Is the pursuit of happiness making us miserable?

In case you get bored in this post. I need to put my last sentence first: ‘So come to what looks like a fabulous evening in Sydney, run by the innovative MIND special interest group of the Australasian Faculty of Rehabilitation Medicine – ‘Happiness, depression and health care: Is the pursuit of happiness making us miserable’. It will be worth it. ’

I have two confessions to make. First, I was at an evening seminar a few weeks ago run by the South Australian branch of the Australian Physiotherapy Association. Dave Butler and I were ‘on the couch’ (actually we were on separate recliners – Dave’s was electric – mine was manual I seem to recall – I am not bitter about it…..) and Mark Jones was hosting us. I got asked a question about the role of positive psychology in chronic pain rehab.  My answer was, in retrospect, naïve and hasty. I have to admit to a cortical error when I encounter  ‘positive psychology’ – it somehow get’s transformed into ‘pop psychology’. I know they are different but why this miscategorisation? I think it is because I automatically think of the ‘happy’ industry. I know positive psychology is not about happiness.

I realize now that our evening on the couch was scheduled around about the time that Dr Martin Seligman was here in Adelaide – doing a few lectures and working with some of our schools as part of his gig as ‘South Australia Thinker in Residence’.  My brother gets a woosh of South Aussie pride when he reflects on the Thinker in Residence programme and I can understand why – it feels like the mark of a sophisticated community. That we got turned away from a cafe in town at 4pm because it was closing does not have the same feel.

Now I really like Seligman’s messages – I prefer optimism to self-esteem, resilience to avoiding failure, and I really do think these things seem to be a lovely fit with some of what we are trying to do in chronic pain rehab and prevention. However, for some reason, my internal cognitive machinations do not equate Seligman with ‘positive psychology’, which is daft in the extreme. I transform positive psychology into ‘happy training’. I think of self-help books that supposedly teach you how to be happy. So, it was naïve and hasty of me to answer an excellent question from a position of some ignorance and through a flawed process of cognitive transformation. I should have said ‘dunno – what do you reckon?’ To the lovely person who asked the question, the crowd who were gathered, to Dave who probably would have offered a far more helpful and informed response, and to Seligman et al, I apologise.

My second confession: The happy market doesn’t grab me. The idea that one can read a book to become happy feels a bit like buying a latte or flat white (see our very interesting experiment on black noses and flat whites here) that is entirely crema. Crema is a significant contributor to a great coffee, but to have a cup full of crema would feel empty somehow I reckon. Happy feels like something that happens when a complex mix of things internal and external, chemical and circumstantial, planned and fortuitous, align. It feels like something that takes a whole of training and a fair bit of luck.

I concede that I find happy pretty easy – my folks reckon I was born happy – what a fantastic stroke of luck that is – so I may not understand what the chance of learning happiness might offer some people. But I can’t help but wonder if this swelling of fervour for happiness might be distracting us from a deeper longing – perhaps to love and be loved (I fear I may have just crossed the line here – is such a phrase allowed in a clinical science post?) Could the pursuit of happiness be making us miserable? Could the pursuit of happiness make recovery from pain even more difficult? Is it missing the point?

I don’t really know the answers to these questions and I am, pleasingly, not naïve nor hasty enough this time to offer them. However, there are people who are taking this on. Dr Jane Malone is an executive member of the MIND special interest group of the Australian Faculty of Rehabilitation Medicine. She and her colleagues have lined up two people very well placed to address these questions. If you are in Sydney you should go.

I would also be interested in what people who are not inflicted by a dodgy cognitive transformation think about the potential role of positive psychology in chronic pain rehab. Are there empirical studies on this? Are there research groups who are taking this on? Anyway, for now, let me say this: “Come to what looks like a fabulous evening in Sydney, run by the innovative MIND special interest group of the Australasian Faculty of Rehabilitation Medicine – ‘Happiness, depression and health care: Is the pursuit of happiness making us miserable’. It will be worth it. “

About Lorimer Moseley

Lorimer is NHMRC Senior Research Fellow with twenty years clinical experience working with people in pain. After spending some time as a Nuffield Medical Research Fellow at Oxford University he returned to Australia in 2009 to take up an NHMRC Senior Research Fellowship at Neuroscience Research Australia (NeuRA). In 2011, he was appointed Professor of Clinical Neurosciences & the Inaugural Chair in Physiotherapy at the University of South Australia, Adelaide. He runs the Body in Mind research groups. He is the only Clinical Scientist to have knocked over a water tank tower in Outback Australia.

