In other countries, psychotherapy is not as needed or as popular as in the West because a great deal of good and natural therapy is happening daily among families, friends, and communities. People have several means by which to interact and express themselves, to seek guidance and advice, to enjoy support and encouragement, and to draw from their communal and spiritual resources. They know that they are not alone in their life j ourneys in the midst of both their joys and their sorrows. That particular awareness gives people definite meaning and perseverance, a needed sense of belonging and connectivity, and a sound existential hope and spirituality. Instead of allowing the dark side of life, the shadows of the human personality, and abnormal psychology and psychopathology to guide and inform psychological practice, theory, and research, social scientists should indeed focus more on what is good, right, normal, well, and healthy. Some theorists and therapists have a tendency to be so preoccupied with what is wrong, damaged, broken, and pathological that they forget (or run out of time) to fortify what is left, discover what is healthy, strengthen what remains, and find ways to instill meaning and realistic hope. Even when helping and working with traumatized people, after all assessment is done, it is essential to point out to them, as Donald Meichenbaum (1994) often stressed, that in spite of all that has happened to them and in spite of all the pain and trauma they have been through, they obviously somehow have survived. Therefore, they must have some inner strength, remarkable endurance, and a degree of stored resiliency. This reality, which is normally overshadowed by agony, defeat, and despair, should be highlighted by caregivers over and over again. It can only enhance confidence and worth, increase motivation and endurance, and ultimately instill courage, hope, and determination. There is a great need to further develop the psychology of survivorship, resiliency, encouragement, and strength. When working with injured and hurting people, I often ask them at different times during the therapy process some of the following leading questions: "Now after we have spent a lot of time dealing with what is going on that's wrong in your life, could you possibly tell me what is still going on that's right, if anything at all? What is still good, normal, healthy, and perhaps pleasant? Is there anything you are taking for granted? And what are some of the things you can still do relatively well and really enjoy?" A deep and profound principle lies behind such an approach to recovery and wellbeing. The human mind and psyche cannot dwell on hope and despair at the same time— not for too long, at least. By helping people
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mobilize their healthy faculties and resourcCorrespondence concerning this comment should be es, which are often ignored and marginalized addressedtoNaji Abi-Hashem, P.O. Box 1732, Merby the clouds of depression and anxiety, those cer Island, WA 98040-1732. Electronic mail may be parts begin to slowly unfold, gradually sent to
[email protected]. emerge, and strongly come alive to be well. Eventually, the positive begins to overshadow the negative, and the healthy surpasses DOl: 10.1037//OOO3-066X.56.1.86 the unhealthy. Hopelessness begins to be replaced by hopefulness and meaninglessPositive Psychology and ness by meaningfulness. All the while, theraPositive Reinforcement peutic encounters continue the work toward healing, mending, gaining insights, reversing A. Charles Catania undesirable patterns, undoing the paralysis University of Maryland Baltimore County of pathology, and putting struggling clients in a mode of survival and creativity. That new reality can be established through generous In behavior analysis, positive reinforcement support, encouragement, mentoring, and em- is a method for shaping new behavior. For example, it can be used to change a developpowerment. Eventually, encouraging others to dwell mentally disabled child who engages extenon the positive is a skill and a virtue that must sively in self-injurious behavior to one who be further studied and incorporated into the has learned communicative skills and theretherapeutic professions. It is about helping fore has been empowered to deal in more clients or patients shift their paradigms. Fur- constructive ways with his or her caregivers. thermore, it is essential to note that the care- Those who have expanded the applications giver's own positive attitude and anchored of behavior analysis have demonstrated that personality are quickly detected by other peo- contrary to common stereotypes about recple and will infuse the atmosphere with a ommended procedures, undesirable behavior cheerful, confident, and peaceful spirit. This should not be dealt with by taking reinforcers in turn instills in others a better