Serious mental illness: accentuate the positive!

As the popular song implies, “accentuating the positive, spreading joy to the maximum” keeps stress at bay and improves mental health. Research in psychology has shown that it is not the presence or absence of fortunate events that predicts happiness but, rather, the way we react to such events. In general, healthy individuals focus on the event, savor it, bask in the pride and satisfaction of it. They find opportunities to celebrate it, commemorate it and later to reminisce about it. This prevents the glow that comes with good fortune from fading too quickly or undergoing “hedonic adaptation,” the technical term for the eventual disappearance of heightened emotion that follows both positive or negative life events. Unfortunately, regaining one’s composure after a loss or defeat usually takes much longer than the time it takes to come down to earth after a success, which means that we all need to learn how to savor the joy and prolong it. Savoring refers to ways of regulating the emotional impact of a positive event so as to enhance its significance and make it last (Fig. 1).

Fig. 1. Savoring success.

Capitalizing on an event is a form of savoring that depends on communicating the good news to others (Fig. 2). It has been shown that sharing and publicizing a positive occurrence increases the pleasure derived from it and, in addition, contributes to a longer duration of well-being by increasing the significance of the event and ensuring that its memory lingers. Telling others generates good feeling over and above that produced by savoring joys privately. Sharing requires retelling the details of the story, which means reliving and re-experiencing the pleasurable feelings. Retelling also makes it more likely for the event to be remembered for a longer period because social interaction deepens and extends the traces of its memory.

The listener’s response is relevant. If the listener responds positively, the recounting boosts the sharer’s self-esteem. An enthusiastic response heightens pleasure, but a neutral or negative response can be disheartening. Depending on personal and relationship variables and on the way the story is shared, a listener can respond with envy or resentment or criticism.  Instead of increasing pleasure, a response of this kind causes distress. It is important, therefore, to know how to share good news effectively, without undue self-promotion or any hint of disparagement of others.

Fig. 2. Capitalizing on positive events.

On this basis, a novel therapeutic intervention for people who suffer from serious mental illness (SMI) is warranted. This population is known to have difficulties in processing rewards, in accepting the fact that they deserve a reward, in sharing news of positive events, in knowing with whom to share the news, in knowing how to elicit a positive response from listeners, and in having positive feelings endure. The new therapy encourages persons with SMI to replay joyful events in their minds, relishing and savoring them. Patients learn how to keep alive the memory of a good event by documenting it, treasuring photographs and souvenirs of it, writing about it, publicizing it. They learn to reflect on past positive events and to share them with friends. In the SMI population, the anticipation of a negative response may stop people from communicating good news – in the past, such sharing may have been perceived as ill-placed or delusional and been met with ambivalence, disapproval, or alarm.  It is important, therefore, for therapists to model effective ways of sharing joyful experiences and to provide numerous opportunities for rehearsal. Whereas therapy time is traditionally spent in analyzing negative events, teaching individuals with SMI to savor and capitalize on the positive events in their lives holds the promise of significantly aiding the process of recovery.

Mary V. Seeman
Department of Psychiatry, University of Toronto, Canada

 

Publication

Schizophrenia: Reaction to Positive Life Events.
Seeman MV
Psychiatr Q. 2016 Oct 29

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