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A prescrip)on for Happiness 10 things I have learned from my pa6ents Dr. Timothy Lau Dis)nguished Teacher Program Member Faculty of Medicine Director of Undergraduate Psychiatric Educa)on Geriatric Psychiatry, The Royal
Before we begin… • Who here would describe themselves to be extremely happy? • What do you think the happiest age is? • Who amongst us is here to try and make someone else happy?
Happiness • Would you be happier 1. winning a loMery or 2. breaking your neck? • The answer may surprise you.
Winning a loMery? • Ecsta)c at ﬁrst. • BUT…winning the loMery tends to have a terrible eﬀect on social rela)onships. – People almost always get jealous and become alienated from their friends and their family members. – They oRen loose what really maMers, the people in their lives.
Breaking your neck? • "Much recent data show that people fare reasonably well in a variety of tragic and trauma6c circumstances…Paraplegics are generally quite happy people • …blind people o@en say the worst problem they have is that everyone assumes they are sad. People do feel devastated if they go blind, but it does not last” – Dan Gilbert, Professor of Psychology, Harvard – See TED (Ideas Worth Spreading) talks for the principle of synthe)c happiness
Breaking your neck? • It is the triumph of the human spirit that allows us to ﬁnd joy and survive in the bleakest of situa)ons. • People who suﬀer long, terrible traumas oRen have tremendous senses of humour.
Having less • May help us focus on what’s important. – Finding meaning in our struggles. • Having less helps us see how every moment, nothing is taken for granted, everything is a giR – You don’t need to visit third world countries to see how poor children can be incredibly cheerful.
Happiness Economics • Gross na)onal happiness (GNH) is a concept introduced by the King of Bhutan in 1972 as an alterna)ve to GDP. – Slipping in 2011 United Na)ons Human Development Index. #144 • In 2006, Thailand also ins)tuted an index. – The Thai GNH index is based on a 1-‐10 scale with 10 being the most happy. As of May 13, 2007, the Thai GNH measured 5.1 points.
Happiness Economics • Australia, China, France and the United Kingdom are also coming up with indexes to measure na)onal happiness. • North Korea also announced an interna)onal Happiness Index in 2011 through Korean Central Television. – North Korea itself came in second, behind #1 China.
Why is happiness important? • Mental wellness – We will not truly understand ourselves nor be able to help others unless we knew as much about mental wellness as we do about mental illness. • Happiness and Depression – Are they incompa)ble?
Happiness vs. Depression • Jerome Wakeﬁeld of New York University and Allan Horwitz of Rutgers have penned “The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder” • Has our preoccupa)on with happiness paradoxically come at the cost of sadness
Hedonic Treadmill • Happiness is oRen imprecisely equated with pleasure. • If, for whatever reason, one does equate happiness with pleasure, then the paradox of hedonism arises. • When one aims solely towards pleasure itself, ones aim is frustrated. • THOUGHT EXPERIMENT
Pleasure paradox • John Stuart Mill, the u)litarian philosopher, in his autobiography: • "But I now thought that this end [ones happiness] was only to be aPained by not making it the direct end…Ask yourself whether you are happy, and you cease to be so.”
Pleasure paradox • Viktor Frankl in Mans Search for Meaning: • “Happiness cannot be pursued; it must ensue, and it only does so as the unintended side eﬀect of ones personal dedica6on to a cause greater than oneself”
The problem with pleasure • Pleasure IS NOT the same as happiness • Quick Fixes – Modern man tends to reach for superﬁcial quick ﬁxes like extravagant purchases and ice cream (or other comfort foods) to suppress nega)ve feelings that overcome us. • They don’t last – Indeed, a body of research shows instant indulgences do calm us down—for a few moments. – But they leave us poorer, physically unhealthy, and generally more miserable in the long run
Depression • In the western world clinical or major depression is growing at an incredible rate. • WHY? • Depression is the leading cause of disability and its eﬀects are increasing. – 4th in 2000 by 2020 2nd WHO • 10 )mes more people suﬀer from major depression now than in 1945 • 850 000 lives lost to suicide each year
The changing rate of major depression. Cross-‐na)onal comparisons. Cross-‐Na)onal Collabora)ve Group. JAMA 1992;268:3098-‐3105.
