MISUNDERSTANDING POSITIVE EMOTION
One of the biggest questions I've been asking myself is why positive emotions have been so deeply neglected, particularly in the understanding of mental illness. I think of this as the neglected role of positive emotions.
We know a lot about negative emotions in psychopathology, which has been important in getting to the root of disorders such as anxiety, substance abuse, and depression. This knowledge has been effectively disseminated in order to develop etiological models and create effective treatment. We know far less about the role of positive emotions in human health and also human dysfunction, which is one of the biggest questions that I've been trying to tackle lately. It's not a trivial question.
Why should we care about the fact that studying positive emotions has been absent in our understanding of severe and chronic mental illness? There're two broad reasons as to why this question matters and why I've been spending time thinking about it. One of them is a practical reason and one of them is a more theoretical reason. The practical reason we should care about positive emotions in our conceptualizations of human health and severe mental illness is because, to put it plainly, severe and chronic psychiatric diseases are a societal burden. We know that, for example, substance use disorders alone are accounting for $500 billion a year in annual cost. Anxiety disorder is not far behind in terms of cost relating to days missed in work productivity and healthcare utilization. We also know that many common and chronic disorders—depression or bipolar disorder—are in the top ten causes of leading worldwide disability.
You may think that we're talking about a small segment of the population, but quite contrary. If we just look at lifetime prevalence rates across all of the DSM Axis I disorders, the major clinical phenomena—the World Health Organization has mapped out these annual prevalence rates—you see that within the US alone, up to 50 percent of people at some point in their lives have met clinical criteria for a severe or common psychiatric disorder.
It's a practical concern because it affects many people and places a huge burden on the individual and on society. To me, this hastens the need to think, from a scientific perspective, about some of the mechanisms that we can probe to gain better insights into how the human mind works and what might be the breakpoints—the points at which some of those psychological processes break down. This is where the neglected role of positive emotion becomes important, because it has the potential to delve into the deep mechanisms of how the human mind works and how we function on a daily basis, our emotions being a critical part of that.
That's a practical reason to care about the neglected role of positive emotions and the way we study and think about psychopathology. But there's a more theoretical reason as to why it matters. This is equally compelling. In some collaborative work that I've done recently with Tania Lombrozo, a professor at UC Berkeley, we've been tackling some of the most common misconceptions about the human mind. In many ways, the science of the mind is still in its infancy. Granted, in recent years there's been remarkable progress spanning levels of social, psychological, and neural levels of analysis, in providing insights into how we think the mind works. At the same time, newly emerging findings are suggesting that some of those intuitions are correct, whereas other lines of work are overturning the way we think about the mind, opening up entirely new possibilities for understanding how we think, feel, reason, and the way we interact with others.
These misconceptions of the mind are critical to understand because they have implications not just for the scientific conceptualization of the mind, but also for well-being, intergroup relationships, and even social and education policy. I come back to the role of positive emotions. There's been a longstanding misconception about the role positive emotions play in our psychological functioning and well-being. In part, this is because it's been a neglected topic, as I mentioned, in thinking about mental illness and psychopathology.
We think of emotions as these signals and pieces of information you get from the environment that provide clues as to what's important and what motivates our behavior to go in certain directions. To be more concrete, an emotion is thought to be an evolutionary, hardwired response to our environment. It has many components. When you feel fear, for example, you have a subjective experience—a qualia—of what it's like to feel fear. You have a behavioral display; it may be your nonverbal posture or an expression in your face. There's also a physiological correlate; it may be that your heart rate is increasing. It may be that we see, at the neuroendocrine level, cortisol levels rising. Emotions are thought to be these critical to our survival responses to the environment that have a feeling state, a behavioral state, and a physiological level.
What are positive emotions? What's thought to distinguish positive emotions from the traditional class of negative emotions—fear, sadness, anger—is that these are thought to help guide us towards and signal rewards or opportunities in the environment. These could be financial opportunities or incentives, they could be connecting with another person, they could be savoring an achievement; they're thought to signal things that are important to us and that are rewarding or meaningful. This can span a whole gamut of positive states, such as joy or enthusiasm, pride, gratitude, love, or awe. There's a huge multitude of these positive states. They're important for our health because they tell us about important opportunities in the environment, and they help us savor when we've accomplished or are currently experiencing one of these opportunities.
