A Harvard Medical School Special Health Report Positive Psychology  Harnessing the power of happiness, mindfulness, and inner strength In this report:
7 happiness exercises
Leveraging your
virtues and strengths
Learning to
savor pleasure
The art of gratitude
Getting in the flow
Finding meaning
The brain on positive
emotions
SPECIAL BONUS SECTION Mindfulness:
A path to well-being Price: $29 This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu POSITIVE PSYCHOLOGY
SPECIAL HEALTH REPORT Medical Editor
Ronald D. Siegel, Psy.D.
Assistant Professor of Psychology (part time)
Harvard Medical School,
Cambridge Health Alliance Executive Editor
Anne Underwood
Writer
Julie Corliss
Susan Ince
Copy Editor
Robin Netherton
Creative Director
Judi Crouse
Production Manager
Lori Wendin
Illustrator
Scott Leighton
Published by Harvard Medical School
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The goal of materials provided by Harvard Health Publications
is to interpret medical information for the general reader.
This report is not intended as a substitute for personal medical
advice, which should be obtained directly from a physician. Contents
Studying satisfaction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Tracking happiness levels scientifically. . . . . . . . . . . . . . . . . . . . .
The roots of positive psychology . . . . . . . . . . . . . . . . . . . . . . . . .
The brain on positive emotions. . . . . . . . . . . . . . . . . . . . . . . . . .
Positive psychology’s critics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
3
5
6 Happiness: What is it?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Happiness and your genes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Pleasure’s fleeting nature. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Happiness and health. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 How do you ‘get happy’?. . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Routes to happiness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
What won’t make you happy. . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 Finding your inner strengths. . . . . . . . . . . . . . . . . . . . . . . . 14
Shedding light on character. . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
What are virtues and strengths?. . . . . . . . . . . . . . . . . . . . . . . . 14 Gratitude. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Counting your blessings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Savoring pleasure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Happiness and choice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Flow: Getting engaged and absorbed. . . . . . . . . . . . . . . . . 22
What is flow?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
Matching your skill level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Flowing through the work flow . . . . . . . . . . . . . . . . . . . . . . . . . . 23 SPECIAL SECTION: Mindfulness: A path to well-being. . . . . . 25 Self-compassion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Defining self-compassion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Why develop self-compassion? . . . . . . . . . . . . . . . . . . . . . . . . . 30
Learn to have self-compassion . . . . . . . . . . . . . . . . . . . . . . . . . 31 Finding your life’s meaning. . . . . . . . . . . . . . . . . . . . . . . . . 32
Practice random acts of kindness . . . . . . . . . . . . . . . . . . . . . . . 33 Positive psychology during difficult times. . . . . . . . . . . . . . 35
Taking positive psychology beyond yourself. . . . . . . . . . . . 37
Positive relationships. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Positive communities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Using positive psychology in psychotherapy . . . . . . . . . . . . . . . .
Finding help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Moving forward. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
38
39
40
42 Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu Dear Reader,
In the summer of 2015, the surgeon general of the United States, Dr. Vivek Murthy, appeared
on National Public Radio’s show Wait Wait … Don’t Tell Me! and shared some thoughts
about how to improve Americans’ health and well-being. Most people think that you need to
be healthy in order to be happy, said Dr. Murthy, a cardiologist at Harvard-affiliated Brigham
and Women’s Hospital. “But I actually think a lot of times it’s the other way around,” he said.
He went on to describe some of the things people can do to improve their happiness, like
spending time with friends, boosting social connections, and exercising.
These strategies are among those described in this report, which focuses on the field of
mental health research and treatment known as positive psychology. Positive psychology
seeks to help people capitalize on their strengths, to heighten their awareness of pleasure and
well-being, and to develop the wisdom needed to live a more fulfilling life.
Early on, much of the focus in this nascent field was on the pursuit of happiness, which
was understood as having pleasant feelings more of the time. But in recent years, positive
psychology has evolved to emphasize cultivation of long-term satisfaction, contentment, and
well-being, as opposed to often-fleeting pleasurable experiences. In fact, studies show that
people who experience a wide range of emotions—including negative ones—tend to report
greater satisfaction with their lives than those with a more limited range of feelings. Contrary
to what you might expect, trying to resist painful emotions creates a certain degree of psychological suffering. By opening to pain, people suffer less.
