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Positive Psychology Interventions with Depression

written by Miriam Akhtar March 15, 2012

Miriam Akhtar, MAPP from the University of East London, runs Positive Psychology Training, which provides courses, coaching, and communication in the science. Miriam is the author of Positive Psychology for Overcoming Depression and the co-producer of The Happiness Training Plan. Twitter: @pospsychologist. Full bio.

Miriam's articles for PositivePsychologyNews.com are here.



Sometime in the last century I was stuck in the Geneva airport waiting for a snowstorm to pass so that I could catch my long-delayed flight home. My mood had turned as bleak as the sky. This was no surprise. My default position seemed to hover somewhere just above depression. I fished Martin Seligman’s Learned Optimism out of my bag. Within a few pages, the seeds of my transformation were sown, and I had found a path that would lead to authentic happiness. A decade later I was a member of the first European MAPP class. When Martin Seligman came to speak to us, I asked him to sign my much-thumbed copy of his book, wondering if he ever still got that wet weather in the soul?

Tropical Storm of the Soul

What Does Positive Psychology Have to Do with Depression?

My own experience was more akin to tropical storms in the soul with highs followed by lows. There is a certain irony in being a positive psychologist with a history of depression, but as the saying goes, “We teach best what we most need to learn.” Personal experience tells me that positive psychology works as a treatment for depression.

One of the most dispiriting things about having a visit from the black dog (a frequent symbol for depression) is the narrow range of treatment available, which usually boils down to anti-depressant medication or one of the talking therapies. Positive psychology has much to offer at the milder end of the depression spectrum as drug-free, evidence-based self-help which avoids constantly picking over emotional scabs.

Positive psychology forged its reputation as the study of happiness with a goal of increasing the tonnage of happiness on the planet. Less attention has been paid to the role that positive psychology could play in dealing with the shadow side of life, in reducing the global burden of depression.

   Black dog

As the science moves into its second decade there is potential for the interventions to be applied, not only as protection against depression but also as therapy. An article by Seligman and colleagues as well as a meta-analysis by Sin and Lyubomirsky confirm that positive psychology interventions (PPI) are efficacious in alleviating depression just as they are in enhancing happiness and well-being.

One of the reasons why PPIs work may be a simple case of “What you focus on grows.” If you focus on activities that increase your happiness, the likelihood is that your happiness will grow. If you focus on your depression as therapy often does, the chances are that you might get to know the black dog more than you care to…!

My First PPI

What worked well for me first off was learning to savor as a way to build positivity. Depression is almost a form of reverse savoring, where awareness of the negative is intensified into an experience of the bleakness, ashes, and utter greyness of life.

This dog isn't so black...

I remember once being at a spa hotel as a treat with a group of girlfriends. Despite all the pampering and fun, my mood was low. I took myself outside and sat staring at a rosebush. As an experiment I put my full attention onto the roses, noticing their beauty, enjoying their delightful fragrance, and marveling at this wonder of nature. Lo and behold my mood lifted!

This was a turning point. Pretty soon I was starting to savor my way through daily life: the smell of good food on the stove, a crisp spring day, buds on a tree, a cheery conversation with a neighbor. I’d even go to department stores to sniff my way through all their lovely soaps and perfumes! This approach of engaging all the senses drew me into savoring. I began to feast on life’s good stuff and by doing so was able to distract the analytical side of me which slipped so easily into ruminating over all that was bad.

Coaching for Depression

In my coaching practice I’ve found that increasing positivity is key to the positive psychology approach to depression recovery, no surprise when you consider that low positivity is one of the main symptoms of depression. Here is one area in which positive psychology has a strong contribution to make to depression treatment.

Applying optimistic explanatory style helps to puncture the pessimistic beliefs that take on monstrous proportions and can drag you into the downwards spiral.

Dry Weather

I also find that strengths have a role to play, acting like vitamins providing a boost of energy to counteract the lethargy of depression. The black dog is often a reflection of something not working well in life. Your strengths can help you to move forward by providing a clue to a new, positive direction that lends meaning and purpose to life and helps to rebuild from low states.

Learned Optimism was one of the first positive psychology books I ever read and it continues to be on the book list that I give to clients. Under Martin Seligman’s signature in my copy, the author has added two words, “dry weather.”
 

Editor’s note: Miriam has just published a book, Positive Psychology for Overcoming Depression; Self-help Strategies for Happiness, Inner Strength and Well-being, that explores how positive psychology can be used as self-help for depression. We will be publishing a review within a week or two.


 

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

Bryant, F. & Veroff, J. (2007) Savoring: A new model of positive experience.. Mahwah, New Jersey: Lawrence Erlbaum Associates.

Seligman, M. E. P. (2006). Learned Optimism: How to Change Your Mind and Your Life. 2nd Edition. New York: Vintage.

