英文原文
Results of several studies suggest that traumas need not be debilitating and that most people are resilient and even grow in the wake of a trauma. Understanding and highlighting the sources of this resilience and posttraumatic growth and focusing on hope and optimism help professionals foster these strengths in their clients, as opposed to focusing on what is wrong with them, which can have a discouraging effect. From a solution-focused perspective, the focus in treatment shifts from posttraumatic stress to posttraumatic success.
KEY WORDS posttraumatic success, posttraumatic growth, resilience, solution-focused brief therapy, crisis intervention
Experiencing trauma is an essential part of being human history is written in blood. Throughout evolution, humans have been exposed to terrible events. Yet most people survive without developing psychiatric disorders. To be distressed is a normal reaction to the horror, helplessness, and fear that are the critical elements of a traumatic experience. The typical pattern for even the most catastrophic experiences, however, is resolution of symptoms and not the development of posttraumatic stress disorder. Only a minority of the victims will go on to develop posttraumatic stress disorder, and with the passage of time, the symptoms will resolve in approximately two-thirds of these.
Seligman observed that exposure to uncontrollable negative events leads to helplessness. In a series of famous experiments in the 1970s, Seligman demonstrated that animals subjected to pain by being given electric shocks which they had no control over, became passive, developed symptoms that resemble depression, and were more prone to physical ailments. This passivity or helplessness persisted even if later they did have the power to control the situation and escape the shock.
Additional studies have demonstrated that this phenomenon of learned helplessness also applies to humans. To explain these findings, Seligman proposes that individuals develop expectancies about the occurrence of adversity in their lives. These expectancies are powerful predictors of behavior. The expectancy that adversity will continue and that one will be powerless in its wake leads to helplessness, passivity, withdrawal, anxiety, depression, and even physical illness. In contrast, expectations of control engender persistence, the ability to cope, and resilience to depression and physical health problems.
Children who grow up in troubled circumstances have a statistically higher chance of developing problems at a later stage than children with a normal childhood. However, correlation is not the same as cause. Look at these two generally accepted statements Child has difficult youth, thus will suffer problems in the future. Adult has problems, thus had difficult childhood. Neither statement is correct. The idea that what a child experiences during his youth determines his future, is too simplistic. One would then assume that the child is a passive vessel and that childhood experiences will unavoidably overshadow the rest of his life. Rather, it is the manner in which the child deals with these early experiences that determines to a great extent what the outcome will be.
Furman It's natural to think that our past has an effect on how our future will turn out, but we rarely look at it the other way around. The future—that is what we think it will bring—determines what our past looks like. If you are depressed, the past appears darker, if you are in love it appears somewhat brighter. Therefore, it might be helpful to ask your therapist the following question prior to a therapy How shall I view my past once we are finished here? Compare this with a movie that you have seen and enjoyed but that your friends later criticize this is likely to influence your perception of the film.
O'Hanlon proposes a nice way of working in the present toward the future to resolve trauma. First of all, this involves the acknowledgment of the facts along with the present and former inner experience of the trauma. Next, it focuses on helping clients’ value, own and associate with dissociated aspects of themselves. Finally, it helps clients develop a clear sense of a future with possibilities.
Duncan, Hubble, and Miller state that their treatment failures taught them three lessons which, although conceptually simple, are difficult to implement all theoretical models have limited applicability the therapeutic relationship is more valuable than expert interventions and what clients know, think, feel, and want has far more relevance to problem resolution than the favored academic conceptualizations. Pathways to impossibility occur when there is anticipation of impossibility either by the therapist or the client or by both due to therapeutic traditions or conventions when therapist and client persist in a therapeutic approach that is not working or when the client's motivation is ignored. There is no such thing as an unmotivated client. Clients may not share the goal of the therapist, but they certainly hold strong motivations of their own. When psychotherapy is changed from theory directed to client directed, then possibilities emerge. This involves learning the client's theory of change and adapting the therapy to that theory as a pathway out of impossibility.
Duncan, Miller, and Sparks believe that feedback from clients is essential and improves success. Therapists do not need to know in advance what approach to use for a given diagnosis but rather whether the current relationship is a good fit and is providing benefit, and, if not, they need to be able to adjust and accommodate early enough to maximize the chances of success.