Some of the tenets of positive psychology echo advice heard from wise elders and religious
teachers across cultures and centuries. For example, the practice of mindfulness—paying
attention to your thoughts, emotions, and other experiences on a moment-to-moment basis,
without judgment—has roots in Buddhism and other wisdom traditions. Mindfulness,
which has enjoyed a surge of popularity in recent years, is perhaps the best-known practice
for enhancing well-being. But there are many others, including gratitude, self-compassion,
and cultivation of your personal virtues and strengths. You can explore all of these in the
following pages.
Sincerely,
 Ronald D. Siegel, Psy.D.

Medical Editor Harvard Health Publications | Harvard Medical School | 10 Shattuck Street, Second Floor | Boston, MA 02115
This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu Studying satisfaction Tracking happiness levels
scientifically
Well-being, of course, is a very subjective and individual experience. Doctors can’t quantify it the way
they can measure blood pressure or body temperature.
In order to conduct valid studies, psychologists have
needed to seek ways to measure satisfaction that can
be used to compare one group of people with another,
2 Positive Psychology  Thinkstock P ositive psychology is an umbrella term that encompasses the study of positive emotions, full
engagement in activities, virtuous personal characteristics, and paths to fulfillment and meaning in
life. It also investigates how people and institutions
can support the quest for increased satisfaction and
meaning.
The study of mental health used to focus primarily on treating mental illness and paid scant attention
to the development of meaning, fulfillment, positive
emotion, and connection—all of which are crucial to
the quality of daily life. Positive psychology doesn’t
consider the traditional approach of treating mental
illness to be misguided. Rather, it supplements the
study of mental disorders and their treatment, placing attention on strengths as well as weaknesses, and
taking what has been learned about psychological
science and applying it to the goal of greater happiness and meaning.
What if you don’t have a psychological disorder
but you’d like to improve your emotional state, find
more meaning in your life, or fulfill your potential?
The growth of the field of positive psychology has
expanded the number of individuals who are benefiting from techniques and therapies aimed at helping
them develop a positive outlook that improves the
quality of their daily lives. This burgeoning field also
addresses questions of happiness, vitality, and meaning in life as worthy of serious scientific research. The field of positive psychology has led to the development
of techniques and therapies that can help you find greater
satisfaction and meaning in life, harness your strengths,
nurture positive emotions, and connect with others. and to track individuals over time to assess the impact
of life events or interventions. These measures focus
on people’s emotions and how they assess their lives.
Some measures, such as the Positive and Negative
Affect Schedule, frequently used by researchers, ask
people to rate their current experience of various positive and negative emotions. Others ask people to think
about their lives and rate their satisfaction. Satisfaction measures may focus on a specific domain of life,
such as health or career, or they may use more general
questions that rate overall satisfaction, factoring in
various aspects of life.
To get a sense of your current level of satisfaction, try the Satisfaction with Life Scale (see “Measuring your level of satisfaction,” page 3), a quick
measure that is used in many positive psychology
studies. In-depth assessment questionnaires are
available online at the Authentic Happiness website
( www.authentichappiness.com ) run by psychologist
Martin Seligman and other researchers at the University of Pennsylvania.
w w w.h ealt h .ha r va r d.e du This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu The roots of positive psychology
The concepts underlying positive psychology are not
new. Virtually all of the world’s religions and philosophies offer paths to inner peace, meaning, and fulfillment. Buddhism, one source of ancient wisdom,
teaches that a person can find psychological freedom
and inner peace through recognizing the interconnectedness of all things, transcending the illusion of a
separate self, and coming to accept the inevitability of
change. Other religions, including Judaism, Christianity, and Islam, have for many centuries embraced the
idea that happiness and rewards result from following
God’s will as revealed in scripture.
Philosophers from the ancient Greeks onward
have promoted differing schools of thought on how to
find happiness and fulfillment and held varying views
on the positive aspects of human experience. Aristotle believed that happiness, which he called eudai- monia (“eudaemonia” in English), is achieved through
knowing your true self and acting in accordance with
your virtues. By contrast, Epicurus and the Hedonists
held that maximizing pleasure and minimizing pain
was the way to happiness, while the Stoics extolled
the value of remaining objective, unswayed by either
pleasure or pain.
Centuries later, the utilitarian philosophers of the
18th and 19th centuries, including John Stuart Mill,
believed that moral actions maximize happiness—
not for the individual, but for the greatest number
of people. Other schools of thought have been more
individualistic. The Romantics, for example, valued
individual emotional expression and high passion.
In its early days, the science of psychology also
explored pathways to well-being. For example, during a long career at Harvard, the psychologist William
James (1842–1910) was fascinated by whether and Measuring your level of satisfaction
This one-minute survey is used in many studies to gauge contentment and satisfaction.
