The research is pouring in from all over the globe indicating that sustainable ways to shift our thinking and perception toward a more optimistic perspective of life has amazing health and well-being benefits — not the least of which include a longer, healthier, and more productive life.

Here are six questions about some of the findings that may intrigue you and test your knowledge. The good news?  You can’t fail a positive psychology quiz!  Use this as a guide to learn more about the developing field. Or, if you got them all right, you know how good it is to be kind — so get out there and help someone!

1.  True or false?  Negative thoughts are more powerful than positive thoughts.

A: True

Barbara Fredrickson’s (2009) work on positivity created a way of measuring internal dynamics by using a Losada ratio, a measure of positive to negative thoughts. She found a ratio of 3 to 1 seems to be a tipping point of sorts for positivity.   In other words, we need three positive thoughts to counteract the effect of one negative thought.

This is the equivalent of the discovery that we have good and bad cholesterol, HDL and LDL, and that the ratio between the two determines cardiovascular health.  We need more positive than negative thoughts in the same way we need more HDL, the good cholesterol, than LDL.  You can assess your current ratio at her website.

 “You have to make the mind run the body.”
~General George S. Patton Jr.

A recently published article in the Journal of Clinical Psychology by Kearney, McDermott, Malte, Martinez, and Simpson (2012) may have broad implications for veterans suffering with symptoms of Post-traumatic Stress Disorder (PTSD). 

These researchers demonstrated that engagement in mindfulness-based stress reduction (MBSR) showed significant improvements after six months in reducing soldiers’ symptoms of PTSD, depression, behavioral activation (the ability to engage in activities to achieve a goal in spite of aversive symptoms), and self-acceptance. 

Forty-seven percent of the veterans in the study showed clinically significant improvements in their PTSD symptoms. This highlights the fact that sustainable symptom reduction may be possible by employing a mindfulness technique. MBSR and other mindfulness-based meditation practices may provide broad-based ancillary interventions in the treatment of PTSD that can complement the current psychotherapeutic and pharmacological practices.

PTSD is a particularly nasty collection of symptoms.  Some of the more difficult indications include hyperarousal, rumination about the event, depression and anxiety. In addition to the study noted above, other researchers (Vujanovic, Niles, Pietrefesa, Schmertz, & Potter, 2011) have also found a link between mindfulness meditation and reduced PTSD symptoms in veterans.  In both studies it appears that accepting one’s emotional pain appears to actually help alleviate that pain.

This is good news for the toolbox needed to treat PTSD — because there is also evidence that being unable to accept and adequately regulate trauma-activated emotional responses may cause poor interpersonal relationships (Roth, Newman, Pelcovitz, ver der Kolk, & Mandel, 1997). In turn, poor relationships may make using the more traditional exposure-based treatments (such as desensitization) a risk for exacerbating symptoms (Cloitre, Koenen, Cohen, & Han, 2002).  What is valuable about mindfulness techniques is that they can be practiced independently after training.

Mindfulness meditation has largely been derived from Buddhist practices known as the eight-fold path.  Of the eight, mindfulness is specifically devoted to enhancing the ability to focus our attention. Developed to cope with human suffering, it involves a cultivation of private experiences with the aim of nurturing calmness.  The primary goal is to help achieve self-acceptance.  According to Pema Chodron (2001), an American Tibetan Buddhist nun (or Ani), there are four components of this self-acceptance: commitment; awareness; willingness to experience emotional distress; and attention to the present moment.

Over the years, a number of researchers have shown that meditation practices — including cultivating self–acceptance and the tolerance for emotionally distressing experiences — both reduce stress and increase well-being (Kabat-Zinn, 1990, 1994; Simpson, et al., 2007; Thompson, & Waltz, 2008; Smith, et al., 2011).  But the question has always been if these changes are sustainable.  At least one study has indicated that they are.

Researchers Michael A. Cohna and Barbara L. Fredrickson (2010) demonstrated that, after an initial meditation practice was introduced, subjects sustained positive experiences for fifteen months. Although veterans were not part of the investigation, this was one of the first studies to show a link between meditation and sustainable positive experiences.

Acceptance-based therapies such as mindfulness provide an alternative to traditional Western approaches for dealing with pain (Folette, Palm and Pearson, 2006).  As Ekman, Davidson, Ricard and Wallace (2005) have pointed out, mindfulness is used to tolerate emotional distress rather than to try to control or overcome negative feelings. In other words, trying to control or avoid negative emotions may not be the most effective way to manage them.

It also appears that mindfulness may facilitate resilience.  In another study, Jha, Stanley, Kiyonaga, Wong and Gelfand (2010) found that providing military personnel mindfulness training (MT) might help to guard against functional impairments in stressful contexts.

The more mindfulness meditation is researched, the more it appears to be able both to prevent and correct trauma, particularly for military veterans.

In the past few years the Army has invested in training soldiers to be psychologically as well as physically fit. The Master Resilience Training (MAT) program (Reivich, Seligman, & McBride, 2011) has a series of modules designed to help soldiers maximize their potential and cope with combat stressors.  Meditation is specifically identified as a technique to be taught as part of the larger resilience effort and part of Comprehensive Soldier Fitness program.

Self-acceptance through mindfulness meditation is an ancient tool that is needed now more than ever, but it is no easy task. In the words of Pema Chodron: “The most fundamental aggression to ourselves, the most fundamental harm we can do to ourselves, is to remain ignorant by not having the courage and the respect to look at ourselves honestly and gently.”

References
Chodron, P. (2001). The places that scare you: A guide to fearlessness in difficult times. Boston: Shambhala.

Ekman, P, Davidson, R. J., Ricard, M., & Wallace, B. A. (2005). Buddhist and psychological perspectives on emotional well-being. Current Directions in Psychological Science, 14(2), 59–63.

Follette, V., Palm, K. M., & Pearson, A. N. (2006). Mindfulness and trauma: Implications for treatment. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 24(1), 45-61.

Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life (1st ed.). New York: Hyperion.

Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Dell Publishing.

Kearney, D. J., McDermott, K., Malte, C., Martinez, M., & Simpson, T. L. (2012). Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample.Journal of Clinical Psychology,

Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, D. (1997). Complex PTSD in victims exposed to physical and sexual abuse: Results from the DSM-IV field trial for posttraumatic stress disorder. Journal of Traumatic Stress, 10(4), 539–555.

Simpson, T., Kaysen, D., Bowen, S., MacPherson, L., Chawla, N., Blume, A., . . . Larimer, M. (2007). PTSD symptoms, substance use, and vipassana meditation among incarcerated individuals. Journal of Traumatic Stress, 20(3), 239-249.

Smith, B. W., Ortiz, J. A., Steffen, L. E., Tooley, E. M., Wiggins, K. T., Yeater, E. A., . . . Bernard, M. L. (2011). Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters.Journal of Consulting and Clinical Psychology, 79(5), 613.

Thompson, B. L., & Waltz, J. (2008). Self‐compassion and PTSD symptom severity.Journal of Traumatic Stress, 21(6), 556-558.

Vujanovic, A. A., Niles, B., Pietrefesa, A., Schmertz, S. K., & Potter, C. M. (2011). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Professional Psychology: Research and Practice, 42(1), 24.

And it is free.

Like anything worthwhile, there is a learning curve that needs to be dealt with, but it is worth the time and trouble to learn it.  Since December, every presentation I have done has been Prezi-based, and literally every person I have shared it with was eager to learn how to do his or her own.

It was developed by Adam Somlai-Fischer, a Hungarian architect, as a tool to help with visualization.  But instead he has developed one of the more interesting storytelling devices yet created.  It follows the speaker with a visual narrative of the material.  True to the developer’s mission to “make sharing ideas more interesting,” this presentation tool does just that.  What it does is give the user complete freedom to exploit the visual experience by using a zoom feature. The techies among you will recognize this as a Zooming User Interface, cloud-based SaaS, (Software as a Service) presentation delivery model.

With Prezi you don’t have to think outside the box — because there is no box.  Imagine a huge screen — no, bigger — the size of a movie screen in a theater.  Then imagine you could design any kind of saying, photo, image, anything you’d like.  You could start anywhere on the screen and put photos, videos, words in colors and different sizes — anything you want to show in any angle or size.  Then imagine there is a flying camera that will zoom in on your images and scoot across the screen making each image right-side up for the audience.  If you can imagine that you have a taste of what it is like to watch a Prezi.