O'Hanlon and Rowan add to this the importance of transforming the belief patterns of both therapist and client to encompass the possibility of change, thus drawing attention away from beliefs in the impossibility of change and from ideas that blame, disempower, or invalidate clients or that see clients as nonaccountable.
Professionals pay much attention to diagnosis and the negative consequences of posttraumatic stress and posttraumatic stress disorder. Now the subject is also being approached from a different angle what do people do to survive and what makes them strong? In this, the terms resilience and posttraumatic growth come to the fore. Resilience Latin resilio I bounce back is defined as the ability to survive, recover, and persevere in the face of various obstacles and threats. If a person was asked Did your difficult childhood make you stronger or weaker? the reply is likely to be that it actually made him stronger What does not kill me, makes me stronger. Bonanno, Rennicke, and Dekel state that resilience is often the most commonly observed outcome following a traumatic event.
A good way of exploring a client's resilience is to look for fluctuations within the experience of the problem ask clients in detail about the times they did not or to a lesser extent experience the problem when they expected they would, find out what happens as the problem ends or starts to fade, and ask why the problem is not worse.
It is also helpful to look for success stories in the past. How was the client able to survive or find protection? Achieving a sense of distance from one's negative past actions and a sense of connection to one's positive past actions promotes a favorable view of the present self.
Drugan carried out research into the neurochemistry of stress-resilient and stress-vulnerable animal subjects. During experiments, the release of neurosteroids differed in both groups. In the stress-resilient group, positive neurosteroids are released, leading to reduced stress and anxiety and behavioral and neurochemical stability. The level of gamma aminobutyric acid is enhanced. Specific neurochemical receptors or drug recognition sites in the brain are found to specifically bind minor tranquilizers, such as valium. These benzodiazepine receptors are associated with the major inhibitory neurotransmitter gamma aminobutyric acid. There is also impaired emotional memory of stressful events and less rumination.
In the stress-vulnerable group, negative neurosteroids are released, leading to high stress and anxiety and both behavioral and neurochemical instability. The level of gamma aminobutyric acid in the brain is reduced. There is enhanced memory of stressful events and increased rumination. Drugan's conclusion is that active behavioral coping or stress control is associated with the enhanced release of a valium-like substance in the brain.
Studies of early trauma and neglect reveal that neural structure and function within the brain can be severely affected and lead to long-lasting and extensive effects on the brain's capacity to adapt to stress. If a certain pattern has been stimulated in the past, the probability of activating a similar profile in the future is enhanced. If the pattern is fired repeatedly, the probability of future activation is further increased. The increased probability is created by changes in the synaptic connections within the network of neurons. This is called Hebb's axiom neurons that fire together, wire together.
However, the creation of new neural integrative links may be a learning process that remains possible into adulthood. Our brains retain the ability to continually reshape emergent properties that allow us to learn and grow with new experiences. By focusing on resiliency, coping, and competencies solution talk, new—positive—neural networks will emerge and old—negative—ones will die away.
A recent study shows that extensive discussions of problems and encouragement of problem talk, rehashing the details of problems, speculating about problems, and dwelling on negative affect in particular, lead to a significant increase in the stress hormone cortisol, which predicts increased depression and anxiety over time.
Rubin states that people who as a child have endured traumatic experiences actually changed little—when looking at their inner qualities that enabled them to overcome these experiences and also at the strategies and adaptations that they used to that effect. Still present is the ability to cope with pain in a way that prevents it from becoming overwhelming, as is their ability to withdraw when the outside pressure becomes too high. The proficiency in finding other sources of support is still present in their later lives, along with the ability to feel involved in something beyond them, which is reflected in the need to feel useful, for example, by helping others who are having similar experiences. The determination, with which they as a child overcame obstacles, persists as they work toward their goals as adults. And this is particularly visible in their refusal to perceive themselves as victims, despite the hardships of their lives. They reject the culture of victimization because they see that as a trap for those who believe in it. These events may have determined their past but they refuse to let them dominate the present This is what has happened to me, not what I am.
