Beyond Psychopathology: The Emergence of a Positive Psychology
Marti Kranzberg, PhD, CGP

"Medical necessity" has become the standard by which the need for psychotherapy is determined in these times of cost containment and managed health care. Although managed care is a relatively new phenomenon, clinicians have practiced therapy within a medical model, identifying and treating mental diseases for many years. However, psychopathology has not always been the axis on which the practice of psychotherapy has turned. Now there is a momentum for the reemergence, with fresh eyes, of a positive psychotherapy concentration on human strengths and competencies.

History
Before World War II, psychology had three missions. According to Martin E. P. Seligman, PhD, President of the American Psychological Association (APA), these included "curing mental illness, making the lives of all people more fulfilling, and identifying and nurturing high talent." After the war, two significant events determined the primary focus of psychology. The Veterans Administration was created in 1946, and psychologists found that they could make a living by treating mental illness. Secondly, the following year, the National Institute of Mental Health (NIMH) was created, and academic psychologists discovered that they could get grants for research on mental illness. Thus, economic factors heavily influenced the practice of psychology.

Of course, there have always been advocates in the field who have focused on identifying human strengths and growth. Therapists from the field of psychological counseling and social work have figured prominently in a strength orientation with clients. In addition, the "Third Force" or Humanistic movement, led by Abraham Maslow, Carl Rogers, and others in the 1960s provided initiative for the human potential movement and accentuated a model of strength, competence, and human development.

Many people have asserted that the 1980 release of the American Psychiatric Association's DSM–III shifted clinical psychiatric and psychological nosology from a psychoanalytic emphasis on pathological internal process to a medical model based on a definable set of pathological disorders. Once again, economic factors emerged when insurance companies began to cover psychotherapy as medical treatment for mental diseases. Clinicians of all persuasions began competing for health care dollars, and psychotherapy became a medical subspecialty.

New Developments
In the early 1990s, the NIMH convened a workshop to focus on psychological strengths. "Personal Resilience in Adversity and Psychopathology" still focused on pathology but highlighted the lack of a vocabulary to define psychological strengths. Participants were interested in identifying resilience and other "protective factors" that mitigated against pathological development. They catalogued four principle domains of psychological strengths: self/personal; cognitive; biological/temperamental; and occupational/social. They defined seven dimensions of personal resilience: insight; independence; relationships; initiative; creativity; humor; and morality. They defined the "hardy personality" as consisting of a sense of commitment, positive response to challenge, and internal locus of control. They identified the importance of hopefulness, as opposed to hopelessness.

In February 1998, 200 researchers gathered in Philadelphia for a symposium on the "science of optimism and hope." They compared data on personalities, coping styles, and the general well-being of optimists compared with pessimists. They stressed the need to study and promote optimism, altruism, and other human strengths.

In May 1998, the Workgroup of the National Advisory Mental Health Council convened. Seligman testified about the urgency of making prevention of mental illness a research priority. He challenged NIMH to financially entice researchers from other fields to: study human strength and resilience; create mechanisms to encourage communication across fields; and attract the brightest students and assistant professors to prevention research.

A Positive Psychology
Seligman notes that psychology has done a good job of repairing damage, but that the other two goals of psychology before WW II—making people's lives better and nurturing high talent—have fallen by the wayside. His commitment as President of APA has been to nurture a "science and practice of positive psychology" that would address these goals. He stresses that we can no longer continue to look at prevention from a disease model because:

• By focusing on what makes people "sick" rather than what makes them well, we may be ignoring the human strengths and competencies that are buffers against mental disorders.
• By concentrating on a narrow range of "diseases," we may be neglecting even more harmful states, such as violence, cowardice, or explosive anger.
• We have not explored the mechanism of "disease." For example, poor impulse control may play a critical role in substance abuse. If this is true, we may identify ways to strengthen impulse control during childhood.

To implement his mission, Seligman created the APA Task Force on Prevention: Promoting Strength, Resilience and Health in Young People. The goals of the Task Force are to identify and disseminate information about prevention programs that work, and to create a training program in prevention and health promotion that would first involve psychologists and then incorporate other fields in interdisciplinary training.

The Good Life
To make people's live better, Seligman says that we must explore the taxonomy of the "good life." We need to measure, understand, and then build human strengths and civic virtues. He proposed several ways of casting about for definitions of the "good life."

1. Sanity. Is there an array of qualities that define sanity? Are they the opposite of insanity?
2. Parental. What qualities would parents want to teach their children?
3. Political. What qualities would define the "good life" across cultures and political systems?
4. Self-actualization. Do we have standards by which to judge how our own lives compare with the "good life?"
5. Best examples. Who might be examples of those who have led "good lives?"
6. Tradition. What do cultural and religious writings have to say about the "good life?"

To tackle these complicated questions, Seligman proposes three beginnings. The first would involve a multidisciplinary gathering of eminent senior scholars who will ponder these questions and suggest a framework for categorizing and measurement. A second meeting would gather 20 specialists who are experts in the measurement of each of the categories that seem the most promising. A third meeting would refine the taxonomy and develop a battery of measures.

The next development would involve a week-long meeting of 18 young psychology professors from around the world who would debate the most burning questions in positive psychology. These might include: Is happiness a means or an end? Do positive motivations derive from negative ones? What is the relationship of the individual to interpersonal strengths? Can psychology survive outside the healthcare system? What is the evolutionary function of positive feeling?

Finally, Seligman proposes a special issue of the American Psychologist, an official journal of the APA, to address issues associated with positive psychology: happiness, high talent, responsibility, initiative, wisdom, self-determination, creativity, health and mood, positive psychodynamics, and optimism.

High Talent
The nourishment of high talent, the last mission of pre-World War II psychology, has been seriously neglected. Seligman proposes several ways to encourage gifted youngsters. He suggests creating a Teachers of Psychology in the Secondary Schools National Award that would honor three high school winners. He has already assembled a Task Force on Gifted and Talented Youth. The Task Force plans to create a virtual university as a clearinghouse and advisory service to gifted secondary school students who are seeking advanced on-line instruction. In a second phase, the virtual university will provide electronic mentoring to students by world-class faculty.

The other project of the Talent Committee is to study truly extraordinary people and bring together idiographic studies of genius with the more nomothetic studies of gifted children. Thus, different research methodologies could be combined to provide more information about talent and identify ways to help talented individuals realize their abilities for themselves and for the good of the community.

Conclusion
While the medical model of diagnosing and treating psychopathology has been a dominant force in the field of psychotherapy, a psychology of human potential, which nurtures growth, civic virtues, and talent, is not new. It may be the timeliness of Seligman's focus on a "positive psychology" that commands attention. The medicalization of psychotherapy has left many clinicians feeling trapped in a system not of their making. Seligman is challenging us to risk leaving the confines of our paradigm and to think more creatively about the science and art of psychotherapy.

This article was published in the February/March 1999 issue of The Group Circle.