Positive Psychology for Depression (Book Review)

Positive Psychology for Depression is a book specifically designed to help people with a predisposition toward depression foster and maintain more positive moods. The book presents a concise overview of concepts in the field of positive psychology such as positive emotions, optimism, resilience, meditation, strengths, positive relationships, goal-setting, and the mind-body connection.

The author, Miriam Akhtar, has suffered from depression herself. She includes many personal anecdotes that show how positive psychology has helped her to combat her depression and maintain a more cheerful mood over time.From Rumination to SavoringRumination is a style of thinking that involves mentally reviewing things that have gone wrong, as well as their causes and consequences. It is also a significant risk factor for depression. Rumination is cyclical and self-reflexive in nature, and frequently operates like a record skipping over the same thoughts again and again.

As Akhtar notes, “I had […] a curious habit of interrupting positive experiences by asking myself ‘But am I happy?’ And in an instant the happiness would evaporate.” She notes that when she took time to explore what to do with her life, she commonly experienced a downward spiral because she kept dwelling on bad feelings. As a psychotherapist, I have noticed that emotional problems have a tendency to develop and to stick when people ponder questions like, “Why aren’t I happier?” “Why am I feeling anxious?” or “Why can’t I sleep?” It can be more helpful to accept the moment as it is and to focus on noticing and savoring what’s going well.

Putting the “Positive” Back Into Psychotherapy

I enjoyed reading Positive Psychology for Depression because the author’s experience demonstrates a path for healing that is hopeful and inspiring. As I have written in the past, in my work with therapy clients, I am trying to put the “positive” back into psychotherapy.

Akhtar reports that “strategies that build the positive have been shown to shrink the negative,” and “40 percent of happiness is under your control and can be increased by the activities you engage in and your outlook on life.” Below are some well illustrated ideas from her book that may be especially helpful for maintaining a positive mood and reducing the risk of depression.

1. Build and Savor Positive Emotions.
   • Ask yourself “What’s going right in my life right now?”
   • Identify what you enjoy doing, and do more of it.
   • 

     Savoring the beach together

     Engage with a positive experience in the moment, without analyzing it.

   • Learn to savor your positive experiences. Slow down and stretch out the experience. Engage your full attention. Use all your senses. Reflect on the source of the enjoyment.
   • Avoid the tendency to compare yourself to others. Stop asking yourself questions like, “Am I as successful?” “Am I as happy?” “As attractive?” “As rich?” “As slim?” Instead, notice and appreciate what you’ve got and the person that you are.
2. Learn to Think Like an Optimist.
   • When things go wrong, try to think of all possible causes, and don’t automatically blame yourself. Remind yourself that this is likely to be temporary even though, at the moment, it may feel like it will last forever. Look at your past experience for evidence that things can improve. Focus on other areas of your life that are currently working well.
   • When good things happen, recognize your responsibility and give yourself credit for the occurrence. You can also expect more good things to happen, and relate this realization to other areas of your life.
3. Build Positive Relationships.
   • Increase the positivity ratio in your relationships to 5:1 – it takes five positive experiences to make up for every negative event in a relationship.
   • Practice active constructive responding. In other words, respond to someone’s good news with enthusiasm and energy rather than in a passive or destructive manner. This will help them to think of more positives and to savor the good news even more.
   • Don’t get drawn into other people’s misery. Try to be compassionate without taking part.
   • Forgive others and let go of ruminating on past hurts. This is good for your health. Forgiveness does not mean acceptance. You can forgive someone and still decide you don’t want them to be part of your life.

1. Identify and Focus on Positive Goals.
   • Focus on developing your strengths rather than on fixing your weaknesses. This is where you’ll get the maximum return on your investment.
   • Aim low by taking many small steps rather than one big step. Small steps are more likely to get you going in the right direction.
   • Cultivate hope. Identify what you want. Think of a variety of ways to reach your goal. Apply yourself to achieving that goal and be persistent with your efforts.

More Research on Positive Psychotherapies is Needed

In the mental health field, cognitive behavior therapy (CBT) is the gold standard for treating depression and anxiety. In hundreds of research studies, CBT has been shown to be helpful for a wide variety of emotional problems and life issues.

Positive psychology evolved out of the CBT tradition and has focused primarily on “healthy” i.e. non-clinical populations, generally in a coaching or training setting. Given the many commonalities between CBT and positive psychology, I think therapists who adopt a positive, strengths-based approach can integrate positive psychology concepts and techniques into evidence-based cognitive-behavioral treatments. Examples of both practice and research into putting positive psychology and therapy together include

• Christine Padesky, a prominent CBT therapist, co-authored a book on strength-based case conceptualization for building client resilience. She travels around the world training therapists on this approach.
• Quality of Life Therapy by Michael Frisch combines CBT with positive psychology and has some research behind it, but this approach has not been widely disseminated.
• In 2006, Seligman, Rashid and Parks published promising results for a positive psychotherapy approach for depression based on two studies. I’ve heard that Oxford has plans to publish a step-by-step treatment manual.
• Nancy Sin and Sonja Lyubomirsky published a meta-analysis which included 25 studies on a variety of positive psychology interventions (PPIs) for depression and concluded that PPIs do help ameliorate depressive symptoms.

Going forward, I  hope that positive psychology researchers and clinicians will focus greater resources on developing comprehensive, evidence-based positive psychotherapies for depression and anxiety as well as training therapists on these approaches.

Who This Book Can Help

Positive psychology may be able to protect you against depression by building your resilience and well-being. In a way, positive psychology is like a vaccine – it may not completely prevent or cure depression in everyone but it certainly can help many long-time sufferers of depression from escalating a downward spiral as well as help people bounce back more quickly from adversity. I recommend this book to anyone who wants an overview of positive psychology concepts and suggestions for how to apply the ideas to develop more positive emotions, thinking, and acting in order to reduce the risk of depression.

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References

Akhtar, M. (2012). Positive Psychology for Overcoming Depression: Self-Help Strategies for Happiness, Inner Strength and Well-Being. London: Watkins.

Akhtar, M. (2012). Positive Psychology Interventions with Depression. Positive Psychology News Daily, March 15, 2012.

Academy of Cognitive Therapy (no date). Cognitive Behavioral Therapy (CBT) Outcome Studies. Downloadable from What Does Cognitive Therapy Treat?

Frisch, M. B. (2006) Quality of Life Therapy: Applying a Life Satisfaction Approach to Positive Psychology and Cognitive Therapy. New Jersey: Wiley & Sons.

Kuyken, W., Padesky, C. & Dudley, R. (2011). Collaborative Case Conceptualization: Working Effectively with Clients in Cognitive-Behavioral Therapy. The Guilford Press.

Seligman, M. E. P., Rashid, T., & Parks, A.C. (2006). Positive psychotherapy. American Psychologist, 61, 774-788.

Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis. Journal of Clinical Psychology, 65(5), 467-487

Images
Savoring the beach – together courtesy of Vonns
Taking small steps – with Gusto courtesy of Nico Cavallotto

Edited by Natasha Utevsky