Beautiful Thinking in Action

Positive Psychology, Psychodrama, and Positive Psychotherapy

A truly therapeutic procedure can have no less of an objective than the whole of mankind.

— J. L. Moreno

Abstract

Like three strands of a braided vine, positive psychology, psychodrama, and positive psychotherapy have been woven together since their beginnings. Having separate yet connected roots, their combined effect offers evidence-based interventions for improving communities, organizations, and relationships. The foundation of evidence-based positive interventions, and broad interest in these topics, has now provided a platform from which this braided vine can flourish. This article shows the historical roots of these movements and how they intersect, overlap, and mutually inform each other. A positive clinical intervention, the virtual gratitude visit (VGV) will be used as an exemplar to highlight future potentialities. The promising impact that the continued interactions between these movements is poised to have for the future is discussed.

History

Eunoia (pronounced u-noy-ah) is a rarely used term. Aristotle first used it to refer to the benevolent feelings that form the basis for the ethical foundation of human life. It comes from a Greek word meaning, “well mind” or “beautiful thinking.” But it is also a nearly forgotten medical term referring to a state of normal mental health (https://en.wikipedia.org/wiki/Eunoia).

Normal mental health.

Why is the term rarely used? One possibility is that the history of psychology has traditionally been focused on correction. Normal, positive feelings like love, gratitude, and hope were deemed too difficult to study or understand, so the focus remained on pathology and correction. “Normal” was simply free from suffering, and feeling good was a temporary, transient state too fleeting to be researched and understood.

But not being depressed isn’t the same as being happy. We can’t learn what makes people maintain their weight by investigating obesity. Or, why children succeed in school by studying dropouts. The rich area of research that has been initiated by positive psychology has already changed the way we think about sustainably feeling good. Perhaps it is time for those of us who care for the well-being of others to define what eunoia looks like and what contributes to “beautiful thinking.”

I believe psychodramatists are uniquely positioned to play a central role in this new era of well-being. We have a long-standing connection to this effort that reaches back to the very beginning of scientific investigation of eunoia.

The history of positive psychology, positive psychotherapy, and psychodrama have been integrated for nearly fifty years. There are multiple overlapping intersection points, and three of these will be outlined to highlight these inflections. There are certainly many other influential connections, yet these three will give the reader an illustration of the reciprocal influences.

The history of the positive psychology movement shows the influence of its two founders, Martin Seligman and Mihaly Csikszentmihalyi. Seligman’s work has tremendous effect on the use of positive interventions, while Csikszentmihalyi’s impact is on the psychology of optimal functioning.

Highlights From the History of Evidence-Based Positive Psychology

About fifty years ago, psychologists began developing evidence-based theories and practices about happiness that are now gaining momentum. From the human potential movement of the 1960s through the current proliferation of professional societies and discipline- specific journals and degree-granting programs, there has been a greater push for research on the effectiveness of positive interventions. In the nearly twenty years since positive psychology was labeled and formally initiated, a plethora of research from every corner of the world has been published in peer-reviewed journals.

Martin Seligman, former president of the American Psychological Association, made his 1998 presidential term a clear platform for the development of positive psychology (Seligman & Csikszentmihalyi, 2000), which constitutes one of the most comprehensive evidence-based perspectives available on positive psychology (Seligman, 1992, 2002, 2011; Seligman, Ernst, Gillham, Reivich, & Linkins, 2009; Reivich, Seligman, & McBride, 2011). Through his contributions, Seligman—often referred to as the father of positive psychology—promotes a science that gives well-being a prominent position. His goal is not to usurp the work of psychologists and psychology, but rather to add to the ever-increasing knowledge of human behavior. Seligman’s work has been crucial in sparking a movement.

Seligman was influenced by and has built on the work of many pioneers who have come before him, and the contributions of some of his predecessors are particularly worth noting. Specifically, the work of humanistic psychologists Carl Rogers and Abraham Maslow—both of whom also served as presidents of the American Psychological Association—stand out. Rogers and Maslow positioned psychology at the center of a major transition in society and became part of what was known as the human potential movement. At a time when the theories of Freud (1977) and Skinner (1972)—psychoanalysis and behaviorism, respectively—dominated the academic and clinical literature, Rogers and Maslow made a push for a more positive approach to individual therapy and to conceptualizations of human nature. Rogers’s “client-centered therapy” (1951) helped psychology move away from the medical model and a disease orientation by promoting that psychologists refer to the people they work with as “clients” rather than “patients.” Abraham Maslow (1954, 1962) theorized that people have a hierarchy of needs, and argued that as more basic needs (food, shelter) were satisfied, there would be a natural tendency to move toward full personal potential, which he called self-actualization. These two approaches reflected a departure from the psychoanalytic and behavioral models and were major influences on the culture. One important shortcoming of this “third way” proposed by Maslow and Rogers, however, is that although the human potential movement drew a very wide range of thinkers and followers, very few of them carried out evidence-based research on these emerging ideas. As a result, the humanistic theories did not have a substantial empirical base (Seligman & Csikszentmihalyi, 2000).

