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BRUCE CARROLL: Okay, so one of the things I do,
I use gratitude diaries, and these are considered
the mega-strategy by Sonja Lyubomirsky.
These are things like counting your blessings,
three things that you do.
Now, Oprah Winfrey recommends it, so
that's the highest form of evidence. [laughter]
Oprah is, if you want something implemented,
if you want newspapers to stop printing negative news,
get Oprah to tell them to stop doing it, and that will happen.
I can tell you a funny story about a friend of mine who ended up on her show...
Talk about implementing things, you can implement things instantly with her.
I suggest it to probably two of my patients every half day,
and the instructions are, I have written instructions:
Buy a nice, new book.
So you sort of treat yourself.
Write down three things you're grateful for,
and what you've done to cause that.
Okay, particularly this is often to people who are depressed,
but even people who are just aching,
is to remind yourself that you are inventing your world.
Now, we tend to think we're not, but actually
just being here, you've invented being here.
And you tend to think, "Well, you just came,
"you had to come, or you came, or whatever today."
Ideally, it's not stopping a negative event.
And I have to give people examples.
Sometimes people think, "I can't think of anything."
I say, "Well okay, you've got food in the fridge,
"you paid for it, you've got a friend, you keep in touch with them."
Do this daily, for a week and then once a week after.
For people who are depressed, that's enough to keep them
less depressed for six months, doing it, going on.
So you don't, just doing it daily for a week,
and then once a week thereafter seems to be enough.
Does it work? Well, Seligman has published some stuff on this.
It was an Internet-based study, and it was a randomised-control trial.
And at six months, the people who did the diary
were much happier than those who did not.
I love this. This is a definition of gratitude:
a felt sense of wonder, thankfulness, and appreciation of life.
And I think that's, that's part of it.
So what is happiness? I mean, it's not just happiology,
have a nice day.
It's positive emotion, pleasure, engagement, the engaged life,
meaning, the meaningful life, and there's this quote down here,
"Most people who're satisfied are the ones who orient their lives to all three,
"the greatest weight being on engagement and meaning."
So I think that's quite an interesting definition.
So it's become quite a science now,
there are quite a few people in the world doing research on it.
My experience with the gratitude diaries would be,
I'd say about 90% of people are interested.
You know, you sort of think people are going to think you've gone off your rocker
as a doctor, but no. They do say to me sometimes,
"You're a bit different from usual doctors, aren't you?"
Which I actually take as a compliment.
I do pick my audience, of course,
I mean, you know, some people, I probably wouldn't think...
I'd say about 50% of people do them, some of the time.
I don't ask them to bring them in.
I have one very unmotivated young man
who's on the sickness benefit, so I ask him to bring his in.
And one of the issues I think would help with
non-flourishing is probably 100% employment.
I have to say, seeing unemployed young men in particular
is pretty devastating. They don't do very well in our society.
From... My own experience was I kept one beside my bed
for a couple of months, and I just found I became a lot more grateful,
like I'm grateful to be here today,
grateful that Hugh and Judi have invited me.
My son says I don't curse my computer anywhere as much,
I don't get upset in traffic, if somebody cuts on me, I think,
"Well, maybe they just found out their mother's got cancer, or their wife's got cancer,
"or their daughter's got cancer, or something, you know?"
And I actually have to say, I just feel this pressure has come off my body,
through this gratitude, so it's been very good.
I think it focuses people on what they've got, rather than what they haven't got,
and I say to people, "Look, any day in New Zealand's
"better than a day in Haiti." You know.
I think it increases the issue of being mindful
and letting go, and I'm going to talk more about these later.
Meditation, there's been a bit about that all morning.
John Raeburn, whom many of you will know,
and Tony Fernando, who's an extraordinary psychiatrist,
you don't tend to think of psychiatrists being interested in
flourishing, but he's actually very interested.
They're both daily meditators, and I have to say,
they're two people who are in very good shape.
There's evidence that it reduces the recurrence of depression.
This was a randomised trial in primary care.
Once I saw that, I was right into it with my patients.
Because you know, if you have diabetes,
and you get it under control, we keep following you.
If you have a depression and get better, we don't.
