In other countries, psychotherapy is not
Correspondence concerning this comment should be
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
This document is copyrighted by the American Psychological Association or one of its allied publishers.
mobilize their healthy faculties and resourc-
as needed or as popular as in the West be-
cause a great deal of good and natural therapy
is happening daily among families, friends,
and communities. People have several means
by which to interact and express themselves,
to seek guidance and advice, to enjoy support
and encouragement, and to draw from their
communal and spiritual resources. They know
that they are not alone in their life j ourneys in
the midst of both their joys and their sorrows.
That particular awareness gives people defi-
nite meaning and perseverance, a needed sense
of belonging and connectivity, and a sound
existential hope and spirituality.
Instead of allowing the dark side of life,
the shadows of the human personality, and
abnormal psychology and psychopathology
to guide and inform psychological practice,
theory, and research, social scientists should
indeed focus more on what is good, right,
normal, well, and healthy. Some theorists
and therapists have a tendency to be so preoc-
cupied with what is wrong, damaged, bro-
ken, and pathological that they forget (or run
out of time) to fortify what is left, discover
what is healthy, strengthen what remains,
and find ways to instill meaning and realistic
hope.
Even when helping and working with
traumatized people, after all assessment is
done, it is essential to point out to them, as
Donald Meichenbaum (1994) often stressed,
that in spite of all that has happened to them
and in spite of all the pain and trauma they
have been through, they obviously somehow
have survived. Therefore, they must have
some inner strength, remarkable endurance,
and a degree of stored resiliency. This reality,
which is normally overshadowed by agony,
defeat, and despair, should be highlighted by
caregivers over and over again. It can only
enhance confidence and worth, increase mo-
tivation and endurance, and ultimately instill
courage, hope, and determination.
There is a great need to further develop
the psychology of survivorship, resiliency,
encouragement, and strength. When working
with injured and hurting people, I often ask
them at different times during the therapy
process some of the following leading ques-
tions: "Now after we have spent a lot of time
dealing with what is going on that's wrong in
your life, could you possibly tell me what is
still going on that's right, if anything at all?
What is still good, normal, healthy, and per-
haps pleasant? Is there anything you are tak-
ing for granted? And what are some of the
things you can still do relatively well and
really enjoy?"
A deep and profound principle lies be-
hind such an approach to recovery and well-
being. The human mind and psyche cannot
dwell on hope and despair at the same time—
not for too long, at least. By helping people
86
es, which are often ignored and marginalized addressedtoNaji Abi-Hashem, P.O. Box 1732, Mer-
by the clouds of depression and anxiety, those cer Island, WA 98040-1732. Electronic mail may be
parts begin to slowly unfold, gradually sent to najiah@worldnetatt.net.
emerge, and strongly come alive to be well.
Eventually, the positive begins to overshad-
ow the negative, and the healthy surpasses DOl: 10.1037//OOO3-066X.56.1.86
the unhealthy. Hopelessness begins to be
replaced by hopefulness and meaningless- Positive Psychology and
ness by meaningfulness. All the while, thera-
peutic encounters continue the work toward Positive Reinforcement
healing, mending, gaining insights, reversing
undesirable patterns, undoing the paralysis A. Charles Catania
of pathology, and putting struggling clients University of Maryland Baltimore County
in a mode of survival and creativity. That new
reality can be established through generous In behavior analysis, positive reinforcement
support, encouragement, mentoring, and em- is a method for shaping new behavior. For
powerment. example, it can be used to change a develop-
Eventually, encouraging others to dwell mentally disabled child who engages exten-
on the positive is a skill and a virtue that must sively in self-injurious behavior to one who
be further studied and incorporated into the has learned communicative skills and there-
therapeutic professions. It is about helping fore has been empowered to deal in more
clients or patients shift their paradigms. Fur- constructive ways with his or her caregivers.
