Use uplifting memories to benefit patients

“The more tranquil a [person] becomes, the greater is [one’s] success, [one’s] influence, [one’s] power for good. Calmness of mind is one of the jewels of wisdom.” Especially for professionals treating persons with addictive disorders, this observation by James Allen more than a century ago remains highly relevant. As a successful British businessman turned writer, Allen was attuned to the value of equanimity in daily life, asserting, “People will always prefer to deal with [one] whose demeanor is strongly equable.”

Though it took scientists a long time to investigate human ability to maintain a positive mood, this situation is swiftly changing. It is now clear that “self-regulation,” as it is known technically, has major consequences for the individual.

Evidence from both clinical and experimental studies has linked poor self-regulation to a variety of behavioral health difficulties, including chronic anxiety, depression and addictive disorders.1,2 Daily physical well-being, such as that involving sleep quality, is also adversely affected by this deficit.3 Research has established that self-regulation comprises two different—but perhaps equally vital—skills essential for everyday flourishing: minimizing negative feelings such as anger, sadness and worry, and amplifying happiness.4

In my earlier article for Addiction Professional, I focused on the first of these aspects: the inability of many people to overcome what Sigmund Freud identified more than a century ago as “obsessive brooding,” labeled today as “rumination.”5 This article highlights the second feature of self-regulation: our capacity to create, sustain and magnify a happy mood.

Perhaps due to longstanding conceptual biases as well as grant-funding pressures, psychologists know a lot more about inadequate self-regulation than its smooth or optimal functioning. For this reason, I initiated an international study with colleagues to understand how people use cheerful memories to enhance their daily mood.

Getting into the groove

Before examining our findings and their implications for addiction counseling, let’s see what is known about positive self-regulation.

How people create a good mood for themselves is a relatively new specialty of psychology. Though its antecedents lie in cognitive dissonance theory formulated by Leon Festinger, PhD, in his famous 1950s study “When Prophecy Fails,” most of the research is less than 20 years old, and strikingly little is known about how we develop this skill. For example, there is almost no research on children’s capacity to bolster mood, possibly because most developmentalists believe that children’s mood depends mainly on short-term situational factors (“Yea! My favorite cartoon is on TV now!”).

Based on early experiences involving primary caretakers, children gradually develop strategies for coping with their emotions. Children with close, loving attachments are likely to initiate experiences that generate pleasant feelings, whereas those lacking such attachments tend to be emotionally passive or even avoidant. A study by Mary Haskett, PhD, and colleagues at North Carolina State University found that parents of physically abused children who expressed positive emotions at home (“It’s a beautiful day outside, isn’t it?”) induced better self-regulation in their preschool children’s behavior than less verbally upbeat parents.6 The presence of a warm, stable family life—particularly rooted in what Diana Baumrind, PhD, described as an authoritative parenting style—generally keeps most children in a pleasant mood.

Adolescence, of course, is very different. Research has consistently shown that the teenage years are associated with escalating rates of anxiety, depression, eating disorders, self-injury, delinquency and suicide. Young adolescents report feeling extremely happy far less often than do 5th-graders, and feeling unhappy far more often, especially in a free-floating, mildly negative way identified technically as dysphoria.7

Almost everyone who has been a teenager can remember such moods—often a mixture of vague uneasiness, resentment and irritability. For decades, best-selling books and countless magazine articles attributed such moods to adolescent envy of adult freedom. But more recently, developmental psychologists regard adolescent dysphoria as encompassing a significant longing for childhood’s comforting security and simplicity. To paraphrase fictitious adverting whiz Don Draper in a “Madmen” episode, teenagers are angry not because they’re not adults, but because their childhood is gone and they can’t get it back.

Adolescent “mood management” or “mood repair,” as labeled by researchers, has generated empirical study. Researchers have consistently found that listening to music is a primary strategy that teens employ, mainly while socially alone and wearing headphones/earbuds, to uplift their mood.7,8,9,10 In Reed Larson, PhD's view, listening to popular music “allows adolescents to internalize strong emotional images around which a temporary sense of self can cohere.”7 Certainly, there is scientific validation for the view that music enables teens to bolster their mood. In an Australian study, older teens reported listening to music an average of 17 hours a week—chiefly either to escape from boredom or to enhance a good mood. Findings also showed that listening to heavy metal was linked most to emotionally troubled teens. Yet they too reported music as psychologically beneficial.9

Although adults listen to music to uplift mood, they also commonly use a second major strategy in self-regulation: accessing happy memories. A variety of experimental studies have shown that recalling a positive event from one’s life is a definite mood enhancer, especially if done through concrete imagery rather than verbal description.11,12,13 In other words, if a summer hike with your spouse provides a wonderful memory, picture the scene as vividly as possible—but don’t replay it using words or contrast it verbally with gloomier memories. A caveat is also in order: Such studies reveal that the act of remembering an upbeat life event doesn’t help individuals with a history of clinical depression—only those who have never experienced it.14

