Psychosocial Aspect of Health and Illness

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Psychosocial Aspect of Health and Illness Edited by Dr. Sandhya Ojha Dr. Shambhu Upadhyay Publish by Global Vision Publishing House Positive Psychology and its Intervention Programmes for Academic Institutes Kamlesh Singh Positive psychology was launched in 1998 by Seligman during his term as president of the American Psychological Association. In his presidential address to the Association, Seligman (1998) revealed that since World War II psychology has focused mainly on pathology, hence, the aim of positive psychology is to have a change in psychology from a preoccupation only with repairing the worst things in life to also building the best qualities in life. To redress the previous imbalance, we must bring the building of strength to the forefront in the treatment and prevention of mental illness, (Seligman, 2005). Only some earlier perspectives of Psychology have developed successful theories and practices that involved human happiness and positive aspects of Human life especially humanistic psychologists like Carl Rogers and Abraham Maslow. Recently, the theories of human flourishing developed by these humanistic psychologists have held up as historical background of Positive Psychology What is Positive Psychology? Positive psychology is a recent branch of Psychology that studies the strengths and virtues that enable individuals and communities to thrive, Compton, (2005). He also added that Positive psychologists seek to find and nurture genius and talent, and to make normal life more fulfilling. The field of positive psychology at the subjective level is about positive subjective experience: well-being and satisfaction (past); flow, joy, the sensual pleasures, and happiness (present); and constructive cognitions about the future optimism, hope, and faith. At the individual level it is about positive personal traits the capacity for love and vocation, courage, interpersonal skill, aesthetic sensibility, perseverance, forgiveness, originality, future mindedness, high talent, and wisdom. At the group level it is about the civic virtues and the institutions that move individuals towards better citizenship: responsibility, nurturance, altruism, civility, moderation, tolerance, and work ethic, (Gillham & Seligman, 1999; Seligman & Csikszentmihalyi, 2000). Kamlesh Singh is currently Assistant Professor, in Indian Institute of Technology, Delhi.

312 Psychosocial Aspect of Health and Illness Sheldon, Frederickson, Rathunde, Csikszentmihalyi, and Haidt (1999) defined Positive Psychology as a scientific study of optimal human functioning. It aims to discover and promote the factors that allow individuals and communities to thrive. The positive psychology movement represents a new commitment on the part of research psychologists to focus attention upon the sources of psychological health, more than only focus on disease and disorder. To meet these objectives we must consider optimal functioning at multiple levels, including biological, experiential, personal, relational, institutional, cultural, and global, they added. This field is founded on the belief that people want to lead meaningful and fulfilling lives, to cultivate what is best within themselves, and to enhance their potentiality. Importance of the Perspective We have been working exclusively on personal weakness and on damaged brains, and deifying the Diagnostic and Statistical Manual (DSM), in contrast, it has provided science poorly equipped to do effective prevention. Seligman (2005) emphasised that we now need to call for massive research on human strength and virtue. We need to develop a nomenclature of human strength the UNDSM- I, the opposite of DSM-IV. We need to measure reliably and validly of these strengths. Despite the significance of happiness, psychology throughout its history has more often focused on negative emotions. Myres (2004) did meta-analysis and reported that Since 1887, Psychological Abstracts (a guide to psychology s literature) has included, as of this writing, 10,735 articles mentioning anger, 70,845 mentioning anxiety, and 86,767 mentioning depression. For every 13 articles on these topics, only one dealt with the positive emotions of joy (1161), life satisfaction (7949), or happiness (3938). Positive traits Negative traits Aim of our life Our aim is to get normal level on negative traits and several specialists like clinical psychologists, counselors, psychiatrists contribute through their specialties. How people should inculcate positive traits which supply positive emotions, positive individual traits, and positive institutions sheltered by this perspectives. It is observed that human nature is directional and it attracts its own kind of characteristics, that is why, mostly, whether we have constellation of positive or negative traits. Consisting to this statement, Tennant, (2002) found that higher daily life stressors and perceived stress were associated with poorer outcome in major depressive disorder, Furthermore, anxiety, which has not only emotional but also cognitive correlates, may be associated with the stress response, [Endler and Kocovski (2001) and Seifert and Kollbrunner (2005)] 11 E. Seifert and J. Kollbrunner, Stress and distress in non-organic voice disorders, Swiss Med Wkly 135 (2005), pp. 387 397. View Record in Scopus Cited By in Scopus (5). For a disorder, muscle tension dysphonia (MTD) reported that anxiety, depression, introversion, neuroticism, inhibition, and social anxiety and stress observed correlated to this disorder, [Seifert and Kollbrunner (2005), Aronson, Peterson and Litin (1966) Lauriello, Rossi, Rienzo and Tirelli (2003), Mersbergen, (2005)]

