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Dare to Be Happy

Positive Psychology, IBT and

Group Psychotherapy

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Dan Tomasulo, PhD, TEP, MFA, MAPPDare2BHappy.com

The art of resilience

IBT is the most widely used evidenced-based group model for people with intellectual and psychiatric

disabilities in the world

Healing Trauma: The Power of Group Treatment for People with Intellectual DisabilitiesNancy J. Razza, Ph.D., Daniel

J.Tomasulo, Ph.D.

American Psychological Association’s first bookon people with intellectual disabilities.

Social Skill Training Groups

IBT Groups

Positive IBT Groups

Overview of Positive Psychology,

PERMA & Positive Psychology

• Therapeutic Factors and Character Strengths

• Readiness For Participation & Priming

• Warm up and Sharing and Engagement

• Enactment and Relationship

• Affirmation and Active-Constructive

Responding, Meaning, and Achievement /

Accomplishment

Reliability Ratings on Therapeutic Factors

(Part of a Study by Ellen Keller, PsyD.)

1. Acceptance/cohesion .862. Universality .903. Altruism .764. Installation of hope .865. Guidance 1.006. Vicarious Learning/Modeling.457. Catharsis .968. Imparting of information .91

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An IBT Outcome Study

• Linda Daniels, PSY.D.(J. of Psychotherapy Practice & Research 1998; 7:167-176)

• IBT TreatmentVs

• Waiting List(20 subjects each)

• 16 sessions(50 minutes each)

Global Assessment of Functioning

TREATMENT

Mean SD43.88 (pre) 10.950.83 (post) 11.6

WAIT LIST

Mean SD43.94 (pre) 8.5845.13 (post) 9.36

PositivityWithin a given period of time, a ratio at or above three times the positive

affect to negative affect corresponds with flourishing, and ratios below that

correspond with languishing.

• Barbara Fredrickson and the Positivity Ratio

• Negative thoughts are three time stronger than positive thoughts

• The “Tipping Point” for thinking positively occurs when we reach a critical mass of 3 to 1 ratio of positive to negative thoughts.

• PositivityRatio.com

10 forms of Positivity

Joy

Gratitude

Serenity

Interest

Hope

Pride

Amusement

Inspiration

Awe

Love

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Positivity Ratio

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What does your tongue have to do

with your brain and positive

psychology?

If the tongue is a tool of survival…

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Positive Psychology is the study of:

• Positive emotions

• Positive character traits

• Positive institutions.

The positive emotions consist of emotions about:

• The past (e.g., serenity, satisfaction, pride)

• The present (pleasure and gratification)

• The future (e.g., hope, optimism, faith)

.

Corey Keyes (Keyes, 2003, 2005)

A model of mental health which is a continuum running from complete mental illness to

complete mental health.

Illness----------------------------------------zero----------------------------flourishing

Life above zero Roughly

17% of 3032 adults

Languishing Keyes describes languishing as a state of incomplete

mental health, because while there are few signs of illness, there are

also few signs of health. People in this part of the range may lead lives

of “quiet desperation and distress.”

Moderate mental health: 60% of a sample

of 3032 adults age 24-74

What you See in Others,You Strengthen in Yourself

A Course in Miracles

Positive Psychology is about a shift in

perception

Reframe and refocus

..and reframing what we think of as

happiness

Happiness is often an illusion. We

pursue something that we think will make us

happy only to find out it isn’t so…

What do you see?

This glass is completely full

Half with water ---

Half with air

Dan Tomasulo, PhD, MFA, MAPP

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It all started with...

• Flow

Mihaly Csikszentmihaly

• In 1976 a book was written that arguably created the field of positive psychology’s first book ~

• Flow: The Psychology of Optimal

Experience

• The event is freely chosen.

• The goal is clear.• Feedback on our performance is

immediate and concrete.• The challenge of the task is high, but• We have the skill and competency to meet

the challenge

What makes us flow?✤Csikszentmihaly said thatflow is...

• “being completely involved in an activity for its own sake. The ego falls away. Time flies. Every action, movement, and thought follows inevitably from the previous one, like playing jazz. Your whole being is involved, and you’re using your skills to the utmost.”

How are Flow and Moreno’s

psychodramatic theory alike?

In Psychodrama anxiety and

spontanaeity are inversely related.

In Flow there is inverse relationship to both anxiety

and boredom

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Signature Strengths & Flow

Using your signature strengths increase positive

experiences and

Those who use their top strengths regularly

report being in flow more often.