Despite this shortcoming, the work of Rogers and Maslow opened the way for other psychologists to develop alternatives to psychoanalysis and behaviorism. Albert Ellis and Aaron Beck are two of these psychologists. Both Ellis and Beck were trained in psychoanalysis, but found those methods to be unsatisfactory for many of their clients, particularly those struggling with depression. Albert Ellis (1962) had been writing about the ways humans think about situations and how our beliefs change as a result. He proposed the A-B-C model, designed to help understand beliefs that occur in response to life events and the resulting consequences. In this model, A = “Activating event,” the thing that causes us to respond; B = “Beliefs” about the causes of the event; and C = “Consequences,” emotional and behavioral results of these beliefs. There usually are direct connections between beliefs and consequences and there often are patterns in how these connections occur. The A-B-C model is important in the history of positive interventions because it made beliefs a subject for scientific study. Aaron Beck (Beck et al., 1961; Beck, 1967; Braff & Beck, 1974), the father of cognitive behavior therapy (CBT), also was interested in beliefs. He noticed depressed patients had automatic thoughts about themselves, the world around them, and the future. By identifying these situational automatic thoughts and challenging patients to think differently, Beck could demonstrate that a person’s core beliefs and consequent feelings could change. The interested reader is directed to a wonderfully articulated workbook integrating CBT with psychodramatic theory and practice by Tom Treadwell and his colleagues (Treadwell, Dartnell, Travaglini, Staats, & Devinney, 2016).

Seligman’s research on helplessness built directly on the work of Ellis and Beck.

Behaviorism had argued that in each situation the opportunity to gain a reinforcer or avoid an unpleasant stimulus would predict the organism’s behavior. But in Seligman’s research, an organism exposed to a helpless situation that it cannot control creates a perceived absence of control over the outcome in another situation. Seligman termed this “learned helplessness.” Through a series of experiments (Seligman & Maier, 1967; Seligman, 1975), he demonstrated that dogs that were shocked without an opportunity to escape the pain gave up, failing to take advantage of subsequent opportunities of earning a desired reinforcer. The work of Ellis and Beck flew in the face of psychoanalysis and behaviorism and helped shift therapeutic approaches toward helping clients gain control of their own lives by taking control of their beliefs. In a similar way, the results of Seligman’s experiments challenged the existing mechanics of behaviorism and allowed for a connection to be made between the dogs who had no control and depressed clients. Seligman hypothesized that a perceived inability to control the outcome of a condition or situation can activate a sense of helplessness, which in turn can lead to depression. This was revolutionary and led to Seligman writing the trade book: Learned Helplessness: On depression, development, and death, which changed the way psychologists around the world begn treating depression.

Not all the dogs became helpless, however, and this needed to be understood. Some of the dogs (about one-third) that were studied did not become helpless and overcame the learning of the original experiment, finding ways out of the situation. The dogs’ behavior provided speculation about how humans might overcome helplessness. One possibility was to understand how people explained what had happened to them. This was dubbed attributional style or explanatory style. Attributional reformulation (an explanatory style of the situation) was created to account for people’s optimistic or pessimistic reaction styles to difficult situations. Seligman had capitalized on Ellis’s and Beck’s work with his own experiments and demonstrated that people could choose how they think. This was revolutionary. He then began to focus on explanatory style and our ability to change it. Demonstrating that individuals with a pessimistic style could learn to be optimistic, he made the transition from understanding the mechanics of helplessness to teaching people how to be optimistic (Peterson, 2000). He eventually published another groundbreaking book, Learned Optimism: How to Change Your Mind and Your Life (Seligman, 1992), which deepened the public’s understanding of explanatory style. In this work, he skillfully outlined the patterns through which people could become optimistic. He could demonstrate more positive and optimistic ways people could think, primarily by studying people with high levels of optimism, including successful insurance salespeople.

Seligman showed that successful people’s thinking patterns and behaviors could be taught. Optimistic people have a specific thought pattern when it comes to bad events because they view negative events as temporary hurdles, see these bad events as isolated occurrences, and believe that with effort and skill the bad events’ effects can be dealt with and overcome. Optimistic thinkers largely are more immune to depression and have better physical health and greater, more sustainable achievement. The pessimist, in direct contrast, will respond to setbacks by experiencing a sense of helplessness. Pessimists believe negative events are permanent and compromise everything they do; they believe they bear sole responsibility for the event’s occurrence. As simple as it sounds, this was a huge boost for positive psychology. Prior to this, psychologists were battling thoughts as givens instead of variables. Seligman’s work on optimism helped establish a theoretical and empirical base for his positive psychology platform as president of the American Psychological Association in 1998 (Seligman & Csikszentmihalyi, 2000; Seligman, 2002). He suggested that psychology include a model of building strengths— promoting mental health, rather than only treating mental illness.

The publication of Character Strengths and Virtues: A Handbook and Classification (Peterson & Seligman, 2004) was designed to offer a compendium of what is right and virtuous in human beings and was created in direct contrast to balance out the Diagnostic and Statistical Manual’s (2000) list of what is wrong.

The development of a character strength survey by the VIA Institute on Character (viacharacter.org) allowed people to learn their strengths and begin using their top ones in new and different ways to develop them. Peterson and Seligman’s (2004) research classified character strengths and virtues into 24 categories organizing them into six types. The character strength survey based on this reserach has radically changed how character strength is understood and used around the world (Niemiec, 2013). The six virtues followed by their 24 character strengths are:

1. Wisdom and Knowledge: creativity, curiosity, open-mindedness, love of learning, perspective, innovation
2. Courage: bravery, persistence, integrity, vitality, zest
3. Humanity: love, kindness, social intelligence
4. Justice: citizenship, fairness, leadership
5. Temperance: forgiveness and mercy, humility, prudence, self-control
6. Transcendence: appreciation of beauty and excellence, gratitude, hope, humor,
7. spirituality.
8. Understanding character strengths and being able to use your own and spot them in others

has been central to advances in business, education, and psychotherapy. Christopher Flückiger (2008) and his colleagues have developed a procedure, resource priming, where facilitators of psychotherapy take ten minutes before their sessions to focus on the strengths of their individual clients. The result is that the priming leads to resource activation whereby participants focus on the positive perspective of their behavior, which in turn leads to better progress in therapy as measured by greater reduction in symptoms and higher levels of well-being.