Positive Psychology and its Intervention Programmes for Academic Institutes 313 Whilst, Positive traits like gratitude has been shown to be a robust predictor of well-being and social variables, (McCullough, Emmons and Tsang, (2002), McCullough, Tsang and Emmons, (2004) and (Wood et al., 2007 A.M. Wood, S. Joseph and P.A. Linley, Coping style as a psychological resource of grateful people, Journal of Social and Clinical Psychology 26 (2007), pp. 1108 1125. Wood, Joseph and Linley, 2007). Gratitude explained additional variance in SWL after controlling for both the Big Five domains (9%) and facets (8%), supporting conceptions of gratitude as uniquely important to well-being and social life (Lyubomirsky, Sheldon and Schkade (2005) and Watkins, (2004) Watkins, 2004 P.C. Watkins, Gratitude and subjective well-being. In R.A. Emmons and M.E. McCullough, Editors, The psychology of gratitude, Oxford University Press, New York (2004), pp. 167 194. Gratitude also showed a distinctive pattern of correlations with the Big Five, where gratitude appears to correlate most strongly with the facets that represent well-being and social functioning. Singh, (2008 a) investigated that the significant correlation between the Big Five Factors of personality and life satisfaction, gratitude, meaning in life and positive and negative affects. Neuroticism and negative affect were found negatively correlated with positive constructs of personality. In several multiple regression analyses, Vitterso (2001) found that, on average, the amount of subjective well-being variance accounted for by emotional stability was 34%, while similar figures for extraversion were 1%. Singh and Duggal (2008) revealed that the concepts of Grit, Positive Affect, Happiness and Life Satisfaction are significantly positively correlated. Negative Affect showed a significantly negative correlation with Grit, happiness and life satisfaction. Stepwise regression analysis showed that positive affect, grit and negative affect together account for 19% of the variance in life satisfaction, grit, negative affect and positive affect account for 11% of the total variance in Happiness. Consequently, researches have been confirming constellation of positive traits as well as negative traits. Jung, a Neo-psychoanalyst, also pointed out that adding or deleting a characteristic in our personality is just like throwing a pebble in the pond. Positive Strengths The VIA classification of character strengths peterson and seligman (2004) compiled important character strengths by doing large scale of data analysis. Wisdom and Knowledge Cognitive strengths that entail the acquisition and use of knowledge. This factor has following character strengths: Creativity [originality, ingenuity]: Thinking of novel and productive ways to conceptualise and do things; includes artistic achievement but is not limited to it. Curiosity [interest, novelty-seeking, openness to experience]: Taking an interest in ongoing experience for its own sake; finding subjects and topics fascinating; exploring and discovering. Open-mindedness [judgement, critical thinking]: Thinking things through and examining them from all sides; not jumping to conclusions; being able to change one s mind in light of evidence; weighing all evidence fairly. Love of learning: Mastering new skills, topics, and bodies of knowledge, whether on one s own or formally; obviously related to the strength of curiosity but goes beyond it to describe the tendency to add systematically to what one knows.