sense of hope away but by using the available reinforcers to shape more desirable behavior. A parent who and a healthy degree of optimism. ignores an annoying or crying child at a checkOne can gain new insights from studyout counter because a superficial introductoing the concept of hope in other languages, ry course once suggested that the best way to cultures, and traditions. In Arabic, for examget rid of such behavior was to extinguish it ple, there are two terms for hope (as there are has gotten the wrong message. The attention for love): raja 'a and amal. The word raja 'a and other reinforcers that produced and mainis more formal and mostly pertains to the tained the annoying behavior or the crying distant future, whereas the word amal and its must have been important to the child from derivations are more commonly used in evthe start if the child had to behave that way to eryday language and conversation. It pertains produce them. Taking them away is not the to the immediate and coming present. Both solution. Reinforcement isn't everything, but terms imply a strong and beautiful sense of extinction isn't anything. The reinforcers are expectancy. They energize living and cause already there, and they should not be wasted people to have a more positive and empow(Catania, 2000). ered outlook and a meaningful disposition in The point is that the constructive applilife. In closing, it seems only appropriate to cation of positive reinforcement is an applicaquote here from an old and famous Arabic tion to be celebrated in psychology's new poem, which is well used in the Middle East, decade of behavior, and it should be at least "ma adyaka el-aisha lauwla foosshatu el-ama- as central to a positive psychology as other, li," which basically means "how confining more global approaches. The child who has and distressing life (or living) can be without become competent and empowered by posia glimpse of hope and a restful oasis of amal." tive reinforcement may also learn that positive reinforcement becomes even more effective when it is reciprocated. We all shape each REFERENCES other's behavior, and the more we all know about how positive reinforcement works, the Meichenbaum, D. (1994). A clinical handmore likely it is that we will use it productivebook/practical therapist manual for assessly and will avoid pitfalls, such as the coercive ing and treating adults with PTSD. Waterpractices that can occur if the control over loo, Ontario, Canada: Institute Press. reinforcers remains one-sided. Psychologists Myers, D. G. (2000). The funds, friends, and faith of happy people. American Psycholo- have long known about the damaging side effects of aversive techniques for the modifigist, 55, 56-67. cation of behavior (e.g., Sidman, 1989). A Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introducmutual reinforcement society in which reintion. American Psychologist, 55, 5—14. forcers are delivered reciprocally and openly
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is likely also to be a happy society (cf. Skinner, 1948). My early impulse on perusing the American Psychologist's special issue on positive psychology (January 2000) was to write that I was saddened that I did not see positive reinforcement represented, but that would have been totally inappropriate to the present point. A technology that deals with the consequences of behavior that are positively reinforcing and that can do great good has been at hand for some time (see any recent volume of the Journal of Applied Behavior Analysis).Now, the decade of behavior gives psychologists an opportunity to make more productive use of it. We can make children happier to be in school and happier to learn. Let us think positively of reinforcement. I urge those who advocate a positive psychology to embrace behavior analysis, its applications, and positive reinforcement in particular by learning more about it, by teaching it to their students, and by promoting it in our culture and in the world at large. I am positive that it will make a difference. In closing, I can arrange only a tiny consequence for what you have been doing here, but my hope is that it will have some small reinforcing effect on your attending to the writings of behavior analysts: It is to thank you for reading this far. I look forward to additional positive consequences. REFERENCES
Catania, A. C. (2000). Ten points every behavior analyst needs to remember about reinforcement. In J. C. Leslie & D. Blackman (Eds.), Experimental and applied analyses of human behavior (pp. 23-37). Reno, NV: Context Press. Sidman, M. (1989). Coercion and its fallout. Boston, MA: Authors Cooperative. Skinner, B. F. (1948). Walden two. New York: Macmillan. Correspondence concerning this comment should be addressed to A. Charles Catania, Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250. Electronic mail may be sent to
[email protected].