Do you see yourself or does your client see himself as a victim or as a survivor? If you see yourself as a victim, it becomes more difficult to play an active role in shaping your life. You were unable to do anything about what has happened to you and you expect that you cannot change much about the way the rest of your life pans out. You probably feel powerless and feel that you have lost control. However, when you see yourself as a survivor, the possibility of a more active role becomes apparent. It offers the opportunity to organize and take control of your life, despite what you have experienced. This initiates a spiral of positivity and more control. The following four-step exercise can help you to find out which role you want to play in the rest of your life, that of victim or survivor. How would you like to see your life in a month's time? The same people and circumstances are still present, but you feel a little less influenced by what you have experienced. If you think about your answer to the previous question, that is, your goal in a month's time, how would you then think and feel, and how would you behave in order to reach your goal if you see yourself as a victim? Answer the same question, but now from the perspective of a survivor. What differences do you notice? What will you be doing differently? Which attitude is the most helpful to you?
Dolan states that overcoming the immediate effects of abuse, loss, or other trauma and viewing yourself as a survivor rather than as a victim are helpful steps but are ultimately not sufficient to help people fully regain the ability to live a life that is as compelling, joyous, and fulfilling as it used to be. People who remain at the survivor stage see life through the window of their survivorhood rather than enjoying the more immediate and unobstructed vision of the world around them that they previously held. All experiences are evaluated in terms of how they resemble, differ from, mitigate, or compound the effects of past events. This diminishes their ability to fully experience and enjoy life and is responsible for the flatness and depression reported by so many people who categorize themselves as survivors.
As a political dissident, Solzhenitsyn was for many years banished to a Russian labor camp. In discussing corruption of prisoners in the camps, he says he is not going to explain the cases of corruption Why would we worry about explaining why a house in subzero weather loses its warmth? What needs to be explained is why there are houses that retain their warmth even in subzero weather.
Hope is like a journey a destination, a map, and a means of transport are needed. Research on the subject of hope has shown that it is important to have a goal and ways to reach that goal. Hopeful people have a clearer goal destination than nonhopeful people. They also have a clearer image of the route via which they can reach their goal they have a mental map. In addition, they believe that they themselves can do something to get closer to their goal they are their own means of transport. And should the route to the goal be blocked, optimists will think of an alternative more easily and will continue to feel better than pessimists. These three factors are so closely connected that if you have a grasp of one, chances are high that the rest will follow. There is a connection between optimism and hope.
If you want to regain a glimmer of hope, even in crisis situations, ask yourself or your client the following questions What helped in the past, even if only marginally? How do I cope with everything that is going on and all I have gone through? How do I succeed in getting from one moment to the next? Could it be worse than it is? Why is it not worse? What does my social environment say I do well, also in very bad times? Imagine that in 10 or 15 years, when things are going better, I look back on today, what will have helped me to improve things? Suppose there is a solution, what difference would that make, what would be different—and, more specifically, better?
Seligman, founder of the positive psychology approach, shifted his attention from learned helplessness to learned optimism. He undertook research into the factors that lead people to perceive an event as positive or negative and their reasoning behind this. Pessimistic people attribute negative events particularly to stable, global, and internal factors. They say Things never go right with me stable, I will never be happy again global, and I am good for nothing internal. They attribute positive events to temporary, specific, and external factors. They say That was only luck, which had nothing to do with me, if something positive happens.
Optimistic people think in the opposite way. They attribute positive events to stable, global, and internal factors. If something positive happens, that does say something about them, for example, I really am valuable. Optimists attribute negative events particularly to temporary, specific, and external factors. They might say I could not do anything about it, because he threatened me. Thinking in a pessimistic way, especially about negative events, leads to expectations of hopelessness.
Einstein said I would rather be an optimist and a fool than a pessimist who is right. People who think pessimistically run more risk of becoming depressed than people thinking optimistically. However, a little pessimism at times cannot hurt. It forces people to confront reality, and depressed people tend to have a more realistic view of the world. Every day could be your last you could be involved in a traffic accident or catch a fatal disease. Depressed people harbor few illusions about how safe and predictable the world and life actually is. Yet it turns out that we feel better and happier if we do hold these illusions and are able to preserve them.
Optimism and pessimism are relatively stable personality traits, but they can be influenced by the way someone acts and by what he is focusing on. Optimism contributes to more adaptive survival strategies, namely more positive reappraisal, better coping abilities, and more use of positive distractions hobbies and exercise.