314 Psychosocial Aspect of Health and Illness Perspective [wisdom]: Being able to provide wise counsel to others; having ways of looking at the world that make sense to oneself and to other people Courage Emotional strengths that involve the exercise of will to accomplish goals in the face of opposition, external or internal. It includes following Character Strengths: Bravery [valor]: Not shrinking from threat, challenge, difficulty, or pain; speaking up for what is right even if there is opposition; acting on convictions even if unpopular; includes physical bravery but is not limited to it. Persistence [perseverance, industriousness]: Finishing what one starts; persisting in a course of action in spite of obstacles; getting it out the door ; taking pleasure in completing tasks. Integrity [authenticity, honesty]: Speaking the truth but more broadly presenting oneself in a genuine way and acting in a sincere way; being without pretense; taking responsibility for one s feelings and actions. Vitality [zest, enthusiasm, vigour, energy]: Approaching life with excitement and energy; not doing things halfway or halfheartedly; living life as an adventure; feeling alive and activated. Humanity Interpersonal strengths that involve tending and befriending others with subsequent Character Strengths: Love: Valuing close relations with others, in particular those in which sharing and caring are reciprocated; being close to people. Kindness [generosity, nurturance, care, compassion, altruistic love, niceness ]: Doing favours and good deeds for others; helping them; taking care of them. Social Intelligence [emotional intelligence, personal intelligence]: Being aware of the motives and feelings of other people and oneself; knowing what to do to fit into different social situations; knowing what makes other people tick. Justice Civic strengths that underlie healthy community life with following Character Strengths: Citizenship [social responsibility, loyalty, teamwork]: Working well as a member of a group or team; being loyal to the group; doing one s share. Fairness: Treating all people the same according to notions of fairness and justice; not letting personal feelings bias decisions about others; giving everyone a fair chance. Leadership: Encouraging a group of which one is a member to get things done and at the time maintain time good relations within the group; organising group activities and seeing that they happen. Temperance Strengths that protect against excess having. It has following Character Strengths: Forgiveness and Mercy: Forgiving those who have done wrong; accepting the shortcomings of others; giving people a second chance; not being vengeful. Humility/Modesty: Letting one s accomplishments speak for themselves; not regarding oneself as more special than one is. Prudence: Being careful about one s choices; not taking undue risks; not saying or doing things that might later be regretted.

Positive Psychology and its Intervention Programmes for Academic Institutes 315 Self-regulation [self-control]: Regulating what one feels and does; being disciplined; controlling one s appetites and emotions. Transcendence Strengths that forge connections to the larger universe and provide meaning. It has following Character Strengths: Appreciation of Beauty and Excellence [awe, wonder, elevation]: Noticing and appreciating beauty, excellence, and/or skilled performance in various domains of life, from nature to art to mathematics to science to everyday experience. Gratitude: Being aware of and thankful for the good things that happen; taking time to express thanks. Hope [optimism, future-mindedness, future orientation]: Expecting the best in the future and working to achieve it; believing that a good future is something that can be brought about. Humor [playfulness]: Liking to laugh and tease; bringing smiles to other people; seeing the light side; making (not necessarily telling) jokes. Spirituality [religiousness, faith, purpose]: Having coherent beliefs about the higher purpose and meaning of the universe; knowing where one fits within the larger scheme; having beliefs about the meaning of life that shape conduct and provide comfort. However, In Indian sample, it is observed that all above mentioned character strengths were highly correlated with each other and loading only on one factor, when Hindi translated VIA survey was used on college students (Singh and Choubisa 2008). Values/Positive Strengths in Indian Context Perceived values have reported slightly different in students of India. Above 70% villager college girls reported values as hard work, self confidence, determination, Dutiful, ek achhi beti, behen aur patni banna helpful, mujhe doosron ki madad karna achha lagta hai sociable, main har kisi ke saath mil jul ke rehti hoon empathy, doosron ki bhaavnaon ki kadra karna learning, respect for elders, belief in God, orientation towards the community, kuch aisa karna ki doosron ke kaam aa sakoon, garibon ki sahayta karna family mata pita ki achhi santan banna and Respect for elders, apne se badon ka aadar aur choton se pyar love, patriotism, social welfare, samaj ke liye accha kaam karna koi bhi aisa kaam na karna jis se kisi ka nuksan ho belief in God, helping others, garibon ki maddat, being sociable and friendly, sabhi ke saath miljul ke rehna, Unity, Honesty, Hard work, Discipline, Helpful and kindness Doosron ki sewa karna, doosron ko khushi dena self confidence, Duty apna kaam kisi pe naa chodna, intelligence, self reliance apna kaam swayam karna, equality sabhi dharmon ka samman karna Social welfare samaj sudhar, doosron ki bhalai karna mujhe accha lagta hai, integrity main kabhi kisi ka vishwas nahin todta, attachment with others, sociable, respect for country desh aur samaj ke liye kuch karna, love, fairness, samaj mein bhedbhav nahin hone chaiye duty apni padhai ko imandari se karna, hard work apne lakshya ke prati kadi mehnat, Cooperation, Parents I value the happiness of my parents the most in my life Humor, Patience, Hard work, I value success and hard work Family, Friends, Self discipline, A person should be disciplined to achieve goals Love, optimism, spirituality, intelligence, loyalty, success Determination, Respect for elders, Belief in God, Optimism, Self Confidence, Hardworking, Family orientation, My biggest strengths are my parents and family,