In the same timeline as Seligman’s Learned Helplessness, another researcher (Fordyce, 1977) had pioneered a series of happiness interventions, such as increasing socialization, becoming more active, and deepening one’s relationships. He found students trained in a variety of 14 different approaches demonstrated fewer symptoms of depression and were, in general, happier than a control group. Deci & Ryan (1985), along with a few others (e.g., Fordyce, 1977, 1983; Csikszentmihalyi, 1976, 1990; 

Diener, Emmons, Larsen, & Griffin, 1985) moved the theoretical into the empirical, substantively ushering positive psychology to its current position. Evidence-based interventions demonstrating effective changes toward increased well-being and flourishing are now the standard (Seligman, Steen, Park, & Peterson, 2005). Indeed, the fact that we have this current focus in positive psychology is a direct outgrowth of more than two decades of empirically validated treatments and research studies. Positive and transcendent experiences are now investigated with rigorous scientific methods and robust results.

While Seligman was unraveling the dynamics of depression, another researcher, Mihaly Csikszentmihalyi, published Flow: The Psychology of Optimal Experience (Csikszentmihalyi, 1976/1990). It was groundbreaking on many levels because it was considering a very different type of human experience. It offered up an experience that many people could relate to, but did not fully understand. Perhaps it could be said that Csikszentmihalyi did for flow what Sigmund Freud (1977) did for dreams: He identified and analyzed something most people experienced, but that no one had yet studied. Csikszentmihalyi brought a powerful, positive, and mysterious experience closer to our understanding. When flow happens, external or internal demands cannot be reached. A person has entered an altered state of consciousness and the usual rules of engagement with one’s surroundings have changed drastically.

Flow has been in the global consciousness since it was released more than forty years ago. Back then it was revolutionary—shocking, even—both to label a universal experience and to identify its features. But now “flow” is woven into our popular language and culture. We have heard about it, read about it, and want it in our lives.

In his own words, Csikszentmihalyi said that flow 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” (1990, p. 1). At a presentation at the European Positive Psychology Conference (EPPC) in Moscow (EPPC June 26, 2012), Csikszentmihalyi added a nuance to this definition. He spoke of flow as a more transcendent experience as it begins: “Youare at this blessed moment when this feeling is about to come.” In his book, Csikszentmihalyi (1990) identifies some specific features of the experience of flow. Flow tends to occur, he argues, when the following statements hold true:

• The event is freely chosen;
• The goal is clear;
• There is a high degree of focus;
• A loss of self-consciousness occurs by engaging in the action;
• Time is distorted;
• Feedback on performance is immediate and concrete;
• There is a sense of control in the situation or activity;
• The challenge is high, but there is balance between ability and the task;
• Bodily needs are less noticed; and
• There is effortlessness in the activity because it is intrinsically rewarding.

It is the balance between the challenge and our skill that keeps us engaged in flow. When the balance is off, we experience the other end of the spectrum: boredom or anxiety. Flow is a very enjoyable experience marked by a sense of timelessness and engagement, and something about the experience makes us want more of it. Once we have experienced a flow moment in our lives, we usually crave it again. It certainly makes intuitive sense that we would want to repeat such an enjoyable experience. But this craving may also be one of the most important features of positive psychology since it shows that positive emotional experiences can initiate an upward spiral (Fredrickson & Joiner, 2002; Fredrickson, 2001). Such an upward spiral can counteract depression’s downward pull. Even more important, this may be the essence of what makes positive changes sustainable (Frederickson, 2001).

Just as Seligman’s work has inspired ongoing research, so has Csikszentmihalyi’s. The flow experience was initially described as an individual phenomenon. Walker (2010)1 suggests that well-being may exist on a continuum, finding that when comparing solitary vs. co-active or interactive social flow, the two social conditions were more enjoyable, with interactive social flow being the most pleasing. Co-active social flow occurs when we are part of a group doing something, from watching TV with friends to participating in a foot race. Interactive social flow is enhanced through social interdependence. This occurs when we are part of a collectively competent group where there is complementary participation and a surrender of the self to the group. People participating in this have surrendered the self and acquired a collective sense of purpose and meaning, such as might happen on a successful athletic team.

Many of the indicators for social flow are like the well-known attributes experienced in solitary flow, but with some interesting additions. There is emotional communication throughout the group as members are participating—an emotional broadcast and resonance within the group and external observers. Members feel joy, elation, and enthusiasm throughout the group

1A version of the material in this section has been discussed in a blog written by the author: https://psychcentral.com/blog/archives/2010/06/21/shall-we-flow/performance. Finally, rituals are put in place to institutionalize social flow. The participants want to find ways to make it happen again. In other words, doing things together is better than doing things alone.

The two important works we have examined from Seligman (1975) and Csikszentmihalyi (1976), which were published within a year of each other, together created a paradigm shift in understanding human nature. By delineating the conditions under which depression can be alleviated and flow can be activated, psychology charted a new, albeit tentative, direction—the science behind well-being and human flourishing. These pioneers initiated a research platform for positive psychology that continues to thrive today. For Seligman, using Ellis’s A-B-C model and Beck’s cognitive therapy helped him shift from learned helplessness to learned optimism. The publication of these trade books (Helplessness: On Depression, Development and Death (1992) and Learned Optimism) took the science of psychology out into the public arena. While the research for both landmark works was stellar, the description of it in a more accessible form inspired people to change. Seligman’s work on optimism has served as a foundation for positive interventions, residing at the core of the Penn Resiliency Program (PRP) for the prevention of depression (Seligman, Ernst, Gillham, Reivich, & Linkins, 2009), and finding its way into education (Reivich, Gillham, Chaplin, & Seligman, 2005) and the military (Reivich, Seligman & McBride, 2011).