Link to Lorimer’s published research hereDownloadable PDFs here.

Comments

  1. You are absolutely right, and it goes further. Our society tells people that they should be happy, have lots of money/new possessions, be thin, be beautiful, be famous, be in love… it breeds disappointment and dissatisfaction because human life is not like that. Resilience and developing strength in the face of adversity are hardly poular virtues at present but they are what most of humanity has to cope with every day.

  2. Jos Steinmann says:

    We have an annual “happiness lecture” that explores aspects of happiness, contentment, well-being or whatever one might call feeling good about your place in the world – The last one I went to was on a positive psychology approach to this broad term “happiness” – much of it was based about learning your own personal style and natural state of contentment – there is evidence that it is quite difficult and temporary to change our natural level of contentment – and acceptance of this is the first step in finding a contented balance in ourselves
    We all know a miserable pessimistic person who really enjoys wallowing in their negative view of the world – and of a seemingly upbeat person who is always searching for something but never really finding it.

    It would be interesting to consider which would manage a persistent sensitised pain state better. My money is on miserable b****r – there must be research on this – the psychologists love this sort of trial

    I’m a physio working in the Bristol community NHS with a supply of Explain Pain for loan – we indoctrinated the whole team with one of your talks in Stroud, UK –
    Our approach is Explain Pain to read, a positive psychology approach and patient activation to optimise self management with some well placed manual therapy – add in a few good drugs and a lot of our patients never need the traditional Pain Clinic – Thanks Lorimer

  3. The work of transpersonal psychology (spirituality, particularly contemplative spirituality, overlapping with psychotherapy) should not be ignored in the management of chronic pain. That is as a facet to the management of chronic pain. Contemplative practices are aimed at healing deep rooted emotional trauma of a lifetime. It is understood chronic pain has a connection with unresolved hurt. So utilizing the gifts of contemplative spirituality and psychology in managing chronic pain makes perfect sense. I have personally tried it with clients, it may not eliminate the pain but lessens the suffering in the midst of suffering .

  4. i wonder about my happiness sometimes. After 5 years of waking up and facing the punching bag of pain (mostly with a smile on my face) i feel it comes down to our brain’s individual cocktail (and mine has a lotta bubbly in it). Of course it could also be that we all have different lengths of endurance and i received the right advice (thank you very much Lorimer!) before reaching my limit. I’m not sure if it matters what the world tells us, our brains will steer us to cope according to its cocktail.

  5. Jos – How strange is this – you add a reply next to mine on an Australian website – we were sitting next to each other at Bristol Zoo on Tuesday evening – I work as a specialist MSK physio at Spire and have long-standing interest in pain etc.

    Jos Steinmann Reply:

    I love this international global community we live in – I buy my tea direct from a shop in China – get my Pain research info from Aus – support a local physio in Uganda
    But get my lunch locally crafted from a bespoke sandwhich shop and my veg from a farm only 15 miles away
    This worlwide effort to progress pain management will be valuable in all these places – I feel very priveledged to be a physio who is able to cut across medical disciplines to use the new knowledge and ideas.
    Thank you for the shoulder workshops at the zoo – it’s an area of interest of mine – along with the thoracic spine underneath – Catch up at another session

  6. Anonymous says:

    The people of Bristol are lucky people. Sounds like a great approach which should be copied within the NHS community teams.

  7. Scott Swinson says:

    One interesting way of looking at happiness and chronic pain is that each are processes not “things”. We make them into nouns instead of the verbs that they are. You don’t have chronic pain you “do” chronic pain as it’s an output/process. Just like doing a salsa dance you are either doing a salsa dance or you are not doing it. You would not say “I’ve got a salsa dance”. Happiness is a complex thing as is chronic pain but they are still processes that we are either “doing” in one moment or not “doing”. If happiness is an issue then maybe we just need to learn how to “do” that neural pathway until we become better at doing it, maybe it could even become automatic, as in Lorimer’s case, just like driving a car. And maybe for chronic pain we just need to learn how to “do” calm, relaxed, comfortable (not activate the flight/fight responses) and stop doing a body check every few seconds – check your pinkie instead. And of course read explain pain! Just thoughts….

    soula Reply:

    hi scott,
    i like your definition but i feel if i say i’m ‘doing’ pain today it’s like i’m responsible for it, as if i’m causing it. i don’t feel i am… can i change it to it’s ‘doing me’?!! i’m not sure about ‘body check’ either. certainly i assess where i’m at but most often what happens is that i end up wondering why i’m feeling so aggrevated, so bothered and why i can’t attempt a simple task and i realise i’m in pain. does this make sense to anyone?

