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Susan Folkman
To cite this article: Susan Folkman (2008) The case for positive emotions in the stress process,
Anxiety, Stress, and Coping, 21:1, 3-14, DOI: 10.1080/10615800701740457
SUSAN FOLKMAN
UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco,
CA, USA
Abstract
For many decades, the stress process was described primarily in terms of negative emotions. However,
robust evidence that positive emotions co-occurred with negative emotions during intensely stressful
situations suggested the need to consider the possible roles of positive emotions in the stress process.
About 10 years ago, these possibilities were incorporated into a revision of stress and coping theory
(Folkman, 1997). This article summarizes the research reported during the intervening 10 years that
pertains to the revised model. Evidence has accumulated regarding the co-occurrence of positive and
negative emotions during stressful periods; the restorative function of positive emotions with respect
to physiological, psychological, and social coping resources; and the kinds of coping processes that
generate positive emotions including benefit finding and reminding, adaptive goal processes,
reordering priorities, and infusing ordinary events with positive meaning. Overall, the evidence
supports the propositions set forth in the revised model. Contrary to earlier tendencies to dismiss
positive emotions, the evidence indicates they have important functions in the stress process and are
related to coping processes that are distinct from those that regulate distress. Including positive
emotions in future studies will help address an imbalance between research and clinical practice due to
decades of nearly exclusive concern with the negative emotions.
Keywords: Stress, meaning-focused coping, positive emotion, coping theory, benefit finding, adaptive
goal processes, reordering priorities, positive meaningful events
One of the most exhilarating aspects of research is coming upon an unexpected finding that
prompts a new direction in thinking. In my case, the unexpected finding was the
observation that positive emotions and negative emotions co-occurred during the intensely
stressful experiences of caring for a dying loved one and then actually losing that person.
This finding first appeared in our longitudinal study of gay men who were the caregivers of
life partners dying of AIDS. The study took place in the 1990s, when AIDS was basically an
untreatable terminal illness with a horrific clinical course. I published these findings in 1997
(Folkman, 1997) and suggested revisions to the stress and coping theoretical model to
*This article was invited by the editors following Professor Folkman’s address at the 27th Stress and Anxiety
Research Conference held in July 2006 in Rethymnon, Crete, Greece
Correspondence: Susan Folkman, UCSF Osher Center for Integrative Medicine, Box 1726, UCSF, San Francisco,
CA 94143, USA. Tel: 1 415 353 7719. Fax: 1 415 353 7554. E-mail: folkman@ocim.ucsf.edu
incorporate positive emotions. In the interim, a number of studies produced findings that
are relevant to the revised model. In this article, I revisit the propositions set forth in the
model in light of these findings. My overall goal in this is to advance stress and coping
theory and help establish directions for research and clinical care.
Studies about the beneficial effects of positive emotion in the context of stress are still few
in number and found mainly in the resilience literature. Fredrickson and her colleagues
found that positive emotions buffered resilient people against depression and fuelled
thriving in the aftermath of 9/11 (Fredrickson, Tugade, Waugh, & Larkin, 2003),
accelerated cardiovascular recovery from laboratory-induced negative emotional arousal
in people high and low in trait resilience, and helped individuals find positive meaning in
negative situations (Tugade & Fredrickson, 2004). Bonanno and his colleagues (Bonanno &
Keltner, 1997; Keltner & Bonanno, 1997) found that bereaved individuals who showed
laughter at least once during a narration about their lost relationship also reported better
adjustment. Interestingly, when untrained observers viewed video tapes of the narrations
with the sound off, the observers experienced more positive emotion and less frustration in
response to bereaved participants who laughed compared with bereaved participants who
did not laugh.
Threat
Emotion-
Challenge focused
Unfavorable
Distress
Person: Situation:
Dispositions Demands
Beliefs Resources
Goals
Negative Emotion
Figure 1. Original stress and coping model (Lazarus & Folkman, 1984).
brief review that covers diverse topics, I try to highlight what has been found and some of
the key issues that need to be considered.
Mean- Positive
Restores Emotion
Resources
ing
Sustains focused
Coping Coping
POSITIVE EMOTION
Negative Emotion
Figure 2. Revised stress and coping model (adapted from Folkman, 1997).