Moreno’s contribution with the history of positive psychology is multilayered. To begin with, it turns out there are direct links to positive psychotherapy and the development of Csikszentmihalyi’s Flow.

As noted above, Csikszentmihalyi identified the experience of flow as a balance between boredom and anxiety. People find themselves fully engaged in an activity that is challenging, but not impossible, and rewarding to their skill set (Csikszentmihalyi 1975/1990). This integral balance between challenge and skill is “flow,” the state during which we experience the greatest productivity and joy in our work. This state is said to be autotelic as it has value in and of itself. A careful read of Csikszentmihalyi’s original work reveals a remarkable likeness to Moreno’s theory of spontaneity (Moreno, 1955). For Moreno, spontaneity is inversely related to anxiety, where the greater the anxiety, the less spontaneous our behavior. This is the essence of Csikszentmihalyi’s flow. Too much anxiety would keep one from achieving the state of flow, and too little would not allow for engagement. In writing about spontaneity, Moreno (1955) offers a highly similar description. In his own words and italics, he reveals: “An “adequate” response is “appropriateness, competency, and skill in dealing with the situation, however small or great the challenge of its novelty.” (P.109). This concept appears in print twenty years before Csikszentmihalyi’s classic description of flow.

At the previously mentioned Moscow conference (EPPC June 26, 2012), I had the opportunity to speak to Csikszentmihalyi personally about how close his theory of flow and Moreno’s theory of spontaneity were, and if he was familiar with it (Csikszentmihalyi, personal communication). Not only did he explain that he was familiar, but also offered an intriguing detail—that David Kipper a friend and colleague of his in Chicago had read and helped with the manuscript. At that time, David was the leading researcher and scholar in psychodrama and spontaneity, as well as a practicing clinician. He said that David’s contributions were accounted for in the acknowledgements of the original publication of the book. This fact places Moreno’s thinking at the inception of the positive psychology movement in the United States. But, as will be discussed below, it also seems Moreno’s influence had already been established in 1968 in a movement in Germany promoting positive psychotherapy.

But the link between flow and spontaneity runs deeper than sharing elements of a defined state. Each has a direct connection to character development. For Moreno, spontaneity enhances one’s character as a byproduct of interpersonal relationship. For Csikszentmihalyi, the use of one’s top character strengths provides a prescriptive path for activating flow. What is likely to be true is that flow and spontaneity states are bi-directional with character development. Optimum use of character strengths strengthen the experience of flow—and spontaneous flow states influence character. In fact, some new theoretical positioning on character strength lends support to this notion.

In a compelling article by Seligman (2015) referring to the unfinished masterwork of his deceased friend and colleague Chris Peterson, Seligman reveals a comprehensive extrapolation of how character strengths may be more than just a way to activate flow states. Their overuse, underuse, or absence may be the reason why flow and interpersonal relationships suffer. This, according to Seligman, may be a more direct understanding of mental illness.

The Origin and Evolution of Positive Psychotherapy

In 1968 Nossrat Peseschkian, a psychiatrist working in Germany, proposed “positive psychotherapy” as a theory and collection of interventions that promoted well-being. Heavily influenced by the humanistic movement, Peseschkian took a positive notion of human nature (Cope, 2014). Inspired by personal encounters with prominent psychotherapist and psychiatrists, such as Viktor Frankl, Jacob L. Moreno, Heinrich Meng, the teachings of Bahá'í Faith, and transcultural observations in more than 20 cultures, Peseschkian began searching for a combined method that was both integrative and culturally sensitive. This humanistic, psychodynamic therapy was built on a positive conception of human nature, which includes a holistic approach to well-being containing spiritual aspirations and influences (Cope, 2014). This early version of positive psychotherapy (as there is a newer one that will be discussed below) was built on the principles of hope, moderation as a portrayal of social identity, and consultation.

The principle of hope is a worldview founded on the idea that every person is good by nature (EAP, 2011). In addition, every person is endowed with different capabilities and potential. Each person is seen as having the major virtues of love and knowledge, and through these virtues various interventions are used to motivate the process of healing. The major goal of the therapeutic process is balance, helping the client to actualize his or her abilities.

The second principle is that of moderation, as a representation of social identity. The encouragement is to develop all areas equally, with the distribution of energy to be balanced when tending to the body, work, relationships, and the future (Peseschkian, 2012).

The final principle of Peseschkian’s positive psychotherapy is consultation. This is the essence of the therapeutic process and employs a five-stage process. In this manner, the client is led to address his conflicts based on the symptoms. But the interventions here are framed in non- pathological ways, and the examples drawn from daily life situations or what Peseschkian referred to as “micro-traumas” of daily living (Peseschkian, 2012, 1998).

This five-stage process involves observation, taking inventory, situational encouragement, verbalization, and broadening of goals. During the observation phase, the client is taught to see his or her problems more precisely. The taking inventory phase emphasizes the distinctions between I, you, and we in discerning and understanding what happens during daily life encounters. The essence of situational encouragement is to then look at the history of how conflicts had been successfully resolved. Finally, the expansion of goals places the emphasis on a future perspective (Peseschkian and Tritt, 1998).

