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Positive Psychiatry: A Clinical Handbook, by Dilip V. Jeste
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Long overdue, Positive Psychiatry provides a rigorous and clinically useful guide to the growing body of research that strongly suggests that positive psychosocial factors such as resilience, optimism, and social engagement are associated with better outcomes, including lower morbidity, greater longevity, and a heightened sense of patient well-being. Because most of the research has been conducted outside of the field of psychiatry, it has had relatively little influence on everyday clinical practice. This volume, written and edited by luminaries in the field, hopes to remedy this situation by introducing clinicians to the guiding principles of positive psychiatry, which hold that mental health cannot be defined as the mere reduction or even elimination of mental illness, and that mental health professionals must focus on more than simply controlling the symptoms of illness. To that end, the book, while biologically grounded and exhaustively referenced, is also structured and written to be accessible. It includes many useful features: * Bulleted outlines of key clinical points are included where appropriate, fostering direct application of positive psychiatry constructs, measures, interventions, and outcomes into clinical practice and training.* An abundance of interesting and compelling clinical vignettes illustrate how to incorporate positive psychiatry techniques and treatment strategies into practice.* Comprehensive coverage makes this volume the "go-to" resource for researchers and clinicians seeking an overview and details of what positive psychiatry is, why it is needed, and how to integrate it into research, practice, and training.* The roster of contributors is a "who's who" in the field of positive mental health, rendering this the definitive source of information on positive psychiatry. Chief among the book's strengths is its emphasis on empirically grounded applications, and the editors have ensured that limitations in the available evidence base are identified, as well as directions for further research. Positive Psychiatry fills a critical gap in the treatment literature, and researchers, clinicians, and trainees in psychiatry and allied mental health fields will welcome its publication.
- Sales Rank: #588562 in Books
- Published on: 2015-06-02
- Original language: English
- Number of items: 1
- Dimensions: 8.80" h x 1.00" w x 5.90" l, .0 pounds
- Binding: Paperback
- 385 pages
Review
A wonderful shift in psychiatry and mental health care is upon us. In addition to addressing the suffering that psychiatric illness inflicts on our patients, we can also embrace strategies to help others pursue mental health and well-being, an arena not often addressed in psychiatric care. Discovery of the roots of resilience, the benefits of gratitude, and ways to engage PERMA: positive emotion, engagement, good relationships, meaning, and accomplishment, are some of the offerings available in this book. Rooted in positive psychology but transformed in this well-written tome, this new approach to healing is timely and welcome. We stand to have our field, in addition to our individual patients and ourselves, flourish. --Maria A. Oquendo, M.D., Professor of Psychiatry and Vice-Chair for Education, New York State Psychiatric Institute and Columbia University
Reductionistic paradigms are used to generate knowledge in psychiatry creating a challenge for clinical application in a broad and humanistic framework. Positive psychiatry informs a clinical approach to persons with a mental disorder or at high risk for developing psychopathology. While the World Health Organization gives emphasis to quality of life years, health care in the United States falls far short of an effective focus on promotion of well-being. Positive psychiatry, as defined and richly described in this text, provides clear guidance for a paradigm shift in psychiatry. While maintaining the field s central focus on mental disorder, clinical care implications go beyond diagnosis and treatment. The additional emphasis on positive psychosocial factors including resiliency, optimism, social engagement, and personal strengths have broad implications for health in general, and alleviation of suffering and dysfunction associated with mental disorders. It also provides a broad and friendly model for addressing high risk patients as the field moves rapidly towards early detection and intervention. Positive Psychiatry is a wonderful read at a time when clinical practice in psychiatry is restricted in time and definition of role. --William T. Carpenter, Jr., M.D., Professor of Psychiatry and Pharmacology, Maryland Psychiatric Research Center, University of Maryland School of Medicine
This thought provoking book is a wakeup call for all mental health professionals. It makes a compelling case for the clinical approach in psychiatry to shift from an emphasis on disease models to positive psychiatry. In this creatively compiled volume, the contributors highlight the endeavors of mental health clinicians to go beyond just symptom control to promote a sense of wellbeing. Spread over 16 chapters, the editors have introduced a road map to facilitate this shift while deliberating on a broad range of clinical and ethical facets of the concept of Positive Psychiatry, applicable across the age spectrum. This is, indeed, essential reading for every clinician. --Vihang N. Vahia, M.D., Professor Emeritus of Psychiatry
From the Inside Flap
While there are a number of books on positive psychology, Positive Psychiatry is unique in its biological foundation and medical rigor and is the only book designed to bring positive mental health ideas and interventions into mainstream psychiatric research, training, and clinical practice. After an overview describing the definition, history, and goals of positive psychiatry, the contributors -- pioneers and thought leaders in the field -- explore positive psychosocial factors, such as resilience and psychosocial growth; positive outcomes, such as recovery and well-being; psychotherapeutic and behavioral interventions, among others; and special topics, such as child and geriatric psychiatry, diverse populations, and bioethics. The book successfully brings the unique skill sets and methods of psychiatry to the larger positive health movement.