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

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

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
Tropical Storm courtesy of Lucias Clay
Black dog courtesy of Zel Nunes
Dog and roses courtesy of maryaben
Sunflower courtesy of Diego Sevilla Ruiz

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10 comments

oz March 15, 2012 - 1:30 pm

Miriam – congratulations. What if distraction (ie doing things) is the basis of PP interventions. And what if mindfulness (acceptance) is more powerful than alternative explanatory styles? And there’s exercise.

I’m glad PP worked for you. But perhaps not for everyone.

Reply
Sherri Fisher March 15, 2012 - 4:57 pm

Hi, Miriam–
This is beautifully written and thanks for sharing your story. : ) Sherri

Reply
Sherri Fisher March 15, 2012 - 5:04 pm

Hi, Oz-
I wonder if you have an example of a study with correlation of 1 in the results? Nothing works for everyone, so that does not exist 🙂 Your suggestions about doing something (what Sonja Lyubomirsky calls intentional choices), mindfulness (Barbara Fredrickson’s Loving Kindness Meditation qualifies), and exercise (see several articles by Elaine O’Brien here at PPND) are all within the realm of PP interventions.

Reply
oz March 16, 2012 - 2:31 am

Sherri – ah – so PP is a catch all for everything. It truly is the dodo bird effect – everyone’s a winner.

Didn’t see exercise or mindfulness in Seligman’s latest book – and he is the authority on PP.

And then there is research suggesting mindfulness might bemore powerful than CBT (explanatory style)

But we do agree on one thing – everyone is different – so Miriam’s story might not apply to everyone.

Reply
Student-Practitioner March 16, 2012 - 4:55 pm

Oz,… I certainly hear your criticism loud and clear as to the PP brand, and of mindful living also being very powerful. (I myself have a foot in both of these domains). However, consistent with the mindfulness- and acceptance-based approaches, please adopt “reflective rather than reflexive” patterns of responding within this Comments Section.

First, let us consider the article above as a case example of Ms. Akhtar sharing her experience. She has used “I-statements” and written from first person narrative to reinforce this point.

Second, to advance understanding of PP to you (and frankly…to others), I’d suggest reading this too-infrequently cited article by two very notable scholars. Portions of it are not as up-to-date as others, as it was published six years ago, but it is a good starting point. I’d suggest paying careful attention to sections on what positive psychology is (and more importantly – what positive psychology isn’t). (Hint: A quick internet search will likely yield an open-access pdf copy.)

Gable, S. L. and Haidt, J. (2005). What (and why) is positive psychology. Review of General Psychology, 9 (2), 103-110. doi: 10.1037/1089-2680.9.2.103

Reply
oz March 17, 2012 - 6:30 pm

Hi student practitioner – my response reflects considerable reading – so its probably more reflective than reflexive.

I’m interested that you say you have your foot in both camps – it appears that you are making a distinction between PP and mindfulness.

Interestingly Penn has a different definition of PP to that of the article.

Penn definition: Positive Psychology is the scientific study of the strengths and virtues that enable individuals and communities to thrive.

Article definition: Positive psychology is the study of the conditions and processes that contribute to the flourishing or optimal functioning of people, groups, and institutions.

I think I prefer the latter as it does accomodate a braod church. Probably explains why selligman and co overlook mindfulness – bit of a strenghths obsession going on here.

Could also be a gender thing – it seems to be the female PP researchers who are advocating mindfulness

Reply
Student-Researcher March 18, 2012 - 8:07 pm

Hi Oz,
You do bring up some common and valid criticisms of PP and particularly Seligman’s (one L) brand of PP. However, I do believe that an article that is clearly meant as sharing a personal experience isn’t the right outlet to voice those criticisms.
I also do believe that PP, even Seligman and Penn’s brand of PP, has put a significant but oftentimes under publicized attention on mindfulness, and other none “strengths obsessions.” I also do believe you are making an argument purely based on semantics by just looking at definitions on websites, instead of looking at the attention it’s given in the real world (for example the amount of mindfulness workshops and lectures given at the past IPPA conference or the amount of researchers and practitioners associated with both camps). I agree with student-practitioner, particularly in citing the Gable and Haidt article, as it brings up the point that positive psychology is a movement in shifting attention away from being purely illness based towards a more holistic practice that leads to a full life instead of just a neutral one. In that sense mindfulness, acceptance based approaches, and positive psychology share that in how they approach well-being and treatments of depression.
So those are my two cents on the comments debate. On the article, I do appreciate the personal account that I believe reflects what bought a lot of people to study positive psychology.

Reply
Student-Practitioner March 18, 2012 - 10:58 pm

Hi Oz,

Above, your comments include (1, 2, 3, 4):

1. “I’m glad PP worked for you. But perhaps not for everyone.”

