Dennis Greenberger, Ph.D. University of California, Irvine
Originally published June 2014, Advances in Cognitive Therapy - a Joint Newsletter of the International Association of Cognitive Therapy and the Academy of Cognitive Therapy, IACP Vol. 14, Issue 2/ACT Vol. 15, Issue 2I have always appreciated the durable and expandable nature of the cognitive model. The simple yet powerful idea that there is a reciprocal interaction between thoughts, moods, behaviors and biology is a remarkable way of understanding experiences – pathological and healthy. The model further accounts for early experiences that create or contribute to ways that we look at ourselves and others. The cognitive model allows for a clear understanding of a person’s experience and it creates a map of potential cognitive and behavioral interventions. Positive psychology has been one of the more exciting developments in psychology in the last 15 years. It is not surprising that Martin Seligman, one of the luminaries of CBT has been at the forefront of positive psychology. The field of positive psychology has been embraced and advanced by other “CBTers” including many in the Academy of Cognitive Therapy, a non-profit organization that actively works towards the identification and certification of clinicians skilled in cognitive therapy. The CBT model seems wholly consistent with newer developments in positive psychology. Positive psychology has researched positive emotion, gratitude, a positive vision of one’s self and future, meaning, engagement, optimism, positive ethics, resilience, self-determination, mindfulness, compassion, empathy, altruism and forgiveness. The traditional CBT model may be a template to understand positive as well as negative experiences as well as other dimensions that are the focus of positive psychology. Sonja Lyubomirsky in The How of Happiness describes multiple happiness activities including cultivating optimism (cognition) and practicing acts of kindness (behavior). Cognitive therapists are very familiar with the negative, pessimistic explanatory style of depressed patients. We address this regularly in treatment. The opposite side of this coin is the cultivation of optimism - a positive psychology exercise. Research has demonstrated that optimism is correlated with happiness or a sense of well-being. A change in our thinking (optimism) affecting a change in our mood (happiness) is the nature of the reciprocally interacting CBT model. Lyubomirsky goes on to describe research demonstrating that practicing acts of kindness (behavior) also contributes to happiness. Similarly, this is entirely consistent with the CBT model which suggests that any change in behavior or cognition will be followed by a change in mood. The CBT model is one way of explaining the results of these positive psychology exercises. Research findings in the field of positive psychology may expand the CBT model to positive emotions and a sense of well-being. Gratitude is a foundational theme in many religious traditions and has been extensively researched in the positive psychology literature. Gratitude is the ability and willingness to think about people, events and experiences in one’s life that you are appreciative of. Gratitude may be thought of as a belief or a cognitive processing style while the expression of gratitude is a behavior. Gratitude is a combination of the head and the heart. Research suggests that the activation of a grateful attitude and the behavioral expression of gratitude are likely to lead to a greater sense of happiness. In this situation the CBT reciprocal interaction model continues to work but in a positive direction instead of the negative direction that we traditionally talk about. The link between CBT and positive psychology is also evident in treatment interventions originating out of positive psychology. Martin Seligman and Tayyab Rashid co-authored Positive Psychotherapy: A Treatment Manual. This is a fourteen session group psychotherapy model for depression based on positive psychology principles. In part, the treatment interventions include what may be considered positive cognitive and behavioral exercises including recognizing blessings (cognitive), identifying positive experiences that happened during the day (cognitive), writing (behavioral) a forgiveness (cognitive) letter, writing (behavioral) a gratitude (cognitive) letter, cultivating optimism (cognitive), engaging in pleasurable activities (behavioral), savoring (cognitive and behavioral), and developing meaning (cognitive) in life. Although this is in the very early stages of research, a positive psychotherapy group intervention with depressed patients based on this treatment manual produced significant and encouraging results. The danger in using the CBT model to understand positive psychology is that it becomes a Procrustean Bed which unfairly neglects important and distinctive components of positive psychology. That being said the CBT model that we are all quite familiar with may provide a way for us to understand how positive psychology interventions work in clinical as well as non-clinical populations. There is an integrative power to the cognitive model and many of the exciting findings in positive psychology may be the opposite side of the coin that we are so familiar with. Integrating positive psychology principles and findings into the CBT model may not only help our patients get better but it may help them develop happiness, meaning, a sense of purpose and well-being.