I know it’s a little perverse to begin an article about Pos Psych with a distressing event, but as F. Scott Fitzgerald said, ‘”Show me a hero and I will write you a tragedy”.
The untimely death this week of the Australian actor Heath Ledger, star of the film Brokeback Mountain, has shocked many; he was gifted of course, but more than that he was young, only 28 years old, and had a young daughter. Reports suggest that he may have taken an accidental overdose of prescribed sleeping tablets; ironically in this interview on the Ellen DeGeneres Show, he talks about the exhaustion and sleepless nights that a new baby brings.
I’m sure most of us have suffered from insomnia at some point in our lives; thankfully it’s usually short-lived and we get back to our normal routine pretty quickly. Chronic insomnia, however, is a different matter. It’s long been known that inability to sleep, waking early or disturbed sleep are related to physical ill-health, stress, depression and anxiety.
In Ledger’s case, of course, we can only surmise what was going on in his head, but to describe him at this point as one of the ‘Worried Well’, as he was in The UK’s Telegraph today, seems extraordinarily insensitive.
Depression and other psychological conditions aside, researchers Hamilton, Gallagher and Preacher (2007) provide evidence that insomnia and well-being are linked. After adjusting for both demographic factors and persistent mental and physical health problems, their studies have found a significant relationship between insomnia and both psychological and subjective well–being, with a stronger relationship to the latter, suggesting that being able to sleep (or not) is linked to one’s ability to enjoy life (or not).
Figure 1. Correlates of subjective and psychological well-being. This figure illustrates a model in which the effects of insomnia on PWB and SWB are estimated after adjusting for age, gender, race, stomach trouble, trouble with teeth, emotional disorder, and alcohol or drug problems.
That insomnia might lead to a lack of pleasure and satisfaction in life is easy enough to grasp; if you’ve ever wrestled with something as simple as a family reunion the day after a sleepless night for instance, you’ll know what I mean – it’s hard to feel peppy when you’ve got eye-bags the size of Samsonites.
But what we don’t know from Hamilton et al’s study is which of insomnia and lack of well-being is cause, and which effect. Assuming the absence of a third variable, the implication is that, ‘z’ medicines aside, the symptoms of sleeplessness might persist as long as well-being remains out of reach, regardless of physical and psychological health. If that’s the case, they argue, maybe the problem of insomnia could be addressed by applying some of the positive psychology interventions aimed at increasing well-being. Counting blessings instead of counting sheep, for example? I mentioned the positive interventions approach to several insomniac friends, but the majority were sceptical…
What Hamilton et al’s research highlights very well is that:
- The dividing line between traditional psychology and positive psychology is more blurred than we think.
- Positive psychologists who are not trained therapists or clinicians need to be wary of ‘diagnosing’ clients and proposing positive interventions in such circumstances.
- There is a clear need for further research into the efficacy of positive interventions.
Hamilton, N.A., Gallagher, M.W. & Preacher, K.J. (2007). Insomnia and well-being. Journal of Consulting and Clinical Psychology, 75(6), 939-946.
I wonder if, and I don’t like this term, mindfulness could also be a positive intervention for insomnia? I am quite surprised that there are few to no articles on mindfulness here on the site.
I can understand skepticism, totally. It is odd that people are skeptical…except about their own inner dialogue, the self-talk/imagery that causes so much strife.
Mark Twain: “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.”
Ain’t that the truth.
Good point about mindfulness; no doubt we’ll see a flood of articles now that you’ve mentioned it.
The quote from Twain reminds me of this one from RD Laing:
“The range of what we think and do is limited by what we fail to notice. And because we fail to notice that we fail to notice, there is little we can do to change; until we notice how failing to notice shapes our thoughts and deeds.”
Interesting! I wonder if research on positive interventions that appear to diminish depression might be a good place to start when looking for research on this subject?
Your article made me curious about whether Sonja Lyubomirsky mentioned insomnia in her new book on happiness. She does — but all three mentions are in the chapter about depression, including a statement that disturbances in deep dream-related (REM) sleep is a symptom of depression.
Rumination where thoughts go around and around in negative circles often contributes to insomnia — and depression. So perhaps Sonja’s activity 3, Avoiding Overthinking and Social Comparison, might be a good place to start for a friendly suggestion to someone who is really eager for relief. As a non-clinician, I don’t diagnose. But it seems reasonable to suggest things that people can try. No guarantees – but then, there aren’t any guarantees even with medications that have undergone full double-blind clinical trials.
It makes good sense to be wary of proposing positive interventions for interventions that have significant negative side effects. But it is hard to imagine a downside to controlling rumination.
Thanks for your comments. I suppose I wasn’t thinking so much of positive interventions having negative side-effects, though that’s an interesting thought. I was actually thinking of the possible risk of leaping in with a positive intervention when a clinical/medical intervention was more appropriate. Frisch for one is very clear on the dividing line between clinical/non-clinical work.
Luckily I don’t suffer from insomnia, but if I did, I think I’d try non-medical interventions first!
On a related note, I’ve noticed several researchers writing about well-being (since the arrival of Pos Psych) talk about a decrease in depression/anxiety/other negative symptoms as if this were the same thing as an increase in well-being. This suggests that for the layperson, the distinction is actually not that important, even if it is everything to Positive Psychologists….Your thoughts?
I also think Acceptance & Commitment Therapy has a lot to offer on the subject of insomnia.
Sam from Seattle here. I was suffering from depression and as it got worse, my ability to sleep grew worse. At one point I had not slept in 2 weeks and my body began to break down. At the time, I asked for help online to find a reputable therapist and was referred to a resource that will benefit those of you in dire straits. Goodtherapy.org.