thermore, it is essential to note that the care- Those who have expanded the applications
giver's own positive attitude and anchored of behavior analysis have demonstrated that
personality are quickly detected by other peo- contrary to common stereotypes about rec-
ple and will infuse the atmosphere with a ommended procedures, undesirable behavior
cheerful, confident, and peaceful spirit. This should not be dealt with by taking reinforcers
in turn instills in others a better sense of hope away but by using the available reinforcers to
and a healthy degree of optimism. shape more desirable behavior. A parent who
ignores an annoying or crying child at a check-
One can gain new insights from study-
out counter because a superficial introducto-
ing the concept of hope in other languages,
ry course once suggested that the best way to
cultures, and traditions. In Arabic, for exam-
get rid of such behavior was to extinguish it
ple, there are two terms for hope (as there are
has gotten the wrong message. The attention
for love): raja 'a and amal. The word raja 'a
and other reinforcers that produced and main-
is more formal and mostly pertains to the
tained the annoying behavior or the crying
distant future, whereas the word amal and its
must have been important to the child from
derivations are more commonly used in ev-
the start if the child had to behave that way to
eryday language and conversation. It pertains
produce them. Taking them away is not the
to the immediate and coming present. Both
solution. Reinforcement isn't everything, but
terms imply a strong and beautiful sense of
extinction isn't anything. The reinforcers are
expectancy. They energize living and cause
already there, and they should not be wasted
people to have a more positive and empow-
(Catania, 2000).
ered outlook and a meaningful disposition in
life. The point is that the constructive appli-
In closing, it seems only appropriate to cation of positive reinforcement is an applica-
quote here from an old and famous Arabic tion to be celebrated in psychology's new
poem, which is well used in the Middle East, decade of behavior, and it should be at least
"ma adyaka el-aisha lauwla foosshatu el-ama- as central to a positive psychology as other,
li," which basically means "how confining more global approaches. The child who has
and distressing life (or living) can be without become competent and empowered by posi-
a glimpse of hope and a restful oasis of amal." tive reinforcement may also learn that posi-
tive reinforcement becomes even more effec-
tive when it is reciprocated. We all shape each
REFERENCES
other's behavior, and the more we all know
Meichenbaum, D. (1994). A clinical hand- about how positive reinforcement works, the
book/practical therapist manual for assess- more likely it is that we will use it productive-
ing and treating adults with PTSD. Water- ly and will avoid pitfalls, such as the coercive
loo, Ontario, Canada: Institute Press. practices that can occur if the control over
Myers, D. G. (2000). The funds, friends, and reinforcers remains one-sided. Psychologists
faith of happy people. American Psycholo- have long known about the damaging side
gist, 55, 56-67. effects of aversive techniques for the modifi-
Seligman, M. E. P., & Csikszentmihalyi, M. cation of behavior (e.g., Sidman, 1989). A
(2000). Positive psychology: An introduc- mutual reinforcement society in which rein-
tion. American Psychologist, 55, 5—14. forcers are delivered reciprocally and openly
January 2001 • American Psychologist
 is likely also to be a happy society (cf. Skin-
ner, 1948).
My early impulse on perusing the Amer-
ican Psychologist's special issue on positive
psychology (January 2000) was to write that
I was saddened that I did not see positive
reinforcement represented, but that would have
been totally inappropriate to the present point.
A technology that deals with the consequenc-
es of behavior that are positively reinforcing
and that can do great good has been at hand
for some time (see any recent volume of the
Journal of Applied Behavior Analysis).Now,
the decade of behavior gives psychologists
an opportunity to make more productive use
of it. We can make children happier to be in
school and happier to learn. Let us think
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
positively of reinforcement. I urge those who
This document is copyrighted by the American Psychological Association or one of its allied publishers.
advocate a positive psychology to embrace
behavior analysis, its applications, and posi-
tive reinforcement in particular by learning
more about it, by teaching it to their students,
and by promoting it in our culture and in the
world at large. I am positive that it will make
a difference.
In closing, I can arrange only a tiny
consequence for what you have been doing
here, but my hope is that it will have some
small reinforcing effect on your attending to
the writings of behavior analysts: It is to
thank you for reading this far. I look forward
to additional positive consequences.
REFERENCES
Catania, A. C. (2000). Ten points every be-
havior analyst needs to remember about
reinforcement. In J. C. Leslie & D. Blackman
(Eds.), Experimental and applied analyses
of human behavior (pp. 23-37). Reno, NV:
Context Press.
Sidman, M. (1989). Coercion and its fallout.
Boston, MA: Authors Cooperative.
Skinner, B. F. (1948). Walden two. New York:
Macmillan.
Correspondence concerning this comment
should be addressed to A. Charles Catania,
Department of Psychology, University of
Maryland Baltimore County, 1000 Hilltop
Circle, Baltimore, MD 21250. Electronic mail
may be sent to catania@umbc.edu.
DOI: 10.1037//0003-066X.56.1.87
Integrating Psychopathology,
Positive Psychology, and
Psychotherapy
Georgios K. Lampropoulos
Ball State University
Reading the special issue of the American
Psychologist (January 2000) on the contem-
January 2001 • American Psychologist
porary, data-based movement ofpositive psy-
chology was an uplifting experience in itself.
