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Positive Psychiatry: Promoting Well-Being

  • March 01, 2024

Positive psychiatry focuses on the positive aspects of mental health. It is defined as the “science and practice of psychiatry that focuses on the study and promotion of mental health and well-being through enhancement of positive psychosocial factors,” in a recent special report in Psychiatric News by former APA President Dilip V. Jeste, M.D. As Dr. Jeste notes, while about 20% of people are affected by mental disorders, “100% of people have mental health including some positive traits. Positive psychiatry is an approach to mental health that can speak to everyone with or without a psychiatric disorder.”

Jeste says psychiatrists generally focus on difficulties and problems but do not often ask about the positive aspects of patient’s lives: “What are your strengths? What do you like about yourself? What things do you enjoy doing? What makes you happy? Who are the people you like to spend time with? What makes them your best friends? What do you think prevented a relapse of your depression during the last five years?”

These often-unasked questions can help mental health professionals understand the whole person and help identify therapies and treatments in which people will want to engage. The table below identifies some of the key differences between traditional psychiatry and positive psychiatry.

Table 1. Main Differences Between Traditional Psychiatry and Positive Psychiatry

Variable Traditional Psychiatry Positive Psychiatry
Targeted patients Those with mental illnesses Those experiencing or at high risk of developing mental or physical illnesses
Assessment focus Mental disorders Positive attributes and strengths
Research focus Risk factors Protective factors
Treatment goal Symptom relief and relapse prevention Recovery, increased well-being successful aging, posttraumatic growth
Main treatment Medications and, generally, short-term psychotherapies for symptom relief and relapse prevention Psychosocial/behavioral (and increasingly, biological) interventions to enhance positive attributes
Type of prevention Tertiary prevention Primary prevention

Adapted from Dilip V. Jeste, et al. The Journal of Clinical Psychiatry June 2015.

What is Positive Psychiatry in Practice?

Positive psychiatry interventions include a range of treatments that are supported by research and have a positive effect on well-being. They are focused on enhancing well-being and happiness rather than on reducing psychiatric symptoms which is the focus of traditional behavioral interventions. A few of the key elements and types of interventions highlighted by Dr. Jeste include resilience, wisdom, meaning in life and mind-body interventions.

Resilience intervention studies

Resilience is a trait or a process that describes the ability to recover from adverse situations and to adapt in the face of adversity, trauma, tragedy or other major stress. Numerous studies have reported positive outcomes and reported resilience to be associated with emotional stability, social connectedness and lower rates of depression. For example, a group resilience intervention for older adults with chronic illnesses involving shared lived experiences, relaxation techniques, management of stress, and coping strategies produced a significant increase in perceived resilience. A group-based intervention aimed at increasing positive emotions also led to a significant increase in resilience.

Wisdom interventions

Wisdom is a personality trait with components such as prosocial attitudes and behaviors (empathy and compassion), self-reflection, emotional regulation, acceptance of uncertainty and diversity of perspectives and rational decision-making. Across the lifespan, wisdom is associated with positive outcomes including better overall physical and mental health, happiness, and lower levels of depression and greater life satisfaction. Interventions may target specific components of wisdom such as prosocial behaviors, emotional regulation and spirituality. An eight-session group-based intervention, for example, was effective in improving self-compassion and well-being.

Meaning in life interventions

Meaning or purpose in life is the perception of one’s own life and activities and their value and importance. Multiple research studies have found a strong link between purpose and better physical, mental, and overall health outcomes across the adult lifespan. Meaning in life may also be a protective factor against suicide. One example of a meaning in life intervention is a life review intervention which involves storytelling with a focus on integrating life stories through different phases in life. This storytelling can be in an individual or group setting. Life review interventions have been found to improve well-being and depressive symptoms in older adults. This type of intervention has also been used to enhance meaning in life among patients with advanced diseases. One such effort involving two to eight sessions of 30 to 90 minutes each found positive outcomes of meaning of life, spiritual well-being, quality of life, anxiety, and physical symptoms.

Mind-body interventions

Mindfulness interventions have been found to improve the physical response to stress by promoting acceptance and nonreactivity toward potential stressors. Brain imaging studies suggest that mindfulness enhances neurocircuitry associated with increased empathy and emotional processing. Similar to mindfulness, yoga-based treatments have been reported to have a positive impact on self-regulation and psychological resilience. A research review of the impact of yoga on clinical outcomes in people with schizophrenia found improvement in quality of life. Another approach that is related to but distinct from mindfulness and yoga is focused compassion training. Self-compassion meditation training has been reported to reduce anxiety and improve physiological responses to social stressors.


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