Much of the work on positive emotions to date has been focused on the more apparent adaptive aspects of them. This has been work in the field of what's been called positive psychology, which has looked at the ways positive emotions foster healthier adaptive outcomes. We know a lot about that. We know about the ways in which positive emotions might foster creative thinking or enhance physical immunity to stressors. We even see the way that positive emotions are the glue of social bonds, helping us to foster and maintain important relationships with other people.
When it comes to these positive states, the common conception of the mind is that they are adaptive states, things that we should seek to experience, and when we do, they bring about adaptive outcomes for us as individuals—intraindividually—and in our relationships with other people—interpersonally. That's the common conception of positive emotions. But what I have been thinking about a lot is why that's been the only or limited scope in the way we've thought about these states.
This misconception of the mind can be unearthed when we stop neglecting how positive emotions play a role in psychopathology. This refers to an emerging line of work that's uncovering the ways that positive emotions may also be predictive of more maladaptive psychological outcomes and health outcomes. In many ways, this isn't surprising, but it does change how we think about what positive emotions are.
We see that positive emotions, particularly when they're experienced in heightened levels or when the duration is prolonged, predict a range of maladaptive psychological outcomes or behavioral syndromes. This includes positive emotions facilitating increased risk-taking and facilitating engagement in behaviors that we commonly think of as less adaptive, such as pathological gambling or problematic substance use. It's even been linked in some prospective studies to higher mortality rates, related to the fact that when we're in these heightened positive states, it lowers our inhibition.
In some of our work with clinical populations, we find that heightened positive emotion, especially when it's not in the right context—in times of loss or threat—is predictive of the risk for and recurrence of severe mood disorders, such as bipolar disorder. These are just some examples that suggest that maybe our common conception of positive emotions as these panaceas that are going to cure any type of psychological stress, or as an antidote to those sorts of things that foster a myriad of desirable outcomes, now seems outdated. It seems that the more we study the broader portrait of these positive emotional states, the more we'll see that this misconception of the mind—that positive emotions are always good—needs to be challenged and overturned. Sometimes they're adaptive, sometimes they're not, but it's really about when, why, and how we experience them.
The clinical disorders, the severe psychiatric populations, help provide these unique case examples for how we can understand the way positive emotions work in the human mind. They're not always good for us and sometimes they may be things that we want to curb in. My point in this is to say that it's important to study positive emotions and their "downsides" because they have practical and pressing public health and societal motivations, but they also have important theoretical motivations for how we think about the mind.
When you think about positive emotions, you might wonder how you would go about designing an experiment to test this. Do you simply ask people how they feel? It's not quite that easy. Emotions are complex phenomena that have multiple components: They have a subjective experience—qualia; they have behavioral signatures, in these prototypical ways that we move our faces around and contract muscles; they also have important, deeply rooted psychophysiological phenomenon.
When we try to study emotions in the laboratory, we take a multimodal approach. We will have someone come to the lab, for example, and present them with a variety of emotion-evocative stimuli. This could be externally presented stimuli, like having people look at evocative emotional images of people, places, or things. We will also show people more dynamic stimuli, like watching film clips, where they can see over time different emotional scenes unfold. That's one way to elicit emotions. Another way is more internally generated, what we call more ideographic stimuli. These can be having people recall personal autobiographical memories. Both of these are an intraindividual level of emotional excitation. So watching stimuli on a screen, videos or images, or internally recalling emotional experiences.
There's also an important movement to capture emotions as they unfold in real life—interacting with other people. This is where we get into some of the richest emotional experiences that characterize our daily lives. We've done things like bringing two people into the lab and having them engage in an emotional conversation. Some of this is with romantic partners, where they will take turns sharing times of emotionally salient events, or having them engage in either a positive conversation or a conflict conversation. It's often not too easy to get long-term partners to find something to talk about that they have conflict over.
