Editor’s Note: This is the first article by Denise Quinlan on PPND. We are delighted you’re here, Denise!
We take in new information all the time. We assess it, make sense of it and move on, often without literally more than a moment’s thought. Then there are other pieces of information that once filed away, keep coming back for further attention. We turn them over like smooth stones in our hands, hoping that through time and attention they will reveal their meaning and significance. Over the past year, I’ve been turning over three such smooth stones and wondering what they might add up to. I’d like to share them with you this week and then discuss them each in turn over the coming months.
Stone One: The Dark Side of Strengths
The first is Christopher Peterson and Martin Seligman’s table of the 24 Values-In-Action character strengths along with the opposite, lack of, and too much of each strength. Peterson has said he thinks that these “disorders” (opposite, absence, and excess) of character strengths may be “the real DSM” (Diagnostic and Statistical Manual of Mental Disorders) (Peterson & Seligman, 2004; Peterson, 2008). The absence of a naturally occurring strength or its “abnormal” development may be what causes pathology. In other words, what really goes wrong with us may be a failure of things to go right with us.
Imagine in 50 years’ time having a DSM based on a theory of strengths where illness stems from disorders of these strengths. It’s perhaps even harder to imagine the sheer volume of work and the sea change in thinking that would go hand-in-hand for that to happen. How can I use this Peterson prediction to develop practical interventions that will help keep me or my clients on the strength path rather than the disorder one?Stone Two: Mindfulness in Managing Pain
The second relates to the role of mindfulness and acceptance in managing chronic pain. Lance McCracken works with chronic pain patients and believes that “In many cases of human suffering, at least some of the time, control is not the solution; it’s the problem” (2008). Trying to control the uncontrollable only increases suffering; instead McCracken and his colleagues at the Royal National Hospital for Rheumatic Diseases focus on mindfulness, acceptance of pain, and helping patients carry on with the life they want, despite the pain (McCracken, Gauntlett-Gilbert, & Vowles, 2006).
Mindful of Wilbert Fordyce’s observation that “those who have something better to do don’t suffer as much,” they ask patients to identify what’s most important to them and to commit to acting in alignment with those values, an approach based on Acceptance and Commitment Therapy (McCracken, Vowles, & Eccleston, 2005). Knowing what’s most important to you and acting in alignment with those values sunds similar to identifying your strengths and using them on a daily basis. Perhaps we can learn from our clinical colleagues and explore how mindfulness and values-based action could benefit the healthy as much those in pain.
Stone Three: Our Bodies and Our World
The third stone I’ve been turning over is Peter Gluckman’s theory of “mismatch” between our bodies and our world. He describes “maturational mismatch” as the interaction of biological plasticity and environmental differences. The reality of this mismatch was apparent to anyone who saw recent international media reports of a thirteen year old boy in England who has fathered a child with a fifteen year old girl. When asked if he would be financially responsible for the child he had to ask his father what “financially” meant.
In his book with Mark Hanson, Gluckman argues that our gene-environment interactions have, for a variety of reasons, resulted in mismatches which are producing the epidemic of metabolic diseases such as diabetes and obesity, and a maturational mismatch. “The coincidence of reproductive and psychosocial maturation which existed for most of our history has been lost” (Gluckman & Hanson, 2006). As children have become healthier and our society has become more complex, the age of puberty has fallen while the age of psychosocial maturity has risen.
Gluckman’s advice to those working with adolescents was that the culture of blame is not appropriate, that we need to re-think how we address biological maturity with younger adolescents, and consider how we can help them develop psychosocial maturity at an earlier stage. Five hundred years ago when no maturational mismatch existed, eighteen year olds were full members of their communities — connected and contributing — with a sense of belonging and perhaps even purpose. Positive psychology has highlighted the importance of these factors for well-being. Perhaps they are also candidates for reducing the maturational mismatch.
The Three Stones
Part of what these three stones add up to is further evidence that how we think about health and illness is changing. Strengths and their dark side, mindfulness and pain, our bodies and our world. The old dichotomies are blurring. The line between the body and mind is increasingly shown to be of our making and not a reflection of how we function. We may pursue control when acceptance may be more effective. And acceptance involves sitting with what we don’t yet understand and turning it over in our hands. I’m turning these stones over to you and look forward to hearing what other meaning or significance you may find here.
Gluckman, P. & Hanson, M. (2006). Mismatch: The Lifestyle Diseases Timebomb. Oxford: Oxford University Press.
McCracken, L. (2008). Presentation to the International Congress of Behavioural Medicine, August 2008, Tokyo, Japan.
McCracken, L., Gauntlett-Gilbert, & Vowles, (2006). The role of mindfulness in a contextual cognitive-behavioral analysis of chronic pain-related suffering and disability. Pain, 131 63–69.
McCracken, L., Vowles, K., & Eccleston, C. (2005). Acceptance-based treatment for persons with complex, long standing chronic pain: a preliminary analysis of treatment outcome in comparison to a waiting phase. Behaviour Research and Therapy, 43, 1335–1346.
Peterson, C. (2008). Lecture comments. MAPP program, University of Pennsylvania, February 2008.
Peterson, C. & Seligman, M. (2004). Character strengths and virtues: A handbook and classification. Oxford: Oxford University Press.
Images: Creative Commons 2.0
“Wallpaper Zen Spirit 1400×900 edition 2006” by CyboRoZ
Two stones courtesy of keepps
“Zen” by cheesy42
“White Balance” by chefranden