One of the more fun features I’ve found is to write something very, very tiny on a photo I am showing — then ZOOM into it.  The words, the statistics, the data comes alive because the material is visually interesting.  Even with a lengthy presentation the surprise factor is there to engage the learner. I am certain someone will be doing studies showing the retention with Prezi-style presentations is higher:  The level of engagement and attention certainly warrant it.

You can upgrade your PowerPoint or Keynotes by putting them into Prezi and making your changes there.  Again, be prepared for a bit of a learning curve, but the online tutorials are excellent, and more and more users are finding their way to Prezi.  Take a peek at some of the samples linked at the end of the article, and look at the companies who are using it.  It is the next generation of presentation.

The other interesting feature is the use of frames to group material so you can alternate between a structured presentation with a linear format and one that accesses frames of images collected around a central topic.  This means that you can use a “path” to move in a linear fashion from one topic to the next, like the way a PowerPoint is organized, but you can also select out the material and group it within a frame so when the question and answer time comes your material is all instantly visually available to you.  You can then fly — well, actually, zoom — to the cluster of images you want to refer to.  There is also the capability to leave all of your images on this huge screen freeform and not linked by a path.  This gives you the freedom to move from topic to topic as needed.

The free version allows you to create and download your Prezis on your computer or iPad.  There is a size limit, but it is very generous.  There are two other levels, an EDU and a PRO, for which there are modest annual fees.   But if you have an .edu email account as either a student or teacher the Edu / Enjoy level is available to you with no charge. This level gives you more storage capability. The Pro level lets you develop a Prezi without being online. There is also a Prezi meeting feature, which allows people to create a Prezi from different locations all at one time.

But the main attraction here isn’t even the glitz or technology or the entrepreneurship.  It is the statement of values upon which the company is built.  A while back I wrote an article about generosity as a business model. This was before I knew about Prezi.  They have a page devoted to their values.  It clearly provides their moral rudder as well as explaining the ethical and constructivist nature of their endeavor.  It is worth reading if for no other reason than to learn a bit about the company’s character.

I chose to write about Prezi because it had four elements that were very positive.  First, it was fun to learn, use and get others excited about.  Second, it had a strong positive value and mission statement, something I think businesses are moving toward.  Then it directly linked the visual arts with science, education and business — not-too-shabby enterprise — and finally, it directly invites creativity into presentations. That’s something that anyone who has been tortured by a dull PowerPoint can appreciate.

So what are you waiting for?  Zoom over and see their examples!

Shawn Achor spent over a decade living, researching, and lecturing at Harvard University, and has been involved in one of the largest studies of happiness and potential at Harvard and others at companies like UBS and KPMG.  He brings a truly unique perspective of applying positive psychology to the business world.

In 1998 Martin Seligman, then president of the American Psychological Association, set a new direction for the discipline:  Positive psychology. What has followed is an unprecedented publication of robust research and applied interventions.  In 2000, Seligman and Mihaly Csikszentmihalyi, author of Flow:  The Psychology of Optimal Experience, published an article in the American Psychologist that anchored positive psychology as an evidence–based practice.

Since then the positive psychology movement has boomed.  Founded with the intention of building thriving individuals, families, and communities, proponents of the discipline can be found in popular and academic publications, working with an array of corporate entities, and teaching on college campuses throughout the world. There are even graduate degrees in positive psychology.

In 2005, under Seligman’s guidance, the University of Pennsylvania offered the first applied positive psychology master’s program. It continues to thrive today. Undergraduate courses are showing up in the curriculum of colleges around the world. Dozens of universities now offer masters degrees in positive psychology.  Csikszentmihalyi has even created a Ph.D program at his Claremont, Calif. campus.

Shawn Achor is rapidly becoming a leader in each of these areas.  In 2006, he was Head Teaching Fellow for Dr. Tal Ben-Shahar’s “Positive Psychology,” the most popular course at Harvard University at the time.

The following year, Achor founded Good Think Inc. to share his research with a wider population.  He has since gone on to speak in over 45 countries, and found tremendous success with his book The Happiness Advantage.

Achor offers a dynamic, research-based shift for businesses wishing to apply positive psychology.  He has taken time out of his busy schedule to do an enlightening interview for Psych Central about the background and direction of his work.

PC: In “The Happiness Advantage” you seem to employ a careful balance of science and storytelling.  How did this develop?

SA: I was a debater in high school, which means two things: I didn’t date much, and I write like I’m making a case.  But watching my academic heroes, I realized that they were terrible communicators.  Fantastic ideas presented in a non-engaging way means that the passion for the subject and its import are not translated to the listener.

Even more importantly, stories help you remember and implement the information. My favorite professor at Harvard, Brian Little (who wasn’t even tenured), used to fill his lectures with engaging stories. I actually thought it was a waste because I’d have to listen to like 3 to 5 minutes of a story before finding a single nugget to write down in my notes to prepare for the exam. But I not only remember almost all those stories, I remember all the nuggets, whereas intro psych courses are often a waste because they are an information dump, which leads to your brain quickly dumping that information from working memory.

So after crafting the scientific case for why happiness fuels performance and not the other way around, I then went back through and actually highlighted in blue jokes, interesting facts, or stories in my manuscript. If I had a block of black on a page with no blue, I went back in and added more blue-worthy sections.

PC: What are the main effects of the happiness advantage?

SA: The biggest effect is the belief that your behavior matters.  If you start a positive habit and see that it has a positive effect upon your business or health outcomes, your brain is more willing to utilize resources to continue that behavior and scan for new ones.  The resulting effect is a cascade of success as greater meaning and well-being fuel more successes than garnered by defensive pessimism or cynicism.

In HBR Magazine this January, I talk about an assessment I’m working on testing not whether you receive social support, but if you give it.  Individuals in the top quartile on this assessment were 40 percent more likely to have received a promotion in the past year and were 10 times more engaged at work than those in the lowest quartile. Companies who are interested in engagement, which was the flavor of the year for 2011, should start understanding more about what causes engagement than merely evaluating it.  Yet many companies think, “we can talk about happiness once the economy recovers,” but if positive mindset leads to greater success rates as Lyubomirsky’s meta-analysis suggests, then it’s too late.

Each year is a transition.  We let go of relationships, connections to places, jobs and ways of being.  But this opens us to new people, new associations and different ways of relating.  Through death or circumstance or choice we move away from those we loved, or cared for, or knew: The unknown, the surprise, the unexpected takes their place.  This is life.

Too often the losses weigh us down with a centrifugal sadness that keeps us pinned to the passing.  Our energy is invested in the mourning, often for longer than what may be healthy or helpful.

But the loss we experience is directly proportional to the joy and love and engagement we’ve had.  We feel the pain because we knew the joy.  So the grieving must honor the connection as well.

The research on gratitude keeps demonstrating how powerful a positive intervention of having gratitude in our lives can be.  To acknowledge someone for being in your life is one of the most dynamic ways to increase your well-being and the well-being of others.  This exercise works best if you write it down, and even better if you can deliver a letter of gratitude to the person involved.  Here’s how it works.

Think of a person who has been a positive person in your life, but with whom you are no longer involved.  Write out a letter of gratitude for the positive features of your relationship.

If it is possible and appropriate, meaning that it would not cause harm, embarrassment or upset to the other person, find them.  Track them down and read them the letter.  This is the famous gratitude visit exercise researched by Martin Seligman, the positive psychology researcher.

If they are unavailable or have died, read the letter out loud to an empty chair.  Let them know how much you appreciate who they are (were) and the joy and gratitude you have for them being (or have been) in your life. 

Now for the interesting part: Reverse roles. Sit in the empty chair and become them for the role play. As them, respond to the letter that was just read to you.

Finally, come back into your own chair and say the final things you wish to say.  Notice how you feel.  Yes, they may no longer be in your life, but honoring the joys they brought you can help them if they are available, and you feel better if it is done through an empty chair.  I call this second method the Virtual Gratitude Visit (VGV).

There may be others you would like to share your gratitude with.  New research has show that gratitude toward God is perhaps one of the most powerful ways to evoke feelings of well-being.  With a VGV you may want to express your gratitude toward God.  Yes, it is okay to reverse roles and become him, but don’t forget to come back to your own chair.  Otherwise you are going to find a lot of prayer requests in your email inbox.

Last but not least, as we transition into the New Year, perform a VGV toward the people we haven’t met.  When I think back to last January and the people I said goodbye to over the year, literally several dozen new people came into my life who have filled me with unexpected joy and hope and wonderment.  Gratitude can be used to open us up to the future.  Try a VGV with a person you haven’t met yet but know you are scheduled to meet, or to the unknown, unexpected encounters you are bound to have. You may even want to express your gratitude toward a future self, the person you are becoming over the next year.

