Friday, 5 October 2007

Changing the focus of psychotherapy to what is good in your life

Martin Seligman: "For one hundred years psychotherapy has been where you go to talk about your troubles. Looking over hundreds of controlled outcome studies, it is a moderately effective process. But does the troubles part matter?

We have recently been looking at a process—called Positive Psychotherapy—in which talking about what is good in your life is the central focus: strengths, virtues, flow, meaning, positive emotion, gratitude, hope and the like. We do not neglect troubles (depressed patients are socialized into the belief that troubles must be discussed and rapport would be undermined otherwise), but they are not the central focus and often form a segue into talking about strengths and meaning. Similarly trouble-focused psychotherapy does not wholly neglect the positive side of life, but damage and its repair are the central focus. Trouble-focused therapy, unlike strength-focus therapy, is not much fun (worse, sometimes patients unravel and cannot be ravelled up again), is stigmatizing, and has a considerable drop-out rate.

So let us finally test experimentally if it is troubles and repairing damage or building strength, meaning, and positive emotion that is the (more) active ingredient in psychotherapy: 200 depressed patients, randomly assigned to therapists, trained to deliver either trouble-focused or strength-focused psychotherapy. It could even be within subjects in an ABAB design. And how would these compare to medication or medication plus strength or trouble-focus?"

Dr Martin Seligman is Leadership Professor of Psychology at the University of Pennsylvania. He has written over twenty books and two hundred articles on motivation and personality.


Jon said...

I would think that Brief "Solution Focused" Therapy has been doing this for some time. In that it utilizes a client's past history and focuses on the good things. For example, remembering when the relationship "worked" and then using simple behavioral techniques to get back to that better place.

However, any idea of "just think happy thoughts" is just a distorted form of cognitive therapy with a heavy dose of denial as a coping mechanism.

With that being said, I think the therapist's rapport, coupled with a balance of focusing on the positive and negative realities in the client's life, is probably the best approach.

Anonymous said...

This is a great post, thank you. I find the point about stigmatising very interesting; I would like to see a culture where psychotherapy is more normalised, as working with a personal trainer, life coach or private tutor is.

Jon, I was previously also very sceptical of positive psychology and had similar ideas of what its central tenets might be. Since then I've been particularly persuaded by reading the "Handbook of Positive Psychology" (Snyder & Lopez), which contains a paper arguing that mindfulness is better for mental health than either negative or positive thinking.

Anonymous said...

I am a counsellor who for the last few years has developed a real interest in positive psychology. Don’t be fooled, it is not magic or an end to misery, but it can change your way of thinking. When I was in training I suffered. The trouble-focused therapy was in force, I had to look to myself and see what was wrong. My ability to keep smiling and my use of humour to keep me going, all wrong apparently, all defence mechanisms. They were however the very essence of me. Should psychotherapy disregard or pathologise people’s strengths and qualities, ensuring that the focus is on one’s troubles, the burdens of childhood and so on? Positive psychology can offer a client a great deal, a kind of tool kit that can be drawn upon as and when needed and perhaps most importantly, hope.

Anonymous said...

Scott Adams had some interesting things to say about the power of focusing on the positive in a Dale Carnegie public speaking course:

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