Accessing cheerful memories

Although experimental studies can be informative, it is difficult to generalize them to everyday life. For this reason, my research team has sought information on how people actually use happy memories to improve mood. Our sample comprised 110 adults with good overall mental health in Asia, Europe and the Americas. They reported relatively high life satisfaction and the ability to cope well with stress. Though persons with addictive disorders are less likely to present such an appealing picture of their lives, it is certainly relevant to learn about this important skill from psychologically healthy people.

Nearly everybody engaged in this form of mood regulation, with most doing so at least weekly (see results at end of article). Interestingly, there was a wide spectrum on what spurred people to evoke a happy memory—including daydreaming, desiring to magnify a happy mood, and wanting to reduce sad feelings.

A slight majority of participants reported evoking a happy memory when physically alone, such as in a car, while relatively equal groupings reported doing so while socializing or socially alone but not isolated (such as when shopping or riding on a bus). Participants reported most frequently that the event associated with the happy memory usually happened between a month and a year ago.

To describe a memory’s content, participants were presented with a choice of 10 categories. The most frequently reported were a social activity, such as that involving friends, a personal achievement, a family activity, travel or a vacation, a romantic experience, and a song or musical piece. At the bottom of the list, nobody reported a happy memory involving an Internet website (sorry, Facebook!).

Confirming previous research, we found that accessing a cheerful memory is an excellent way to enhance one’s mood. When asked how much it usually did so, more than one-quarter reported “a very large amount” and nearly half reported “a moderate amount.” Our question concerning stress reduction yielded more divergent results, perhaps because stress can be either temporary (being late for work due to a traffic jam) or long-term (coping with a chronically ill relative) and our survey didn’t distinguish between the two. Nevertheless, nearly one-quarter of participants related that accessing a cheerful memory usually reduced stress “a very large amount.”

The take-away for counselors

What implications do these findings have for counselors? Like all of us, people with addictive disorders need to self-regulate effectively for healthy living, yet often lack this ability. As my earlier article recounted, they are far more likely to engage in rumination (repetitive negative thoughts or memories) and to believe mistakenly that such patterns are helpful. In reality, these only exacerbate emotional difficulties, including anxiety and depression.

For those prone to rumination, it is therefore essential to get off their cognitive treadmill and improve their problem-solving skills. The second aspect of self-regulation involves positive mood management, and many persons with addictions lack this capacity too. They find it difficult to create, sustain or amplify a good mood. This situation too requires skill learning, and my findings provide counselors with practical direction in this regard. Here’s what seems most relevant:

1. Since nearly everyone has enjoyed some happy events in life, it is safe to assume that your patients can improve self-regulation by accessing cheerful memories. While they’ve probably done so at least occasionally, it most likely has been sporadic due to their tendency to ruminate. A first step, therefore, is to describe the dual facets of self-regulation and the importance of positive mood maintenance—as well as the value of minimizing dark states such as brooding—for optimal emotional functioning.

From my clinical experience, most adolescents and adults readily grasp these concepts. Questions such as “What activities or events usually put you in a good mood?” and “What kinds of experiences start sending you into a bad mood?” are effective ice-breakers for patients who find it difficult to initiate self-disclosure. The more specific your patients’ answers, the more meaningful your discussion will be.

2. Once your patients show that they understand the relevant concepts and can apply these to their own emotionality, it’s time to personalize the topic more closely. This can be done by eliciting descriptions as to when and where they deliberately recall a happy memory—and then suggesting additional commonplace situations. For example, if your patient relates doing so only when alone in her apartment and feeling sad, you can explain that many people also evoke a cheerful memory while daydreaming on the bus or pleasantly making small talk. The goal is to help your patients learn to diversify the circumstances in which they are most likely to self-regulate positively in this way.

3. Just as importantly, guide your patients in diversifying the type of memory they usually access. Participants in my study most often recalled a social activity, a personal achievement, or a family activity in order to generate a happier mood. Others preferred to remember a vacation experience, a romantic activity, or a musical piece. Undoubtedly, such variability reflects individual personality differences, and perhaps cultural factors too. But I’m convinced that we all can learn to expand our preferences for the memories we choose to bolster our moods. In this light, it might be worthwhile to present patients with my 10-category list, and over a series of sessions see if they can recall a personal example of each.