Finally, when the dust from the VGVs settles down, take a moment and review the year. Notice your breath.  Just like people and events in our life, our breath is drawn in and released.  We don’t hold on or just breathe out: we take in and let go.  What we are left with is the stuff of life.

We began with the words of the brilliant Brazilian lyricist and novelist, Paulo Coelho.  I don’t think anyone could say it more clearly than him, so it seems fitting to end with his thoughts as well. “When someone leaves, it’s because someone else is about to arrive.” 

References

Rosmarin, D.H., Pirutinsky, S., Cohen. A., Galler, Y., & Krumrei, E.J. (2011). Grateful to God or just plain grateful? A study of religious and non-religious gratitude. Journal of Positive Psychology, 6(5), 389-396.

Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validation of interventions. American Psychologist, 60(5), 410.

Tomasulo, D. (2011). Can God and Gratitude Help Your Mental Health?. Psych Central. Retrieved on December 27, 2011, from http://psychcentral.com/blog/archives /2011/12/11/can-god-and-gratitude-help-your-mental-health/

But he loves you. And he needs money!
~ George Carlin, from “You Are All Diseased”

Every morning I wake up and push back the anxieties and frustrations and the never-ending things-to-do list.  I awakened to the struggle of coping with these pressures for years until I found a positive psychology intervention that was, beyond a shadow of doubt, the most powerful tool in changing my thought process:  Gratitude. 

I began the day with flooding my mind with the gratitude I had for events, people, experiences and conditions in my life.  I’ve written elsewhere about how this struggle evolved.  But I never gave where I was sending my gratitude toward any thought.  I just sent it out into the ether.  Just doing this every morning changed my attitude about life and allowed me to look forward to the day (for the most part) with less angst and more hope.  Not a bad deal.  Two minutes in the morning and the day brightened up.

There was good reason for me to begin doing my morning gratitude list. 

The research has been stellar with regard to gratitude’s influence on things such as happiness, vitality, positive feelings, self-esteem, better interpersonal relationships, promoting generosity, less stress, greater life satisfaction and higher reports of general well-being. It also appears to help guard against PTSD, depression and sleep dysfunction.

So along the way I have recommended this to my clients, students, friends and colleagues.  This seemed like the easiest thing in the world and it was free.  Gratitude for what has happened in my life over the past 24 hours, as well as more global gratitude, had very strong, positive, sustainable effects.

But in spite of all that research, and the obvious benefit it has had for others as well as myself, I have changed my morning mental hygiene ritual.  Why?  Because (with apologies to George Carlin) the research is pointing toward the invisible man.

I now think it makes a difference if you send your gratitude toward God, or if you simply send it out to the universe hoping it doesn’t get hijacked by a sunspot or asteroid.

In a fascinating new study in the Journal of Positive Psychology (Rosmarin, Purutinsky, Cohen, Galler, and Krumrei, 2011) researchers from Harvard, Columbia, Arizona State, Rutgers and Pepperdine have collaborated to apply an evidence-based approach to religious vs. non-religious gratitude.   They asked whether gratitude to God is better for well-being than generalized gratitude.  The study looked at the relationship between dimensions of gratitude and measures of religious commitment and mental and physical well-being.

The authors, like other researchers, found that gratitude was significantly correlated  with religious commitment.  No surprise here.  But these researchers found that the relationship between these two variables was fully mediated specifically by having gratitude directed toward God.  In other words, gratitude is more potent when you have both religious commitment and gratitude is directed specifically toward God.

Through an online survey, the researchers looked at 405 adults of varying religious backgrounds and used gratitude questionnaires that measured both religious and non-religious expressions of gratitude.  These results were then compared to measures of religious commitment.  (Religious commitment was determined by a person’s degree of belief in god, importance of religion, and religious identity.)  Happiness, satisfaction with life, positive and negative affect and physical and mental health were measured using well-known scales or adaptations of them. 

What the research found was that general gratitude was predicted for all the outcome variables.  This means that gratitude in general, as other studies have shown, works very well. 

What was most interesting to me, however, is the degree to which a person is religiously committed was found to actually enhance gratitude’s effect.  As the authors put it, “we propose that religion facilitates gratitude through a religious lens” (p. 393).

The research is provocative and brings forth some new questions.  Does a strong belief in God alone and having gratitude to him affect our happiness, satisfaction with life, positive and negative affect and physical and mental health? I wonder because I would score very high on the strong belief dimension and lower on the other two.  Future research will have to figure this one out.

But until then I have a new morning plan.  I get up with the Boogiemen in my head, take my strong belief, and address my morning gratitude directly to the invisible guy in the sky.

This got me wondering if a 12-step process might be worth identifying. So guess what…? I think it is.

Here is what I propose for the 12 steps of positive psychology.

The 12 Steps of Positive Psychology

1.  We admitted we have more power than we realized over negative thoughts and that our lives can become more manageable if we deal with them directly.

2. Came to believe that a power greater than our current self, positivity, could be accessed and nurtured.

3. Made a decision to help God as we understand him to bring forth a feeling of well-being.

4. Made a searching and fearless inventory of  our virtues and strengths.

5. Admitted to God, to ourselves, and to another human being the exact nature of our goodness, kindness and courage.

6. Were entirely ready to have God remove all these defects of character so that we can replace them with our signature strengths. 

7. Humbly asked Him to remove our shortcomings — but not until we have learned to understand how these shortcomings might be opportunities to grow.

8. Made a list of all persons who have helped us and became willing to express our gratitude to them all.

9. Made direct effort to thank such people wherever possible, except when we are prevented from doing so.  In this case we write a letter to them as if they were going to receive it and keep it as a reminder of the gratitude we have for them.

10. Continued to take personal inventory and look for opportunities to be kind and compassionate, and when finding them promptly take advantage of them.

11. Sought through prayer, meditation and a daily gratitude list, to improve our relationship with others and our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

12. Having had a spiritual and psychological awakening as the result of these Steps, we tried to carry this message to those not yet flourishing, and to practice these principles in all our affairs.

Of course there is always room for more.  Let me know if there are ones you would like to see added to this list.

Two things happen when you feel happier in your life.  First, you catch on to the fact you have a choice in how you see the world. Second, you let go of what doesn’t work.

At least this is what I have learned.  I am a happier person now than I was a couple of years ago because I have directly cultivated and experienced more positive emotion in my life.  This happened through many positive interventions, but chief among them are: having gratitude, asking what went right in my day (and why), and daily attempts to scatter kindness.

These are the main ones I’ve used, but they rest on hundreds of studies of other such positive interventions. This has left me feeling a deeper engagement with my daily activities, enhanced commitment to others, and a percolating fountain of creative pursuits  (The Happiness Café (The Happiness Café, n.d.) being the latest.) Interestingly, there are more new and dynamic relationships in my life, and a deeper, more profound respect for my friends and family.  I also have a clearer sense of purpose and meaning, which together seem to operate like the rudder of a boat and a gentle wind in the direction of my goals.

But these changes were deliberate, not random. How I orchestrate and navigate them in my life is an art, but their design and validation came from the science.

The major advances have recently come to be known as flourishing (Seligman, 2011). As I see it there are three broad advances in theory, measurement, and the practice of well-being.

The base of understanding that change is possible and progressive is through measurement. We need a comparison so we can measure how our thoughts have changed. Barbara Fredrickson’s (2009) work on positivity created a way of measuring internal dynamics.  Using a Losada ratio, a measure of positive to negative thoughts, she found a positive to negative thought ratio of 3 to 1 seems to be a tipping point of sorts for positivity.   By using a self-referenced point of comparison, the internal dynamics of positive and negative thinking can be measured against themselves. For more on this click here.

I believe this is the equivalent of the discovery that we have good and bad cholesterol, HDL and LDL, and that the ratio between the two determines cardiovascular health.  We need more positive than negative thoughts in the same way we need more HDL, the good cholesterol, than LDL.  She has given us a barometer for assessing our mental hygiene.

Frederickson’s work is not alone in the measurement and scaffolding of a model of well-being: Seligman and Peterson (2004) created an analysis of signature strengths, a compendium of 24 character strengths and six categories of virtues intended to highlight what is right with people.  This is a direct contrast to the standard psychological categorical bible Diagnostic and Statistical Manual of Mental Disorders: DSM –IV-TR, (American Psychiatric Association and American Psychiatric Association Task Force on DSM-IV, 2000) which classifies various conditions to help clinicians diagnose disorders. Seligman and Peterson believe strengths of character and virtues are present and need to be highlighted, rather than simply identifying what is wrong as the DSM does. To take the survey and learn more check here.