This version of positive psychotherapy is a culturally sensitive method (Peseschkian Foundation, 2016). The premise being that each person is impacted by the cultural environment where he or she developed, influenced by the family they are born into, and altered by the individuals they’ve encountered along the way. Yet the underpinning of the goals of positive psychotherapy is transcultural, meaning that goals and interventions are universally human. The tools of the therapist involve using words of wisdom, humor, storytelling, and introducing moments of surprise through the session.

Peseschkian’s pioneering effort of positive psychotherapy was directly influenced by his thinking. As anyone who has watched Moreno himself, or the original films of Moreno’s work in session (Moreno Movies: 4-Video Series [Video file]. (n.d.), or witnessed a trained psychodramatist work, the director’s words of wisdom, humor, storytelling, and introducingmoments of surprise through the session are often elements woven into the tapestry of the process. The psychodramatic theory and methods are aligned with these five stages, where enactment of the situation becomes the vehicle for both observation and inventory taking.

During this process, there are typically verbalizations from the client about what the issue is and how things could be improved, or enacted instances of when the conflicts in the past have been worked through successfully. The natural resolutions come from a correction of the dynamics either through re-enactment and/or broadening of goals for the future. Psychodramatists might argue that the psychodramatic method is an amplification or action-oriented form ofPeseschkian’s model of positive psychotherapy, but the point here is not to argue effectiveness or efficiency, but rather to cast light on the shared concepts and elements being employed.

Martin Seligman’s Influence on Positive Psychotherapy (PPT)

Growing out of his work at the University of Pennsylvania, Seligman began focusing on the use of positive intervention in a psychotherapy environment and began showing very promising effectiveness (Duckworth, Steen, & Seligman, 2005). Tayyab Rashid, a former fellow of Seligman’s, has furthered the research base of this form of positive psychotherapy separate and apart from Peseschkian’s work (Seligman, Rashid, & Parks, 2006). The use of positive interventions in a structured way engages clients in activities and events that use the activation of positive emotions as a foundation for change.

This version of positive psychotherapy is based on three assumptions that are like Peseschkian’s but have some important differences derived from the research on positive interventions. First, clients inherently desire growth, fulfillment, and happiness, not just the avoidance of depression and anxiety. Second, positive resources such as strengths are just as real as symptoms and disorders. Finally, effective therapeutic relationships can be formed through conversation and use of positive resources, not just thorough analysis of weaknesses and deficits (Seligman, Rashid, Parks, 2006; Rashid & Ostermann, 2009).

Consider one of the studies in positive psychotherapy conducted in a group therapy format (Rashid & Ostermann, 2009). Forty mild to moderately depressed University of Pennsylvania students were divided into a treatment group and a non-treatment group. The treatment condition consisted of two groups of 8-11 participants seen for six weeks for two-hour sessions. Each session was half a discussion of the exercise assigned from the previous week and half an introduction to the new exercise. The participants carried out homework assignments and reported back each week on their progress. The first week, participants were asked to take the VIA survey (mentioned above) and use their top five strengths more often in their day-to-day lives. Week two involved the participants writing down three good things that had happened during the day and why they thought they had occurred. The third week, participants were asked to write a brief essay on what they want to be remembered for the most; a biography of having lived a satisfying life. The next session involved composing a letter of gratitude to someone they may never have thanked adequately, and then reading that letter to the person, personally or by phone.

During the fifth session, the members were asked to respond very positively and enthusiastically each day to good news received by someone else (known as Capitalization with Active Constructive Responding (Gable, Reis, Impett, & Asher, 2004). The final session involved savoring daily events in their lives that they normally did not take the time to enjoy, and journaling how the experience differed from their normally rushed occurrences. Time was also spent during this last session on tailoring the exercises for the participant’s use following the end of the study.

Each intervention: The use of five top strengths from the character strength survey, three good things that happened and why, a written biography of having had a satisfying life, a letter of gratitude, and enthusiastically responding to someone else’s good news are all well-known and established positive interventions, as is the savoring and planning for future exercises following the end of the study. When used in this weekly series format, the results were on assessments of depression and satisfaction with life. But there is a powerful finding beyond this positive change. The gains made by the PPT groups were maintained with no other.

A version of the material in this section has been discussed in a blog written by the author:https://psychcentral.com/blog/archives/2013/01/27/moving-from-whats-wrong-to-whats-strong-introducing-positive- psychotherapy-ppt/notable.

As one might expect, the group PPT participants did better than the no-treatment group intervention by the researchers throughout a one-year follow-up, while the baseline levels of depression for the non-treatment group remained unchanged.

Six sessions and twelve hours, with no booster sessions during the year. This is very unusual in the study of depression and highlights how the use of these exercises involved self- maintaining features that served the participants beyond the intervention. As will be noted below, the results from positive psychotherapy as put forth by Seligman and Rashid have a very promising future. This is where psychodrama may have its greatest potentiality—to take the existing positive interventions and convert them into action modalities. Below is an example. Narrative Enactment: The Virtual Gratitude Visit (VGV)