Happiness as an end • “Happiness" is oRen thought of as merely subjec)ve contentment. How you feel. – From the Old english word ‘Hap’ which refers to fortune, luck or chance. Something that happens to you. • Eudaimonia refers to an objec)vely desirable life. – A choice-‐virtue, a ﬁnal state. – A result of something good that you chose.
Happiness as an end • Eudaimonia – (Greek: εὐδαιμονία) is a Greek word commonly translated as happiness‘. – Etymologically, it consists of three words • "eu" ("good") • "daimōn" ("spirit"). Happiness is a maMer of the soul. • “ia” las)ng state, permanent
Aristotle • Summum Bonum – The purpose and end to life – The chief excellence; the highest aMainable good. – ARISTOTLE said that happiness is the greatest good. Never as a means to anything else. 10 Lessons…. YOGI BERRA
Money can’t buy you happiness • No, but our material needs must be met ﬁrst Easterlin paradox
Money and happiness • "Although the people in the West have for decades got richer, they have not become happier.… • Studies show that people are not happier today than 50 years ago. And this is despite the fact that the real median income in this period has more than doubled. • Richard Layard, Bri)sh Economist
Status anxiety • Some are more obsessed with status than others, but to some extent were all aMuned to how were doing in life rela)ve to those around us. • To help prevent status worries from ge•ng to you, carefully decide who you want to be around. • Owning the smallest mansion in a gated community could make you feel worse oﬀ than buying the biggest house in a less aﬄuent neighborhood.
It is more important who you livewith than where!
Op)ons make us miserable • The paradox of choice – facing many possibili)es leaves us stressed out—and less sa)sﬁed with whatever we do decide. – Having too many choices keeps us wondering about all the opportuni)es missed. • By having some, but overall fewer op)ons – “The secret to happiness is low expecta6ons.” (Barry Schwartz TED Talk)”
Happiness is living your values • Be authen)c – (provided you are not an authen)c jerk, or an authen)c heroin addict) • Follow your conscience – If you arent living according to your values, you wont be happy, no maMer how much you are achieving. – Some people, however, arent even sure what their values are.
Human conscience • “A quiet conscience sleeps in thunder.” – English Proverb • “A clear conscience is the greatest armor.” – CHINESE PROVERBS
Character • Character is an integra)on of what the great minds of an)quity used to call the virtues. Those powers of the mind and will and heart built up through repeated prac)ce. • Jus)ce (fairness) • For)tude (courage) • Temperance (self control) • Prudence (wisdom or sound judgment)
Acceptance • Some things are out of our control • Arguably the most important ones – Our family, our temperament, our natural abili)es (intellectual, physical), our disabili)es/illnesses, when we are born, when we die…etc • Serenity prayer
Don’t try to be something you are not. • Some people are born happy – Twin correla)ons. – Personality-‐ extroversion, neuro)cism • The tyranny of the posi)ve a•tude. – Looking on the bright side isnt possible for some people – When you put pressure on people to cope in a way that doesnt ﬁt them, it not only doesnt work, it makes them feel like a failure on top of already feeling bad.
Don’t try to be something you are not. • Defensive pessimism – Anxious people oRen use this to help them get things done, which in turn makes them happier. – A naturally pessimis)c person can set low expecta)ons for an upcoming presenta)on and review all of the imagined bad outcomes to prepare carefully and increase chances of success.
• Have the courage to change the right things you can
“You miss every shot you do not take.” Wayne Gretsky
Pain • “I wish the ring had never come to me.” Frodo • “So do all who live to see such 6mes. But that is not up to us to decide. What we have to decide is what to do with the 6me we have been given.” LOTR FOTR 1:46:20s • Gandalf
Doing the best you can with what you have • If youre climbing a mountain, you some)mes have to backtrack or surmount obstacles or thrash your way through tangled shortcuts • as long as you keep moving upward, youll reach the summit.