316 Psychosocial Aspect of Health and Illness friendliness, honesty, patience, being helpful, equality tolerance, patience, honesty, determination, courage, hard work, goal orientation, parents, blessings of parents and elders originality, family, cooperation, knowledge, optimism, are the prominent values which are informed by college students across northern India, (Duggal & Singh, 2008). On the basis of above analysis as well as review of literature, a positive personality trait test has developed mainly having factors like, positive self image, commitment, self belief, orientation towards culture (Singh & Duggal, 2008). A detailed description of the four subscales follows: Positive Self Image: Measuring participants orientation towards maintaining a positive self image. It includes looking at the self and life positively, looking at the self in relationships in a positive manner, seeing the self as flexible, emotionally intelligent, fair, spiritual, honest and self reliant. Commitment: This includes the tendency to be committed towards the self in terms of beliefs and goals and to be committed towards others in relationships. It also includes the inclination to initiate actions towards one s own life and in response to others. It includes aspects of goal orientation, of resilience, a desire to learn new things, independence, originality, gratitude, generosity and loyalty. Self Belief: This aspect measures the confidence that a person places in himself/herself. This includes the ability to be outgoing and gregarious in social situations, a zestful approach, selfesteem and the confidence to lead others. Orientation Towards Culture: These items mainly look at an individual s orientation towards one s culture and country. This includes aspects of orientation towards one s traditions, patriotism and tolerance towards others. Specific Coping Approaches Sharing one s story is an approach to positive psychology is to document the psychological factors that promote physical and mental health. In 1997, Pennebaker research participants in the experimental condition enjoyed the writing process and found it to be extremely valuable and meaningful. Similarly, 98% of participants reported that they would participate in the study again if given the choice tragic and depressing stories rape, family violence, suicide attempts, drug problems, and other horrors were common topics. Participants in the experimental condition had significantly reduced numbers of physician visits in the next year (in comparison to those in the control condition). Similarly, Benefit-finding, positive response to loss, humor, meditation, spirituality and some other approaches have been linked to psychological and physical health, and play a prominent role in theories of cognitive adaptation to threatening circumstances, posttraumatic growth and psychological thriving (Snyder & Lopez, 2002). Intervention Programmes in Positive Psychology Intervention strategy as positive psychological exercises were used by Seligman, Steen, Park and Peterson (2005) found that exercises lead to reduction of depressive symptoms (mild to moderate) and enhances the subjective well-being (happiness) of the individual. The exercises were as follows:

Positive Psychology and its Intervention Programmes for Academic Institutes 317 Using Your Strengths: Take the VIA-IS strengths questionnaire to assess your top five strengths, and think of ways to use those strengths more in your daily life. Three Good Things/Blessings: Each evening, write down three good things that happened and why you think they happened. Obituary/Biography: Imagine that you have passed away after living a fruitful and satisfying life. What would you want your obituary to say? Write a 1 2 page essay summarising what you would like to be remembered for the most. Gratitude Visit: Think of someone to whom you are very grateful, but whom you have never properly thanked. Compose a letter to them describing your gratitude, and read the letter to that person by phone or in person. Active/Constructive Responding: An active-constructive response is one where you react in a visibly positive and enthusiastic way to good news from someone else. At least once a day, respond actively and constructively to someone you know. Savoring: Once a day, take the time to enjoy something that you usually hurry through (examples: eating a meal, taking, a shower, walking to class). When it is over, write down what you did, how you did it differently, and how it felt compared to when you rush through it. Bughi, Sumcad, and Bughi (2006) reported effective in decreasing the reported stress level and increased the subjective well-being of Individuals. Some major intervention Strategies to manage stress, and enhance subjective well being focus is on stress reduction by using simple mind-body intervention techniques have used by researchers, such as: A psycho-educational lecture on stress. Deep diaphragmatic breathing (pro-longed expiration or deep yoga breathing). Relaxation (i.e., repetitive focus on a word, imagery of relaxing scene, or body scan meditation). Walking meditation (mindfulness when walking). PMR (Progressive Muscle Relaxation). Biofeedback. Laughter therapy and other indigenous therapies. Joining a social welfare group or community/organisation. Emphasis on pleasant activities like altruistic activity, art therapy, catering redesign in long-term care, home massage, occupational therapy, pet therapy, sleep management, video games, etc. In the same way, Emmons and McCullough (2003) documented An Experimental Investigation of Gratitude and Subjective Well-Being in Daily Life and found positive change in life. Forgiveness, Emotional Intelligence, time management, stress management, making happier have been some other interests for researchers. Proposed Model for College Students in Indian Context In lecture classes overall view of positive aspects of our life through lectures, videos, and presentations will be shared with students. In tutorial/practical classes with small group in more interactive sessions following strategies will be followed:

