Photo: Michael Blann

About 20 years ago, Randy J. Paterson, a clinical psychologist and currently the director of the Changeways Clinic in Vancouver, wasn’t having much success with one particular therapy group he was leading. It was composed of individuals who had faced such severe depression that all of them had been hospitalized at one point or another. Paterson’s job was to keep them safe and out of inpatient care, and to alleviate their symptoms to the extent he could.

The trouble stemmed from the group’s understandable pessimism. Paterson’s patients had all been through eviscerating battles with mental illness — what reason did they have to think that group therapy would help? “The patients were quite skeptical that anything we would do in our little eight-session group was going to make them feel happier,” Paterson explained in an interview with Science of Us. Then, he and his colleagues had an insight: What if they asked the members of the group, “Well, what if you wanted to feel worse?” “Suddenly the floodgates opened,” recalled Paterson. “People came up with all kinds of answers to that question,” and a much more productive therapeutic environment followed.

That insight eventually gave rise to Paterson’s wry new book How to Be Miserable: 40 Strategies You Already Use, in which Paterson offers a counterintuitive counterpoint to our national happiness obsession: Focus on the bad. “Between the influences of our culture, our physiology, and our psychology,” Paterson writes, “it appears that striving for happiness is a tiring matter; we’re swimming against a powerful current. We might almost say that happiness in such circumstances is unnatural.” In other words, the pressures of our culture (we need to earn more!), our bodies (on less sleep!), and our minds (and be happy about it!), contribute to a cycle in which the pursuit of contentment only results in an ever-snowballing accumulation of disappointment and self-blame. But if we consciously go after the opposite, if we, as Paterson puts it, “optimize misery” by becoming more aware of our own detrimental habits, we can paradoxically open up new and helpful behavioral pathways.

Such a premise — misery is the new happiness — might seem like a mere marketing trick, but, as Paterson explained, a little mental counterprogramming goes a long way. In our interview, he also talked about why people get overwhelmed by the prospect of change, the problems with self-help culture, and the weird mental-health potency of exercise.

We tend to think of reverse psychology as a trick you play on children to get them to do something they don’t want to do. Why is thinking about how to be miserable a good way of increasing your happiness?

You mean, Why bother doing it given that obviously it wasn’t our agenda to make people feel worse? The path upward and the path downward are usually part of the same mental terrain. So if you can isolate the things that you do that would make you feel worse — like continuing a behavior that doesn’t help you — then you can similarly isolate the things that will make you feel better.

Another reason this method is effective is that people can recognize they’re not as miserable as they could possibly be. That realization can be very powerful. It can give a sense of hope.

Give me an example.

If you realize that if you want to feel worse, you could be completely inactive, get no exercise, eat nonnutritious food, or compare yourself negatively to others, you can then go, well, wait a minute, maybe I could do the opposite of that and that would be helpful.

But how does someone than take that insight and turn it into changed behavior?

Well, that’s the tricky part. What we have to do is recognize the choice points. We find ourselves sliding into these misery-inducing behaviors without even realizing that we’re doing so. And before we can make an alternative choice we have to recognize, “Wait a minute. I know the direction I’m going to go in if I completely foul up my sleep schedule.” Once you begin recognizing the behaviors you’re doing that make you unhappy, then you can begin shifting them bit by bit. The challenge is to let go of the idea that you’re going to change your entire life all at once.

Because thinking of massive change is overwhelming?

Well, people often think of depressed folk as being unambitious or not very motivated. And the problem is actually that most of them are too motivated. You ask them what they want to do and they’ll say, “I should get this entire house cleaned up.” Or, “I should start exercising. I need to start making all my own meals from scratch.” And the goals that they automatically select without thinking are so great that they cannot possibly do them. They get discouraged before they’ve even really started.

So in psychotherapy what we’re often trying to do is rein people in a little bit. We’ll say, “I think that change you just described is much too difficult. What if we were just to do this smaller, more manageable thing?” So how do we change the things that are making us miserable? Often it’s by being incremental, and much less ambitious about those changes.

Some of the impetus for the book, even if it was in a tongue-in-cheek way, seems like it was to point out the problems of all the self-help books that promise happiness. Is that right?

Yes. How to Be Miserable actually does belong in the positive-psychology section of the bookstore, but there is a problem with positive psychology and a problem in the field of mental health: We have taken certain normal, natural human emotions — like sadness and anxiety, disappointment, despair, even bereavement — and we’ve reclassified them as disorders. And we have taken happiness and we’ve said that that’s how you should be. Twenty-four-hour-a-day happiness! You should be pretty happy and pretty content most of the day, nearly every day!