Research has revealed that even people with a pessimistic nature felt happier if over the course of a week they made notes of when in the past they had been at their best every day, during a week, they would note down something about their strengths express gratitude to someone whom they had not yet properly thanked or made a note of three good things that were happening in their lives. Six months later, these people were still feeling happier, although the exercise took place over a period of only 1 week. Research has also shown that happy people are optimistic about their future and that optimistic people are in better health than pessimistic people. Four positive elements significantly contribute to a happy life. Happy people like themselves, are mostly extrovert, have the idea that they are in control and are optimistic. The question relevant to all four is does optimism make people happier A or are happy people more optimistic B? It turns out that A leads to B and B leads to A.
The results of several studies suggest that traumas need not be debilitating and that most people are resilient and even grow in the wake of a trauma. Understanding the sources of this resilience and posttraumatic growth will help psychologists foster these strengths in their clients, as opposed to focusing on what is wrong with them, which can have a discouraging effect. Tedeschi and Calhoun developed the Posttraumatic Growth Inventory, an instrument for assessing positive outcomes reported by persons who have experienced traumatic events. It includes factors of New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life. Women report more benefits than do men, and persons who have experienced traumatic events report more positive change than do persons who have not experienced extraordinary events. The Posttraumatic Growth Inventory is modestly related to optimism and extroversion.
Solution-focused brief therapy SFBT differs from traditional forms of psychotherapy. Also the approaches to trauma are different, as Table 1 illustrates. The focus in SFBT is on the preferred future and the steps clients can take to reach this future. A meta-analysis shows that although SFBT does not have a larger effect than traditional forms of psychotherapy, it does have a positive effect in less time and satisfies the client's need for autonomy. SFBT revolves around four main questions. These questions can help clients to regain hope, even in crisis situations What is your best hope? What difference would that make? What is already working in the right direction? What would be the next step or next sign of progress?
Dolan With solution-focused questions the therapist asks the client to describe the smallest signs of progress one by one and encourages her to then carry out the smallest and easiest of these. This enables the client to experience in a safe and gradual manner control over the symptoms, without becoming afraid or feeling overwhelmed by tasks that she is not yet ready for. These small changes may pave the way for increasingly large changes, but then in such a way as to prevent relapse.
Solution-focused questions are very effective in encouraging clients to participate in and develop their own treatment plan, while implicitly a context of hope is also being created. Clients relate that this way of looking at their recovery process has influenced many aspects of their lives positively because they learned to see that what they do is good, healthy, and effective.
As an example of posttraumatic success, Frankl is often cited. He says of his stay in a German concentration camp that a prisoner who no longer believed in the future—his future—was doomed. He describes an incident where he staggered along in a row of prisoners on his way to the work area, in the cold and without food. He forced himself to think about something else. Suddenly, he saw himself standing on the stage of an auditorium where he was giving a lecture about the psychology of the camp system. In this way, he succeeded in lifting himself above the suffering of the moment and was able to view the torment as if it already were in the past. His focus on the future saved him for that moment. And this vision of the future even became reality as after the war he conducted many successful lecture tours. In his logotherapy, Frankl explains that the meaning in suffering is resilience itself the trick is to handle as well as possible the challenges that we face in life.
Furman, a solution-focused psychiatrist, asked the readers of two Finnish magazines who had endured difficult childhoods to reply to three questions relating to their experiences What do you think helped you survive your difficult childhood? What have you learned from your difficult childhood? In what way have you managed in later life to have the kind of experiences that you were deprived of as a child? The nature of the 300 or so replies convinced him of the ability of human beings to survive almost any trauma. This gave him the belief that people can view their past—including even the most extreme suffering—as a source of strength rather than of weakness. Our past is a story we can tell ourselves in many different ways. By paying attention to methods that have helped us survive, we can start respecting ourselves and reminisce about our difficult past with feelings of pride rather than regret.