318 Psychosocial Aspect of Health and Illness Sr.No. Activity (session) 1. Introduction 2. Pre- testing Demographical Variables: Academic Achievement and other relevant data Emotional intelligence Positive Affect and Negative affect Subjective well being Depression Scale 3. (i) Introduction (ii) Self Talk: Introspect and Retrospect your Life (Self report) (iii) Accurate Self Knowledge (Emotional, cognitive and Behavioural) Purposefulness/meaningfulness in life 4. Introspect and Retrospect of your last week (Academic goal and self management) Where are you spending/putting your energy? Immediate vs Delayed gratification Special session (individual session if it is required to someone) 5. Introspect and Retrospect of your last week (Academic goaland self management) Self Management (Time, Relationship and Stress Management strategies, Goal setting) Proportion of sharing Internal and External world 6. Introspect and Retrospect of your last week (Academic goal and self management) Progressive Muscle relaxation Deep Breathing exercise Meditation 7. Introspect and Retrospect of your last week (Academic goaland self management) Enhancing self esteem Recognise your strengths Best possible selves Three good events of your life Making wise Comparisons. Entertainment of your day 8. Introspect and Retrospect of your last week (Academic goaland self management) Review your religion/custom/tradition and analyse, how it enhance/contribute to subjective well-being (contribution to forgiveness, gratitude etc.) Role of religious teachings in your life. Never compromise on your core values. 9. Introspect and Retrospect of your last week (Academic goaland self management) Cultivate a sense of gratitude Forgiveness Altruism Empathy What will you give back to society? 10. Introspect and Retrospect of your last week (Academic goaland self management) Internal vs. External Locus of control. Contd. table...

Positive Psychology and its Intervention Programmes for Academic Institutes 319 Contd. table... Be optimistic but realistically. Take responsibility of your action. Willingness to learn from all surroundings. Enjoy a journey not only destination. 11. Introspect and Retrospect of your last week (Academic goaland self management) Analysis of Vignettes regarding students problems. 12. Introspect and Retrospect of your last week (Academic goaland self management) topics preferred by Students 13. Post testing on same variables Introspective report on the modules 14. Interactive session and Thanks giving day Through Pre-post designing effectiveness of intervention programme is studied, new plan with new group is formulate as well. There is need of translating research into practice. We could get abundance of instances of folklores in rural and urban India. Urban Indian folklores may be documented more but it does not mean these are higher in urban educated communities. Rural people also involve in satsang having simple and charming massage driven Bhajan (songs) like bande soch samajh, Jai tera ho.jain s samma Yachana day is another example of healthy living. Due to westernisation, urbanisation and modernisation it seems that we are moving towards collectivistic to individualistic culture. However, level of collectivism is gradually reducing but still all areas from village to city to Metro city observed collectivistic cultures in Northern India. (Duggal Jha & Singh, 2008) We are bombard by abundance of stimuli and not able to get difference between right and wrong life style ensuing reinforces wrong activities, faulty life style. Hence need to review traditions and reinforced which help us in our healthy life. Students education can improve by making greater use of intrinsic motivation, positive affect, meaning, optimism, experience states of flow and self-healing creativity within institutions suggested by various positive psychology researchers. I think best methodology for this approach is participatory action research, where, we review our plan by analysing our first data, get new insight, plan next and analysing our second data, get new insight further and so on. Finally, develop some module through this process which will lead to healthy and flourishing students life in all directions. Participatory action research method has found noteworthy for introspecting hostel life of college students (Singh, 2008 b). REFERENCES American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Aronson, A.E., Peterson H.W. and Litin, E.M. (1966). Psychiatric symptomatology in functional dysphonia and aphonia, J. Speech Hear Disord, 31, 115 127. Bughi, S.A., Sumcad, J. and Bughi, S. (2006). Effect of brief behavioural intervention programme in managing stress in medical students from two southern California universities. Med. Educ. Online [serial online], 11: 17.

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