Flow.

Signature StrengthsThe positive alternative to the DSM

6 Virtues (24 Character strengths)

•Wisdom and Knowledge•Courage•Justice•Humanity•Temperance•Transcendence

Flourishing & Well-Being What does it mean to flourish?

PERMA• Positive Experiences• Engagement• Relationship• Meaning

• Achievement20 tests on AuthenticHappiness.com related to

PERMA

Positive Experiences(Pleasure)

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Engagement Relationship

MeaningBeing part of something more or larger than yourself

Meaning

Achievement

May 6,th 1954, Roger Bannister

breaks the 4 minute mile.

Two months later John Landy and

Roger Bannister both break the 4

minute mile in the same race.

Landy lost the race by glancing

over his shoulder.

Since then over 1000 men have

done it– some over a hundred

times.

Grit

Angela Duckworth-UPenn

Perseverance and Passion~ Grit

and self discipline are 2 X better

prediction than IQ for

achievement.

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Sonya Lyubomirsky from The How of Happiness40% of our happiness can come about from intentional

activities –Positive InterventionsPositive Psychology

• Choice• Change• Cultivate• Create

Resource Priming

& Resource Activation

• Focusing on ’strengths results in a higher degree of

resource-activating interventions.

• Higher resource-activating interventions leads to a

better outcomes--patients’ experience of mastery

• A higher degree of resource-activating interventions

leads to larger symptom reductions and augments

well-

Positive Psychotherapy PPT

• Wrong to Strong

• Strength-Based

• Application of Positive Interventions

• 6-12 weeks

• Individual and group

Positive Group Psychotherapy

6 weeks 2 hours a session

• Week one -VIA-IS survey and use their top five

strengths more often in their day-to-day lives.

• Week two involved writing down three good

things that have happened during the day and

why you think they occurred.

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Positive Group Psychotherapy, Cont.

• Week 3: Biography written about how they

want to be remembered

• Week 4: Deliver a letter of gratitude to

someone they may not have thanked

adequately in their lives either in person or by

phone.

Positive Group Psychotherapy, Cont.

• Week 5: Asked to respond very positively and

enthusiastically each day to good news

received by someone else (ACR).

• Final Week: Savoring daily events and

journaling how this experience differed from

our normally rushed occurrence..

Positive Group Psychotherapy, Cont.

• Time was also spent during this last session on

tailoring the exercises for their use following

the end of the study.

• A Total of 6 Weeks

• 12 Hours of therapy

Positive Group Psychotherapy

• Positive Group Psychotherapy

The gains made by the PPT groups

were maintained with no other intervention by

the researchers throughout a one-year follow-

up, while the baseline levels of depression for

the non-treatment group remained unchanged.

• Duckworth, A. L., Steen, T. A., & Seligman, M. E. P. (2005). Positive psychology in clinical practice. Annual Review of Clinical Psychology, 1, 629–651

• Peterson, C., & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook of classification. New York: Oxford University Press.

• Rashid, T., & Ostermann, R. F. (2009). Strength-based assessment in clinical practice.Journal of Clinical Psychology, 65, 488–498.

• Seligman MEP, Rashid T, Parks AC (2006). Positive psychotherapy. American Psychologist.2006;61:774–788.

ReferencesIn a test of positive psychotherapy with severe depression, the patients were randomly assigned to either individual positive psychotherapy following the table above or to treatment as usual. A matched but nonrandomized group of equally depressed patients underwent treatment as usual plus antidepressant medication. Positive psychotherapy relieved depressive symptoms on all outcome measures better than treatment as usual and better than drugs. We found that 55 percent of patients in positive psychotherapy, 20 percent in treatment as usual, and only 8 percent in treatment as usual plus drugs achieved remission

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Positive Psychotherapy: A Treatment Manual (Rashid and Seligman, in press):

• Session 1:

• The absence or lack of positive resources (positive emotions, character strengths, and meaning) can cause and maintain depression and how these can create an empty life.

• Homework: The client writes a one-page (roughly three hundred words) “positive introduction,” in which she tells a concrete story showing her at her best and illustrating how she used her highest character strengths.

• Session 2:

• The client identifies his character strengths from the positive introduction and discusses situations in which these character strengths have helped him previously.

• Homework: the client completes the VIA questionnaire online to identify his character strengths.

• Session 3:

• We focus on specific situations in which character strengths may facilitate cultivation of pleasure, engagement, and meaning.