Regardless of which of these elicitation techniques we use, it's important to sample emotion across multiple levels. We're having people rate what they're feeling using continuous-rating dials. We're videotaping their behavior live, coding the expressions on their face as it unfolds, and we're recording their body's autonomic signatures—their heart rate, their respiration, their breathing. In this, we've been able to answer a lot of important questions. For example, we've looked at how self‑conscious emotions are impacted in individuals who differ in their level of self-awareness or self‑presentation. We've done things like have people watch videos of themselves performing an embarrassing task, so that we can look at their emotional responses to the self. We've also done some collaborations with a colleague of mine, Jamil Zaki, looking at how people experience and perceive emotions of another target while they're telling a life event—a time of extreme loss or extreme joy. We can track, second by second, how they're feeling as they watch and listen to someone else share an emotional event, and also how good or how empathically accurate they are at perceiving that other person's emotion.
Here, we found some interesting things with respect to positive emotion. The more positive emotion you experience on a daily basis, the more confident you are in thinking that you're good at picking up others' emotions. Your perception of how empathically accurate you are is inflated. In the moment, however, you don't perform quite so well in picking up others' emotions, especially their negative emotions. It's harder for you to drop down and get into another's emotional state when they're in distress. Positive emotions don't necessarily make us more empathic at all.
There are a lot of opportunities you have when you study emotion from an experimental perspective, in terms of the kinds of stimuli used to elicit emotion and the multi-channel response you can sample, all the way from higher-order experience or meta-emotions—thinking about what you feel about your emotions—down to the body's most basic responses, such as how our pupils dilate or our heart beats. It's always important to take these multiple levels of analysis when sampling emotion in the lab.
It might seem strange that I'm sitting here talking about positive emotions, and at the same time talking about things like mortality rates, substance abuse, risk-taking, chronic impairment. It may seem that I'm coupling constructs that don't align together or don't seem to mesh together. That's part of the problem in the study of positive emotions, to be frank. For whatever reason, we always think of this construct of positive as being universally good. Maybe we shouldn't be calling positive emotions positive anymore. Part of the problem might be that these states are like any other emotion in that it depends on the context as to whether they're going to help you meet your goals, or if they're going to get in the way and impede or hinder your ability to thrive.
How do you take these laboratory findings, these experimental studies about positive emotion—and since we're talking about psychopathology, we're talking about real-world health outcomes—and translate it? This has been probably one of the biggest challenges in the field, and has been part of a movement that Greg Siegle, a faculty member at the University of Pittsburgh, has been at the forefront of. How do we design the clinic of the future, where you can intimately pair the science that we do in the lab with the treatments that real people coming into clinics receive? He's been suggesting that it might be important to stop using these laboratory tasks as merely scientific tools and start implementing them as diagnostic tools as well. So, when we bring people into a clinic, we don't simply ask them how they're feeling; we run them through tasks where we look at their patterns of brain activation to emotional images; we look at the cognitive processes that underlie the ability to retrieve and remember emotional material—things that people with depression and anxiety have difficulty with; and we use this information not simply to write an empirical journal article that we disseminate to other scientists, but take this information to the patient and use the data to say, "This is the thought process and emotional profile you have, and here's the particular effective treatments that we would pair with it."
An exciting next step on the horizon is how we take tools from the laboratory to the bedside and merge the science and practice to create the clinic of the future.
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I'm an assistant professor in the Department of Psychology and Neuroscience at the University of Colorado Boulder, and I direct the Positive Emotion and Psychopathology Laboratory. We have a two-pronged approach. The first is to run basic laboratory studies where we elicit and measure emotion in both healthy adults and adults suffering from mood disorders. We look at bipolar disorder and depression. We use this information, in part one, to gain a basic scope of what the psychological processes are that characterize these groups when it comes to positive emotion, and the ways in which people's patterns of reactivity or ability to regulate emotions may be different among these groups. Then we take these scientific findings and, in collaboration with some of our intervention colleagues or people who do the day-to-day psychotherapeutic work, we take these laboratory findings and translate them to intervention studies. For example, we may take some of the tasks that look at attentional biases to emotion—what we call dot-probe tasks—as well as some of our classic emotion reactivity and regulation tasks, paradigms drawn from research by James Gross and others, and instead of just looking at them in a lab study, we use them as pre-and post-treatment markers. We'll take lab tasks and look at them in a group of people before they begin treatment for interventions that are common in empirically supported cognitive behavioral therapy, dialectical behavioral therapy, and then reassess with those same tasks post-treatment to look for the first time not just at whether a treatment changes or alleviates symptoms of depression, but what processes in the mind are changing as a function of those treatments.