O'Hanlon, a solution-focused psychotherapist, who introduced the term posttraumatic success, gives some guidelines for therapy with survivors Find out what the client is seeking to gain from treatment and how he will know when the treatment has been successful. Ascertain to the best of your ability that the client is safe. If not, take whatever steps necessary to ensure this. Do not assume that the client needs to go back and work through traumatic memories. Some people will and some would not. Remember that everyone is unique. Look for resources and strengths. Focus on underlining how the client made it through the abuse and what he has done to cope, survive, and thrive since then. Look for nurturing and healthy relationships and role models he had in the past or has in the present. Look for current skills in other areas. Have the person tell you how he stopped himself from acting on destructive impulses, got himself to seek therapy, and so forth, despite enduring the aftereffects of trauma. Validate and support each part of the person's experience and self. Make provisions e.g., contracts for safety from suicide, homicide, and other potentially dangerous situations if necessary. Make these mutual. Stay focused on the goal of treatment rather than getting lost in the gory details. Do not give the impression that the person is damaged goods or that his future is determined by trauma. Remember that change can occur in the interpretations and actions or interactions associated with the events. Gently challenge self-blaming or invalidating identity stories the person has or has accepted from others.
O'Hanlon also describes the three C's of spirituality as sources of resilience. Connection means moving beyond your little, isolated ego, or personality into connection with something bigger, within, or outside yourself. Compassion means softening your attitude toward yourself or others by feeling with rather than being against yourself, others, or the world. And contribution means being of unselfish service to others or the world.
Imagine you have become an old and wise person and you look back on this period of your life. What do you think this old and wise person would advice you to do in order to get through the present phase of your life? What would this person say that you should be thinking of? What would this person say that would help you the best to recover from the past? What would this person say how you could console yourself? And how, from this person's view, could psychotherapy if needed be most useful to you?
Tedeschi and Calhoun offer some important caveats on posttraumatic growth Posttraumatic growth occurs in the context of suffering and significant psychological struggle, and a focus on this growth should not come at the expense of empathy for the pain and suffering of trauma survivors For most trauma survivors, posttraumatic growth and distress will coexist, and the growth emerges from the struggle with coping, not from the trauma itself Trauma is not necessary for growth, individuals can mature and develop in meaningful ways without experiencing tragedy or trauma Trauma is not ‘good’ in any way, life crises, loss and trauma are seen as undesirable Posttraumatic growth is neither universal nor inevitable. Although a majority of individuals experiencing a wide array of highly challenging life circumstances experience posttraumatic growth, there are also a significant number of people who experience little or no growth in their struggle with trauma, and this sort of outcome is quite acceptable.
Conclusion Bannink Brief interventions are en vogue. Both psychotherapy and waiting lists should and can be shorter. No longer the ‘moaning and complaining’ attitudes of clients should be reinforced, clients should be strengthened and stimulated to undertake positive action. The focus in psychotherapy should shift from impossibilities to possibilities and from posttraumatic stress to posttraumatic success. Other implications of SFBT are that training in diagnostic and treatment methods of psychopathology can become shorter and be replaced by training in SFBT. In this scenario a lot could change for the better in mental health care, for both clients and therapists.