Positive emotions in the stress process 7
caregivers. Moskowitz, Folkman, Collette, and Vittinghoff (1996) found that some kinds of
coping were associated with negative and positive moods pre and post-bereavement, but
other kinds were associated primarily with either positive mood or negative mood. Problem-
focused coping and positive reappraisal, for example, were consistently associated with
positive mood, but inconsistently and more weakly associated with negative mood. It was
our qualitative analyses of narratives of stressful events, however, that took us to the next
level of understanding about coping and positive emotion and to our decision to define a
category of ‘‘meaning-focused’’ coping.
Meaning-focused Coping
Meaning-focused coping is, in its essence, appraisal-based coping in which the person
draws on his or her beliefs (e.g., religious, spiritual, or beliefs about justice), values (e.g.,
‘‘mattering’’), and existential goals (e.g., purpose in life or guiding principles) to motivate
and sustain coping and well-being during a difficult time (Park & Folkman, 1997; see also
Aldwin, 2007 for her discussion of transformational coping).
In general, meaning-focused coping tends to be less situation-specific than both problem
and emotion-focused coping. In our first effort to distinguish among types of meaning-
focused coping, we identified four categories based on analyses of both quantitative data
from the Ways of Coping (Folkman & Lazarus, 1988) and qualitative data drawn from
nearly 2000 interviews about recently experienced stressful events. These categories were
positive reappraisal, revision of goals, spiritual beliefs, and the infusion of ordinary events
with positive meaning (Folkman, 1997; Folkman, Moskowitz, Ozer, & Park, 1997). We
later modified the list to include findings from reports in the rapidly expanding literature
and our own subsequent work, resulting in five categories: benefit finding, benefit
reminding, adaptive goal processes, reordering priorities, and infusing ordinary events
with positive meaning (Folkman & Moskowitz, 2007). Here, I briefly summarize what has
been learned by other researchers as well as our own research group about each of these
ways of generating positive emotion.
Benefit Finding
Affleck and Tennen’s seminal research on benefit finding (see Tennen & Affleck, 2002 for
review) and the growing interest of others in the related topic of stress-related growth
(Tedeschi, Park, & Calhoun, 1998; Park & Ai, 2006) has resulted in a substantial literature
(for reviews see Linley & Joseph, 2004; Helgeson, Reynolds, & Tomich, 2006). Benefit
finding is often assessed in terms of growth in wisdom, patience, and competence; greater
appreciation for life, greater clarity about what matters, strengthened faith or spirituality;
and improved quality of social relationships. It is by far the most commonly reported kind
of meaning-focused coping.
Helgeson et al. (2006) published a meta-analysis of the relationship of benefit finding to
mental and physical health. Their definition of benefit finding was quite broad: ‘‘the
positive effects that result from a traumatic event’’ (p. 797). Within this broad definition
they make an important distinction between benefit finding as coping that reduces distress,
which refers to an ongoing difficult situation, and benefit finding as an outcome, which
refers to ‘‘actual change or growth’’ (p. 798).
The meta-analysis showed that the only effect that approached a moderate size was the
relationship between benefit finding and positive well-being. At the level of small effect
size, benefit finding was associated with some negative states as well as some positive
8 S. Folkman
ones. This is consistent with other reports, indicating a consistent association with
positive affect and an inconsistent and usually weaker association with negative affect
(Linley & Joseph, 2004).
Helgeson et al.’s (2006) review also provided intriguing findings regarding the timing of
benefit finding and its effects. The beneficial effects were greater when the time since the
traumatic event was more than 2 years. In contrast, when the event was less than 2 years in
the past, benefit finding was associated with increased distress. Based on this observation,
one could conclude that benefit finding caused distress. Another explanation suggested by
the revised stress and coping model is that meaning-focused coping such as benefit finding
comes into play when things are going badly. What we would expect to see when the
situation continues to be unresolved over time is a co-occurrence of positive emotions
generated by benefit finding and the negative emotions associated with the unwanted
outcome. In major stressful events, such as loss of a loved one, distress is likely to remain
elevated for several years (Carnelley, Wortman, Bolger, & Burke, 2006). Over time, we
would expect to see negative emotions decline and positive emotions get stronger.