That’s actually a fairly abnormal state. Most people are not like that. But if we tell people that their negative emotions are pathological, and their failure to experience fairly constant positive emotion is pathological, then people begin seeing themselves as inadequate. And inadvertently, we end up bringing on even greater misery.

So a healthier goal would be what? Equanimity?

Yes. The mushy middle. The idea of openness to, and acceptance of, negative emotional states is often very helpful. If we recognize that I am going to be anxious and sad, I am going to experience disappointment, I am going to feel just sort of “blah” some of the time — all of those are absolutely normal aspects of being human. Those feelings don’t mean you’ve failed at life. They don’t mean you’re immature. They simply mean you’re having a fairly normal human life. If we can accept distressing feelings for what they are — part of the normal flow of human emotion —then, paradoxically, we will be less distressed. Our distress comes not from experiencing those emotions, but from our reaction to them as being unacceptable or abnormal.

What does that acceptance look like in practice?

With clients in my practice, they’ll report “I’m feeling anxious right now.” And I’ll ask them if that’s a familiar feeling, and it is. And then I’ll say, “So that means you’ve felt it before, and that means it didn’t kill you, and that means it’s not lethal, and that means it’s not comfortable and you’d rather not experience so much of it — but you don’t really have to be afraid of it.” So we can kind of open the door and welcome fear or sadness in. It’s okay that it’s there. The more sort of detached we can get from the emotion, the less we resist these uncomfortable emotions, and the less intense they get.

In terms of changing behaviors: A lot of our misery-inducing behaviors, I think, are a result of elements beyond our control. Like, for example, if our jobs are causing us to do things that then later we beat ourselves up over. What’s a way to address these larger things that can’t be solved by, say, eating healthier?

It’s about the choice points again. There is no magic formula, but there are things people can do. A lot of people think they have a great deal of urgency at work: Oh my gosh, look at all this paper that I have to get through. So the natural normal temptation would be let’s eat lunch at my desk, even though I hate that. I just don’t have the time for anything else.

And, in fact, if these people turn around and look at their histories they will realize Okay, when I eat lunch at my desk for a week in a row, I begin to feel overwhelmed and swamped by my work. But taking that short walk at lunch is in all likelihood not going to cause you to lose traction at work. You know, one of the groups of people I see in my practice a lot are executives, and they will often say things like they don’t have time to exercise. But, they will also be complaining that they have this tremendous brain fog, that they can’t really think straight. That kind of stuff. I’m constantly trying to indoctrinate them in the idea that exercise gives more time than it takes. Exercise is magical in that it creates time, because when you get back to work, and when you’re in better shape, you’re much more efficient, you’re more effective, you’re more motivated, you’re more interested by the work, and you will actually accomplish more than you would have if you’d never got up from behind your desk.

You bring up exercise a lot.

This doesn’t make a very interesting answer for a journalist, I suppose, but I think the answer is to exercise. In a couple of trials, there haven’t been enough, but there have been some pretty good ones, the effectiveness of exercise is approximately equal to antidepressants. The longevity of the positive effect is longer and the side effects are positive rather than negative. It’s beginning to look like exercise is probably the most powerful antidepressant we’ve got.

In the book you write about how people who have a more positive or optimistic outlook tend to do less self-evaluation than folks with a more negative outlook. What’s the trick to shifting or reducing our internal evaluations? It seems like they happen so quickly in the moment.

The element of the book you’re talking about is based on an observation that I and others have made, which is that self-esteem is a myth. It doesn’t really exist. Self-loathing exists, but self-esteem doesn’t. People who are happy tend not to walking thinking I feel happy in the way that people who are unhappy think I’m miserable. So rather than trying to convince yourself how wonderful you are and give yourself all kinds of positive affirmation, simply recognize that when you wake in the morning, before you start constructing your story about yourself and your life, mostly you’re actually kind of fine. The process is about recognizing the script that you write in your head that makes you feel miserable. Actually writing it down, getting it outside your head — all the reasons why you’re a terrible person and will never achieve anything and so on — tends to make them look less convincing. You start to see how your story about yourself isn’t necessarily true.

You realize that the internal interpretation isn’t in line with the external reality.

It begins to crack apart. Well, this is true; I have failed at that, but I haven’t failed at it every time I’ve tried it. This is a little bit extreme. We don’t need to contradict all of our negative thoughts, our negative beliefs about ourselves, but we need to begin recognizing that they are constructions. They’re not a complete nor even valid representation of reality.