中文翻译
多项研究结果表明，创伤不一定使人衰弱，大多数人在创伤后具有韧性甚至能够成长。理解和强调这种韧性和创伤后成长的来源，并关注希望和乐观，有助于专业人士培养客户的这些优势，而不是关注他们的问题，后者可能产生令人沮丧的效果。从焦点解决的视角来看，治疗的重点从创伤后应激转向创伤后成功。
关键词 创伤后成功，创伤后成长，韧性，焦点解决短期治疗，危机干预
经历创伤是人类本质的一部分，历史是用鲜血书写的。在整个进化过程中，人类一直暴露于可怕的事件中。然而，大多数人幸存下来而没有发展出精神障碍。对创伤经历的关键要素——恐怖、无助和恐惧——感到痛苦是正常的反应。然而，即使是最灾难性的经历，典型模式也是症状的解决，而不是创伤后应激障碍的发展。只有少数受害者会继续发展创伤后应激障碍，随着时间的推移，大约三分之二的人的症状会得到解决。
塞利格曼观察到，暴露于不可控的负面事件会导致无助感。在20世纪70年代的一系列著名实验中，塞利格曼证明，动物因受到无法控制的电击而遭受痛苦，变得被动，出现类似抑郁的症状，并且更容易患上身体疾病。这种被动性或无助感即使后来它们有能力控制情况和逃避电击也会持续。
其他研究已经证明，这种习得性无助现象也适用于人类。为了解释这些发现，塞利格曼提出，个体对生活中逆境的发生形成期望。这些期望是行为的强大预测因素。期望逆境会持续并且一个人在其后无能为力会导致无助、被动、退缩、焦虑、抑郁甚至身体疾病。相比之下，控制的期望会产生坚持、应对能力和对抑郁及身体健康问题的韧性。
在困境中长大的孩子比童年正常的孩子在后期出现问题的统计概率更高。然而，相关性不等于因果关系。看看这两个普遍接受的陈述 孩子有困难的青年时期，因此将来会遭受问题。成人有问题，因此有困难的童年。这两个陈述都不正确。认为孩子在青年时期的经历决定其未来的想法过于简单化。人们会假设孩子是一个被动的容器，童年经历将不可避免地笼罩他的余生。相反，孩子处理这些早期经历的方式在很大程度上决定了结果。
弗曼 认为我们的过去会影响我们的未来是很自然的，但我们很少从相反的角度看。未来——我们认为它将带来的东西——决定了我们的过去看起来如何。如果你抑郁，过去显得更黑暗，如果你恋爱，它显得更明亮。因此，在治疗前问你的治疗师以下问题可能是有帮助的 当我们在这里结束时，我应该如何看待我的过去？这就像你看过并喜欢的一部电影，但你的朋友后来批评它，这可能会影响你对电影的看法。
奥汉伦提出了一种在现在朝着未来解决创伤的好方法。首先，这涉及承认事实以及创伤的现在和过去的内心体验。接下来，它侧重于帮助客户重视、拥有并与自己分离的方面联系起来。最后，它帮助客户发展一个具有可能性的未来的清晰感。
邓肯、哈勃和米勒指出，他们的治疗失败教会了他们三个教训，虽然概念上简单，但难以实施 所有理论模型都有有限的适用性 治疗关系比专家干预更有价值 客户知道、思考、感受和想要的东西比偏爱的学术概念化对问题解决更有相关性。不可能之路发生在治疗师或客户或两者由于治疗传统或惯例预期不可能时 当治疗师和客户坚持一种不起作用的治疗方法时 或者当客户的动机被忽视时。没有所谓的无动机客户。客户可能不分享治疗师的目标，但他们肯定有自己的强烈动机。当心理治疗从理论导向转向客户导向时，可能性就会出现。这涉及学习客户的变化理论，并使治疗适应该理论，作为走出不可能的途径。
邓肯、米勒和斯帕克斯认为，客户的反馈至关重要并提高成功率。治疗师不需要提前知道对给定诊断使用什么方法，而是需要知道当前关系是否合适并提供益处，如果不是，他们需要能够及时调整和适应以最大化成功机会。
奥汉伦和罗恩补充了转变治疗师和客户的信念模式以包含变化的可能性的重要性，从而将注意力从变化不可能的信念和责备、剥夺权力或使客户无效或将客户视为不负责任的想法上转移开。