My report indicated that creativity, ingenuity, and originality are my top strengths and that I like to think of new ways to do things — I am not satisfied with convention. My ability to provide perspective makes people want to turn to me for advice. Humor and playfulness round out the top tier.  This list was not a surprise to me, but what captured my attention was how I used the listing of these and my other top ones as permission to let them shine.  They were the encapsulated version of who I am when I put my best foot forward. Knowing this allows me to employ them more liberally than I did before taking the survey. One of the outcomes of this was to write the Proof Positive blog (Tomasulo, D., n.d.) distilling information from the literature into the popular press.

The clarity of Sonja Lyubomirsky’s (2008) work highlights the fact that some 40 percent of our happiness can be improved upon.  This was a strong motivation for me to maximize that 40 percent.  She tailors the interventions by matching the best of interventions with our nature. Daniel Gilbert’s (2006) sobering contribution to flourishing allowed me to step back and consider the fact that I may not be the best judge of what will make me happy.  He puts forth a convincing argument that our current situation overinfluences our future determination of happiness.

But it has been the steady, persistent, challenging and immensely broad work emanating from Martin Seligman that has offered the most illuminating light in the woods (Seligman, 1992, 2002, 2011; Seligman and Csikszentmihalyi, 2001; Seligman, Ernst, Gillham, Reivich, and Linkins,  2009).  Such history has (recently) yielded a new chant for the converted: PERMA is  the acronym for well-being reflected in our positive emotions, engagement, relationships, meaning, and achievement.  I’ll be damned:  The very areas in my life I said changed me for the better in my opening paragraph.

In the same work Seligman (2011) is setting an ambitious goal for 51 percent of the world to be flourishing by the year 2051. I have used my journey as an illustration of one path.  But I am acutely aware of those in my sphere who are also flourishing. They display many of the thinking patterns, zest for life and capacity for resilience that I have known.  For the past two years I have begun every keynote, each clinical training, college course, psychodrama demonstration, and supervision with a quote from A Course in Miracles (The Foundation for Inner Peace, 2008).  “What we see in others we strengthen in ourselves.” This profound truth about the real nature of projection casts the responsibility of what we notice directly with us.

If 51 percent of the world can catch on to that, we can let go of what we don’t need, and most of us can be flourishing by 2051.  I will be 100 years old July 20th of that year.  Consider yourself invited to one helluva party.

References

American Psychiatric Association, & American Psychiatric Association. Task Force on DSM-IV. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Publishing, Inc.

Foundation for Inner Peace. (2008). Course in miracles 3rd Foundation for Inner Peace.

Fredrickson, B. (2009). Positivity: Groundbreaking research reveals how to embrace the hidden strength of positive emotions, overcome negativity, and thrive. Crown Archetype.

Gilbert, D. T. (2006). Stumbling on happiness. New York, Knopf.

Lyubomirsky, S. (2008). The how of happiness: A scientific approach to getting the life you want. New York: Penguin Press.

Peterson, C., & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook and classification. Washington, D.C.: American Psychological Association.

Seligman, M. E. P. (1992). Learned optimism. New York: Pocket Books.

Seligman, M. E. P. (2002). Authentic happiness: Using the new positive psychology to realize your potential for lasting fulfillment. New York: Free Press.

Seligman, M. E. P. (2011). Flourish: A visionary new understanding of happiness and well-being. New York: Free Press.

Seligman, M. E. P., & Csikszentmihalyi, M. (2001). “Positive psychology: An introduction”: Reply. American Psychologist, 56(1), 89-90.

Seligman, M., Ernst, R., Gillham, J., Reivich, K., & Linkins, M. (2009). Positive education: Positive psychology and classroom interventions. Oxford Review of Education, 35(3), 293-311.

The Happiness Café Retrieved from http://web.me.com/tomasulo1/The_Happiness_Cafe/Welcome.html

The architect of the curriculum is Martin Seligman, former president of the American Psychological Association and now considered the father of positive psychology.  It is a rigorous and ambitious year-long program of courses, readings, lectures, group activities and projects designed to bring participants up to speed in this new, but geometrically exploding field. The five-day course I attended was peppered with stellar professors at the very pinnacle of their careers. Martin Seligman, Angela Duckworth, Ray Baumeister, Barry Schwartz, and Barbara Fredrickson — all luminaries in the field — were among those making presentations.

But it was James O. Pawelski, Ph.D., director of education and Senior Scholar in the Positive Psychology Center who was able to lead us with a series of lectures on the foundations of positive psychology.  He initiated one of his lectures with a slide of a glass filled halfway and smiled at us.

“So, what do you see?” he asked.

The answers ranged from giggles to the obvious answer, considering we were devotees of the positive psychology approach, and we all naturally assumed this was the introduction to a presentation on perception.  It turned out it was, but not in the way any of us expected.

The naturally curious and well-read group began diving in philosophically, metaphysically and neurobiologically.  We spent a good 20 minutes or so offering thoughts about how we saw the glass, with James fielding responses and challenging the answers.  His engaging style had the ability to foster both support for an answer and a challenge to make us think.  Finally he turned around and faced the slide on the screen, and then turned back to us.

“When I look at this,” he said, “I see a completely full glass.”  Each of us took another gander at the slide.  I can tell you this glass was only half filled to my eyes, and yes, I was willing to put forth the argument that it was seen that way rather than half empty, but there was no way it was full.

People challenged him, some spoke of distortions, or the fact that, like when you fill a water reservoir for your coffee maker there is a line that tells you “fill to here” because that is the “full” mark.  But none of these defenses, descriptions or persuasions influenced James.  He held firm, turning back to the screen and then back to us.

“No,” he said smiling, “that glass is definitely completely full.”

We stopped putting forth our points of view and waited to hear his explanation.

“It is completely full,” he began as he looked at each of us around the room, “half with water, and half with air.”

This rocked the class, but it dumbfounded me.

I realized that this truth had completely escaped me.  I was so focused on the visual that I wasn’t able to look past it to the intangible.  I was trained to understand the question and thought there were only two answers to choose from.  The more I argued my perception, the further away I got from the truth and the greater understanding of the problem in front of me.

I now understood: The glass was indeed completely full.

This realization ushered in a more global discussion of what positive psychology is actually about.  With all the hype it is receiving lately and the fact that it is being embraced on a worldwide level it has also caused some opponents to misperceive it as Pollyanna-ish:  A type of misplaced enthusiasm that ignores the struggles of life. But this couldn’t be further from the truth.  Understanding the mechanisms that prompt resilience and such things as post-traumatic growth are woven into the understanding that a positive perspective is often evolved from a negative experience.  The struggle is in understanding that the negative isn’t the final perception.  There are other ways of perceiving and understanding the problems that allow for a true shift in perception.

What was interesting about this was to learn that the opponents saying we were Pollyanna-ish actually didn’t know the story of Pollyanna.  She, as we learned, was not at all like the popular myth of the story.  We read and came to understand she was often overwhelmed by sadness and grief, and what she actually displayed was a coping strategy, the glad game, to help her shift her perception and focus.  She didn’t deny her reality, but rather demonstrated resilience in finding productive ways to cope.

During the five-day immersion I got to talk to many of my classmates. They were from all walks of life: a yoga instructor, a composer, a musician’s agent, a comedy writer, an opera composer, a TV producer, a physician, a personal trainer, to name a few.  Almost to a person they explained a difficulty, a struggle that prompted them to move toward positive psychology.  They seemed to be the very example of trying to reframe life toward greater well-being — in essence, what most people on the planet are trying to do.

So the air in my glass, or your glass, can be the negative aspects to life that we’ve had to overcome or cope with. It could be the spiritual features of life we may not be noticing (which seem to take on an even more important role as we age). It could be the unknown, the seemingly chance encounters that shape and mold our lives.

But whatever is in the air, there is one thing I can tell you for certain.

I will never see that glass again as half anything.

It is as full as it can possibly be.

Bummer.

To make matters worse, the hotels in London were filled because of an annual carnival in the city.  There were no rooms.

Double bummer.

The airport staff was stressed because, well, weary travelers were stressed, which made for some unpleasant encounters.  A woman was spewing at the counter in front of me.

“I must leave today, leaving tonight or tomorrow isn’t an option.”

“I am sorry, the airports are closed tonight and tomorrow.  They will not be open again until Monday.”