• Homework (starting now and continuing through the entire course of therapy): The client starts a “blessings journal,” in which she writes, every night, three good things (big or small) that happened that day.

• Session 4:

• We discuss the roles of good and bad memories in maintaining depression. Holding onto anger and bitterness maintains depression and undermines well-being.

• Homework: The client writes about feelings of anger and bitterness and how they feed his depression.

• Session 5:

• We introduce forgiveness as a powerful tool that can transform feelings of anger and bitterness into neutrality, or even, for some, into positive emotions.

• Homework: the client writes a forgiveness letter describing a transgression and related emotions and pledges to forgive the transgressor (only if appropriate) but does not deliver the letter.

• Session 6:

• Gratitude is discussed as enduring thankfulness.

• Homework: The client writes a gratitude letter to someone she never properly thanked and is urged to deliver it in person.

• Session 7:

• We review the importance of cultivating positive emotions through writing in the blessings journal and the use of character strengths.

• Session 8:

• We discuss the fact that “satisficers” (“This is good enough”) have better well-being than “maximizers” (“I must find the perfect wife, dishwasher, or vacation spot.”) Satisficing is encouraged over maximizing.

• Homework: The client reviews ways to increase satisficing and devises a personal satisficing plan.

• Session 9:

• We discuss optimism and hope, using explanatory style: the optimistic style is to see bad events as temporary, changeable, and local.

• Homework: The client thinks of three doors that closed on her. What doors opened?

• Session 10:

• The client is invited to recognize character strengths of significant other(s).

• Homework: We coach the client to respond actively and constructively to positive events reported by others, and the client arranges a date that celebrates his character strengths and those of his significant other.

• Session 11:

• We discuss how to recognize the character strengths of family members and where the client’s own character strengths originated.

• Homework: The client asks family members to take the VIA questionnaire online and then draws a tree that includes the character strengths of all members of the family.

• Session 12:

• Savoring is introduced as a technique to increase the intensity and duration of positive emotion.

• Homework: The client plans pleasurable activities and carries them out as planned. The client is provided with a list of specific savoring techniques.

• Session 13:

• The client has the power to give one of the greatest gifts of all—the gift of time.

• Homework: The client is to give the gift of time by doing something that requires a fair amount of time and calls on her character strengths.

• Session 14:

• We discuss that the full life integrates pleasure, engagement, and meaning.

•

ResilienceWhat Is Resilience?

Ann Masten (2001) “a class of phenomenon characterized by good outcomes

despite serious threats to adaptation or development.”

Ryff & Singer (2003) “…maintenance, recovery, or improvement in mental or

physical health following challenge.”

Bonanno (2004) “…the ability of adults in otherwise normal circumstances who

are exposed to an isolated and potentially disruptive event, such as death of a

close relation or violent life-threatening situation, to maintain relatively stable,

healthy levels of psychological and physical functioning.”

Resilient responses to challenge are quite

common across the lifespan. Ann Masten calls

resilience “Ordinary Magic.”

Albert Ellis A-B-C

Activation Belief Consequesnce

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Albert Ellis and Thinking Traps

• A = Activating event;

• B = Beliefs about the causes of the event;

• C = Consequences of these beliefs.

Beliefs in this paradigm tend to have patterns

that become “thinking traps .”

Relationship

THE RESEARCH OF BARBARA

FREDRICKSON

The mutual caring that underlies love

is identified as “positivity resonance”,

It involves micro-moments of shared

positive emotion.

It is the confluence of biochemistry

and behavior, particularly initiated

through the eyes that gives us these

micro-moments.

POSITIVITY RESONANCE

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A bold and radical approach

Proposes a general theory of love rather

than how love might be specifically

experienced within a domain.

Love, as defined by these moments of

positivity resonance, is the same whether

they occur between parent and child,

friends, lovers, or total strangers.

In her words,these are “virtually identical.”

The idea of attunement and being in

sync is central to the understanding of

positivity resonance

Fredrickson makes her case from three

primary perspectives:

• oxytocin activation

• vagal tone

• mirror neurons, or “brain coupling.”

Vagal Tone

Micro Moments

Brain Coupling

What Do We Know About Oxytocin?

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Affirmation Stage

• Validate Each Member’’’’s Participation

• Therapeutic Factors / Signature Strengths Affirmed

• Teach Members to Affirm Each Other

IBT Micro-Moments and PERMA

Priming prior to group

Orientation

Eye contact non-verbal

readiness

Warm-up and Sharing

Engagement

Relationship

Enactment

Positivity resonance

thru micro-moments

Affirmation

Signature strengths

validated, PERMA

reviewed,

Therapeutic Factors

acknowledged

Active and Constructive Responding

• Shelly Gable, assistant Professor of Psychology at the University of California, has examined the different types of responses we give to other people's good news.