Expressing gratitude as a positive intervention has been central to the positive psychology movement. The gratitude visit, where participants write and deliver letters of gratitude to people they feel they have not properly thanked, was one of the first positive interventions studied (Seligman et al., 2005). In the initial report, when compared to other interventions, those who performed the gratitude visit were found to be the least depressed and the happiest of all the participants. As discussed by Tomasulo (2014), gratitude has also been found to enhance self- esteem (McCullough et al., 2002), life satisfaction (Kashdan et al., 2006), prosocial behavior (Wood et al., 2008), and better interpersonal relationships (Algoe et al., 2008; Tsang, 2007). It was also found to directly influence the capacity to broaden and build positive emotions (Fredrickson, 2004, 2009) and was noted by Lyubomirsky, Sheldon, and Schkade (2005) as one of the main interventions that can lead to sustainable happiness. But not all gratitude exercises are the same and there have been some surprising results of such. Boehm and Lyubomirsky (2009) studied participants who savored positive events by writing in a gratitude journal five things they were grateful for either once a week or three times a week, and then compared them with a control group that did not keep journals. Pre- and postmeasures on well-being revealed that gratitude journaling worked better once a week rather than three times a week or in the control group. In fact, the once a week approach was the only condition in which improvement in well-being was noted. The authors theorize that the success of a positive intervention depends not only on what the intervention is, but also how it is delivered.

Expanding on the method of delivery is where the VGV finds applicability. New research by O’Connell, O’Shea, and Gallagher (2017) focuses on the enhanced power of expressing gratitude to others. They compared a gratitude journal group to a similar group that, in addition, verbally expressed their gratitude. The researchers found the expressive group did better than gratitude journaling alone or the control group. In the expressing-to-others group, negative emotions and depression decreased, which provided greater emotional balance. The authors concluded that other-oriented gratitude is enhanced when it is outwardly expressed. It is the deliberate verbal expression to others that has relevance to the VGV.

There are three ways the traditional methods and research of a gratitude letter and visit can be re-envisioned and restyled with the VGV. First, most evidence-based interventions concerning gratitude involve writing and/or reading through the use of journals, letters, and sharing of the same. As O’Connell et al.’s (2017) article highlights, expressive writing is only one means by which a therapeutic improvement can happen. The VGV uses an enactment of feelings of gratitude in a role-play with an empty chair. Importantly, the VGV format liberates the technique from a written procedure, as the enactment with the empty chair is unscripted. This unscripted enactment has the potential to reap the benefits of expressing gratitude toward others, yet can be accomplished without them present. Drama therapy (Tomasulo & Szucs, 2016), psychodrama (Fong, J., 2006; Yazdekhasti, Syed, & Arizi, 2013), and role-playing (Nikzadeh & Soudani, 2016) are all methodologies that have shown to offer therapeutic gains (Kipper & Ritchie, 2003), and delivering gratitude with such enactment methodologies is worthy of further investigation. Additionally, the usefulness of the VGV as a non-reading and non- writing intervention could have tremendous value for the more than 775 million adults in the world who are illiterate (list of countries by literacy rate, 2017). Interventions that can address the need to deliver the advantages of expressing gratitude to these individuals deserve research and application attention. People with concomitant intellectual and psychiatric disabilities who have no or low literacy are a primary clinical interest to the author, and the use of VGV in this context for the interested reader can be found elsewhere (Razza & Tomasulo, 2005; Tomasulo, 2014; Tomasulo & Szucs, 2016).

Second, the delivery of a gratitude letter as originally intended involves the availability of a live recipient. As the VGV uses role-playing with an empty chair to enact a gratitude visit, the intervention can include others who are unavailable. Using this empty chair approach may be helpful in four ways:

1. The person one has gratitude for may no longer be living and an enactment would be one way to activate the positive effects of the relationship.

2. The person may be alive, yet unavailable. As an example, it may be a person from childhood who has moved or a friend one has lost contact with.

3. As internal family systems have shown, there may be “parts” of ourselves that we have gratitude toward (such as a time when we had more resilience, grit, or joy in our lives). An enactment with these parts may be helpful in activating strength from another memory point in time. Role-playing allows this type of intra-psychic exploration of gratitude to take place.

4. Expressing gratitude toward God through an enactment may be particularly helpful.

Research by Rosmarin, Pirutinsky, Cohen, Galler, and Krumrei (2011) has shown (as others have) that gratitude is significantly correlated with religious commitment. But their research also found that the relationship between these two variables is fully mediated specifically when gratitude is directed toward God. With the VGV, using an unscripted monologue of God-directed gratitude toward an empty chair highlights this specific intention. It has also been demonstrated that when there is spiritual content in an enactment, mental health, happiness, and joy can be positively affected (Yazdekhasti, Syed, & Arizi, 2013).

Finally, a VGV performed in-vivo in the therapist’s office allows for both immediate feedback about its effectiveness and integration of the experience with the therapist. Accordingly, the client may be inspired to continue the work with more traditional positive clinical interventions beyond the session. In fact, recent research by Shahar, Bar-Kalifa, and Alon (2017) has shown specifically that the use of empty chair role-playing will help do just that. VGV Technique

(This description is taken largely from the article by Tomasulo, 2014). For this technique, two chairs are arranged, one for the protagonist and the second the (auxiliary) empty chair for the unavailable/other. The protagonist arranges the chairs in a way that symbolically depicts the relationship; that is, are the chairs close? Far apart? Side by side? One behind theother? The chairs’ arrangement sets the emotional tone for the encounter. The protagonist then sits in his or her chair and expresses gratitude toward the imagined unavailable/other in the empty chair. Following this, the protagonist reverses roles and becomes the auxiliary. In doing so, the protagonist responds as if the gratitude had just been expressed to him or her. This auxiliary role is then relinquished and the protagonist returns to the original chair, saying a closing remark to the empty chair. This ends the enactment.