A clear sign that the literature on benefit finding is maturing is the controversies that are
appearing in the literature. Butler (2007) summarizes some of the key issues, namely,
whether to conceptualize the report of benefits as a means of coping as an adaptive
mechanism or a defensive, self-protective maneuver, as an outcome in and of itself
representing true change, or as something else altogether.
Whether or not benefit finding is a defensive, self-protective maneuver is a question that
is asked more generally with respect to research on positive aspects of psychology. ‘‘Even
when positive aspects of human functioning are studied, negative motives are frequently
ascribed to them, resulting in some fundamental misunderstandings of positive phenom-
ena’’ (Aspinwall & MacNamara, 2005, p. 2549). Benefit finding could be maladaptive if it
impedes important problem-focused coping such as information gathering and evaluating,
decision-making, or relationship repair. However, research by Aspinwall and her colleagues
indicates that positive beliefs and states serve as resources that actually facilitate these
processes, allowing people to consider negative information appropriately, and further,
fostering greater selectivity in the allocation of effort to problems, based on whether the
problems are controllable (Aspinwall & MacNamara, 2005).
The question about whether the benefits that are appraised at the outcome are actual also
seems to reflect many psychologists’ general suspicion about positive states of mind in
the stress process. Whether or not the benefits are actual, which is probably difficult to
determine in many instances, seems less important than whether the person believes
the benefits are actual, especially when such benefits relate to psychosocial resources. The
perception of benefit, for example, can restore self-confidence, which is an important
resource for both appraisal and coping. An inaccurate estimate of some perceived benefits,
however, such as the acquisition of skill, could prove detrimental in future outcomes. An
overestimation of one’s medical knowledge following extensive caregiving, for example,
could result in harm to another person.
Benefit Reminding
Tennen and Affleck (2002) distinguish benefit reminding from benefit finding as effortful
cognitions in which the individual reminds himself/herself of the possible benefits stemming
from the stressful experience. Benefit reminding is a form of meaning-focused coping that
occurs during the stressful situation. Tennen and Affleck’s research on benefit reminding
involved patients suffering from fibromyalgia who were asked to keep a daily diary and to
Positive emotions in the stress process 9
indicate how much that day they had reminded themselves of the benefits of their chronic
pain. On days when these patients made greater efforts to remind themselves of the benefits
that had come from their illness, they were more likely to experience pleasurable mood,
regardless of the pain they had experienced that day.
The distinction between benefit reminding and benefit finding becomes blurred unless
benefit finding is labelled as an outcome. However, as noted above, the distinction may be
arbitrary and depends on where in the stress process the variable is measured.
need to give up the goal that you had with respect to having that particular job. However,
what about ‘‘You need to improve your work’’ or ‘‘I am not happy in this marriage.’’ The
evaluation of threats to goals involves a psychological calculus that weighs odds of success
and failure; the value attached to the goal (e.g., where threatened goal sits in the goal
hierarchy), which affects the costs of giving up or persisting; and the availability of goals that
can be substituted for the one that is threatened. Giving up a goal prematurely can be as
damaging as persisting too long.
A rich and well-established literature on goals originally focused largely on the structure
of goal hierarchies, substitutability, and complexity (e.g., Miller, Galanter, & Pribram,
1960). Although more recently, goals have been examined in relation to their motivational
(e.g., Kruglanski, Shah, Fischbach, Friedman, & Chun, 2002) and self-regulatory proper-
ties (Carver & Scheier, 1998), the issue of when to give up a valued goal in real life involves
a complex calculus that probably eludes neat, structural models.
A second issue has to do with what happens after a goal is in fact appraised as unrealistic
and the decision is made to relinquish it. Yielding goals that were previously valued is a
stressful process that involves loss and the distress associated with that loss (Klinger, 1977).
The process of disengaging is analogous to the process of coming to terms with the loss of a
loved one. In their dual process model of coping with bereavement, Stroebe and Schut
(2001) described a process of oscillation between loss-oriented coping and restoration-
oriented coping. The oscillatory pattern of coping is also consistent with Carver and
Scheier’s (1998) self-regulatory theory. The process of goal revision is obviously complex
and as a consequence we should expect it to generate a complex and dynamic picture of
positive and negative emotions. The oscillation described by Stroebe and Schut, as well as
Carver and Scheier can explain variability in the mix of positive and negative emotions while
the disengagement process is still underway.