The quadrants utilize four possible ways to respond to someone’s good news about

promotion and a pay-rise

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Positive Psychology

• We have a choice about what we feel.• We can change how we feel• We can cultivate a sustainable feeling• We can create and inspire this awareness

in others

May I be filled with loving kindness.

Mai be safe from inner and outer dangers.

May I be well in body and mind.

May I be at ease and happy.

I am larger and better than I thought. I did not

know I held so much goodness. ~Walt Whitman

81

Date

““I was born on September 26, 1909, the eldest I was born on September 26, 1909, the eldest

of seven children, five girls and two boys... My of seven children, five girls and two boys... My

candidate year was spent in the mothercandidate year was spent in the mother--house, house,

teaching chemistry and second year Latin at teaching chemistry and second year Latin at

Notre Dame Institute. With GodNotre Dame Institute. With God’’s grace, I s grace, I

intend to do my best for our Order, for the intend to do my best for our Order, for the

spread of religion and for my personal spread of religion and for my personal

sanctification.sanctification.”” Marguerite DonnellyMarguerite Donnelly

•• ““God started my life off well by bestowing God started my life off well by bestowing

upon me grace of inestimable value... The upon me grace of inestimable value... The

past year which I spent as a candidate past year which I spent as a candidate

studying at Notre Dame has been a very studying at Notre Dame has been a very

happy one. Now I look forward with eager happy one. Now I look forward with eager

joy to receiving the Holy Habit of Our Lady joy to receiving the Holy Habit of Our Lady

and to a life of union with Love Divine.and to a life of union with Love Divine.””

Celia OCelia O’’PaynePayne

Deborah D. Danner,Ph.DUniversity of Kentucky

t

Date

There is a link between positive emotions and longevity.

The Nun Study (Danner, Snowden, Freisen (2001)

Only positive feelings predicted longevity:• Age 85: 90% of most cheerful quartile alive; • 34% of least cheerful quartile alive.• Age 94: 54% of most cheerful quartile alive; • 11% of least cheerful quartile alive

HEAVEN HELP USTHE NUN STUDY AFTER DEATH

We’ve received over 500 brains. ~ Dr. Karen Santa Cruz, neuropathologist

• OF THE MORE THAN 500 BRAINS THERE IS A UNIQUE 15 THAT HAVE DEMENTIA AND ARE CLEARLY DISEASED

• BUT THESE BRAINS ARE FROM THE NUNS THAT WERE RANKED POSITIVE

• THEY DID NOT DISPLAY ANY OF THE CHARACTERISTICS OF THEIR DISEASES WHILE THEY WERE ALIVE. !

“I donated my brain, so when the time comes, they can make a study of it. The fact that I have not had any of this Alzheimer’s disease , or even an inclination so far is something they would naturally want to study.”~Sister M. Celine Koktan was 97 in March 2009

“There is no way to happiness,

happiness is the way.”Thich Nhat Hanh

The Miracle of Mindfulness

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The Benefits of MeditationSince 1979 the University

of Massachusetts

Medical School’s Center

for Mindfulness Based

Stress Reduction

Program has followed 15

000 participants. Those

taking part in the

program have shown a

35% reduction in the

number of medical

symptoms and a 40%

reduction of

psychological symptoms

Seven Habits of Happiness Hygiene

1. Learn and use your signature strengths in new ways.

2. Develop a meditation practice.

3. Daily Gratitude List: Note your gratitudes each day for the previous 24 hours

4. Generate three blessings: Three outstanding memories in your life. (You can always add to this list, but start with three.) Use these to break the downward spiral of negative thoughts. Keep your “pattern” in mind.

5. Count the number of times you are kind in a day.

6. Exercise regularly

7. Start a Positive Portfolio.Create a file of all your positive memories. This can be a physical file, a series of photographs, images you can have on your phone, or a combination of these.

Positive Practices

• Identify all the things your will use and

remember from this workshop.

• Write out a plan that you will commit to for

the next 30 days.

• Share this plan with someone today and make

a time to follow up.

• We have a choice about what we feel~• We can change how we think and feel~• We can cultivate sustainable positive

feelings~• We can create and inspire this in others~

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The Power of Positive Being