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Bulimia Nervosa

How Can Positive Psychology Be More Open to the Negative?

What can psychopathology teach us about how to flourish?

This is part of a series of blog posts from chapters of Designing Positive Psychology, a book edited by Dr. Ken Sheldon, Dr. Michael Steger, and myself.

Detectible among at least some positive psychology circles is an inflexible insistence that only the positive be studied. Recently, there has been a defensive reaction to this statement by the positive psychology community who claim that there are studies of post-traumatic growth, perseverance, and evidence that people require a certain frequency of positive events to offset a negative event. My response would be this—for most researchers and coaches tying themselves to positive psychology, the attention to negative events and disturbances is superficial at best. Of course, there are beautiful, underappreciated exceptions such as:

Boyce, C. J., & Wood, A. M. (2011). Personality prior to disability determines adaptation: Agreeable individuals recover lost life satisfaction faster and more completely. Psychological Science, 22, 1397-1402.

Denson, T. F., Spanovic, M., & Miller, N. (2009). Cognitive appraisals and emotions predict cortisol and immune responses: a meta-analysis of acute laboratory social stressors and emotion inductions. Psychological Bulletin,135(6), 823-853.

Segerstrom, S. C. (2008). Social networks and immunosuppression during stress: relationship conflict or energy conservation?. Brain, Behavior, and Immunity, 22(3), 279-284.

Without question, an obsessive focus on the positive (emotions, traits/strengths, relationships, communities) has led to many important insights about the factors that contribute to human flourishing. By shutting their eyes to the negative, however, positive psychology folks are falling short of their full potential. In this brief post, I introduce psychopathology theory and research to demonstrate that insight about the positive can and should be gleaned from the negative as well as the positive. Similarly, I argue that psychopathology researchers should both study psychopathology and simultaneously draw out its general implications for human nature, regardless of whether such implications are of direct value for people suffering from disorders or normal, healthy blokes.

An Example of Abnormal Conditions Illuminating the Nature of Psychological Well-Being

Why are bulimic symptoms so persistent? Self-verification theory (e.g., Swann, Stein-Seroussi, & Giesler, 1992) provides one possible answer. An intriguing possibility is that bulimic women, in an effort to meet self-verification needs, solicit information from others that perpetuates their body dissatisfaction and low self-esteem, and thus their bulimic symptoms. Bulimic women clearly experience self-esteem problems—problems which involve physical appearance and body satisfaction, and also include other aspects of self-esteem. But is it possible that bulimic women structure interpersonal discourse such that these negative views—views which by all accounts are quite painful—are stabilized and perpetuated? Isn’t this the last thing a bulimic woman would want (by all clinical accounts, it is)? With a goal of providing a preliminary answer to these questions, Joiner (1999) conducted a study that looked at the relationship between interest in negative feedback, bulimic symptoms, and body dissatisfaction.

There were 3 primary findings.

1. Results showed that interest in negative feedback from others was correlated with bulimic symptoms and body dissatisfaction, thus suggesting that bulimic women—despite grave concerns about physical appearance—may preferentially solicit negative feedback from others.

2. Women who expressed interest in negative feedback at one point in time were more vulnerable than other women to future increases in body dissatisfaction and bulimic symptoms, thus suggesting that negative feedback seeking is involved in instigating and perpetuating the occurrence of bulimic symptoms.

3. The relation between interest in negative feedback and bulimic symptom increases was mediated by changes in body dissatisfaction.

Overall, these results show that bulimic women may get caught in a vicious cycle wherein they need the very interpersonal responses that serve to maintain or exacerbate their symptoms. An excruciating dilemma emerges: Either sacrifice self-confirmation needs and thus escape from bulimia; or, meet self-confirmation needs at the price of bulimia. Why don’t bulimic women choose the former option (i.e., sacrifice self-confirmation and escape bulimia)? According to Swann and colleagues (1992), the self-confirmation motive is extremely difficult to overcome because it serves fundamental human needs for predictability, certainty, and a consistent identity. A main point of this study, then—and the reason it is relevant to understanding well-being—is that this study illuminates the fact that the desire for self-verification is so fundamental to human nature that bulimic women will seek the very feedback they dread in order to satisfy it.

Without investigating the negative to glean insights about the positive, it would be difficult to gain a comprehensive understanding of just how vital the desire for self-verification is for people. Research on self-verification in bulimic women provides an example of not only the potential that exists for positive psychology researchers/practitioners to glean insights about the positive from the negative, but it also highlights how important it is for psychopathology researchers to bring their own research findings back from the depths of despair to what humans require to function at their best.

I am calling for positive psychology researchers/practitioners and psychopathology researchers/practitioners alike to take on the “double duty” of keeping their eyes open to both the hellish and the heavenly. If researchers allow their work to be informed by both the positive and the negative, this integration will undoubtedly lead the field to progress. A superficial mention of the evolutionary value of fear, anger, and guilt will not suffice. Integration is the key word here. Each of us has to decide on the end game—is the goal to help people become more positive or a fully functioning, human being? The former is artificial and the latter is messy and nuanced. Choose to see the complexity of human beings, and we will be of greater service to helping ourselves and humanity.

Bulimia Nervosa Essential Reads

Most of the ideas in this post have been drawn from Chapter 20, authored by Jennifer Hames and Thomas Joiner, in Designing Positive Psychology.

NEWS: check out my lab's long awaited meta-analysis on ‪anxiety disorder‬ distress and impairment. Pay attention to the storyline that how much distress someone experiences tells us rather little about how impaired they are.

Dr. Todd B. Kashdan is a public speaker, psychologist, and professor of psychology and senior scientist at the Center for the Advancement of Well-Being at George Mason University. His new book is The upside of your dark side: Why being your whole self - not just your “good” self - drives success and fulfillment. If you're interested in speaking engagements or workshops, go to: