Positive Psychotherapy (PPT) is a strength-based approach focussed on improving wellbeing and functioning by building on positive emotions, relationships and character strengths.
The aim is to make people more resilient, thereby protecting them against future stressors. People can take part in positive psychotherapy individually or as a couple or family.
WHAT IS POSITIVE PSYCHOTHERAPY?
Positive Psychotherapy (PPT) is a relatively new therapeutic approach, influenced by both the humanistic and psychodynamic approaches towards diagnosis and treatment. Its core focus is on moving away from what’s ‘wrong’ or the negative aspects of an individual, and instead move towards what’s good and positive.
Seligman, Rashid, and Parks (2006) offer the following definition for PPT concerning depression:
Positive psychotherapy (PPT) contrasts with standard interventions for depression by increasing positive emotion, engagement, and meaning rather than directly targeting depressive symptoms.
PPT often uses a range of interdisciplinary approaches of psychotherapy, including the use of multicultural stories, ideas, and metaphors to help individuals create a new view of their mental health in positive ways.
Therapists using PPT often invite the individual to place themselves in the stories used, so they become active in their healing process in an empowered way, and in so doing, become the ‘therapist’ of their own recovery.
While the emphasis is on positivity and positive outcomes, the overall theory of PPT also asserts that three core principles need to be addressed to allow this to happen:
- The Principle of Hope: This principle encourages the individual to focus on the overall positivity of humanity, and negative experiences are to be seen as having a higher purpose with a positive reframing. Any disruptions to a sense of well-being are encouraged to be explored and reframed as signals that there is an imbalance that requires addressing.
- The Principle of Balance: This principle examines how we experience discontent and the coping methods we might use to address this. According to PPT, negative symptoms arise when these coping methods aren’t working, and our areas of life are out of balance, with discontent impacting how we think and feel.
- The Principle of Consultation: This principle sets out the five stages of therapy that must be worked through to address any issues that arise in the above two principles, to achieve a positive outcome:
- Observation – where the individual provides an account of the issues, challenges, or situations that are upsetting them and those that are making them happy.
- Inventory – where the therapist and individual work together to explore and highlight the correlation between negative feelings/symptoms and the individual’s true capabilities.
- Situational Support – where the individual is asked to focus on their positive traits and those of the people around them who significantly offer them support.
- Verbalisation – where the individual is encouraged to verbally discuss and talk openly about any negative feelings, challenges, or symptoms.
- Development of Goals – where the individual is invited to turn their focus to the future, setting positive goals, and envisioning the positive feelings they want to cultivate, as well as connecting these with their unique strengths.
Another core component of PPT is the emphasis it places on core capabilities. According to PPT theory, everyone – regardless of gender, age, class, ethnicity, or preconceived ideas of their mental health – has two core capabilities:
- The Capability of Perception: Our ability to draw connections between the different areas of life with more significant reasons behind the meaning of not only our own existence but the existence of everything around us.
- The Capability of Love: Our ability to develop emotionally and develop interpersonal relationships.
HOW DOES PPT WORK?
Positive psychology recognises that mental health is more than just the absence of mental illness. It focuses instead on enhancing psychological wellbeing to help people to function optimally and feel as good as they can.
The particular way this is applied in therapy depends on the specific approach. The two most well-known approaches are discussed below:
In Peseschkian’s model4, elements of other types of therapy, including cognitive behaviour therapy (CBT) and psychodynamic therapy, help people to focus on their strengths, abilities and potential. Stories and anecdotes are woven with practical strategies during therapy.
Positive psychotherapy is underpinned by three main principles in Peseschkian’s model:
- Hope: The therapist helps you to see mental health challenges in a more positive light by helping you to find meaning in difficult experiences. If you are experiencing insomnia and are feeling distressed; positive psychotherapy would help you to reinterpret the experience to see what an achievement it is that you are able to get by on so little sleep.
- Balance: Mental health challenges are seen as the result of an imbalanced focus on one area of life to the detriment of other areas. Positive psychotherapy helps you to achieve balance across four areas of life, which are:
- Body and health
- Achievement and work
- Contact and relationships
- Future and purpose
- Consultation: This principle relates to the process of therapy. The therapist works collaboratively with you, educating and problem-solving.