DOI: 10.1037//0003-066X.56.1.87
Integrating Psychopathology, Positive Psychology, and Psychotherapy Georgios K. Lampropoulos Ball State University Reading the special issue of the American Psychologist (January 2000) on the contem-
January 2001 • American Psychologist
porary, data-based movement ofpositive psychology was an uplifting experience in itself. Positive psychology seems to emerge as a renewed humanistic approach to the individual and collective potential for happiness, but this time it is strengthened by empirical data and adequate research methodologies. Seligman and Csikszentmihalyi's (January 2000) call for a shift from a disease-oriented science to a science of optimal functioning, wellbeing, and happiness provides psychology and related disciplines with a noble goal to pursue in the beginning of the new century. Indeed, what can be more positive, rewarding, and fulfilling than studying and facilitating people's happiness? However, transforming therapeutic psychology from a science based on the medical model to a science that emphasizes positive experience and prevention is easier said than done. Although Seligman and Csikszentmihalyi (2000) recognized the domination of the disease model in mental health, they suggested that because psychologists have now found treatments for the majority of psychological problems, they should start studying how to make people's lives even better. They proposed that psychologists could use the same research methods and even the same laboratories that have developed psychology and psychiatry as healing sciences during the past half century to focus on the study of positive psychology, with only a slight shift of emphasis and funding. Although certainly feasible, how easy or likely is that to happen? How can a long tradition of conceptualizing and treating people in psychopathological terms shift to the study of positive functioning? How do psychologists change not only their mind-set of focusing on the negative but also the pathology-based therapeutic practices that are currently empirically supported and embraced by third-party payers? How can psychologists convince the scientific and professional mental health establishment to make scarce monetary and human resources available to positive psychology research and practice? To achieve a major scientific shift to positive psychology (which could complement the dominant disease-oriented focus in mental health), psychologists should reconcile and merge the two foci; this could be best done by gradually infusing positive psychology into current models of psychopathology and treatment. To ease the integration and transition from a psychopathology-focused to a strength-focused approach in therapeutic psychology, programmatic research might be necessary; here are three possible areas of attention: 1. Client strengths and positive traits should be included in the study of psychopathology (see also Vaillant, January 2000)
and, most important, in treatment-effectiveness research. In addition to measuring symptom reduction, outcome measures can include the assessment of positive aspects of clients' functioning, their subjective well-being, and their effective application of solutions to problems. The benefits of this are twofold: First, the additional assessment of positive changes in other areas of clients' lives can provide the much desired differential effects in treatment outcome research. Although traditional outcome research has shown a paradoxical equivalence in symptom reduction among different therapies (Stiles, Shapiro, & Elliott, 1986), the measurement of neglected aspects of clients' positive functioning can make a meaningful difference. That is, psychological treatments should also be evaluated in terms of their ability to make life more fulfilling for clients. Second, measuring increases in positive behavior and well-being in tandem with measuring reductions in negative behavior can provide the bridge between pathologyoriented and nonpathology-oriented approaches; after all, one could argue that when psychologists measure increases in successes, solutions, and positive experiences, they really measure problem and pathology reduction, and vice versa. This practice can also facilitate the rapprochement and reconciliation of traditional psychopathology-oriented models of treatment with humanistic or solution-focused models. 2. Mental health and health psychology can currently reach only a small fraction of the people who are in need of counseling and modification of self-destructive health behaviors (Prochaska, 1999). The pathologizing nature of psychological diagnoses and treatments, as well as the threat to self-esteem and the social stigma often attached to them, seem to contribute to keeping people away from helping services. In addition, many people seem to rely on and successfully use selfchange and nonprofessional helping services that capitalize on their internal ability to overcome problems and difficulties. Several forms of self-help, self-change, and other sources of informal psychological help have been reasonably supported by research (Bohart & Tallman, 1999; Christensen & Jacobson, 1994; Hubble, Duncan, & Miller, 1999; Prochaska, 1999), and their effectiveness suggests the utility of nonmedical approaches to treatment. The self-change and self-help trends build on people's positive traits and selfprotective survival mechanisms, as well as their skills, to activate their social support systems. These trends obviously represent the expression of the positive psychology movement in the field of therapy, and if further researched and embraced by mainstream therapeutic psychology, they can offer a great preventative service (in the spirit of giving
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