Article Image

The ABCs of Positive Thinking

Op-Med is a collection of original articles contributed by Doximity members.

If we want to stay resilient in this current state of uncertainty, we need an evidence-based practice to help us build a sense of realistic optimism. According to University of Pennsylvania psychologist and researcher Martin Seligman, a founding father of positive psychology, some of us appear to be hardwired to respond optimistically to life's downs and ups. Others are wired to respond in the opposite way. Thankfully, we are not tied to our genes. With practice, we can cultivate resilience and genuine hopefulness by building strong positive thinking abilities. I like to consider the process of cultivating hopefulness, strength, and positive thinking abilities as an analogy to developing physical fitness: it takes attention, repetition, concentration, and commitment. You can nearly constantly enhance your physical fitness if you approach an exercise program with the same qualities.

The first difficulty to get past is the belief that you are required to be in a different position in life in order to prosper. You do not. You can start from here: overwhelmed, concerned, anxious, whatever. Do not fall for your story about how you feel. Decide for what you plan to accomplish and where you would like to (not "should") go. It all begins with a decision. You don’t need to feel much better before you attempt the practices below — do them now! And you don’t need to assess your progress in the short-term. Measuring increased strength and endurance after a single exercise would not show much improvement.

Seligman points out that people with a positive approach to life habitually accept positive thoughts and dispute negative ones. Optimists tend to think that their life balance will be brought back, excellent events will take place again, and that bad events are an exception; pessimists assume the reverse.

The ABC(DE) practice is based on more than three decades of research. It focuses on challenging negative thoughts while accepting the emotions. I successfully used it with clients to help them re-examine the thoughts behind their pessimistic views — rather than focusing on their emotions — in order to achieve "pragmatic optimism." Here’s how it works:

Adversity: Start by spelling out the situation. Stick to the facts of what happened.

Beliefs: This is your chance to write down/dictate/email yourself the thoughts you had during and after the situation.

Consequences: Look at the repercussions of these thoughts — how did you feel? What happened then?

Disputation: This is the hardest part of the exercise. Actively dispute beliefs that break your life balance and send you into a downward spiral. Think about what you would say to your best friend when they call you to ask for help. If this friend was in the same situation — for which you already know all the details — how will you gently dispute their thoughts without belittling their emotions? Practice arguing with yourself or a friend in a productive way. Stick to the facts. Otherwise, your mind won't buy into your arguments!

Energization: When you have been effective in challenging the problem beliefs, you can take action and feel an increase of energy, a sense of renewed hope, or a bit of serenity. 

Could you see how this system works? It is about acknowledging the situation, thoughts, and feelings, and then challenging the thoughts, not the feelings. Next, take action; any small step counts. Here's an example from one of my client's life situations during the COVID-19 crisis:

Adversity: "When I was laid off from my job as a nurse in a top managerial leadership position during the coronavirus crisis, I felt a paradoxical relief. I was waiting anxiously for my fate at my current job. There were rumors all around, but no one was fired — yet. At the same time, I was ready to move forward. I was all right. I was optimistic and survived well for almost three days. Anxiety and stress started to sneak into my thinking. My positive thinking left me. I felt like bursting into tears."

Beliefs: "How will I ever regain my confidence and get things done if I can't stop worrying? How will I be able to get a job when many of my friends are laid off? I do not know where to start."

Consequences: "These thoughts left me feeling unfortunate about my situation. I questioned myself about whether I could become a leader again in my field. I was not able to focus and I just wished to vanish."

Disputation: "Well, I did not lose my positive thinking capability. It is a separate quality from my job. It is there inside me and it needs to be ignited. It might be wise to let some friends know what is going on. I don’t have to suffer alone under a rock. And while some job opportunities might end up being passed on to others, there will constantly be other opportunities that will pop up."

Energization: "I decided to set up a phone call with a close friend who was in a similar nursing managerial position level. After telling him about my situation, he confided that he was also laid off a week ago from his managerial position. I was shocked and relieved at the same time; I was not alone in this situation. Midway through our call, we started to think together about the next small steps that we could take to network and see what’s available in the market."

How will you ever restore your sense of positive thinking and get things done if you can't stop imagining a terrible outcome? Positive psychology teaches us that maintaining a sense of optimism is not a trivial task, even for personalities that are hardwired to respond optimistically to life's ups and downs. Taking a step back and disputing our thoughts — rather than disputing our emotions — is one way to do it. The ABC(DE) method helps us let go of negative narratives that we only think that we have no control over.

Dr. Soliman is Certified Life Coach. He is a graduate of Weill Cornell Medicine and Cornell Johnson College of Business. He did his PhD at the University of Toronto. He is interested in behavioral health, behavioral economics and behavioral health care strategies. He can be connected with at his website: www.drsoliman.com

More from Op-Med