Each chapter highlights key points for current clinical services, as practiced by psychiatrists, primary care doctors, and nurses, as well as those in allied health and mental health fields. These readers will find Positive Psychiatry to be immensely helpful in bringing positive mental health concepts and interventions into the clinical arena.
About the Author
Dilip V. Jeste, M.D., is Senior Associate Dean for Healthy Aging and Senior Care; Estelle and Edgar Levi Chair in Aging; Director, Sam and Rose Stein Institute for Research on Aging; and Distinguished Professor of Psychiatry and Neurosciences at the University of California, San Diego in La Jolla, California. Barton W. Palmer, Ph.D., is Professor in the Department of Psychiatry at the University of California, San Diego, in La Jolla, California.
Most helpful customer reviews
1 of 1 people found the following review helpful.
Books like Positive Psychiatry renew our faith in the eternal values ...
By Renato D Alarcon
Books like Positive Psychiatry renew our faith in the eternal values of our profession, and of a Psychiatry aspiring, once and for all, to get rid of its Cinderella role and become the legitimate leader of a truly comprehensive, humanistic Medicine. Chapter after chapter, the reader grasps the meaning of profound reflections, sophisticated neurobiological advances and pragmatic pieces of advice that, together, show the way towards dispositional optimism, constructive social engagement, effective stress management and an authentically high quality of life. We learn that aging wisely enhances neurogenesis and synaptogenesis and, concomitantly, reduces the weight of risk factors by generating useful behavioral and physical preventive strategies. Above all, the knowledge, ongoing research and integrated practice of a truly Positive Psychiatry restore the human dignity of patients, strengthen the hopes of the healthy, show a safe road to the practitioner, and illuminate the pathway of younger generations. These perspectives and their demonstrable impact are solid accomplishments of an exceptional volume. --- Renato D. Alarcon, M.D., M.P.H., Emeritus Professor of Psychiatry, Mayo Clinic College of Medicine; Honorio Delgado Chair, Universidad Peruana Cayetano Heredia, Lima, Peru.
0 of 0 people found the following review helpful.
Must-add to your library!
By Maria Lapid
Imagine a world where psychiatrists focus on mental health as much as they focus on mental illness. That is the challenge made by Dr. Dilip Jeste, former president of the American Psychiatric Association, who is the leading proponent of positive psychiatry. With psychologist Dr. Barton Palmer, Dr. Jeste writes and edits this handbook for practitioners to understand what positive psychiatry is and how it can be used to promote mental health in our patients. He has assembled a group of experts on this topic to write chapters on all aspects of positive psychiatry.
As a psychiatrist, I appreciated his explanation of positive psychology, the precursor and motivation for putting forth a model for positive psychiatry. Positive psychiatry focuses helping our patients with illness to maximize their well-being, contrasting the original idea of positive psychology which targets healthy individuals. Positive psychiatry fits very well into today’s holistic treatment of the patient, and urges focus on areas such as resilience, coping, optimism, wisdom, personal mastery, and spirituality. These areas are sources of strengths for our patients which we frequently overlook.
