In the Room

Easy and Cheesy: Simple Techniques from the Happiness Research

I like the happiness stuff, how can you not. It is simple, positive and easy to apply. Sometimes I like a break from all the deep stuff that demands so much more from me both as a person and a therapist. It has certainly seen rapid growth both in research and commercial exploitation.

I must admit I find some of the research confusing. I remember reading a New Scientist article (can’t find the link now) on happiness indicating that most of your happiness is genetically determined, around about a whopping fifty percent. The next biggest contributor off the block at two per cent (yes only two per cent) was marriage. This is actual marriage (ring on the finger stuff) not just living together.

At the same time there is some compelling research on the use of very simple techniques that appear to make significant differences to both people’s levels of depression and their perceived levels of happiness. This research challenges those therapeutic ideas that the harder and deeper the work the longer lasting and more real the change. Marty Seligman and others published a good review, in the American Psychologist, on the current state of happiness research with a focus on demonstrating the utility of some very specific and simple techniques. They identify two techniques as being particularly effective over the long term (six months).

Three good things in life: Participants were asked to write down three things that went well each day and their causes every night for one week. In addition, they were asked to provide a causal explanation for each good thing.

Using signature strengths in a new way: Participants were asked to take our inventory of character strengths online at Authentic Happiness and to receive individualized feedback about their top five signature strengths. They were then asked to use one of these top strengths in a new and different way every day for one week.

This signature strength exercise has similarities with some of the values based exercise from the Acceptance and Commitment Therapy as well as some of the behavioural activation techniques.

The outcomes for these techniques are graphed below. Remember participants only did the exercise for one week.

Bring out your Blogs

Discovering stuff and blogs in the blogosphere is an interesting experience. Googling or Dogpiling, as I prefer, for psychology blogs provides a limited list of the more well known blogs. However I like the way the discovery of many new blogs come through the author commenting on my postings or email in my inbox or a new listing on the blogroll of the other psychology blogs I read.  There is a personal connection element to blogging I have discovered I really like.

A recent comment sympathising with my posting about creeping commercialisation in the blog world is a case in point. Annette is an Irishwoman with a psychodynamic focus on organisations. She has a very professional looking blog called: Interactions. She is living proof that Freud was wrong. Sigmund is quoted as saying the following about the Irish.

This is one race of people for whom psychoanalysis is of no use whatsoever.

Hat Tip: Modern Psychoanalysis.

While her blog focuses more on the business world she has interesting posts from time to time on psychotherapy.

Another site is not really a blog I spend a reasonable amount of time at is the Behavior Online Forums particularly the Cognitive Behavioral Therapy forum.

This is set up as a discussion forum which is quite different from a blog setup. Topic headings are provided in a listing and you can dip into whatever takes your fancy. This forum has been around for quite a few years; however I only discovered it last year. For anyone using a CBT approach it keeps you up to date and thinking about things. James Pretzer who moderates the forum is very knowledgeable on CBT and keeps the postings regularly updated.

To Blogroll or not to Blogroll

If I list every blog of interest that comes my way, my blogroll can get out of hand. You see some sites where the blogroll disappears down the right column into the ether and beyond.

This makes for some interesting decisions at times about who to put on the roll. Recently the author of All About Forensic Psychology approached me to let me know about his site. In my private practice outside of the university I do mainly forensic work and this site is an excellent one in that regard and one I read regularly. At the same time it is somewhat outside the area of psychotherapy technique and as a result I have not listed it.

Similarly I received an email from Oxford University Press about their blog. This appears to have some good psychology stuff on it but not all that regular (actually only on Mondays). There was a nice interview with Stephen Hinshaw recently about his book: The Mark of Shame, however not quite enough psychotherapy material to list.

Today I get an email from the Australian Institute of Professional Counsellors about exchanging listings. This is what started this particular posting and I suppose the advantage of writing a blog is that when things get up your nose you can bitch about it. The email is addressed to “The Blog Editor” and goes on to tell me about the organisation and the many thousand of people they have accessing their website and all the benefits of mutual link exchanging and what a wonderful opportunity this will be for me. It then tells me if I list them they will list me (but I have to first). When I go to the front page of the blog most posts link back to something commercial. The vast majority of psychology and psychiatry blog do not push their own products or skills commercially in their posts. Many of them have advertising around the side but that is about it.

