, and cynicism? Or, how often are low levels of intimacy, kindness, or social intelligence part and parcel of problems in living? This line of inquiry may lead to clinical interventions that focus on building appropriate levels and expressions of various strengths of character.

Eating Disorders Essential Reads

The Quiet Radicalism of Looking After Your Body

Hope and Hesitation in the Journey of Anorexia Recovery

So, far from being a toy hammer in the toolbox of serious psychotherapeutic approaches, character strengths and positive psychology are substantive additions that hold much promise in helping us be effective agents of positive change.

References
Losada, M. (1999). The complex dynamics of high performance teams. Mathematical and Computer Modelling, 30 (9-10), 179-192.

Seligman, M.E.P, Steen, T.A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60 (5) 410-421