Positive psychology seems to emerge as a
renewed humanistic approach to the individ-
ual and collective potential for happiness, but
this time it is strengthened by empirical data
and adequate research methodologies. Selig-
man and Csikszentmihalyi's (January 2000)
call for a shift from a disease-oriented science
to a science of optimal functioning, well-
being, and happiness provides psychology
and related disciplines with a noble goal to
pursue in the beginning of the new century.
Indeed, what can be more positive, reward-
ing, and fulfilling than studying and facilitat-
ing people's happiness?
However, transforming therapeutic psy-
chology from a science based on the medical
model to a science that emphasizes positive
experience and prevention is easier said than
done. Although Seligman and Csikszentmi-
halyi (2000) recognized the domination of
the disease model in mental health, they sug-
gested that because psychologists have now
found treatments for the majority of psycho-
logical problems, they should start studying
how to make people's lives even better. They
proposed that psychologists could use the
same research methods and even the same
laboratories that have developed psychology
and psychiatry as healing sciences during the
past half century to focus on the study of
positive psychology, with only a slight shift
of emphasis and funding. Although certainly
feasible, how easy or likely is that to happen?
How can a long tradition of conceptualizing
and treating people in psychopathological
terms shift to the study of positive function-
ing? How do psychologists change not only
their mind-set of focusing on the negative but
also the pathology-based therapeutic practic-
es that are currently empirically supported
and embraced by third-party payers? How
can psychologists convince the scientific and
professional mental health establishment to
make scarce monetary and human resources
available to positive psychology research and
practice?
To achieve a major scientific shift to
positive psychology (which could comple-
ment the dominant disease-oriented focus in
mental health), psychologists should recon-
cile and merge the two foci; this could be best
done by gradually infusing positive psychol-
ogy into current models of psychopathology
and treatment. To ease the integration and
transition from a psychopathology-focused
to a strength-focused approach in therapeutic
psychology, programmatic research might be
necessary; here are three possible areas of
attention:
1. Client strengths and positive traits
should be included in the study of psychopa-
thology (see also Vaillant, January 2000)
and, most important, in treatment-effective-
ness research. In addition to measuring symp-
tom reduction, outcome measures can include
the assessment of positive aspects of clients'
functioning, their subjective well-being, and
their effective application of solutions to prob-
lems. The benefits of this are twofold: First,
the additional assessment of positive changes
in other areas of clients' lives can provide the
much desired differential effects in treatment
outcome research. Although traditional out-
come research has shown a paradoxical equiv-
alence in symptom reduction among different
therapies (Stiles, Shapiro, & Elliott, 1986),
the measurement of neglected aspects of cli-
ents' positive functioning can make a mean-
ingful difference. That is, psychological treat-
ments should also be evaluated in terms of
their ability to make life more fulfilling for
clients. Second, measuring increases in posi-
tive behavior and well-being in tandem with
measuring reductions in negative behavior
can provide the bridge between pathology-
oriented and nonpathology-oriented ap-
proaches; after all, one could argue that when
psychologists measure increases in success-
es, solutions, and positive experiences, they
really measure problem and pathology reduc-
tion, and vice versa. This practice can also
facilitate the rapprochement and reconcilia-
tion of traditional psychopathology-oriented
models of treatment with humanistic or solu-
tion-focused models.
2. Mental health and health psychology
can currently reach only a small fraction of
the people who are in need of counseling and
modification of self-destructive health behav-
iors (Prochaska, 1999). The pathologizing
nature of psychological diagnoses and treat-
ments, as well as the threat to self-esteem and
the social stigma often attached to them, seem
to contribute to keeping people away from
helping services. In addition, many people
seem to rely on and successfully use self-
change and nonprofessional helping services
that capitalize on their internal ability to over-
come problems and difficulties. Several forms
of self-help, self-change, and other sources
of informal psychological help have been
reasonably supported by research (Bohart &
Tallman, 1999; Christensen & Jacobson,
1994; Hubble, Duncan, & Miller, 1999;
Prochaska, 1999), and their effectiveness sug-
gests the utility of nonmedical approaches to
treatment. The self-change and self-help trends
build on people's positive traits and self-
protective survival mechanisms, as well as
their skills, to activate their social support
systems. These trends obviously represent
the expression of the positive psychology
movement in the field of therapy, and if fur-
ther researched and embraced by mainstream
therapeutic psychology, they can offer a great
preventative service (in the spirit of giving
87