Below are five statements that you may agree or disagree with. Using the 1–7 scale below, write down a score to indicate
your agreement with each item. Be open and honest in your responses.
1
Strongly
disagree 2
Disagree 3
Slightly
disagree 4
Neither agree
nor disagree STATEMENT 5
Slightly agree SCORE In most ways my life is close to my ideal.
The conditions of my life are excellent.
I am satisfied with my life.
So far I have gotten the important things I want in life.
If I could live my life over, I would change almost nothing.
Add up your scores 6
Agree 7
Strongly agree INTERPRETATION 31–35 Extremely satisfied 26 –30 Satisfied 21–25 Slightly satisfied 20 Neutral 15–19 Slightly dissatisfied 10–14 Dissatisfied 5–9 Extremely dissatisfied A short test such as this can give only a general idea of your level of satisfaction and happiness. Your score will depend on
your feelings about your life to date, your current circumstances, and the short-term effect of recent events.
If your score indicates you are satisfied or extremely satisfied, you find most areas of your life to be very rewarding.
If you score as slightly satisfied, neutral, or slightly dissatisfied, there are probably several areas of your life that you
would like to improve. If so, this report offers a number of strategies.
If you score as dissatisfied to extremely dissatisfied, you may be reacting to recent bad events. However, if you have felt
this way for a long time and are not feeling optimistic about the future, you may need to make significant changes in your
life, and you might benefit from seeking help from a mental health professional. ww w. h ealt h . h ar v ar d . e du Positive Psychology This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu 3 knowledge to assist people in their quest for joy and
fulfillment.
In this transition, the American psychologist
Abraham Maslow (1908–1970) proved to be a key figure. Maslow is credited with coining the term positive
psychology in 1954. He also introduced the concept of
“self-actualization,” a yearning for growth and meaning in life that some people pursue after their more
basic needs—such as food and safety—have been met
(see Figure 1, below).
The field took another step forward in the 1990s
when University of Pennsylvania psychologist Martin Seligman broke new ground with his concept of
“learned optimism,” widely considered a precursor
to today’s study of positive emotions. Learned optimism was an outgrowth of Seligman’s earlier work on
the concept of “learned helplessness,” the apathy and
depression that can ensue when people or animals are
placed in distressing situations where they have little
control (like a baby whose cries are never answered).
Seligman described optimism as a trait of most happy
people and found that optimism could be nurtured by
teaching people to challenge their
patterns of negative thinking and
Figure 1: Maslow’s hierarchy of needs
appreciate their strengths. This
idea that people can become hapThe human pursuit of higher goals and
pier by bolstering and using their
fulfillment (represented in the upper layers
inherent strengths is central to
of the pyramid) can only be undertaken
positive psychology.
after basic needs are met (represented in
morality,
creativity,
the lower layers), according to Abraham
More recently, Harvard psyspontaneity,
Maslow’s hierarchy of needs,
chologist Daniel Gilbert began
problem
developed in 1943.
exploring how well people predict
solving,
lack of prejudice,
what will make them happy. In a
acceptance
of
facts
series of experiments, he and colSelf-actualization
leagues demonstrated again and
self-esteem, confidence,
again that people are remarkably
achievement, respect of others,
respect
by
others
poor at this. The problem lies in
Esteem
the human ability to imagine the
friendship, family,
future or the past. How you feel
sexual intimacy
Love/Belonging
in the moment colors how you
imagine you will feel in the future,
security of body, of employment, of resources,
and alters your ability to predict
of morality, of the family, of health, of property
Safety
whether something will make
you happy in the future, Gilbert
breathing, food, water, sex, sleep, homeostasis, excretion
Physiological
explained in his book Stumbling on
how various transcendent and mystical experiences
help people live better, fuller lives.
In contrast to these earlier traditions, most of
20th-century psychiatry and psychology shifted the
focus to psychological disorders, working within a
medical model designed to move people from painful
mental states to more neutral ones. Sigmund Freud,
for example, sought to turn “hysterical misery into
ordinary human unhappiness.” After World War II,
clinical psychology, with its focus on treating mental
disorders, quickly became the largest psychological
discipline, spurred on by the necessity of treating the
many soldiers who returned from combat with mental health issues. Although this was clearly beneficial
to those in need, eventually some psychologists and
other mental health professionals became dissatisfied with the field’s predominant focus on treating
mental illness, alleviating the effects of psychological
trauma, and interrupting maladaptive behavior patterns. Instead, these new thinkers sought to understand positive emotions, psychological strengths,
and optimal human functioning, and to use that 4 Positive Psychology  w w w.h ealt h .ha r va r d.e du This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu Happiness. The truth is, Gilbert said, bad things don’t
affect people as profoundly as they expect them to.