专业人士非常关注诊断和创伤后应激及创伤后应激障碍的负面后果。现在这个话题也从不同角度被探讨 人们做什么来生存，什么使他们强大？在这方面，韧性和创伤后成长这两个术语变得突出。韧性拉丁语resilio 我反弹被定义为在面对各种障碍和威胁时生存、恢复和坚持的能力。如果一个人被问 你的困难童年使你更强还是更弱？回答很可能是它实际上使他更强 杀不死我的，使我更强大。博南诺、伦尼克和德克尔指出，韧性通常是创伤事件后最常见的结果。
探索客户韧性的一个好方法是寻找问题体验中的波动 详细询问客户他们没有或较少经历问题的时间，当他们预期会经历时，找出问题结束或开始消退时发生了什么，并问为什么问题没有更糟。
寻找过去的成功故事也有帮助。客户是如何能够生存或找到保护的？实现对自己负面过去行为的距离感和对自己正面过去行为的联系感促进了对当前自我的有利看法。
德鲁甘对压力韧性和压力易感性动物受试者的神经化学进行了研究。在实验中，两组神经类固醇的释放不同。在压力韧性组中，释放积极的神经类固醇，导致压力和焦虑减少以及行为和神经化学稳定性。γ-氨基丁酸水平增强。大脑中的特定神经化学受体或药物识别位点被发现专门结合轻微镇静剂，如安定。这些苯二氮䓬受体与主要抑制性神经递质γ-氨基丁酸相关。还有对压力事件的情感记忆受损和较少反刍。
在压力易感性组中，释放消极的神经类固醇，导致高压力和焦虑以及行为和神经化学不稳定性。大脑中γ-氨基丁酸水平降低。对压力事件的记忆增强，反刍增加。德鲁甘的结论是，积极的行为应对或压力控制与大脑中类似安定的物质释放增强相关。
对早期创伤和忽视的研究表明，大脑内的神经结构和功能可能受到严重影响，并对大脑适应压力的能力产生长期和广泛的影响。如果过去刺激了某种模式，未来激活类似模式的可能性增加。如果模式反复触发，未来激活的可能性进一步增加。这种增加的可能性是由神经元网络内突触连接的变化创造的。这被称为赫布公理 一起触发的神经元，一起连接。
然而，新的神经整合链接的创建可能是一个学习过程，直到成年仍然可能。我们的大脑保留了不断重塑涌现特性的能力，使我们能够随着新经验学习和成长。通过关注韧性、应对能力和能力解决方案谈话，新的——积极的——神经网络将出现，旧的——消极的——神经网络将消失。
最近的一项研究表明，广泛讨论问题和鼓励问题谈话，重述问题的细节，推测问题，特别是沉溺于负面情绪，会导致压力激素皮质醇显著增加，这预示着随着时间的推移抑郁和焦虑增加。
鲁宾指出，童年经历过创伤经历的人实际上变化很小——当看他们克服这些经历的内在品质以及他们为此使用的策略和适应时。仍然存在的是以防止痛苦变得压倒性的方式应对痛苦的能力，以及当外部压力过高时退缩的能力。寻找其他支持来源的熟练程度在他们后来的生活中仍然存在，以及感觉参与超越自身事物的能力，这反映在需要感觉有用，例如通过帮助有类似经历的他人。他们童年克服障碍的决心在他们作为成人朝着目标努力时持续存在。这在他们拒绝将自己视为受害者中尤为明显，尽管生活艰辛。他们拒绝受害者文化，因为他们认为那是相信它的人的陷阱。这些事件可能决定了他们的过去，但他们拒绝让它们主导现在 这是发生在我身上的事，不是我是什么。
你将自己或你的客户视为受害者还是幸存者？如果你将自己视为受害者，就更难在塑造生活中发挥积极作用。你无法对你所经历的事情做任何事情，你期望你无法改变余生的大部分方式。你可能感到无力并感觉失去了控制。然而，当你将自己视为幸存者时，更积极作用的可能性变得明显。它提供了组织和控制生活的机会，尽管你经历了什么。这启动了积极性和更多控制的螺旋。以下四步练习可以帮助你找出你想在余生中扮演哪个角色，受害者还是幸存者。你希望一个月后你的生活看起来如何？同样的人和情况仍然存在，但你感觉受你所经历的影响小一些。如果你思考你对前一个问题的回答，即你一个月后的目标，如果你将自己视为受害者，你会如何思考和感受，以及你会如何行为以达到你的目标？回答同样的问题，但现在从幸存者的角度。你注意到什么不同？你会做什么不同？哪种态度对你最有帮助？