Positive psychotherapy based on Seligman’s work is also positively oriented and strengths-based. Therapy is focussed on building three aspects of happiness:
- Building positive emotions
- Using strengths to enhance engagement in life
- Developing purpose and building a sense of meaning in life
These aspects are thought to increase wellbeing. They can also help to reduce symptoms of mental health challenges by disrupting and diverting attention away from unhelpful thoughts.
POSITIVE PSYCHOTHERAPY PROGRAM (P3)
Following is an outline of the Positive Psychotherapy Program (P3) at Life Psychologists:
Session & Topic
Orientation to PPT; Current Positive Resources
Psychological distress is discussed as a lack of positive resources, such as positive emotions, relationships, meaning, and accomplishment. To explore this, the therapist might use an exercise that encourages the individual to write a one-page, real-life story that called for the best in them and has a positive ending.
Individual Character Strengths
In this session, individual character strengths are explored, and the concept of engagement and flow is introduced. To begin exploring individual character strengths, the individual may be asked to identify what they believe are their signature strengths both in the session and through an online self-report. They may also ask two other close persons to rate their signature strengths.
Signature Strengths & Positive Emotions
Following on from the last session, signature strengths are discussed in more detail. As an exercise, the therapist may ask the individual to compile a signature strengths profile, which could include setting SMART (specific, measurable, achievable, realistic, and timely) goals.
Good vs. Bad Experiences, Symptoms or Memories
The concept of how negative experiences and symptoms can be perpetuated is discussed in alignment with positive experiences. The therapist might use an exercise that asks the individual to explore a memory or experience that elicited feelings of anger, bitterness, or resentment and how these feelings further perpetuated the negative experience.
Forgiveness is explored as a resource to reframe negative symptoms and feelings into more positive emotions. The therapist might use a letter-writing exercise that asks the participant to remember a negative experience and to write out a letter of forgiveness towards the perceived transgressor/s of the scenario – themselves included.
Alongside forgiveness, gratitude is explored as a resource for generating better balance, and to view individual circumstances more positively. The role of positive and negative memories, feelings, and symptoms are discussed with an emphasis on gratitude for all the lessons both of these states have allowed for. The therapist might use gratitude journaling as an exercise to help build more focus and awareness of all the things for which the individual is grateful.
At this point, the therapist may follow up on any at-home tasks related to the forgiveness and gratitude sessions, and to revisit any of the previous sessions that may feel unresolved. This is also the opportunity for the individual to discuss their perceived gains or hurdles they might be experiencing so far as an outcome of the sessions. As an exercise, the therapist may seek to explore different ways the individual can overcome any of the hurdles, utilizing their signature strengths uncovered previously.
Satisficing vs. Maximizing
The therapist may now introduce the two concepts of satisficing (mainly, being ‘good enough’) and maximizing. The individual may be asked to explore the different ways in life they have not felt ‘good enough’ and to tell the story of one experience where they did feel good enough, and one where they did not. Again, these can be explored regarding the individual’s signature strengths.
Hope and Optimism
The additional concepts of optimism and hope are explored. As an exercise, the therapist may ask the individual to think about a time when they may have felt they lost out on something, only to discover it opened up new opportunities.
Various interventions that involve developing positive communication, such as Active-constructive, are explored and referenced in association to the individual’s signature strengths.
Signature Strengths of Others
The importance of recognizing, acknowledging, and associating with the signature strengths of the key people the individual has close relationships with is explored. As an exercise, the therapist may ask the individual to draw up a ‘Family Strengths Tree’ where the individual asks their significant relationships to complete an online self-report strengths test and identify their signature strengths. These can then be discussed in the session.
The concept of savouring is explored, as well as some of the techniques and strategies that can be used to prevent adaptation, along with techniques and strategies to safeguard against adaptation.
Gift of Time and Positive Legacy
The benefits of kindness, sharing, and helping others are explored and discussed in alignment with therapeutic outcomes. As an exercise, the therapist might ask the individual to make plans for how they might give the gift of their time utilising their signature strengths.