That's the way in which we take laboratory tasks to first map a phenomenon and the way in which it may be awry among individuals with depression or bipolar disorder, and then see if interventions can change that phenomenon, ideally for the better, in the direction of the treatment goals that the particular individual has. That's why we're trying to start merging some of the basic lab science we do with the work of then translating that lab study to effective real-world outcomes for people.
The field of positive emotion and psychopathology is at that intersection between the affective scientists, who are in the lab studying emotion, and the clinical psychologists, who are trying to treat and confront real-world suffering in everyday life. That's a new field that my lab is at the forefront of and that the broader scientific community is now appreciating.
When I first got into this work, it seemed a little counterintuitive that we were studying positive emotions in a way that hadn't been thought about before. To say that positive emotions could sometimes be inappropriate, or maladaptive, or something you might want to rein in or suppress was very different from the mainstream approach to studying positive emotions.
For better or worse, there has been some mainstream attention to this work. We've been called the dark side of happiness. I've had colleagues joke that we're "haters of positive emotion." That's the furthest thing from the truth. I'm incredibly fascinated with positive emotions. I got started first in this field by working in a lab that was a basic social psychology lab, looking at human flourishing and well-being. At that time, being a graduate student in clinical psychology at Berkeley, I couldn't help but notice that I would be working with patients, particularly those who were manic—people with a history of bipolar disorder—who were describing feeling elated, excited, overjoyed, but they were being hospitalized, losing their life's savings, and engaging in risky behaviors, like driving fast and engaging in sexual liaisons with a bunch of strangers. I thought, is this the same thing? They're feeling positive, but there are all these negative consequences.
That's where it began for me. We've been pushing this forward ever since. To date, when I've been looking for edited book volumes on the topic, there's nothing there. I wasn't sure at first about what scientists who study positive emotion would think of this. The response has been surprisingly good. Everyone can see that emotions are far more complicated than we appreciated. I think it was Richard Feynman who said that nature doesn't give up her mysteries easily—that's exactly the thing with positive emotions. Of course it's not as simple as we thought. It's not this unidimensional state that's universally good and sought after. It has multiple sides and multiple facets, just like every construct.
I've gotten a lot of great support from wonderful pioneers in the field: Marty Seligman, Ed Diener, Barbara Fredrickson, and Dacher Keltner. They've all appreciated this notion that we need to expand our horizon of what positive emotions are, and that if we apply them to clinical psychology not only will we more broadly understand what positive emotion is and isn't, but we can take some of this data and translate it into real-world solutions.
A lot of treatments for clinical disorders thus far are focused on alleviating suffering—reducing symptoms of depression or anxiety. Now we're seeing that there's another piece to it. It may be that we try to build positive emotions. If you're someone with depression, for example, who has trouble experiencing appropriate amounts of pleasure. In the context of bipolar disorder, we're now seeing treatments being developed that are talking about downregulating positive emotions, to engage in emotion de-escalation strategies when you experience too much positive emotion. After a great rewarding life event, people with bipolar disorder are at increased risks for escalating into mania. It's harrowing to say this, but after a job promotion, a marriage, a success, we want to monitor their positive emotion levels, so that if they start increasing we can identify that right away and bring it down.
Another thing we've been working on is the pursuit of positive emotion. There's so much popular attention on becoming happy, being happy, finding all these solutions in books that we can read to attain this state. We find that the more you try to pursue positive emotion, it puts you at increased risk for clinical depression and bipolar disorder. We're working on teaching patients who have these histories not to prioritize positive emotions so much, not to crave or want it to such an extreme state that it may backfire.
