Positive psychology techniques for depression

Positive psychology is sometimes dismissed as so much happy talk. But in some circumstances, these techniques provide a much-needed balance to psychiatry's traditional focus on psychic pain and pathology.

The term "positive psychology" is a broad one, encompassing a variety of techniques that encourage people to identify and further develop their own positive emotions, experiences, and character traits. In many ways, positive psychology builds on key tenets of humanistic psychology. Carl Rogers' client-centered therapy, for example, was based on the theory that people could improve their lives by expressing their authentic selves. And Abraham Maslow identified traits of self-actualized people that are similar to the character strengths identified and used in some positive psychology interventions.

Although initially developed as a way to advance well-being and optimal functioning in healthy people, positive psychology techniques are now being promoted as a complement to more traditional forms of therapy. For example, University of Pennsylvania psychologist Martin E.P. Seligman, a well-known advocate of positive psychology, has described its core philosophy as a "build what's strong" approach that can augment the "fix what's wrong" approach of more traditional psychotherapy.

Seligman and his colleagues at the University of Pennsylvania developed a technique known as positive psychotherapy as a way to treat depression by building positive emotions, character strengths, and sense of meaning, not just by reducing negative symptoms such as sadness. This therapy uses a combination of 12 exercises (such as the following) that can be practiced individually or in groups.

Using your signature strengths. Identify your top five strengths and try to use them in some new way daily.

Three good things. Every evening, write down three good things that happened that day and think about why they happened.

Gratitude visit. Write a letter to someone explaining why you feel grateful for something they've done or said. Read the letter to the recipient, either in person or over the phone.

This is one of the few forms of positive psychotherapy that has been tested in a randomized controlled trial. The study involved 411 participants that compared five different exercises with a control exercise, all of which were administered over the Internet and could be completed in one week. Participants were assessed before the intervention and then periodically afterward for six months.

At the six-month mark, participants who completed the "using your signature strengths" and "three good things" exercises were rated significantly happier and less depressed than the control group. The "gratitude visit" exercise also created positive changes, but only for one month. The two other exercises and the control exercise created briefer and transient effects.

Most other studies have been short-term in nature (several lasted six to 10 weeks, and one lasted three days) and have involved people who did not have psychiatric diagnoses. This means it remains unclear whether positive psychology techniques will help people suffering from depression and other psychiatric disorders.

Another limitation in the research so far is that investigators have evaluated mostly individual strategies, but positive psychology interventions usually combine several techniques at once. It's also unclear how best to combine positive psychology interventions with more traditional types of therapy, such as cognitive behavioral therapy, or with medication.

Although the jury is still out on the clinical impact of positive psychology, leaders in the field are encouraging patients and clinicians to give positive techniques a try. After all, there are few risks involved when someone discovers his or her strengths or focuses on the positive side of life — and there may be valuable benefits.

Have you ever tried a positive psychology technique to alleviate depression? What has worked for you?

Dr. Michael Miller has been on staff of the Beth Israel Deaconess Medical Center, a large teaching hospital in Boston, for more than 25 years. He is also an Assistant Professor of Psychiatry at Harvard Medical School.

Are you Living With Depression? Connect with others with similar health concerns and issues. Click here to join the group.

This content is not intended to substitute for personalized medical advice, diagnosis, or treatment from your healthcare provider. Read our full disclaimer.