The empty chair technique with a role reversal has the potential to activate several therapeutic elements. First, it allows for an unscripted expression of gratitude. There is no reading or writing involved. This would be a significant shift in how gratitude is studied and delivered. The research on expressing gratitude in written form demonstrates the power of expression. The VGV extends the method of expression, which appears to be both a necessary and natural extension of the ways gratitude can be used effectively in a clinical setting.

Second, the understanding accrued by reversing to the other role employs elements of empathy and learning of the other through theory of mind (Goldstein & Winner, 2012). This role-reversal allows for an amplification of the positivity of gratitude and integration as it is experienced as both sender and receiver. This learning helps to facilitate what Moreno referred to as a catharsis of integration: “Mental catharsis is here defined as a process which accompanies every type of learning, not only release and relief but also a catharsis of integration” (Moreno, 1953/1993, p. 206).

Inspire to Rewire: Use of the VGV in Group Therapy

As a member of a group using a VGV, a member can not only enact his or her gratitude, but also witness the expression of gratitude by others. Thus, even in an audience or participant/observer role, a client may derive benefit. Group therapy has traditionally provided a dynamic, low-cost treatment opportunity. By adding the VGV to the toolbox for group therapists, the collective well-being of the group can be enhanced. There are several reasons this approach is a valid and fruitful avenue for future research. First, psychodramatic role-playing has been shown to be effective within a wide variety of clinical conditions (Kipper & Ritchie, 2003; Hurley, Tomasulo, & Pfadt, 1998).

Second, at its core, the VGV is a narrative, which is one of the most pervasive and promising elements of positive interventions. As discussed by Tomasulo and Pawelski (2012), stories play a significant role both in psychological research and application. The expression of gratitude is a narrative of the benefits of the relationship. Several key positive interventions use participants’ narratives as a component in the research (Danner, Snowdon, & Friesen, 2001; Pennebaker, 1997, 2004; Seligman et al., 2005). Furthermore, three of the first five positive interventions reported on by Seligman and his colleagues (Seligman et al., 2005) involved the use of autobiographical narratives: the gratitude visit, you at your best, and three good things in your life. Storytelling was also a central feature in the teaching of positive psychology as Seligman and Chris Peterson began their first course with “serious introductions,” where each person tells a story about being his or her best self, and Paul Zak (Future of Storytelling) has articulated the biochemical changes that take place during an engaging story.

Other major positive intervention programs and research use storytelling as a central element in the means to deliver or facilitate the intervention. In fact, the Penn Resiliency Program (PRP), the world’s most widely researched program for the prevention of depression (Seligman, Ernst, Gillham, Reivich, & Linkins, 2009), includes storytelling as a central component. Paul Bloom (2010) and Jonathan Haidt (2006) believe there is great power in the use of story as a vehicle to extend empathic understanding. They believe the development of empathy using story may be part of the core dynamic inherent in why stories and psychodramas work.

Finally, a positive emotional enactment, as would be demonstrated by a VGV, has the power to activate elevation as defined by Haidt (2003) as an emotion elicited by witnessing virtuous acts of human goodness. Watching others express their gratitude is such an act, and there is direct evidence that elevation can uplift depressed clients (Erickson & Abelson, 2012). Through the established elements of elevation and clinical role-playing in groups, a VGV can elicit a positive emotional response simply by watching others express their gratitude. It is elevation that makes the expression of a positive emotional experience in a group setting an important feature for psychodramatists to amplify in enactments. The research on elevation shows that we are wired to notice human goodness. Haidt (2000, 2003) notes there are three main features of elevation: First, we are drawn to those scenes and stories that are elicitors, such as acts of courage, kindness, loyalty, or any other act of human goodness. Second, there is often a phenomenological and physiological reaction, such as a calm/relaxed, a warm/open/pleasant feeling in the chest, sometimes getting “choked up.” Finally, we are motivated by the elicitors to emulate and self-improve. Haidt (2003) noted that the motivational tendencies that elevation produces include merging with, opening to, and helping others. Psychodramatists are in a particularly good position in a group to use the methods of enactment to take advantage of the natural benefits of elevation. In Haidt’s words, we “inspire to rewire.”

To summarize:

• A VGV uses an unscripted enactment with an empty chair to express gratitude.
• It uses a role–reversal with the empty chair to integrate the emotional experience.
• It extends the method by which the positive intervention of a gratitude visit is delivered.
• Since an empty chair is used, gratitude can be expressed to individuals no longer alive.
• The empty chair also allows for an encounter with other stronger parts of the self.
• It can be used with people with low or no literacy.
• It can be used for spiritual growth by expressing gratitude toward God.
• It is an intervention that can be delivered face-to-face with the therapist during the session.
• In a group, it can benefit the protagonist and members due to the phenomenon of elevation.
• A VGV is a narrative intervention, a storytelling approach, amplified through role-playing.

As recent research and publications have confirmed (Slade, Brownell, Rashid, & Schrank, 2016), the need to extend positive interventions, particularly to difficult populations, is necessary. Psychodramatists have the tools to deliver new and modified versions of positive intervention as the mounting evidence shows that we can be powerfully moved by watching the psychodramativally enacted vignettes of human goodness.

The Hope Circuit...the original theory got it backward. —Steve Maier and Martin Seligman

Before looking to the future of the rich collaborative possibilities between positive psychology, psychodrama, and positive psychotherapy, it is helpful to revisit one of the key pieces of research upon which positive psychology grew.

The latest research by Maier and Seligman (2016) revisits the original work on learned helplessness. This body of investigation is the research foundation that generated the inquiry leading to learned optimism—and the eventual development of the field of positive psychology. Back then, now more than fifty years ago, their research showed that once animals learned nothing they did mattered, they stopped trying to escape—even when escape was possible. Maier and Seligman have now concluded their original hypothesis that animals could learn that their actions do not affect outcomes, was incorrect.