多兰指出，克服虐待、损失或其他创伤的直接影响，并将自己视为幸存者而不是受害者是有帮助的步骤，但最终不足以帮助人们完全恢复过一种像以前一样引人注目、快乐和充实的生活的能力。停留在幸存者阶段的人通过他们幸存者身份的窗口看生活，而不是享受他们以前拥有的更直接和无阻碍的周围世界视野。所有经验都根据它们如何相似、不同、减轻或加剧过去事件的影响来评估。这削弱了他们充分体验和享受生活的能力，并导致许多自称为幸存者的人报告的平淡和抑郁。
作为政治异见者，索尔仁尼琴被流放到俄罗斯劳改营多年。在讨论营地中囚犯的腐败时，他说他不打算解释腐败案例 我们为什么要担心解释为什么房子在零下天气失去温暖？需要解释的是为什么有些房子即使在零下天气也保持温暖。
希望就像一次旅程 需要目的地、地图和交通工具。关于希望的研究表明，拥有目标和达到目标的方法很重要。有希望的人比无希望的人有更清晰的目标目的地。他们也有更清晰的图像，关于他们可以通过哪条路线达到目标 他们有心理地图。此外，他们相信他们自己可以做些什么来更接近目标 他们是自己的交通工具。如果通往目标的路线被阻塞，乐观者会更轻易地想到替代方案，并继续感觉比悲观者更好。这三个因素如此紧密相连，以至于如果你掌握了一个，其余的可能性很高。乐观和希望之间存在联系。
如果你想重新获得一丝希望，即使在危机情况下，问自己或你的客户以下问题 过去有什么帮助，即使只是边际的？我如何应对正在发生的一切和我所经历的一切？我如何成功地从一刻到下一刻？可能比现在更糟吗？为什么没有更糟？我的社交环境说我做得好的事情是什么，即使在非常糟糕的时候？想象在10或15年后，当事情好转时，我回顾今天，什么将帮助我改善事情？假设有一个解决方案，那会有什么不同，什么会不同——更具体地说，更好？
塞利格曼，积极心理学方法的创始人，将注意力从习得性无助转向习得性乐观。他研究了导致人们将事件视为积极或消极的因素及其背后的推理。悲观的人特别将负面事件归因于稳定、全局和内部因素。他们说 事情从不顺利稳定，我永远不会再快乐全局，我一无是处内部。他们将积极事件归因于暂时、具体和外部因素。他们说 那只是运气，与我无关，如果发生积极的事情。
乐观的人以相反的方式思考。他们将积极事件归因于稳定、全局和内部因素。如果发生积极的事情，那确实说明了他们，例如，我真的有价值。乐观者特别将负面事件归因于暂时、具体和外部因素。他们可能会说 我无能为力，因为他威胁我。以悲观的方式思考，特别是关于负面事件，导致绝望的期望。
爱因斯坦说 我宁愿是一个乐观的傻瓜，也不愿是一个正确的悲观者。悲观思考的人比乐观思考的人更容易变得抑郁。然而，偶尔一点悲观无害。它迫使人们面对现实，抑郁的人往往对世界有更现实的看法。每一天都可能是你的最后一天 你可能卷入交通事故或患上致命疾病。抑郁的人对世界和生活实际上有多安全和可预测几乎没有幻想。然而，事实证明，如果我们确实持有这些幻想并能够保持它们，我们会感觉更好和更快乐。
乐观和悲观是相对稳定的人格特质，但它们可以通过一个人的行为方式和关注的内容来影响。乐观有助于更适应的生存策略，即更多的积极重新评估，更好的应对能力，以及更多地使用积极分心爱好和锻炼。
研究表明，即使是悲观本性的人，如果在一周内记录过去他们处于最佳状态的时间，也会感到更快乐 每天，在一周内，他们会记录一些关于他们优势的事情 向一个他们尚未适当感谢的人表达感激 或记录生活中发生的三件好事。六个月后，这些人仍然感觉更快乐，尽管练习只进行了一周。研究还表明，快乐的人对未来乐观，乐观的人比悲观的人更健康。四个积极元素显著促进幸福生活。快乐的人喜欢自己，大多是外向的，认为自己在控制中并且乐观。与所有四个相关的问题是 乐观使人更快乐A还是快乐的人更乐观B？事实证明，A导致B，B导致A。
多项研究结果表明，创伤不一定使人衰弱，大多数人在创伤后具有韧性甚至能够成长。理解这种韧性和创伤后成长的来源将帮助心理学家培养客户的这些优势，而不是关注他们的问题，后者可能产生令人沮丧的效果。泰代斯基和卡尔霍恩开发了创伤后成长量表，一种评估经历过创伤事件的人报告的积极结果的工具。它包括新可能性、与他人关系、个人力量、精神变化和生活欣赏等因素。女性报告比男性更多益处，经历过创伤事件的人比未