“I have to be home tomorrow.  You people need to get me there!  Who closed the airport?”

“The FAA.”

“Don’t they know people have plans?”

“They are concerned with the safety of your travel.”

“Who can I speak to about this?” she said, raising her voice.

Who could she speak to about this?  God would seem the only appropriate choice. As this airport drama unfolded, a handful of us were watching her meltdown.  No one was happy about this diversion – we all had plans.  But watching her frazzle like a drop of water placed on a hot frying pan actually helped.  After a few more exchanges she huffed off to get God on the phone and it seemed as if everyone after her was a little more restrained in their reactions.  No one wanted to be her.

Although there was a part of me that could understand exactly what the woman was feeling, I tried to have an open mind. After the woman stormed off I spoke to the agent and told her I admired her composure during the encounter.  She said some people were better than others, and that she did her best not to get too unraveled by the people who freak out.  We had a very pleasant conversation and she commented on the fact that I seemed to be managing okay, and that I had a rather good disposition as well.  I told her I was busy thinking about what my alternatives and options were for the next couple of days, and was trying to think of how I might maximize my found time in London.

So much was out of my control that I did what I could to think about what good could come from this. I explained my plan was to take the Underground (subway system) out to a hotel away from the carnival to try to get a room.

That was when she gave me the first bit of good news.

The policy in the UK is to reimburse you for hotel and food expenses when the airline has canceled a flight and you are more than a couple of hundred miles from home.  She informed me that they had a block of rooms at the nearby hotel, and that my expenses for the duration of my stay would be covered.  While they were arranging for my stay I received an email that my hometown was under a mandatory evacuation.

Let’s see, free room and board in London to extend my vacation, or be evacuated to a local shelter?

Suddenly the bummers turned into gratitude.  Instead of going home and then being evacuated to a shelter, my vacation was extended, and funded, for a couple of days.

Sweet.

Over the past several years researchers in the field of positive psychology have been researching how adversity may be the very ingredient we need to make our lives meaningful. Researchers have noticed that people who possess (or can cultivate) an optimistic and resilient thinking style deal with misfortune in a way that not only helps them recover, but also allows them to grow from the experience.

While I might not have been as full-tilt as the lady who yelled at the airline personnel, there was a time in my life not long ago when I would have been, well, huffy.  But I’ve been working to change my disposition and reaction to adversity.

A leading researcher in the field of positive psychology, Jonathon Haidt, outlines in his book The Happiness Hypothesis the elements that may be necessary for such a growth event to take place.  In his book he describes something he calls the Adversity Hypothesis, suggesting that people need adversity, setback and perhaps even trauma to achieve the highest levels of strength, fulfillment, and personal development.  He suggests three things to remember after being blown off course in your life.

Rising to the challenge can reveal skills you wouldn’t know you had

The first is rising to the challenge and thereby revealing your hidden abilities — which in turn alter your self-concept.  Having your hidden talent arise when difficulties appear gives a different perspective to the adversity.  The struggle awakens a talent that hadn’t previously needed to be activated. Rising to the challenge in the case of the airport debacle meant me trying to manage how I would respond to the situation, generate alternate plans, and shift my focus from a reactor to an observer and responder.  These skills wouldn’t have arisen if there were no conflict.

Second, relationships change during adversity and the difficulty serves as a filter.  Some people get closer to you during the struggle, some move away.  I watched the woman in front of me leave frustrated, angry and no better off than she was before she came to the help desk.  I wanted to have a better relationship with the airline representative than that.  She was in a position to help and I wanted to ingratiate rather than alienate.  The problem with the planes caused the agent and I to connect, and after the other woman the connection was a positive one.

Finally, there is a shift toward the moment. Seize the day, the opportunity (Carpe Diem, or perhaps Carpe Noche if you are a night owl).   Once you have had a difficulty your concentration moves to the moment where your heightened awareness allows you to appreciate every small detail. This is the essence of hope.

While an actual flight couldn’t be guaranteed for me until September 6th (9 days away), she offered me options of flying to another city in the U.S. or trying two days later for standby. Options and hope.  I decided to do both.  I booked a flight for another city in two days and then decided to take a chance and take my bags to the airport at 6 a.m. that same day for a direct flight.

In the days in between I went to the carnival. It was marvelous.

When I arrived for standby, the gate was already swarming with people, and it was more than four hours before the flight. The woman who waited on me there was the agent I had connected with the other day.  She remembered our conversations and we chatted briefly about the task of moving hundreds of thousands of people around the world each day. She explained that the flight was full, and that the only way I could get on is if someone were a no-show.

“Not likely,” she said, “But there is always hope.”

After the last of the passengers had boarded the agent saw me, smiled, and motioned me to the counter with the curl of her finger.  When I got there she smiled again, and handed me a boarding pass.

The last one, she said with a smile, and it is in first class.

I wonder how that woman’s chat with God was going.

• 5 Tips for Staying Calm in a Hurricane
• 9 Tips for Coping with a Hurricane
• Tropical depression: Hurricane linked to long-term mental distress
• Hurricane Katrina: Mentally ill and addicts cut off from care

Postscript:  Just when I thought I had mastered the adversity thing, I opened the door to my condo to find that the power had been out for three days, the freezer ice had melted and the food had spoiled.  Apparently the opportunities to grow are endless.

A typographical error led Amory Lovins to coin the phrase negawatts. In a brilliant 1989 keynote address to the Green Energy Conference in Montreal he outlined what has become the blueprint for a radical business and energy concept.

Pay people to do nothing.

Twenty-plus years later the idea is deeply taking hold.

Fast-forward to Dr. Ron Denbo who was recently featured on a TED global ideas project. He is the Founder and CEO of Zerofootprint, an international company that provides software to measure and manage carbon footprint.  Individuals, governments and corporations can use these services to reduce the amount of CO2 they generate.

The rising amount of CO2 in the atmosphere is what has been causing global warming. It results in changing weather patterns (such as more frequent heatwaves and downpours), which threatens Earth’s stability and eventually makes it uninhabitable.

Dr. Denbo has a central mission for his company  — to assist employees and citizens worldwide in combating climate change. His premise is simple:

“If we needed one more watt in this country, what would we do?  We could build a new power plant, or we could save that watt.  Which is cheaper?”

His point is that if we can accurately measure energy use, we can help save energy and change people’s behavior patterns for the better. If you measure and pay people for the watts they don’t use, it can offset the watts they do use.

The concept has become a reality for larger companies, but it is working its way down to individuals — new, accurate ways to measure and compare energy use have been developed.  Once a typical usage baseline is established, the software Dr. Denbo has developed could measure what is being saved.

“You could put anything you want into an electrical outlet,” said Dr. Denbo at the forum. “There is no regulation on the efficiency, frivolity or value of what you plug in.  (The power companies) have to supply that electricity.

The Color of Money?

This idea of Negawatts seems to turn consumerism on its head, but it is a model for efficiency and actually may create a market for power companies.  There is even talk of a Negawatt energy market where energy would be sold like a commodity such as silver or copper. Since the cheapest watt is the one that’s never created, power companies could sell their unused power to communities in need at a discount:  Everyone is happy.

While there is no wide-scale rating scheme as yet for enticing the markets into the Negawatt idea, there have been some successful efforts at extending the idea beyond efficiency.  In one community, homes were rated for a green factor, then the rate of loans fluctuated depending on how much energy was saved.  One bank has been able to offer a half-point off homeowners’ mortgages if they were deemed green. This is not unlike how auto insurers set the cost of insurance.  The better driver you are, the lower your insurance rates; the more careless, the higher.

Which brings us to mindfulness.

You would be hard-pressed to look at the field of positive psychology and not see mindfulness, staying focused in the now, as a staple in becoming happier.  By offering incentives to think about your wattage use we are making energy consumption a mindfulness project.  I doubt Eckhart Tolle had it in mind, but his bestselling book, The Power of Now, takes on a deeper meaning when you realize the concept behind negawatts:  We do, literally, have more (electrical) power when we are mindful of its use.

At the heart of positive psychology is Self-Determination Theory (SDT): understanding the source of our motivations.  In the 1970s researchers Ryan and Deci proposed that three innate needs — competence, autonomy and relatedness — are essential to our well-being and psychological health. They are considered to be intrinsic motivation (the source of this drive is inside us).

Pursuing goals for external incentives — such as taking a job you hate just for the money — defines extrinsic motivation.  This type of motivation is common, but less directly associated to fulfilling our sense of well-being.