Rather than pursuing happiness and setting that as your goal when you come into treatment, we're teaching instead to focus on acceptance of all emotional states and the prioritization of a diverse experience of all emotions. Emotional diversity is better for us than just pushing towards only experiencing positive states. But telling people not to experience too much positive emotion is not going to go over well. You're going to get resistance and backlash. In fact, I primarily do research and teaching, but I also have a background and licensure in clinical psychology and have worked a lot with people with a history of mania. One of the biggest predictors of treatment nonadherence and dropout is to bring someone in and tell them we need to tone down their positive emotions. No one wants to do that.
So what do you do? How do you get people to not only understand that there's data suggesting that positive emotions aren't always good, but get them to want to rein in their positive emotions, at the right time, when it's in their best interest? We're not saying eliminate positive emotions. They're wonderful things and they have great attributes that help us in many ways, but there can be particular contexts where they don't help us. How do you get people to buy into that? There're a couple ways. It's not to say, "Squash positive emotions. Calm down right now." That rarely works.
There are a couple of approaches that do a better job, and we've been working on applying these translationally to patients. One is the insight that emotional diversity is healthy. We've been doing some work with colleagues such as Michael Norton and Jordi Quoidbach that look at the human mind as an emotional ecosystem. We know that in the physical ecosystem biodiversity is healthy and important. People can buy into that. We know that biodiversity fosters resistance to pathogens and invasive species. When you explain to someone that the human mind may not be so different, that it's important to have a diverse array of emotions—joy, sadness, love, admiration, guilt—and that these are all important pieces of our internal human emotional ecosystem, people can understand that. People appreciate that diversity is important, that maybe it's some sort of spice of mental life.
When you frame it that way, people are more readily able to not put such a premium on positive emotions and, in some situations, try to foster other kinds of experiences if they think it's part of a more diverse psychological life and repertoire. Framing it less as pushing positive emotions down, but as letting all emotions grow and thrive. They're all important sources of information for us and we have them for a reason. We have evolutionary goals; people can understand that. That's one way we've been thinking about trying to frame this. You don't just want to grow one kind of plant in your garden, you want to have a diverse array.
We've been pushing this notion of emotional diversity and the way it fosters a more adaptive psychological repertoire for the individual. That's one way. The other way is to show people what happens when you put your primary focus on the pursuit of positive emotion. You can do this through large-scale laboratory studies and even case study designs, which look at how much people want to experience positive emotion and how that sets our goals of resisting other emotions, even in contexts where it doesn't suit us. Particularly in US cultures, we know that there's cultural valuation of these high-arousal positive states, where we should be excited and joyful all the time.
You can show people that the extent to which they value those emotions and want to experience them in individual context, that predicts them feeling worse about themselves. If you say, "My ideal state, if I could choose, would be to be excited or joyful," and if I then put you in a context where you watch a happy film, read a happy story, even recall a happy memory, the extent to which you wanted to feel that way predicts reductions in feeling that way in the moment. We set standards when we want to feel something. It often sets us up for disappointment. You can show people in some ways how this overvaluation of feeling positive can backfire. Usually, that can help people scale down the wanting and maybe even open up their mindset to a broader variety of options.
This work we've been doing in positive emotion and psychopathology has the potential to change the way we think about all kinds of emotions. I'm focusing on positive emotions here, but you could bring in negative emotions to broaden our scope of what emotions are; they're not inherently good or bad. There's this idea we call emotional valence. That's why we call certain things positive emotions and certain things negative. That valence label is not its inherent value. What it has the possibility to do is suggest that whether or not an emotion is adaptive for you is all dependent—what we call context-sensitive. Emotions are fine-tuned to help us navigate particular situations, particular encounters, and no one emotion is necessarily always good or always bad for a situation.
That's what this has the possibility to say, that we should throw out and abandon simplistic notions of valence is value: Negative emotions are bad, we should avoid those; positive emotions are good, we should embrace them. We should think more carefully about when, where, and how a given emotion will help us or hinder us.