We don't give you the same after-service care.
So we need to think... and depression's a recurrent illness,
and we have to look at ways of...
of reducing that and helping people flourish more.
They've made this website, calm.auckland.ac.nz,
it's created by Tony Fernando, who's a Filipino-trained psychiatrist who trained in the US,
and Fiona Moir, who's a Scottish GP who works in our department...
I do a lot of work with these two.
There's a whole lot of MP3s there. If you want a MP3 without a copyright on it,
you can download them off that. I've got them on my iPod.
I sometimes put patients in a spare room for thirty minutes on the iPod.
Usually people are very depressed and anxious,
and they invariably come back saying,
"That's the first time I've felt relaxed in two or three months."
So I think it actually works even when people...
in that trial, they were using it to prevent depression and anxiety;
I think it actually works when people are depressed and anxious.
Barbara Fredrickson's done a randomised trial
using loving-kindness meditation,
and found an increase in positive emotions.
I just make the CDs; I just go to *** Smith
and buy 100 of them for 50 dollars, just sit with my computer
and make four or five a night, and take them to work.
And I use the iPod in the office, if I've got a room and people have got time.
I've got very interested in core beliefs,
because I think it's actually something that doesn't get much attention.
And these actually were developed by Aaron Beck,
the cognitive therapy developer,
and I met his daughter Judith in Philadelphia,
and it was quite funny - I emailed her and said,
"Is there any empirical work done on this?"
And she says, "Just a minute, I'll check with Dad,"
And I thought, "That's pretty amazing, Dad's still alive,
he's about 89." And no, there isn't.
So this has actually come out of Aaron Beck's head.
But I think there's a lot of truth in it.
So there are two core beliefs that probably all of us in this room have.
One or both. I have more the second one, sometimes the first one.
Being helpless or unloveable.
The subsets of helpless are powerless, vulnerable, trapped, incompetent.
And these are the things that come up if you get depressed, for example,
or somebody criticises you.
My one would be if someone says, "I don't like your comment up there,"
I would immediately think you didn't like me.
That's my one.
And I've got adjusted to that, and...
but it still operates, if one of you said,
"I don't like your slide," I'd go, "Hmm, that person probably doesn't like me." [laughter]
That's the unloveable one. I'm unattractive, I'm different,
I'm not good enough, I'm bound to be abandoned.
And I see this... we deal a lot with the local high schools,
we... I have a practice in Manurewa in South Auckland,
we work with Manurewa High, James Cook, and Alfriston.
And I see kids occasionally who are not in great shape.
And you know, they've got an incredible number of these negative things:
"I'm no good at maths, I'm not good at this," you know, all this sort of stuff
that is very, very blocking to flourishing, you know.
And I think we need to be able to deal with this,
perhaps a school-based program, I don't know.
This is something I've never heard anybody talk about,
and I just think until you can deal with the core beliefs,
it's hard to flourish, you know.
If you're going on with, "I'm no good,"
it's very hard to start flourishing.
Okay, so. The significance of... this is an ape swinging through the tree.
This is getting back to momentum.
To maintain momentum, you have to keep moving.
And if you've read the book by Mihály Csíkszentmihályi - which is how you pronounce that -
he's getting pretty... he wrote the book, Flow.
You have to have this incremental sense of progressing.
So if you're working on a production line,
you have to have a sense that you're improving your skills
albeit very, very small. Interestingly, when he...
he found that when people were watching television,
they weren't particularly happy. You think how much television people watch.
He put pagers on people and rang them up and said,
"What are you doing, and how happy are you?"
And that was the thing that struck me. I virtually watch no television,
and it was interesting, just how much people watch of television,
and actually are not particularly happy doing it.
It's a bit of a default state, I think.
So my analogy with patients is that you...
to maintain momentum, it's like an ape swinging through the trees.
You need to know when to hang on, and when to let go.
So the hanging on can be about jobs and relationships,
not always, sometimes you've got to let those go.
Most of my time, it's getting people to let go, actually.
Stress, expectations. And I often say to people,
"You need to be committed, but not attached."
Okay, so you may have to strive to get something,
if you don't get it, so be it.