The Negawatt revolution straddles the shift between external and internal motivation, through a process Deci and Ryan called internalization. Negawatt theory is a direct attempt to transform an extrinsically motivated behavior (energy conservation) into an internally valued need (becoming energy-conscious.)  If we look at SDT we see that rewarding people to use power conservatively has the potential to empower them.  Knowing they can regulate wattage use on their own (autonomy) to both save and make money (enhancing their competence) for the betterment of others (community relatedness) strikes the chord Ryan and Deci meant by internalization.  Consider how the work of Nobel Prize winner Al Gore motivated people around the world.  We became conscious of the deleterious results of the greenhouse effect (extrinsic motivation) and have changed our intrinsic behavior accordingly (and buy compact fluorescent bulbs as an autonomous act of commonality).

(As a side note I propose any day that has an abnormality related to global warming, such as a record-breaking heat index, or rainfall, be dubbed an Al Gore-geous day – it is just a suggestion.)

In the case of Negawatts, the external motivator and incentive is to be paid for doing nothing.  Critics see this as ludicrous — getting paid for doing nothing with a commodity you don’t own — but the truth is it is not nothing.  It is mindfulness in the service of efficiency. In California they have rolling blackouts because of excessive energy demands. In India major cities have nearly daily blackouts because of lack of power. If we were able to reduce or eliminate blackouts because people are rewarded for not using power this becomes a proactive, voluntary act leading to greater community productivity and well-being.   It isn’t doing nothing: It is consciously, mindfully making decisions for the betterment of yourself and others.

Negawatts also reduces the need for dependency on oil while simultaneously reducing the aforementioned greenhouse gases, CO2.

Changing our behavior for the better is something others are working on as well.  For a novel approach check out fun theory, a concept being proposed by Volkswagen.

The ultimate question is: Will this work?  Can we help people become more mindful of their energy consumption?  I personally believe it’s possible, but somehow it brings an old joke to mind.

How many psychologists does it take to change a light bulb?

Just one.

But the light bulb has to want to change.

From July 23rd through July 26th, the International Positive Psychology Association’s second congress took place in Philadelphia.  Two years ago, during a particularly miserable time in my life, my best friend, Professor Joel Morgovsky, suggested we go to the first congress together.

I wasn’t in the mood.

But I went, and I was sitting in talk after talk and workshop after workshop; mostly they were interesting, but please, when do we get to go home?

Then I heard Barbara Fredrickson speak.  There are a few transformative lectures I have been to in my life.  This was one of them.

Barbara Fredrickson is the author of Positivity, and one of the leading researchers in the exploding field of positive psychology.  She was able to harness the research on something called the Losada ratio and was able to demonstrate unequivocally that we can measure the ratio of positive to negative thoughts. When that ratio can be enhanced to a 3 to 1 positive to negative ratio there is a shift in our way of thinking that changes everything; a tipping point, if you will.  Couples, individuals, businesses, students, all of us who can operate at this level of positivity can experience much greater well-being in their lives, greater productivity and profit in their business, and better grades. You can take her free test online to check your own positivity ratio. But more than this was a prescription for enhancing the ratio and getting yourself to the tipping point.

From that moment on I made a decision to change my ratio.  I was just below 2 to 1 at the time.  I made changes about how I used my gratitude journal, changed the approach to my practice to include more positive interventions for my clients, and began systematically reviewing the research on well-being and positive psychology.  This led to my writing this blog for PsychCentral.

In  March I made a formal application to the University of Pennsylvania’s Master of Applied Positive Psychology (MAPP) program and was accepted.  I begin my studies in September. I am now going to become one of “them.”

This year’s congress drew more than 1,200 researchers and practitioners from every continent. The MAPP was the first program in the world to offer a degree in Positive Psychology.  This year more then a dozen programs from around the world were featured from Africa, London, South Korea, Australia and Mexico, just to name a few.

Mihaly Csikszentmihaly, the author of Flow: The Pychology of Optimal  Experience, was there with 20 students fro hs new PHD program at Claremont University.

The workshops gave hands-on experiences based on evidence-based research.  The poster sessions gave new, exciting research in eduction, the arts, the military, disabilities, community development, and terrorism and many other topics. A good many publishing houses and  programs were showing their materials at the exhibitors hall, including  Smart Strengths, a unique book identifying research and interventions to build character, resilience and relationships in youth.

There were many extrodinary featured presentations and research as plenaries or keynotes by such luminary figures as Ed Deci,, Chris Peterson, and Ed Diener, that inspired the international crowd. But there are two of the top people, Dr. Martin Seligman and Barbara Fredrickson who gave particularly intriguing information on new directions in the field.

If you don’t know the name Martin Seligman, you should.  He is former president of the American Psychological Association and the person responsible for changing our understanding of depression.  He pioneered the work on Learned Helplessness and in the mid-1970s pointed the world in the direction of treating depression by helping people feel less helpless and more in control of their lives.  He then turned his attention to Learned Optimism, and began in the early 1990s teaching us how to harness the elements of optimism.  He is the Zellerbach Family Professor of Psychology at the University of Pennsylvania and founding director of the Positive Psychology Center.

In 2005 he released a book called Authentic Happiness that brought positive psychology to the forefront, and earlier this year he published Flourish, a book that anchors positive psychology squarely in the history of psychology.  This book offers an amazingly comprehensive review of the most impressive research in positive psychology and Seligman and his colleagues’ role in implementing it in such diverse areas as the military, suicidology, education, clinical psychology and community development. From his presentation two initiatives stood out, the first from his work with the military.

“We’ve never had enough people who have committed suicide who have taken the same test,” said Seligman.  This intriguing fact puts the issue of research and applied uses squarely in front of us.  Dr. Seligman explained that his work with the military, where 1.1 million soldiers are taking the same exams, has already yielded some interesting results.  Eighty-four people have committed suicide and the preliminary analysis of their testing shows that it seems a profile emerges that can identify high-risk individuals.  Could there be any more useful data than information that has the potential to save a person’s life?

Seondly, Seligman discussed the research behind our use of positive and negative words, and that there is a direct link between the kinds of words we use and our well-being in just about every sector.  He is working with Google to measure the lexicon of the Internet, essentially a way to measure positive and negative words and their reflection, and perhaps prediction, of human behavior.

The Barbara Fredrickson spoke.  What is she working on?  She is tackling the most complex of all human emotions:

Love.

In a stunning one-hour presentation she identified the elements of what love is, and isn’t. This got our attention.  Dr. Frederickson made it clear that love is not: Sexual desire; a special bond; commitment; lasting (no emotion is meant to last forever); nor unconditional.

She offered that love is:  “Investment in the well-being of the other for his or her own sake.” To this she presented research showing that this investment in the well-being of others can be understood as an interpersonal situation with socially shared experiences and one or more positive emotions.

There were many features of her research, such as how smiles are interpreted, and the biochemistry of love and something she referred to as “biobehavioral resonance,” concluding that her research is going in the direction of seeing love as “a single act performed by two brains.”

She put forward the idea that there is a positivity spiral that may be more powerful that the kind of negativity spiral we see with depression.

Attendees of the congress left with hope and inspiration. Everyone seemed eager to bring their findings back to their country and get busy. Perhaps this was because they knew Dr. Pawelski was right: the world needs their help.

Check here more information on the International Positive Psychology Association

Last month I was invited to speak for a week for The International Certificate Programme in Dual Diagnosis associated with Brock University under the guidance of Dr. Dorothy Griffiths & Dr. Frances Owen. Work I’ve developed over the past several years on psychotherapy for people with intellectual disabilities has been implemented in the States and most of the countries with socialized medicine.  The Canadians have a real flair and passion for this work, and I savor the opportunity to travel there to teach and train.

The night before I began I treated myself to a day on the Canadian side of Niagara Falls.  Although my diet is mainly vegetarian, I often supplement with fish entrees when I travel.  A restaurant with herb-crusted salmon special and organically grown vegetables caught my eye.  The dinner was delicious.

But around 2 a.m. my stomach heated up and soon I was revisiting the herb-crusted delight.  Naturally I thought it was a bad piece of fish, and vowed to mend my ways back toward vegetarianism.

I was better — but not well.

Two hours later the scene repeated itself, but this time with an intensity that reminded me of the only time I had food poisoning.  The pain increased with a burning in my lower stomach.  The involuntary nature of this was overwhelming.

After a few more sleepless hours the pain in my lower right abdomen was getting worse. As the day progressed I started thinking about getting some post-food poisoning medicine and had the hotel direct me to a walk-in clinic/pharmacy about a mile from the hotel. By the time I mobilized myself the pain had doubled.

