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Perhaps We Were Helping Young Patients To Experience PERMA

March 20, 2015

Perhaps We Were Helping Young Patients To Experience PERMA

I recently met with a large group of university students who will be graduating next year. In the process of trying to give an example of PERMA, the five pillars of flourishing (positive emotions, engagement, relationships, meaning and achievement) proposed by former APA president Martin Seligman; I discovered why I had become so curious about positive psychology at 1st Canadian Conference on Positive Psychology in 2012.

In the example I gave them, I reflected back on the decades I spent building programmes to prevent and reduce stress, across the continuum of care, for seriously ill children and their families.  It was before Martin Seligman brought positive psychology to the forefront in the United States.

In the early years, I witnessed additional trauma to the primary illness: divorces, developmental delay, noncompliance, problems at school, and a range of other mental health problems were common. As a team, we decided to take measures to prevent and minimize as much stress as possible. Over 15 years, we noticed some encouraging transformations.  We started by changing the system to meet the needs of the children instead of expecting families to adapt to the system.

As a result, children actually reported enjoying coming to clinic and the hospital, even when they were faced with painful procedures. School problems all but disappeared and the children and their siblings   demonstrated resilience, and often happiness, in the face of enormous physical suffering.

We suspected, anecdotally, what we were doing worked because we were constantly assessing the situation with the children and their families, but we could not pinpoint exactly why it worked?

In trying to explain an example of PERMA to the group of students, yesterday evening, I suddenly realized that perhaps we were helping young patients to experience PERMA and that is why they flourished in the face of these life challenges.

Positive emotion:  Our premise was that all young patients should have play opportunities morning afternoon and evening, seven days a week. We also took the advice of one child who said “I am still a kid first and sick second”. This daily access to play was possible with the help of nearly 200 highly trained volunteers per year.

Engagement:  With so many volunteers, we had access to art, music, drama, computers, magic, puppetry, games etc.  We persisted with each child until we found what would engage them. Once found, we could do more of it with them.

Relationships: All volunteers contributed 6 hours per week and our volunteers ranged in age from 15 years of age to 90 years of age. They came from all walks of life.  When we found a volunteer who “clicked” with a seriously ill child, we asked them to come more frequently each week, to build a stronger relationship. Our role was then to provide intensive support and training to the volunteers so that families experiencing the highest levels of stress had a little network around them in the community, clinic and hospital.

Meaning:  It came in many different ways: the relationships they built; making or finding something they could leave behind when they died; to helping other kids in their class understand their disease and their needs

Accomplishment:  It is awfully hard not to experience accomplishments when a child is engaged in an activity that they love doing, with someone who they enjoy doing it with. This gave them ongoing opportunities for accomplishment. At other times, during painful experiences, we felt it was a good sign when children were able to continue playing during a painful treatments. Sometimes it took a lot of practice, but they often felt proud of being able to experience the procedure in a different way.

It was such a privilege to share in the lives of these families and provide many of the same kinds of supports to siblings who often suffered more in different ways.  We saw so many families thrive and become stronger, in the face of enormous stress.  Back then, we did not know positive psychology. With its growth around the world, I now look forward to reading about its applications.

Who knows, maybe I will hear more about this at the next Canadian Conference on Positive Psychology in the summer of 2016.

This article was inspired by the late Donna Smith, who dedicated much her life to creating these kinds of experiences in the lives of these families

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