Beyond Abstinence

How to flourish in addiction recovery

What’s Right With This Picture?

Athletes, Addicts Winning With Positive Psychology

The team is leaving the field after an atrocious first half. Trudging into the locker room, everyone knows what’s waiting for them—a screaming, beet-faced coach, veins popping, ridiculing them for every miscue. We’ve all seen the videotape. We’ve seen the movies. That’s how it’s done in football.

But first-year Jacksonville Jaguars’ coach Gus Bradley took a different approach. Week after week, Bradley chose to highlight what his team was doing right. Even after a 45-17 drubbing against the Seattle Seahawks last September, Bradley was determined to accentuate the positive.

The positive?

After losing their first eight games, the Jaguars showed steady improvement and went on to win four of their last eight. 

“He finds a positive in everything,” Jaguars’ running back Maurice Jones-Drew told the Florida Times-Union. “It’s easy to go negative, but Gus finds a positive.”

This same “focus-on-your-strengths” approach is now being used in the life-and-death struggle of mental illness and drug addiction treatment, helping patients who have every reason in the world to dwell on the devastation they’ve brought to their lives and the lives of others.

Whether it’s in recovery from addiction or depression, or an athlete facing seemingly insurmountable odds on the football field, focusing on the best of what you have will take you further than trying to shore up your weaknesses. Bradley’s approach is pure positive psychology.

Flourishing in Recovery

For too long, addiction treatment has applied the same uni-dimensional approach to “attacking” mental illness. We’re not mavericks, mind you. Business as usual in nearly every healthcare sector has been strictly concerned with finding a problem and trying to remove it. This approach makes sense if you think wellness = absence of illness, but it makes no sense if you think wellness = thriving. You see, removing illness is necessary in many cases, but even when you are successful at it, you simply shift to neutral. 

Positive psychology is not a pill, it is not wishful thinking and is not self-help. It uses the same scientific method used in medicine. But instead of concentrating on disease, dysfunction and disorders, positive psychology analyzes the elements that lead to flourishing, a.k.a., “happiness.” This is accomplished by integrating existing effective approaches to treatment with interventions that enhance well-being.

I was called, for lack of a better word, to study at the University of Pennsylvania under Martin Seligman, the father of positive psychology. “Marty,” as I call him, is into his 70s and ranks No. 5 on the list of extremely eminent psychologists. Even with my full-time job, three kids and a wife, I figured that I could not pass up the chance of a lifetime to study under such a master. As it turned out, his supporting cast blew my mind as well, and every month when I flew from Houston to Philadelphia to attend class, I felt as if I were having a 72-hour intellectual orgasm. But I digress.

A simple intervention in positive psychology called “three blessings” - when a patient is asked to write down three things that went well each day and why - is one of many exercises used in positive psychology to increase happiness and life satisfaction. In the words of Seligman: “We looked at the effect on severe depression of doing the three blessings. In this uncontrolled study, 94% of severely depressed people became less depressed and 92% became happier, with an average symptom relief of a whopping 50% over only 15 days. This compares very favorably with anti-depressant medication and with psychotherapy.”

“Best ideal self,” another proven happiness-booster, invites people to write about their best future selves for 20 minutes each day for three days. Here’s how it works: “Imagine that you woke up 10 years from now and your life is ideal in every way. Don't worry about how you got there. What are you doing, with whom and where? Write about the perfect life, the perfect self, the perfect everything.” Beginning with the ideal future and then contrasting it to current conditions builds motivation, optimism and positivity toward making it happen

These two scientifically validated clinical tools appear rather tepid when you see how easy they are to apply. Many clinical interventions we use are expensive, invasive or involve medication. These two are inexpensive, benign and uncomplicated. 

“Positives”are not meant to replace business as usual in mental health or substance abuse treatment, but do serve to balance what has long been overly one-sided and focused on the negatives in life. To me, these ingredients are what a life in recovery provides. Recovery includes abstinence, but is not limited to it in the same way that human flourishing includes the absence of grave illness. Recovery is defined by a much richer experience than just sobriety. Recovery is a lifestyle with sobriety, positivity, engagement, relationships, meaning, service, personal growth and achievement. 

I started applying such tools as the “three blessings” and “best ideal self” in my private practice in Houston. That’s where I met Jana, who was on her fourth detoxification treatment from alcohol. She had PTSD, major depressive disorder and generalized anxiety disorder on top of her alcoholism, and continuously wanted to talk about “what’s wrong with me.” I discovered that she had been in therapy for years, detoxed three previous times elsewhere, and the topic “what’s wrong with me” was foremost on her mind. So naturally, she assumed our visits would be more of the same. She was prepared to dive in and felt the part: She was slumped over, face furrowed, and seemed to be carrying an awfully large but invisible knapsack.

I decided to try a novel approach, using positive psychology, when I asked her to describe her at her best. It’s a little tool called a “positive introduction,” where patients tell stories about themselves doing something that reflects their strengths or other best qualities. The concept was so foreign to Jana that I had to coax her with my own positive introduction so she could grasp what I was asking for, and, finally, she began.

In less than two minutes, her posture improved, her face went to a grin from a frown, and she appeared “lighter” to me - as if I could weigh her with my eyes (which I can’t but you get the point).  Through her story, I discovered that this alcoholic with PTSD and other real issues also was brave, loved learning and had a profound appreciation of beauty.Together we devised a plan that included using her strengths to build up her life instead of always trying to look back in the hope of changing something.

Like Jacksonville’s Bradley knows, you cannot ignore the positives if you expect to thrive. I’m sure he also agrees that you can’t pretend all is well all the time, either. Yes, weaknesses should be identified and shored up ... but it’s even more effective to build up what’s going right to the point that you can make many weaknesses irrelevant. That’s what Bradley has been doing so far, it’s what I hope Texans’ owner Bob McNair will do with my poor Houston Texans, and it’s what we’re about to do in treatment in Houston on a large scale as we launch positive recovery.

For more about the field of positive psychology, check out the website Authentic Happiness.

Since 2006, Dr. Jason Powers, MD, has served as chief medical officer for Right Step in Texas. Before coming to Right Step, Powers had a private medical practice, and worked as an assistant professor in the Department of Family and Community Medicine at Baylor College of Medicine in Houston. In 2003, Powers re-dedicated his career to helping addicts and their families after he personally faced addiction. Powers is board certified in family medicine and certified by the American Board of Addiction.

Jason Powers, M.D., is certified in addiction and family medicine and serves as chief medical officer at Right Step and Promises Austin.
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