That’s true of good things, too. People adapt remarkably quickly to either.
In 2011, Seligman jumped back into the discussion about what makes us happy with his concept of
“PERMA.” The letters stand for the components that
he said allow people to flourish: positive emotion,
engagement, relationships, meaning, and accomplishment. These, he said in his 2011 book Flourish, are the
building blocks of a fulfilled life.
The field of positive psychology has grown exponentially in recent years. Positive psychology conferences are held around the world, academic journals
showcase the research, and hundreds of colleges and
universities offer classes on the topic. Positive psychology methods are now used widely by mental health
professionals to help a variety of people with different
problems. The brain on positive emotions
While many researchers have studied positive emotions by observing human and animal behavior, others are trying to discover what is happening inside the
brain at the structural and molecular levels. Researchers now agree that there is a biological aspect to happiness and that the brain is command central for the
chemical and physiological changes that occur in the
body with positive emotions.
Since the middle of the 20th century, neuroscientists have investigated the mechanisms of positive emotion in the brain and body. Before that time,
positive emotions were regarded as too subjective for
rigorous scientific study. But a better understanding of the brain chemicals known as neurotransmitters and increased ability to use technology to create
images of the living brain opened new opportunities
for study.
In the 1950s, psychologists identified a “pleasure
center” in an area of the brain known as the nucleus
accumbens (see Figure 2, above right). They found
that laboratory animals would press a lever to deliver
an electrical stimulus to their brain’s pleasure center
repeatedly until they were exhausted—undeterred by
ww w. h ealt h . h ar v ar d . e du Figure 2: How the brain feels pleasure
Septum
Prefrontal
cortex
VTA Nucleus accumbens
(pleasure center) Amygdala The brain responds to a pleasure stimulus by activating a reward
system. When the brain receives a positive sensory stimulus (something that feels good), it sends a signal to the ventral tegmental
area (VTA) in the midbrain. The VTA releases dopamine into the
nucleus accumbens (the pleasure center), the septum and amygdala
(parts of the brain related to assessing and responding to threats),
and the prefrontal cortex (the thinking part of the brain). hunger, thirst, or pain. When researchers stimulate
the nucleus accumbens of people, they smile, laugh,
and report feeling pleasure, happiness, or euphoria.
Later, by mapping connected areas, the researchers
identified a reward circuit in the brain that involves
the prefrontal cortex (the thinking part of the brain)
and several underlying areas, including the nucleus
accumbens, the ventral tegmental area (VTA), and
the amygdala.
The chemical basis of these pleasurable sensations
also came under investigation. Researchers found that
the neurotransmitter dopamine activates the reward
system and is associated with positive emotions, exuberance, and desire. On the downside, the dopamine
reward system may also be associated with addictions, in which people develop uncontrollable urges to
repeatedly engage in pleasurable but harmful behaviors, such as taking drugs, gambling excessively, or
compulsively viewing pornography.
Another group of chemicals, the internally produced opiate-like chemicals called endorphins, are
Positive Psychology This Harvard Health Publication was prepared exclusively for June Detrick - Purchased at http://www.health.harvard.edu 5 also associated with pleasurable feelings, such as those
created by eating chocolate or a runner’s high. Endorphins released in the brain also increase the release of
dopamine.
When people feel happy, they often feel physical
sensations—a rush of passion, a flutter of joy—that
correspond to brain signals to nerves in the heart,
circulatory system, skin, and muscles. These physical
sensations are accompanied by chemical changes in
the brain and are interpreted as pleasurable.
Why do humans have these pleasure centers in the
brain? Experts theorize that because human survival
depends on achieving basic goals such as finding food
and procreating, a surge of pleasurable sensations
associated with eating or having sex would positively
reinforce these behaviors, leading people to repeat
them and hence increase their chances of surviving
and reproducing.
Scientists have used modern brain-imaging methods to help determine exactly which areas of the brain
correspond to sensations of pleasure. This approach has
revealed distinct patterns in both the cortex and underlying structures when people feel negative and positive
emotions. In the 1990s, researchers used positron emission tomography (PET) scans to produce three-dimensional images of people’s working brains. They observed
that positive and negative emotions activated different
parts of the brain, and that areas activated by happiness
were deactivated by sadness and vice versa.
More recent research suggests that positive emotions can activate reward pathways in the ventral
striatum, an area that projects into the VTA. Lasting
activation...

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