Sometimes goals are tied to fundamental beliefs that shape the person’s way of viewing
himself or herself and the world around. To give up a goal also means giving up the belief.
Consider decisions to emigrate from one’s country because one is no longer safe there, or
making the decision to stop seeking treatment for cancer. Relinquishing the goal of
remaining in one’s country or giving up the goal of finding an effective treatment for cancer
each involves changing beliefs about oneself and the world (Park & Folkman, 1997), and
this can be a shattering experience (Janoff-Bulman, 1992). Fascinating questions concern
how positive emotions help a person navigate the recovery from shattered beliefs and the
movement toward new goals.
Reordering Priorities
The recognition that priorities need to be reordered is one of the more common responses
to serious stressful events, both acute and chronic. Comments such as ‘‘my perspective
changed’’ or ‘‘I focused on what really matters’’ reflect the coping response to a changed
reality.
The reordering of priorities is a value-based process. Things that now matter more move
up the ladder; things that now matter less move down. This reordering process can be
deliberate or it can seemingly ‘‘just happen.’’
The reordering of priorities can be a very stressful process in itself. To acknowledge that
priorities need to be reordered involves an acceptance by the individual that his/her world
has changed, that things are not as they were or as they were expected to be. The person
appraises his or her world differently now than before.
Positive emotions in the stress process 11
However, the process should also provide the basis for a renewed sense of purpose
(Stroebe & Schut, 2001). Knowing what matters most now, in this changed reality, is an
essential ingredient for formulating goals, allocating resources, and determining strategies
for moving forward.
The reordering process can also lead to increased coping efficiency by narrowing the
person’s focus: ‘‘I decided that the most important thing in my life was to get better, and
that is what I am concentrating on.’’ For example, in a study of maternal caregivers of
children with chronic conditions, there was evidence of a major shift in priorities: 47% of
the maternal caregivers quit working outside the home in order to care for their child
(Wilson et al., 2005)
Similar to the process of giving up meaningful goals, the reordering of priorities can exact
a toll. A decision to quit work in order to take care of a sick child, for example, can lead to
loss of income and increased financial strain. Thus, in real life, the reordering of priorities
may improve well-being because values and goals are aligned meaningfully for the
individual, but at the same time, the realignment process can lead to secondary stressors
and negative emotions. Accordingly, we would expect to see both negative and positive
emotions.
We have only begun the work of defining and systematizing meaning-focused coping. It
is important to be more comprehensive in its exploration than studies have been thus far.
For example, in addition to the types of coping summarized in this article, religious and
spiritual coping processes are involved in meaning-based coping, as are strategies related
to forgiveness and gratitude. Which of these are related primarily to positive emotions?
What coping processes have we overlooked? What is the best way to classify these
meaning-focused strategies? And, of course, what is the best way to measure them? The
difficulties in measuring coping are well known (for review, see Folkman & Moskowitz,
2004; Schwarzer & Schwarzer, 1996) and there is no reason to think the measurement of
meaning-based coping will be different.
For both researchers and clinicians, it is important to maintain a balanced perspective
regarding the role of positive emotions in the stress process. This stress process is
strongly characterized by negative emotions and the inclusion of positive emotions in the
model is just that, inclusion. However, the evidence suggests that the positive emotions
have important adaptational significance and that these emotions are generated by
identifiable coping processes. Stress researchers need to include positive emotions in their
studies to learn more about how people generate and sustain them and to further explore
their adaptational significance in relation to physiological, psychological, and social
outcomes. Clinicians need to give attention to positive emotions with their clients, and
explore the sources of such emotions and how to generate and sustain them. This
attention to positive emotions will address the imbalance between stress research and
clinical practice that has resulted from decades of nearly exclusive concern with the
negative emotions.
Acknowledgements
The writing of this article was supported in part by NIH PO1 AT2024. I thank Judy
Moskowitz for her comments on a previous version of this article.
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