Think positively? It's not that simple. Why deep work is important.

The trendiest trend in pop psych these days is, unquestionably, "positive psychology," and not without good reason. The Greater Good Science Center at UC Berkeley, in particular, has become an interpreter and champion of the movement in recent years, and has gathered some impressive research. But there are two problems with this movement. First, the messages that pop psych websites and mainstream magazines are putting out there are watered down and often distorted versions of the research and theorizing of the likes of Martin Seligman and Dacher Keltner. Second, there's a lot of research and theory out there that contradicts some of the basic tenets of positive psychology, including, in order of relative importance in the positive psychology world: (a) you can think away your negative emotions and (b) negative emotions are bad.

I'll leave the first problem to the positive psychologists themselves, as it's more than I have room for here. Besides, I believe the second problem is far more pressing, because the research out there that's getting overshadowed is important, not knowing about it is hurting people, and there's some serious institutional and systemic resistance to getting the information they need (more on that later). Okay, so let's take a look at those tenets of positive psychology I mentioned above.

This first tenet comes right out of the movement that birthed positive psychology, Cognitive Behavioral Therapy, or CBT. For reasons I'm about to explain, positive psychology and CBT have become the darlings of researchers and insurance companies alike.  You see, insurance companies have a vested interest in showing that short-term treatments work better than long-term treatments. It's the same reason they'd rather you went to your PCP and got a short term script for Celexa or Wellbutrin. So much cheaper than therapy. And so the insurance industry (not to mention the pharmaceutical industry) has poured billions of dollars into trying to prove that drugs work best (actually, they're the least effective treatment on their own (though, for some people, they can be a very important adjunct to therapy), for most conditions, as seen in this chart), or that, failing that, short-term, manualized treatments are superior. If you really want to dive in, this user-friendly article can assure you that, not only are they not, but the more severe, longer-standing, and more complicated and co-morbid (meaning you have more than one kind of symptom, like having anxiety and depression, or OCD and an eating disorder and PTSD) your suffering, and the shorter and more manualized your treatment, the less-likely you are to get anything in the long-term from your therapy.

I know, that all sounds pretty depressing. But remember that user-friendly article I just posted? Even if you didn't read it, there's something pretty important you should know. MOST people who come to therapy fall into the category of having long-standing, complicated, and comorbid suffering, and we've been successfully treating folks like that for over a century! On top of nearly a century and a half of experience helping and healing people like you, we're finally figuring out how to actually research and quantify this without breaking it down into unrealistic manuals and just telling our patients to "choose to be happy!"

This isn’t to say manualized therapies aren’t useful or helpful! There are applications for these treatments, especially when used in conjunction with deeper treatments, by skilled clinicians, but a discussion of the nature of those therapies is beyond the scope of of this post. Short-term, manualized, and simple treatments are still a whole lot easier to research than complex, long-term subjective ones. In other words, treatments that have straightforward, one-size-fits-all, measurable, objective-rather-than-subjective, and rigid-rather-than-flexible applications are easy to research, and tend to be 'manualizable' and short. Exactly what researchers and and insurers like. If you want to know more about the fallacy of the "EVT (Empirically Validated Treatment) Boogeyman," as Irvin Yalom (2017) calls it, see Dr. Johnathan Shedler's clear and cogent summary of the problems and biases facing current research in the social sciences and especially in the study of non-manualized therapies: Where is the Evidence for Evidence Based Therapy?

Which is not to say there’s no such thing as good research or evidence out there on therapy. On the contrary, there are an increasing number of studies that have come out in the last several decades using more holistic and balanced approaches to research, which increasingly support longer-term, more depth-oriented treatments. Check out this article to read more about the research.

So let's get back to that boogeyman and the question of what we do with positive psychology in the age of CBT, EVT, and the quick fix next time. What do you guys think?

Thanks for making all comments anonymous for your confidentiality!

Yalom, I. (2017). The gift of therapy: An open letter to a new generation of therapists and their patients. Harper Perennial. New York: NY