At the clinic I explained I was an American without a national healthcare card.  The receptionist said there was a flat fee of $75 and a few minutes’ wait.  I wanted a professional opinion so I paid the money, and the receptionist explained that I could submit it to my healthcare provider for the possibility of reimbursement.

So far, not much different than the U.S.

The doctor saw me within five minutes. I explained my tale of woe, and he had me lie down on the examination table.  You know the drill:

Does this hurt?

No.

Does this hurt?

No.

Does this hurt?

No.

Does this….

I let out a scream that emptied his waiting room.

Does it hurt more when I press in or out?

Both.

“You are not going to be lecturing at the university this week my friend,” he said.

“Oh?”

“You have acute appendicitis.  You need to go to the hospital NOW.   How did you get here?”

“I drove.”

“The hospital is about two miles straight down the road.  I think you can make it, but if you want I will call an ambulance.”

An ambulance? For salmon?

I drove, and within 15 minutes of seeing the walk-in physician I was in front of the triage nurse at St. Catharines General Hospital in St. Catharines, Ontario.

He was reading the note from the walk-in doctor.

“So, appendicitis,” said the nurse. “Let’s get you set.”

Within ten minutes they had arranged for me to be admitted to the emergency room for observation and testing. They handed me some paperwork and told me to give it the emergency room registration receptionist.

“May I see your healthcare card?” She asked.

“I’m an American.”

“Ok, we’ll take care of that later on.  When you’re done we can figure all that out.”

“Fine,” I said.  But I was surprised that they didn’t want a credit card, a debit card, my bank account number, or a wheelbarrow filled with cash.

I was ushered into an examination with curtains for privacy.  Within a half hour a nurse saw me for vitals and information, then a physician ordered blood work. Dr. Owen and Dr. Griffiths came to see me. I was embarrassed. The fact that I couldn’t rise above this to do this work was almost incomprehensible. But the volcano in my lower right side of my stomach wouldn’t see it any other way.

Instead of focusing on the embarrassment, though, I shifted to thinking about having a profound gratitude for being in the right place at the right time.  The clinic physician told me had my appendix burst on the airplane I most likely would have died.  Gratitude seemed a better way to go. Dr. Owen and Dr. Griffiths rescheduled my training for the end of the summer–another reason to be grateful. For more information on the power of Gratitude Interventions Project and other gratitude work check here.

The surgeon, Dr. Sawula, was on call.  Each nurse, each physician, each orderly, sang his praises. “My, you are lucky,” they would say, “he is one of the best.”

They were right.

The nurse put in an IV line and asked what my level of pain was from 0-10, 10 being the highest.

137.

Then nurse laughed. Then it sounds like time for morphine, ever have morphine?

Nope.

OMG.

After 10 minutes they could have come back in and announced that they were removing my ears and nose as part of the procedure.

Fine.

And your skull and knees.

Good with me.

We might have to take your tongue and spine as well.

Whatever.

The next time I treat someone with an addiction to narcotics I will have much more sympathy.

The surgeon gave me his thoughts and approach and his best guess about my condition. Yes, it looked like appendicitis. Yes, my white count confirms it. Yes the CAT scan confirms it.  And there is a good chance we can remove it laparoscopically with an incision about an inch long. There will be three cuts — one on the left side of the abdomen to inflate your belly, one above the navel for the camera, and the incision below the navel to remove the appendix.

Camera?

“If it is still intact I can tie it off and take it out,” said the good doctor.

Let’s do it.

While I was being prepped, there was an accident. The two people in it were badly hurt, and were rotated ahead of me for surgery.  After the first person was cared for, Dr. Sawula told me he had to wait to do the second person, that I was his intermission.

“I’m not anticipating any problem with this,” he said, “so let’s get it out of there.”

“Sounds good to me,” I said through my morphine haze.

Soon I was in the operating room.  A Dr. Rose and Dr, Maximous assisted in the operation; it was about 11 p.m. when someone put a mask over my mouth.

“Daniel, Daniel Daniel Daniel!”

My eyes shot open.  I’d never had an operation or general anesthesia.

“You did fine, it’s over, they got it out, and you’re in the recovery room. Everything went well.”

My stomach was like a basketball.  The surgeon explained that afterward I would feel bloated, and that I might have gas.  He was right about both.  Toward the end of my two-day stay I asked if I could call Guinness to find out if I had just broken the world’s record of continuous flatulence.

Back home in New Jersey I went to my regular, trusted physician, Dr. Jeff Felzenberg.  I explained that I had gratitude for the responsiveness of the healthcare system in Canada.  They treated me as a person first and foremost, and responded according to my needs.  Money was never an issue. The level of care was based on my need.  When I was the most needy I was first, when I wasn’t I was repositioned.

He checked me out, admired the work of the surgeon and gave me the usual annual physical. We talked about the differences between the two countries and their approach to healthcare.  He stuck a tongue depressor in my mouth, asked me to say Ahhhh, and then took a good look inside.

“Well you’re in great shape, you seem just fine after the operation. And you have a new tattoo on the roof of your mouth,” he said as he tossed the tongue depressor in the waste can.

“A what?”

A new tattoo.  It says “Compliments of the Canadian government.”

Thank you, Dr. Sawula.  Thank you, Dr. Rose.  Thank you Dr. Maximous. Thank you, Dr. Griffiths & Dr. Owen. Thank you, Canada.

To learn more about the healthcare system in Canada click here. To learn more about the healthcare system in the U.S. click here.

Postscript: A special thanks to my Canadian friend Barea for helping me recover until I could fly back to New Jersey.

About a week after I got home I contacted the hospital and paid the full bill for their services. I say anyone who saves your life deserves to be paid. I’ve submitted the forms to my insurance company. I’ll let you know what they say.

Change his diaper.

Yep… Becoming a new father can be a daunting task, but there are ten things to keep in mind that will help you, your new baby, and your marriage.

1. Time and tolerance.

The most important thing you can do is simply spend time with your newborn.  Serious research about fatherhood is only a scant 30 years old, and what we know is that the more time fathers spend with their infants the better. Researchers in the early years of father-infant bonding couldn’t find fathers spending enough time with their infants to study them.  In other words, dads weren’t spending an adequate amount of time with their baby to even start measuring the impact. What we know now is that the time you can just be with your infant is valuable.

Along with time, you will need to have some tolerance for you and your new creation to get to know one another.  This is your first time being a father and your son or daughter’s first time being a human being.  Be kind and gentle with yourselves.  Allow for some learning, experimentation and mutual tolerance. Give yourself time to learn and grow into the role.

2. Eye contact.

We have known for a long time that infants are drawn to the human face, but with computer-enhanced research we were able to realize what they look at: the eyes.  Babies have a preference for the human face in general, and eye contact in particular.  The one thing to remember about this is that they can only see clearly about a foot in front of them, so remember to smile, stay close, and look ‘em in the eye.

3. Repetitive sounds.

Particularly something called the bilabials; Pa-pa, Ma-ma, Ba-ba are the first and most common sounds  infants can make.  They are simple because the two lips are pressed together with a puff of air pushed through them. That is why most first utterances around the globe for mother, father and bottle use these sounds.  They are easy to make and the infant can get some quick language control and feedback from their environment in this way.  (Trust me, the first time your little one says Pa-Pa to you will be a peak experience.) To strengthen the connection, when you hear them making the sound, make it back. Eventually the two of you can start your own bilabial chorus.

4. Infants are fans of motion.

They love it and crave it, and need it.  They love to be held, jostled, bounced and jiggled. There is good reason for this.  Movement helps infants develop everything from their brains to their sense of balance. When you hold your baby, give them a feeling of security, but not too tight or too loose. Don’t be afraid to hold and sway and bounce and cuddle. Learn what he or she likes and cultivate that motion.  You want to be the one with that magic touch when baby needs a motion magician.

5. Change that diaper!

Researchers early on found out that the fathers who helped diapering their baby had stronger, better, and more long-lasting marriages.  So if you want to score points with mom and with your baby — learn the art of diapering and treat it as a shared duty with mom.   If you don’t want the feces to hit the oscillator in your relationship, learn to deal with it at the source.

6. Make a play date with baby.

Maybe Tuesday is girls night out, or you don’t start work until noon on Thursday, but whatever the schedule can permit, have planned time to be the one and only caregiver for your baby. One-on-one bonding is important.  When mom is in the room there is typically a preference by the infant for her to be the one in charge.  Take time to figure out what your relationship is with your newborn — just the two of you. This is important.  You need to be able to manage this baby thing solo, and there is no other way to get this experience.

7. Teamwork.

The above point having been said, you also need to realize you are part of a team.  You and mom are a tag-team.  This may be a different set of skills than when you are one-on-one.  As an example, when mom was out and I was joyfully bottlefeeding my daughter with breast milk we had pumped for her, everything was wonderful.  But the moment mom came home from her classes, my daughter wasn’t in the mood for Mr. second-best.  She could hear and, through the magic of pheromones, smell mom and wanted to be with her.  This was the transition time.  Recognize that the three of you function like a mobile hanging from the ceiling and are in balance with one another.  As the infant’s needs change, the balance of mom and dad will need to change along with it.

8. Keep your promises.

As your child grows and as you develop as a family, remember that dads have to be absolutely certain to do one thing:  keep their promises.  If you promise your spouse you are going to be home at 6:30 p.m., make that the priority in your life that day.  As your child grows, these promises to him or her become the backbone of your relationship.  Deliver on what you promise and the ease and security of the relationship will evolve.  Renege on these consistently and an insecure bonding, something you definitely do not want, can happen.  I encourage parents I work with to only make commitments and promises they can keep.  I’d rather them keep one promise than make three and only keep two.

9. Be responsive.

A reach, a look, a cry, anything your little one does to make a connection with you should be honored.  Remember — they are just learning how to be in the world.  Let them know you appreciate their effort.  Studies have shown that parents who are responsive to their infant’s cries and needs help them develop better communication and language skills.  It makes sense.  If you know you are being responded to, you look to make that process more efficient.

10. Love, love, and then some more love.

Mammalian love is a complex interaction of biochemistry and behavior. Mammals are unique in this regard because we are predisposed to care for each other.  This isn’t true of all species.  Consider the reptiles–they eat their young. But as mammals we are hardwired to love and care for each other.  No one would argue against the fact that mothers have more of this than fathers, but what dads may not have instinctually they can easily develop.  The neuroscientists have shown some interesting data that suggests that when parents and children interact, their limbic systems, the emotional part of the brain, actually resonate and adjust to each other. This means that after a while both you and your baby become attuned to the presence of the other.

And that is the kind of harmony that can last a lifetime.

Love is no assignment for cowards.
— Ovid

In part 1 of this piece I described the atrocities at Willowbrook State School as the cause for changes in the delivery of mental health services in the U.S.  Elsewhere I have described some of the changes in state and federal law surrounding terminology used to describe disabled individuals, and a comparison between the U.S. and the delivery of mental health services in New Zealand. But these descriptions are only the macro version of the movement.  There is another side to this story, a personal side.

In preparation for a forthcoming book I arranged to talk to a very unique couple. On December 15th, 2010 I got to meet two extraordinary people, Michael and Amy (not their real names).  They live in a supported residential program with ancillary services.  They have a wonderful love story.  It is filled with the challenges of circumstance and desire.  Amy is nearly 30 years older than Michael: she is 92, he is 63.  But it isn’t their age differences that make their story unique.

The couple has been married 30 years, but together for 40.  I had a chance to interview them for about an hour at the New York City courtesy of the YAI / National Institute for People with Disabilities.  A dear friend and colleague, Bobra Fyne, MSW, arranged the interview.  It took about two months to set up.  The meeting took place in front of a small group of staff and was videotaped by Jerry Weinstock, of YAI/NIPD, for their archives.  Amy had on a lovely black and red dress with very tasteful jewelry. Michael was dressed in slightly mismatched shirt and pants, with a good quality jacket that clashed with both.  Both were well groomed, in good spirits, and very excited for the interview.  It would be hard not to notice that the color choices of Michael’s shirt and pants could have been better, but his exuberance and energy more than compensated.

For the most part Michael spoke for the couple. They held hands and slowly made their way into the interview room.  Michael guided Amy and helped her get situated in a chair.  He sat down next to her, and both of them smiled at Bobra and me. Two aides were nearby for assistance if needed.

As we began to talk I thanked them both for making the trip out from Long Island to come talk to us.  They were pleased to have come, and Michael explained that Amy now needed a little more time to prepare herself for travel. They smiled and held each other’s hands as they began talking about their lives.

They’d recently returned from a vacation in Boston, and chatted about the sights they’d seen, and the food at the restaurants.  They talked about what we all talk about when we come back from a vacation: the vistas, the travel complications, and the new foods.  All as normal as can be.

Then they gave a small rendition of their physical maladies, their aches and pains, and the fact that they can’t always do the things they used to do.  Michael shrugged and smiled. “But what else are you going to do?” he said. Chatting with an aging couple about a vacation and citing a list of ailments shouldn’t be cause for a videotaped interview.  But this was no ordinary couple.

Willowbrook was the largest and most infamous institution of its kind in America. With 43 buildings the “school” housed nearly 6,000 residents — 65 percent over capacity.  More than 75 percent of the residents had IQs below 50, and most had been residents for more than 20 years. Just to give you some understanding of the jeopardy the inmates were in: In an eight-month period in 1972, there were over 1,300 incidents of assaults, fights or injuries reported.

That is not a misprint:  1,300 incidents in an eight-month period.

Willowbrook has been referred to as a snake pit, as purgatory, or as hell on earth.  It is mentioned in the same breath as the Holocaust, and used as an example of the psychology of evil.

Michael and Amy met as inmates in Willowbrook.  They are the only couple from the institution ever to have met and married.

Beneath the unspeakable horrors, inhumane and unsafe conditions, and the traumatized lives, was an incredible resilience of spirit and of mind.  My original intent was to have them talk about their experiences in Willowbrook and of their transcendence. I asked them how they met.

“I was over on the men’s side; she was over on the women’s side,” began Michael.  “There was a staff member that liked me, and he brought her over to me.”

“Did you like Michael right away?” Bobra then asked Amy.

“No,” she said with a slight smile.

Michael was incredulous.  We all laughed.  He put his hand gently on Amy’s shoulder and spoke directly to her.

“Bobra asked if you liked me right away?”  he said, smiling.

Amy smiled back.

“I like you now!” she said.

More laughter.

Then they talked about their time in the institution.

“I was there for 16 years,” said Michael. In buildings 4 and 5, then building 10.

“Do you remember things from Willowbrook?” I inquired.

“Geraldo Rivera,” he said right away.   “And then pictures of the babies in their own feces.”

“What was your time in Willowbrook like?” I asked.

“It was the worst place to be at.  I didn’t like the way people were treated.  There was a man that had his hands in the food.  He didn’t have no gloves on.  That’s not how you serve food.”

Amy was still thinking about how they met.

“I seen him when they would bring together the boys side and the girls side,” said Amy.

Bobra picked up on Amy’s comment.

“What did you notice about him?” she asked.

Amy paused and smiled at Michael and looked back at Bobra and I.  With the slightest of shrugs she closed her eyes in a reverie of recall.

“He was a snappy dresser,” she said smiling.

Michael beamed.  It was not lost on Bobra or I or the onlookers that Michael might be described as many things, but “snappy dresser” wouldn’t be the first thing that would come to anyone’s mind.

Except Amy’s.

We then pressed Michael for confirmation.

“Is that true?”  asked Bobra. “Were you a snappy dresser?”

In true New York style, complete with the hand gestures that conveyed total self-assurance, Michael turned his palms out in front of him and moved them up and down his torso to reveal his wardrobe.  He didn’t utter a word, but his actions said it for him. Could there be any doubt he was a ‘snappy dresser?’

Amy nodded.

In the words of H.G. Wells, “Beauty is in the heart of the beholder.”

Michael is on the New York State self-advocacy board and has a long list of involvement in advocacy.  He and Amy were part of the original transferees in the Willowbrook Consent Decree.

Toward the end of the interview I asked Michael if he had any parting words of advice for people who want to have a successful marriage.  With the unconscious timing of the great comedic sensitive Art Carney, Michael slowly, deliberately and painstakingly removed a small folded paper from his pocket.  The unfolding of this paper and the anticipation of its message by the gathered audience was spellbinding.  It was a palpable pull of our attention. As I looked at Bobra and the staff, it was clear we all wanted Michael’s secret to be revealed. Once out of his pocket and unfolded he made known the contents.

It was a picture of Amy and Michael kissing.

He held it up for the camera, leaned over and kissed Amy duplicating the pose.

Wise advice, from two of the most resilient people I know.

Back in 1965 Senator Robert Kennedy first spoke of the need for change at Willowbrook.  To paraphrase what he might say now if he could see Michael and Amy…

I think it’s just long overdue ….