    Scott swinson Reply:

    Hi Soula,
    I’m sorry for the quick statement I wrote. It was incomplete and easily misunderstood. I do think pain is a process like a dance. We are either “doing” chronic pain or not “doing” it. As Lorimer stated in his last blog he has been wondering if there is a gap in the “doing” of pain from sleep to waking…… or is he not doing pain until he is awake?….interesting!

    A really important thing I didn’t mention before is that I think most of this occurs unconsciously. So you are not to blame or responsible for your chronic pain. I do think that if you can make conscious what is unconscious then you have an opportunity to influence what is going on.

    Having had two episodes of chronic pain i also think that the physical emergency response (stress response) plays an important role in keeping people stuck. We activate this response when we break a bone, get a bacterial infection, are stuck in traffic running late, have an acute episode of back pain, get irritated about not being able to do what we want because of pain etc. This response, if activated repeatedly, puts our whole body out of kilter – please refer to the book by Robert Sapolsky – why zebras don’t get ulcers.

    This response activates the sympathetic nervous system. Many things change in the body as a result of this which are too many to mention here. It changes the resting excitability of the muscles and effects descending inhibition. There are 14 times as many nerves in our body as there are people on this planet and each nerve has 2000-5000 synapses ( I’m just quoting, haven’t counted them myself!). Many of these synapses are effected by the physical emergency response.

    These are just my thoughts about pain. Hope this is of some help. I think if you can make conscious what is unconscious, interrupt each and every thought that does not promote feeling good (rest/digest – parasympathetic) and create a new thought, you will then get new physiology. Bit hard to explain and keep short…..ish….

    soula Reply:

    hi scott,
    thanks so much for replying and for that great information. i’ll look into the book. oh if only we could control the unconscious…

    i have a great tip from my alexander technique physiotherapist. she made me ‘conscious’ of my mind and body’s state when saying ‘hello’. of course it isn’t a quick fix but the difference is so amazing it helps me understand what you’re saying. i imagine many of those thousand synapses suddenly smiling!

    thanks again. i hope you don’t have any chronic pain now.
    soula

  8. Sandy Hilton says:

    I have no answers, just clinical and life experience, totally non-evidence and chock full of assumptions. I have patients with coping fatigue that are looking for better options. People don’t have a “control” to test options, they just muck along the best they can in trial and error for the most part. All those self-help happiness books are filling the gap in effective options. If positive psychology is teaching resilience and active coping techniques I think it could be helpful in chronic pain rehab.

    The only practical training I have is from the classes on resilience offered with the us military and the unstudied (as far as I know) application for the families… These classes are promoted as teaching options of positive coping skills. Some things that happen just aren’t right and no amount of positive self-talk, ‘laws of attraction’ or affirmation will make that kind of un-rightness go away.

    Resilience – (my own definition) is the ability to keep going even when life sucks. It is knowing there will be happiness around the edges and eventually, even when everything hurts, or is falling apart, there will be fun, laughter, good friends (and food, wine, chocolate, love etc…). Resilience is learning to dance on the edge of insanity; it takes courage, persistence, patience and practice. Sounds like therapy.

    But I don’t claim to be uninflicted by any ‘dodgy cognitive transformations’, and I suppose “dunno – what do you reckon” may be the best answer here after all.

  9. Kory Zimney says:

    I wonder if not being “happy” about getting the short end of the stick on the chair situation with David put your reply on tilt and not offering the better response of – ‘dunno – what do you reckon?’

    Anyway, I see the work by Seligman and others on optimism/resilience as some good stuff as well. Just that it is complex and not as easy and singing “Don’t worry, Be happy” and all will be well – yet the self help books sell a lot of copies with that solution. Sounds like some of the get quick pain relief ideas that are out there. None of those help people in pain and none of the just-be-happy ideas help those lacking resilience and optimism.