I suggest making a distinction between positive psychology (PP) and the specific interventions she lists, namely: savoring, explanatory style, and strengths. The former is an entire field (or perspective, or approach, or brand). The latter interventions are a few (of many) methods dubbed “positive interventions”.

2. “But we do agree on one thing- everyone is different – so Miriam’s story might not apply to everyone.”

Of course. For some, savoring, explanatory style, and strengths seems to resonate well. For others mindfulness practice (formal and informal) may be a chosen path. So why quibble with Akhtar’s approach while also acknowledging that everyone is different?

3. “Didn’t see exercise on mindfulness in Seligman’s latest book – and he is the authority on PP.”
4. “Interestingly Penn has a different definition of PP to that of the article.”

Of course. I suggest not looking at one source for the all-inclusive definition for “Positive Psychology”, even on the Penn Positive Psychology Center Website. Each scholar studies and emphasizes what he/she is interested in, and as such variability expectedly will occur. (See definitions of and approaches to “mindfulness,” from Kabat-Zinn, to Linehan, to Teasdale, to Hayes, to Baer, to Bishop, to Davidson, to Kashdan….the latter two specifically are very active in the domain of Positive Psychology as a field. Lots of variability here too.)

I think we’ve moved far beyond a discussion pertinent to the article above, and on to larger questions, like “What is positive psychology?”. You bring up very common concerns/criticisms of the “Positive Psychology Brand” and frankly, its understandable, given the wide, almost viral usage of the PP label. It would also be useful to distinguish between the “PP Brand” and “PP,” as they have come to mean both similar and remarkably different things.

My apologies on my misleading phrasing both above and within this comment. Mindfulness (the construct) is very much part of the Positive Psychology Field, though (I admit) not readily apparent. One (of numerous) examples would be the work of Dr. Richard Davidson, who served as a keynote speaker at the International Positive Psychology Association’s 2nd Annual World Congress last year. Another would be work by Dr. Todd Kashdan. I bet there are numerous PPND articles on mindfulness too.

Rather than continuing to address your points and risk a back-and-forth about each of them, I think that it would be more constructive to suggest further reading for you.

Sheldon, K., Kashdan, T. B., & Steger, M. F. (Eds.) (2011). Designing Positive Psychology: Taking Stock and Moving Forward (Series in Positive Psychology). New York, NY: Oxford University Press.

Reply
Miriam Akhtar March 19, 2012 - 12:29 pm

Hi there, interesting debate. To offer my perspective as the author of the article, as a positive psychology practitioner and someone with lived experience of the black dog – it may be useful in academic terms to have a clear definition of what positive psychology is, but I am not so sure that this debate is helpful for the end user of the research. And the point of positive psychology surely is to provide knowledge and tools to help people towards a happy and flourishing life. That it is an applied science which exists beyond the campuses. The clue’s in the A of the MAPP!

Positive psychology seems to act as a magpie, adopting many positive fields of research under its umbrella. This is a good thing. There are after all many triggers for depression just as there are many interventions that promote happiness. Well-being is holistic in nature and if positive psychology is the science of well-being then it should reflect its multi-faceted nature. On my MAPP course at the University of East London we had lectures on the positive psychology of the body, exercise, nutrition, mindfulness and yoga. Of course it is the psychological side which is of primary interest to us, but positive psychology would be unwise to ignore what goes on below the neck. As a coach I always refer to the physical dimension of well-being. The benefits of exercise to depression are well known (eg. Babyak). I regard exercise as first-aid for low mood – those endorphins can provide an instant mood lift.

In my book Positive Psychology for Overcoming Depression I include both ‘doing’ interventions and ‘accepting’ interventions in the form of mindfulness. Both have an evidence base and personally I’ve found that both approaches have something valuable to offer. There may be a cultural dimension here – Western society is arguably more attuned to ‘doing’, to goals like the ‘pursuit’ of happiness itself. Eastern society may be more attuned to accepting what is and this is where mindfulness comes in, which is a recognised treatment for depression (eg. in MBSR, MCBT). There are also chapters covering the physical, emotional, cognitive and social aspects of well-being. Different things work for different people. There is no one-size-fits-all.

Editor’s note:
Babyak M, Blumenthal JA, Herman S. , et al.(2000). Exercise Treatment for Major Depression: Maintenance of Therapeutic Benefit at 10 Months. Psychosom Med 62, 633.

Reply
Preethy February 11, 2015 - 10:12 pm

Hi Miriam,
This is a wonderful article and I do relate to it. It takes a great deal of courage to relate one’s experiences with the Black dog (according to me) and you have certainly given hope to those who wish to shrink the dog and retain their dry weather. Kudos to you 🙂

Reply

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