Through a series of intricate studies, Maier and Seligman have demonstrated the original conclusion was opposite of what they now hold to be true. By investigating the neural circuitry that regulates our fight/flight and fear/anxiety responses, it was discovered that both escapable and inescapable shocks activate the dorsal raphe nucleus (DRN). Further, they found that when the ventromedial prefrontal cortex (vmPFC), a part of the brain associated with risk processing, detects that shocks are escapable, it inhibits the DRN and turns off the effects of the shock. Passivity, giving up, is now understood to be a default reaction to extended aversive events. Nothing was “learned” about helplessness. What is learned is the possibility of control. In their own words: “Rather, passivity is an unlearned, default response to extended aversive events. Animals overcome this passivity by learning control, and the expectation of control mediates future responses to aversive events.”

The circuit created between the DRN and vmPFC has been identified by Maier and Seligman as the hope circuit, noting that hope is likely the best defense against helplessness.

Psychodramatists, from the very beginning, are purveyors of hope. Whether it has been untangling the ravages of trauma (Dayton, 2015), deepening the powers of sociodrama (Sternberg & Garcia, 2000) or exploring future possibilities (Baim, Burmeister & Maciel, 2013), we have guided our clients through a labyrinth of obstacles and awakenings. What makes us different in both good and bad ways is that we have, arguably, some of the best methodologies to activate and cultivate hope—with the least amount of research to support our efforts.

Recommendations and Future Directions

Going forward I’d like to make two recommendation: The first, for psychodramatists looking to add a depth of understanding to their work to consider engaging in a formal academic study of positive psychology at such places as the University of Pennsylvania’s Master of Applied Positive Psychology program. Jennifer Cory, a psychodrama trainee, has done this with an emphasis on applying it to resilience in coping with formidable health-related life challenges and is the assistant director at the New York Certificate in Applied Positive Psychology.

Such certificate programs are good ways for, psychodramatists to become engaged. There are several certificate well-established ones such as the previously mentioned New York Certificate in Applied Positive Psychology at the Open Center, as well as the Whole Being Institute, at Kripalu, and The Flourish Institute.

As Trainers of Psychodrama, Group Psychotherapy and Sociometry, Nancy Kirsner (Ph.D, TEP, CIPP, OTR) and Phoebe Atkinson (LCSW-R, TEP, CIPP, BCC) have been creating and teaching workshops over the last 5 years - bringing together main concepts of positive psychology with action methods (psychodrama and sociometry).

Both Phoebe and Nancy are graduates of the Certificate in Positive Psychology (CIPP) spearheaded by Dr. Tal Ben Shahar and Megan McDonough of the Whole Being Institute. Phoebe attended CiPP1 and was a CiPP2 Teaching Assistant. She later joined WBI/CiPP as a faculty member. As CiPP TA Mentor Phoebe utilized concepts from sociometry and positive psychology in order to enhance team effectiveness and accelerate connections throughout the student body. Nancy was a TA in the CIPP Program for two consecutive years and also created an 8 week course, Positive Psychology and Jewish Fundamentals which she has been teaching for the past 3 years. She is also the editor of the Psychodrama Network News (ASGPP) and has written features such as: Psychodrama and Positive Psychology- A Perfect Fit; Story telling, Story Doing and the Brain, and Character Strengths in Action. They have presented their workshops at annual conferences of ASGPP (The American Society for Psychodrama, Sociometry, and Group Psychotherapy) entitled: Moreno and PP: A Perfect Fit; Positive Psychology and Psychodrama: Tools for the Journey; and Character Strengths: Action Explorations. Jennifer, Phoebe and Nancy are exemplars of how enhanced training in positive psychology combined with psychodrama skills can enhance and enrich both fields.

There are also Coursera programs, such as the one by Marty Seligman on the Foundations of Positive Psychology., that are widely available to gain an understanding of the basics, and for professional development there are several continuing education courses within your profession.

There are also a plethora of books on the subject and interested readers are directed to Martin Seligman’s above noted Flourish and Authentic Happiness, or Tal Ben-Shahar’s Happier: Learn the Secrets to Daily Joy and Lasting Fulfillment (2007), or Christopher Peterson’s A Primer in Positive Psychology (2006).

There are countless practitioners integrating many aspects of positive psychology into their work already, and this trend will continue to benefit those who have come to alleviate their suffering while increasing their well-being. This brings us to the second recommendation.

Psychodramatists need to do more research on the techniques they are creatively using. Historically, this has been the greatest stumbling block in more widespread use and understanding of psychodramatic methods. While there have been some notable efforts, the next phase of our growth as a community needs to be aligning ourselves with the demand for evidence-based practices. Not to do so, not to show the effectiveness of what we are doing, will hide our light under a bushel—and our contributions have too much potential to let this happen. Moreno’s influence was woven into the tapestry of the positive psychology and positive psychotherapy movements right from the beginning. Psychodrama continues to have a unique opportunity to cultivate hope through strength-based practices, while bringing a degree of creativity to these movements that may otherwise go unrealized. Because of this, eunoia, and striving toward more beautiful thinking, is within our grasp. In full circle, the theory and methods of psychodrama have initiated and are now poised to advance the most powerful, dynamic development in the history of psychology. Perhaps the words of T.S. Elliot best describe our challenge and the legacy of our journey as psychodramatists:“We shall not cease from exploration, and the end of all our exploring will be to arrive where we started and know the place for the first time.”

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