What got my goat on this email was firstly the impersonal marketing approach. Anyone who reads my blog can see clearly who I am. Secondly is the commercial nature of it. They would be making money off my link in exchange for one more notch for me up the Technorati ladder. Thirdly was the fact that for them to list me, I had to list them.

Nonetheless they are a psychotherapy website who also have some interesting general articles of psychotherapy and case studies in their library. I can’t deny the narcissistic pleasure of writing a blog and having lots of people read it or my own competitive nature and certain desire to be in the top 100 000 on Technorati. Do I list them? I am still thinking.

It seems to me that the creeping commercialisation of the blogosphere is even reaching psychology. Organisations and publishers are beginning to realise that many of the higher ranked psychology blogs access far more people than most professional journals.

How Many of you are in There: The Concept of Multiple Selves

The latest Journal of Clinical Psychology (sadly no free access) has the whole journal devoted to exploring ideas around the internal multiplicity of the self. Basically this is the idea that the self has or consits of multiple parts, aspects, object or persons rather than that the self is some type of unitary concept.  Dimaggio and Stiles offer a very lucid and easy to udnerstand overview of this concept in the opening paper.

Internal multiplicity is present, if not always acknowledged, in most systems of psychotherapy. It is expressed in such cognitive-behavioral concepts as automatic or intrusive thoughts and self-talk or self-statements. Self-criticism and self-blaming, for example, are forms of self-to-self relationships in which a harsh part of the self criticizes or blames another part that is submissive or inferior. Multiplicity is also assumed in such psychodynamic concepts as internal objects and states of mind and in the humanistic focus on contradictory aspects of self and unrealized potentials. Multiple internal voices are central to dialogical accounts of the self , as therapists try to distinguish from what positions patients speak and to understand what parts of the self are suppressed and prevented from expressing themselves. Multiple I positions are deliberately used in the service of therapy, in the facilitation of reflective thinking, in the analysis of reciprocal role procedures in cognitive analytic therapy, in empty chair work and two-chair work in experiential therapies, in archetypal psychology, and in narrative psychotherapy.

The value in this journal issue is not just a discussion of a theoretical concept but a range of papers directly outlining the use of this sort of model in actual therapy with specific clients. Papers are presented from range of therapies using individual case studies to illustrate the value of the multiplicity concept.

For me this multiplicity of selves has always been inherent in my therapy particularly with borderline clients. One of my favourite sayings to my interns who are working with these clients is that working with borderline clients is like doing family therapy inside somebody’s head. To work effectively with a family you must get everybody in the room and this is usually the first task in working with borderline clients, getting all aspects of the self acknowledged and making it safe enough for each of them to express their point of view and problems.

Clinicians who recognize the self’s multiple aspects may be more empathic with their patients’ internal struggles and acute ambivalence. They may exhibit more attunement or responsiveness, thus being more effective as patients present different facets in different sessions or within one session.

To me this is critically important in the delivery of empathy. Neutrality becomes more of a balancing act in ensuring that each aspects of the self is given some attention and understanding rather than a stricter technical neutrality usually demanded in a psychodynamic approach. While it is usually not possible to offer a single empathic statement that acknowledges all aspects of the self it is useful to think at least in terms of responding to which ever dyadic aspects of the self are in the forefront at the time. In virtually all therapies including CBT there are at least two self aspects present.

As respect and empathy are offered to each voice individually, conflicting internal voices can hear and begin to understand each other, a crucial step toward developing internal meaning bridges. On hearing conflicting expressions, a therapist can reflect  rather than try to encompass multiple voices in an omnibus reflection. Reflections that address only one voice may facilitate elaboration by the voice that was reflected, or, alternatively, they may stimulate an opposing response from a voice that was not reflected. Either client response may be productive. Trying to encompass multiple voices with one reflection, on the other hand, is likely to lead to confusion, as it is unclear which voice should respond. Accurate empathy can thus be understood as facilitating conversation and hence mutual understanding among the client’s internal voices as well as between client and therapist.