As a geriatric psychiatrist, I also appreciate the chapter on how to apply positive psychiatry principles to geriatric patients, to improve their quality of life. It cannot be understated how important social support, spirituality, resilience, optimism, and leisure activities are when treating the individual geriatric patient. There are similar chapters describing the application of positive psychiatry to other populations such as to children and minorities, and how to apply it to everyday clinical practice.
There are many other aspects of positive psychiatry (biological, psychotherapeutic, preventive) in this book. It is difficult to mention all the concepts of positive psychiatry in a short review. Suffice to say, Drs. Jeste and Palmer do an excellent job of explaining positive psychiatry and its relevance to improving the lives of our psychiatric patients. It is a book well worth adding to one’s library.
Maria I. Lapid, M.D.
Mayo Clinic Rochester, Minnnesota
0 of 0 people found the following review helpful.
Simultaneously ebullient and circumspect
By Paul R. Fleischman M.D. author of Wonder: When and Why the World Appears Radiant.
Positive Psychiatry is an information dense book that manages to be both rigorous and inspiring.
The goal of Positive Psychiatry is to import into the psychiatric profession the insights and skills that have already animated positive psychology. Positive psychology, pioneered by Martin E. P. Seligman at the University of Pennsylvania, and his many colleagues and followers, has already had a major impact upon psychology, and the authors of this volume want it to have a similar role in rejuvenating and improving psychiatry. Positive psychology is defined by its focus upon facilitating optimal function. It has an educative and exhortative style rather than that of the goal of uncovering psychopathology, as happens in traditional psychotherapy.
I found that Positive Psychiatry provided me with a bracing and welcome reminder about some of modern psychiatry’s strengths. Every article in the book is written and edited to a standard of excellence, and is clear, well-referenced, and relevant. The book is packed with information but is not stuffed with excess. At the end of each chapter there are “clinical key points” that helped me review and keep in mind the wide array of ideas that were presented.
The main thread throughout the volume is the effort to educate, train, and encourage psychiatric patients, across all diagnoses, with virtues and strengths. The advantage of this approach is that it capitalizes on the longstanding traditions of human virtue, sociability, and intelligent self-improvement, such as are found in philosophy, religion, and culturally rich parenting. The vulnerability of this approach is that it veers towards moralizing and insensitive cheerleading, that bring in their train guilt and feelings of inadequacy for those people who cannot live up to the standards that are being promoted. This fine volume, however, gains much of its value by combining the enthusiasm of a charismatic optimism about what positive psychiatry can do, with responsible professional caution about how to define it, measure it, apply it, and monitor it for possible negative effects. I felt delighted to find a psychiatric book that was so simultaneously ebullient and circumspect.
The tone is set by the volume’s editors’ introduction. Jeste and Palmer, colleagues at the University of California, San Diego, state that positive psychiatry is not meant to replace but to complement psychiatry as usual. They remind the reader of the history of positive psychiatry going back to William James, sweeping up Maslow and defined by Martin Seligman’s ideas: “Building the most positive qualities of any individual: optimism, courage, work ethic, future mindedness, interpersonal skill, the capacity for pleasure and insight, and social responsibility…the flourishing individual and the thriving community.” Jeste and Palmer start the book rolling with an attitude of modesty that includes deference to psychology as a teaching discipline to psychiatry. The references in every subsequent chapter will leave no doubt in the minds of any careful reader that this book is inspired and guided by its distinguished editors.
The book’s sixteen chapters express a broad invitation to many contributors approaching the topic with different ways of writing and thinking. Some of the chapters are cautious, carefully referenced professional contributions on economic topics such as what testing scales to use to measure changes in patients who have received interventions based upon positive psychiatry. These chapters are all technically excellent, but I preferred those that expressed a little more of the heart that is supposed to be the point of positive psychiatry.
Chapter Two, “Positive Psychological Traits” by Martin, Harmell, and Mausbach, is the cornerstone of the book and provides core ideas. If you wanted to read only one chapter and feel pretty well educated about the book’s goals and purposes, this would be the one. It focuses on “circumstances and processes that yield successful and optimal function.” It then describes in satisfying detail, optimism, wisdom, personal mastery, perceived self-efficacy, problem-focused-coping, creativity, conscientiousness, and spirituality and religiosity. Each of these traits is presented with enthusiasm, but also with intelligent skepticism about how well it can be defined, separated from other traits in the list, measured, and demonstrated to contribute to mental health. I found this chapter to be informative, bracing, and a notable contribution to the profession’s complexity of thought.
