The Positive Approach | Alan Schlechter, MD, MSCI | TEDxNYU Langone Health

Key Concepts

• Positive Emotions: Feelings such as happiness, joy, and contentment that broaden our attention, build resources, and encourage trust.
• Negative Emotions: Feelings such as anger, sadness, and guilt that narrow our attention to immediate threats and motivate action.
• Broaden-and-Build Theory: A theory suggesting that positive emotions broaden our thought-action repertoires and build lasting personal resources.
• Well-being: A comprehensive state encompassing positive emotions, engagement, relationships, meaning, and accomplishment.
• PERMA Model: A framework for well-being developed by Martin Seligman, comprising Positive Emotions, Engagement, Relationships, Meaning, and Accomplishment.
• Positive Approach (Psychiatric Interview): A method of conducting psychiatric interviews by first exploring a patient's strengths and positive experiences before addressing challenges.
• Gratitude: An emotion that fosters social connection and is cultivated through acknowledging good experiences.

The Science of Happiness and its Impact

The video explores the science of happiness and its profound impact on brain function and interpersonal connections, contrasting it with the evolutionary purpose of negative emotions.

• Evolutionary Purpose of Emotions: Our brains evolved to prioritize survival, hence the prevalence of negative emotions like anger, sadness, and guilt. These emotions serve to narrow our attention to threats and motivate us to address them.
• The Role of Positive Emotions: In contrast, positive emotions, which often follow negative ones, have a "broaden-and-build" effect. They expand our attention, foster creativity, and enhance cognitive abilities.
  • Evidence:
    • Four-year-old children who recall happy memories perform better on puzzles than those recalling sad memories.
    • College students who watch comedy bloopers exhibit better creative problem-solving skills than those who watch the news.
    • Doctors who play a winning video game diagnose faster than those who play a losing game.
• Impact on Brain Function: Positive emotions make our brains more accurate, creative, and faster. They encourage new perspectives and, crucially, foster trust.

The Positive Approach in Medicine

Dr. Schleer advocates for integrating the science of happiness into medical practice, particularly in psychiatric interviews, through a "positive approach."

• Traditional vs. Positive Approach:
  • Traditional: Focuses on what is wrong, often starting with symptoms and challenges.
  • Positive Approach: Begins by identifying what is "wonderful" about the patient, their strengths, and positive experiences.
• Case Study: Eric:
  • Eric, a 25-year-old patient, presented with anxiety, depression, and work difficulties.
  • When asked about what he enjoyed, he initially stated he enjoyed nothing. However, upon recalling his past as a Division I hockey player, he brightened as he spoke.
  • This initial exploration of his positive past experience, even though not directly addressing his current issues, made him more receptive to the interview.
• Study Findings: A study comparing the positive and traditional approaches to psychiatric interviews found that patients who experienced the positive approach reported feeling liked, respected, and appreciated by their doctors.
• Cultivating Gratitude: The positive approach helps uncover positive experiences, which can lead to increased gratitude. Gratitude is described as "the sticky glue that binds people together."

Well-being: Beyond Happiness

The video distinguishes between happiness and the broader concept of well-being, proposing the PERMA model as a framework.

• Defining Well-being: Parents often desire their children to be "happy," but the speaker suggests that "well-being" is a more comprehensive and achievable goal. Well-being is composed of several interconnected elements:
  • Positive Emotions: Experiencing joy, contentment, etc.
  • Engagement: Being fully absorbed in activities ("in the zone"), where time seems to fly.
  • Relationships: Having positive connections with others, essential for sharing both good and bad times.
  • Meaning: Having a sense of purpose and belonging.
  • Accomplishment: Achieving goals and experiencing mastery.
• PERMA Model: This acronym encapsulates the five pillars of well-being: Positive Emotions, Engagement, Relationships, Meaning, and Accomplishment. Each element is like a "bucket" to be filled.
• Well-being as a "Mental Health Vaccination": Striving for well-being acts as a protective factor against the worst effects of mental health disorders. While well-being doesn't eliminate disorders, it can significantly lessen their burden and impact, such as work impairment.

Application in Medicine and Conclusion

The video concludes by emphasizing the potential of integrating the science of happiness and well-being into all areas of medicine.

• Systemic and Personal Elevation: Well-being can be fostered both on a large scale within healthcare systems and on an individual level.
• Rethinking Annual Checkups: The speaker suggests that doctors could begin annual checkups by asking patients, "What is the healthiest thing you have done for yourself in the past year?" This could transform the patient-doctor interaction.
• Eric's Recovery: By focusing on his passion for hockey, Eric was encouraged to return to the sport. This led to improvements in his work, social life, and overall happiness, even after sustaining an injury.
• Future of Medicine: The integration of the science of happiness into medicine has the potential to help people not only live healthier lives but also happier lives.