Such an approach, of course, is highly consistent with strengths-based counseling, and comprises two aspects. By learning to broaden their source of cheerful memories, patients may develop greater appreciation and gratitude—traits that positive psychology consistently links to emotional well-being and life satisfaction.14 For instance, if your patient recognizes that he can evoke happy memories involving his family, and not just his friends or televised football games, he may thereby see his parents or siblings in a more favorable daily light.

Also, as you guide patients in recalling different types of happy events, they not only might learn to broaden their choice of happy memories, but also to seek satisfaction through previously unfamiliar activities. For example, as a big fan of inspirational movies, I frequently recommend specific films to increase patients’ sense of hopefulness, self-compassion, mindfulness, or wonder. So, while some patients may view travel as a source of happy memory, they might never have thought of movie-watching in this way, and might now give it a try.

Edward Hoffman, PhD, is a faculty member at Yeshiva University and co-author of Positive Psychology: The Science of Happiness and Flourishing, published by Cengage. The author wishes to thank Dr. Garima Srivastava and Jenniffer Gonzalez Mujica for their research assistance, and Eric Freedman for his helpful comments.

References

1. Carl JR, Soskin DP, Kerns C, et al. Positive emotion regulation in emotional disorders: a theoretical review. Clin Psychol Rev 2013;33:343-60.

2. Heatherton TF, Wagner DD. Cognitive neuroscience of self-regulation failure. Trends Cogn Sci 2011;15:132-9.

3. Hagger MS. Sleep, self-regulation, self-control and health. Stress Health 2010;26:181-5.

4. Diamond LM, Aspinwall LG. Emotion regulation across the life span: an integrative perspective emphasizing self-regulation, positive affect, and dyadic processes. Motiv Emotion 2003:27:125-56.

5. Hoffman E. Free patients from the rumination trap. Addict Prof 2015;13:50-3.

6. Haskett ME, Stelter R, Proffit K, et al. Parent emotional expressiveness and children’s self-regulation: associations with abused children’s school functioning. Child Abuse Negl 2012;36:296-307.

7. Larson R. Secrets in the bedroom: adolescents’ private use of media. J Youth Adolesc 1995:24:535-50.

8. Saarikallio S, Erkkila J. The role of music in adolescents’ mood regulation. Music Psychol Res 2007;35:88-109.

9. Thomson CJ, Reece JE, Di Benedetto M. The relationship between music-related mood regulation and psychopathology in young people. Musicae Scientiae 2014;18:150-65.

10. Francesca R, Dillman C, Brown JD, et al. Sad kids, sad media? Applying mood management theory to depressed adolescents’ use of media. Media Psychol 2008:11:143-66.

11. Josephson BR, Singer JA, Salovey P. Mood regulation and memory: repairing sad moods with happy memories. Cognition Emotion 1996;10:437-44.

12. Knobloch S, Zillmann D. Mood management via the digital jukebox. J Communic 2002;52:351-66.

13. Nelis S, Holmes EA, Palmieri R, et al. Thinking back about a positive event: the impact of processing style on positive affect. Front Psychiatry 2015;6:3.

14. Joormann J, Siemer M, Gotlib IH. Mood regulation in depression: differential effects of distraction and recall of happy memories on sad mood. J Abnorm Psychol 2007;116:484-90.

Results of survey on happy memories

To put yourself into a good mood, how often do you mentally “replay” a happy memory?

Never 3.6%

Rarely (a few times per year) 16.3%

Sometimes (every few weeks) 26.4%

Often (at least once per week) 31.0%

Very often (at least daily) 17.3%

Highly often (several times per day) 5.5%

When are you most likely to deliberately recall a happy memory?

When I feel like daydreaming 33.6%

When I feel happy 26.3%

When I feel sad 19.1%

When I feel anxious 9.1%

When I feel bored 6 4%

When my mind is a blank 5.4%

When you do so, are you usually...

Completely alone 50.9%

Socializing with others 26.3%

With others near me 22.7%

To put yourself in a good mood, which type of happy event do you recall most often?

A social activity, such as with friends 20.2%

A personal achievement 17.4%

A family activity 17.4%

A vacation or travel activity 16.5%

A romantic activity 15.6%

A musical piece or song 7.3%

A sports match 2.8%

A movie or TV program 1.8%

A religious activity 0.9%

An Internet website 0.0%

How recent usually is the happy event?

Very recent (within the past week) 22.7%

Recent (within the past month) 20.0%

Somewhat recent (within a few months to a year) 37.3%

Not very recent (more than a year ago) 20.0%

How much does this “replay” improve your mood?

Very little 3.6%

A small amount 12.7%

A moderate amount 49.1%

A large amount 26.4%

A very large amount 8.2%

How much does this “replay” reduce your stress?

Very little 4.5%

A small amount 25.4%

A moderate amount 40.0%

A large amount 22.7%

A very large amount 7.3%