My favorite chapter was Three, “Resilience and Post-Traumatic Growth,” by one of psychiatry’s great old gurus, George E. Vaillant. Here we find a writer who has contributed research for nearly forty years, and who has defined many of the important ideas that come to life in this current volume, and who has granted himself the well-earned right to sound irascible, and to shoot from the hip, so that this chapter stands out for its passion, caring, idealism, temerity, and overall brilliance. Only Vaillant could say this: “Sometimes resilience seems as if it results from a system of fate designed by Rube Goldberg, Dr. Seuss, or chaos theory.” Vaillant has the courage to simultaneously insist upon empiricism, while emphasizing its limits. He reminds us that “transformative behaviors often emerge with maturation as delicate mental balancing acts…” This chapter provides a more personalized, non-logical, self-referential legacy that enriches a book that in all other chapters eschews the first person singular.
It was a footnote at the beginning of the last chapter, “Bioethics of Positive Psychiatry” by Ajai R. Singh that revealed to me one of the books most important features. Dr. Singh footnotes his gratitude to Dilip E. Jeste for inviting him to contribute to this volume. Dr. Singh is an Indian psychiatrist who might easily have been overlooked by other editors. The main import of this final chapter is to wag a finger at the rest of the book. Singh reminds the reader that concepts like resilience can become “a blame game…blaming patients who do not recover quickly by not trying to be more resilient.” He reminds readers that exhortations towards self-improvement can become “condescending paternalism.” He warns psychiatrists not to brush aside a patient’s basic character style, nor to try to rectify a patient’s long tailored coping mechanism. He warns that bumptious positivity might override sorrow, grieving, and pessimism, which all have their place in human adaptation. In his clinical examples he implies a Western cultural prejudice.
I was happy to find this sort of self-critical professional self-evaluation marbled throughout Positive Psychiatry. In Chapter Four, Blazer and Kinghorn reviewed Barbara Ehrenreich’s fiery criticism of positive psychology, which makes cancer patients like Ehrenreich, feel guilty that they haven’t been positive enough and that is why they are suffering. Concepts like the “fighting spirit,” as it appears in Chapter Seven, can quickly deteriorate into blaming sick patients for lacking the “fighting spirit” to emerge from their sickness. Blazer and Kinghorn remind us to avoid a pollyannaish Brave New World. Positive psychiatry can be enlisted in service of emotional constriction and the denial of the inevitability of illness.
There can be grace and relief in the acceptance of illness. Illness is not only something to be conquered, but something to be lived with. Positivity can be realism and realism must include an embrace of limits, constraints, sorrow and even tragedy.
It is characteristic of the “Jeste effect” to balance psychology with biology, and so this volume contains a truly excellent chapter on “The Biology of Positive Psychiatry” by Moore and colleagues. Positive traits of psychological well being are “likely to have a moderate to strong genetic basis.” While this chapter reminds us of the force that biology can have upon us, it avoids reductionism by also reminding us that, “positive psychological traits are a function of various neural networks throughout the brain; these traits are not localized to discreet brain structures…”
In short, this extremely rich and educative volume is anchored by “the Jeste effect” which consists of insisting upon judicious balance in the presentation of all things. I really enjoyed reading a dense textbook like this that was also filled with fresh thinking, and optimism for the psychiatric profession and its patients.
When I completed my psychiatric training in 1974, I had to exit from the psychiatric mainstream and seek out rigorous and authentic meditation training in India, in order to locate a psychology that balanced exhumation of negative traits with cultivation of positive traits such as equanimity, gratitude, and loving kindness. So I feel a little bit of pleasant envy when I think of the young psychiatrists starting their residency at the University of California San Diego under the guidance of scholars and humanists like Jeste and Palmer.
Reviewed by Paul R. Fleischman M.D.
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