The Full Life
In the final session, ‘The Full Life’ is discussed in terms of what the individual feels they have that leads to this. Therapeutic gains are discussed, focusing on positive emotions, engagement, and meaning. How to keep this momentum going is also discussed, and ways of doing this are devised with the individual taking the lead and considering their signature strengths to achieve this.
The Positive Psychotherapy Program at Life Psychologists tends to be short to medium-term, typically taking around 12 to 16 sessions. You and your Life Psychologist will decide together when the appropriate time is to end the program.
Alternatively, positive psychology techniques can be combined with other types of therapy, such as cognitive behaviour therapy (CBT), mindfulness practices, or acceptance and commitment therapy (ACT).
EVIDENCE ON POSITIVE PSYCHOTHERAPY
There has been much research into the impacts of the various streams of positive psychology in therapy. Although there are some mixed results, positive psychology-oriented interventions appear promising. Research shows that they can help to reduce symptoms of depression, which can last over the long-term(1,2) and can also lead to higher rates of life satisfaction(2)and happiness(3).
As with all therapy types, positive psychotherapy has its limitations. The therapy is not thought to be a good fit for treating serious mental illnesses, such as schizophrenia or bipolar disorder.
- Positive Psychotherapy
- Seligman, M.E.P., Rashid, T., and Parks, A.C., “Positive Psychotherapy” (PDF)
- A Comparative Study on the Effectiveness of Positive Psychotherapy and Group Cognitive-Behavioral Therapy for the Patients Suffering From Major Depressive Disorder
- World Association for Positive and Transcultural Psychotherapy (WAPP)
- Bertisch, H., Rath, J., Long, C., Ashman, T., and Rashid, T. (2014). Positive psychology in rehabilitation medicine: A brief report. Neuro Rehabilitation. doi:10.3233/NRE-141059
- Headey, B., Schupp, J., Tucci, I., and Wagner, G. G. (2010). Authentic happiness theory supported by impact of religion on life satisfaction: A longitudinal analysis with data for Germany. The Journal of Positive Psychology, 5, 73–82.
- Kashdan, T. B., and Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878.
- Peseschkian, N. (2000). Positive Psychotherapy. New Delhi: Sterling Publishers.
- Rashid, T. (in press). Positive Psychotherapy: A strength-based approach. Journal of Positive Psychology.
- Rashid, T., and Seligman, M. E. P. (2013). Positive Psychotherapy. In D. Wedding and R. J. Corsini (Eds.), Current Psychotherapies. Pp. 461-498. Belmont, CA: Cengage.
- Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York: Simon & Schuster.
- Seligman, M. E., Rashid, T., and Parks, A. C. (2006). Positive psychotherapy. American Psychologist. 61, 774-788.doi: 10.1037/0003-066X.61.8.774
- Sirgy, M. J., and Wu, J. (2009). The pleasant life, the engaged life, and the meaningful life: What about the balanced life? Journal of Happiness Studies, 10, 183–196.
- Theo A. Cope, Positive Psychotherapy: ‘Let the Truth be Told’. International Journal of Psychotherapy, Vol 18, No 2, July 2014, http://www.ijp.org.uk
- Positive Psychotherapie. Theorie und Praxis einer neuen Methode. Fischer Verlag, Frankfurt am Main, 1977
- Positive Psychotherapy. Theory and Practice of a New Method. Springer Berlin Heidelberg New York, 1987
- Kornbichler, Thomas (2006). Die Tiefenpsychologisch Fundierte Psychotherapie. Stuttgart: Kreuz-Verlag. ISBN 9783783125832.
- “Wiesbadener Akademie für Psychotherapie (WIAP)” (in German).
- “Positive Psychotherapy”.
-  European Association of psychotherapy.
- Karin Tritt, Thomas H. Loew, Martin Meyer, Birgit Werner and Nossrat Peseschkian: POSITIVE PSYCHOTHERAPY: EFFECTIVENESS OF AN INTERDISCIPLINARY APPROACH. Eur. J. Psychiat. Vol. 13, N° 4, (231-241) 1999