We are oRen wrong • We might think we know what will make us happy and what made us happy. • Things are almost never as bad—or as good—as we expect them to be. – Your promo)on will be quite nice, but it wont be a 24-‐hour parade. – Your breakup will be very hard, but also a learning experience, and maybe even energizing.
ORen wrong • We are terrible at predic)ng our future feelings accurately with emo)onal reasoning • We recall beginnings and endings far more intensely than those long "middles," whether theyre even„ul or not. • Princeton Colonoscopy trial
ORen wrong • Cogni)ve distor)ons – Automa)c thoughts • All or nothing thinking • Personaliza)on – Core beliefs – Views about ourselves, the world and the future
Self esteem • “Someone cannot take away your self esteem unless you give it to them” • Gandhi
• “The past is history, the future is a mystery, but today is a gi@—that’s why they call it ‘the present’”
Focus on the present • Depression – Regrets about the past – Hopeless about the future • Anxiety – Worry about the future
One day at a )me • When things seem daun)ng, take it one step, one day at a )me. • “When you want to move a mountain start with small rocks.” CHINESE PROVERB
Happiness and perspec)ve • In the moment – Time skews our percep)ons of happiness. – Parents look back warmly on their childrens preschool years, for example. – But when asked in the moment, childcare tasks rank very low on the list of what makes people happy, below napping and watching TV. • Stepping back – Would a spirited stretch of raising children or a steady stream of dozing oﬀ on the couch each day in between soap operas illustrate a "happier" )me?
Be thankful for what you have “It’s not about gedng what you want it’s about wan6ng what you’ve already got.” Sheryl Crow, Every day is a winding road.
Gra)tude • NIH Study Lyubomirsky U of California – The gra)tude journal – Taking the )me to conscien)ously count their blessings once a week signiﬁcantly increased subjects overall sa)sfac)on with life over a period of six weeks • Gra)tude exercises can do more than liR ones mood. – At the University of California at Davis, psychologist Robert Emmons found they improve physical health, raise energy levels and, for pa)ents with neuromuscular disease, relieve pain and fa)gue.
The grass is greener on the other side… • While you are reaching for something, be careful not to loose what you already have • Wan)ng oRen feels beMer than actually ge•ng
Bruce Almighty clip • “Why don’t you buy me a big ship. That will make me happy” • Time 1:03:28s • “Love me….I already did” • Time 1:09:30s
Forgiveness • Le•ng go of hatred • Forgiveness means le•ng go the possibility of a beMer past • Forgiveness is like le•ng a prisoner go free only to discover that the prisoner was you
East meets West • The problem of the self and selﬁshness • We are unhappy when our eyes are turned inwards. Happiest when we are thinking of others.
Trying to hold on to something forever • Stuﬀ vs. People
Detachment • Yoda speaking with Anakin about Padme • REVENGE OF THE SITH @34 minutes The danger of having hope in something hopeless. Holding on no maMer what the cost.
Happiness Is Other People • Make strong personal rela)onships your priority. • Good rela)onships are buﬀers against the damaging eﬀects of all of lifes inevitable letdowns and setbacks. • The basis for IPT for depression
Happiness is love • “Being deeply loved by someone gives you strength while loving someone deeply gives you courage” • Lao Tsu
HAPPY EVER AFTER• Happiness involves a choice• To find yourself you have to give yourself away• Happier giving than receiving• Love and happiness
10 Lessons 1. Money can only buy so much 2. Live with integrity 3. Don’t try to be something you are not – Acceptance and changing only what you can 4. Have the courage to change the things you can 5. Pain may be part of happiness 6. Remember we are oRen wrong 7. Strive for balance 8. Be grounded 9. Be mindful 10. Be open to Love
• “In this world it is not what we take up, but what we give up, that makes us rich.” • Beecher
Happiness by age… Proc Natl Acad Sci U S A. 2010 Jun A snapshot of the age distribu)on of psychological well-‐being in the United States. Stone AA, Schwartz JE, Broderick JE, Deaton A. PEW Research Center