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Anxiety, Stress, & Coping,
January 2008; 21(1): 3Á14


STAR 2006 CONFERENCEÁINVITED ARTICLE



The case for positive emotions in the stress process*


SUSAN FOLKMAN

UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco,
CA, USA



Abstract
For many decades, the stress process was described primarily in terms of negative emotions. However,
robust evidence that positive emotions co-occurred with negative emotions during intensely stressful
situations suggested the need to consider the possible roles of positive emotions in the stress process.
About 10 years ago, these possibilities were incorporated into a revision of stress and coping theory
(Folkman, 1997). This article summarizes the research reported during the intervening 10 years that
pertains to the revised model. Evidence has accumulated regarding the co-occurrence of positive and
negative emotions during stressful periods; the restorative function of positive emotions with respect
to physiological, psychological, and social coping resources; and the kinds of coping processes that
generate positive emotions including benefit finding and reminding, adaptive goal processes,
reordering priorities, and infusing ordinary events with positive meaning. Overall, the evidence
supports the propositions set forth in the revised model. Contrary to earlier tendencies to dismiss
positive emotions, the evidence indicates they have important functions in the stress process and are
related to coping processes that are distinct from those that regulate distress. Including positive
emotions in future studies will help address an imbalance between research and clinical practice due to
decades of nearly exclusive concern with the negative emotions.

Keywords: Stress, meaning-focused coping, positive emotion, coping theory, benefit finding, adaptive
goal processes, reordering priorities, positive meaningful events



One of the most exhilarating aspects of research is coming upon an unexpected finding that
prompts a new direction in thinking. In my case, the unexpected finding was the
observation that positive emotions and negative emotions co-occurred during the intensely
stressful experiences of caring for a dying loved one and then actually losing that person.
This finding first appeared in our longitudinal study of gay men who were the caregivers of
life partners dying of AIDS. The study took place in the 1990s, when AIDS was basically an
untreatable terminal illness with a horrific clinical course. I published these findings in 1997
(Folkman, 1997) and suggested revisions to the stress and coping theoretical model to


*This article was invited by the editors following Professor Folkman’s address at the 27th Stress and Anxiety
Research Conference held in July 2006 in Rethymnon, Crete, Greece
Correspondence: Susan Folkman, UCSF Osher Center for Integrative Medicine, Box 1726, UCSF, San Francisco,
CA 94143, USA. Tel: '1 415 353 7719. Fax: '1 415 353 7554. E-mail: folkman@ocim.ucsf.edu

ISSN 1061-5806 print/ISSN 1477-2205 online # 2008 Taylor & Francis
DOI: 10.1080/10615800701740457
4   S. Folkman

incorporate positive emotions. In the interim, a number of studies produced findings that
are relevant to the revised model. In this article, I revisit the propositions set forth in the
model in light of these findings. My overall goal in this is to advance stress and coping
theory and help establish directions for research and clinical care.


Positive and Negative Emotions Co-occur During Stressful Periods
Some may still question whether our observation that positive emotions co-occur with
negative ones during intensely stressful periods was anomalous. It was not. As noted in
Folkman (1997), positive emotions during stressful periods were observed in earlier studies
(Viney, 1986; Wortman & Silver, 1987), and others have since observed the same
phenomenon (e.g., Bonanno & Keltner, 1997; Larsen, McGraw, & Cacioppo, 2001;
Zautra, Affleck, Tennen, Reich, & Davis, 2005).
   Stress researchers’ lack of attention to the occurrence of positive emotions may have
stemmed from an assumption that positive emotions do not have adaptational significance,
as opposed to negative emotions, which are well known for mobilizing the fight/flight
response (Cannon, 1939) and focusing attention on the problem at hand (Frijda, 1988).
Interest in negative emotions has also been motivated by the accumulating body of research
showing their deleterious effects on health and well-being over the life span.
   Fredrickson’s (1998) ground-breaking ‘‘Broaden and Build Model’’ of positive emotions
has done a great deal to stimulate interest in the positive emotions. Her model provided the
framework for studies showing that positive emotions broaden the individual’s attentional
focus and behavioral repertoire, thereby replenishing the person’s social, intellectual,
and physical resources. The recent interest in positive psychology (e.g., Seligman &
Csikszentmihalyi, 2000) has also fuelled interest in positive emotions, with many reports
about their benefits now in the literature.
   A major review by Pressman and Cohen (2005) shows that positive emotions matter with
respect to morbidity, independent of negative affect. Positive emotions also matter with
respect to risk of mortality with several studies showing positive affect, and not negative
affect, predicting survival (e.g., Moskowitz, 2003; Ostir, Markides, Black, & Goodwin,
2000). In a series of six studies, King, Hicks, Krull, and Del Gaiso (2006) demonstrated
that positive moods may predispose people to feel that life is meaningful and increase their
sensitivity to the meaning relevance of a situation. Steptoe, Gibson, Hamer, and Wardle
(2007) found that positive affect is related to biological responses, including diurnal cortisol
patterns and systolic pressure. They concluded that ‘‘positive affect is related to biological
responses in the laboratory and everyday life that may be health protective’’ (p. 56).
   In contrast to the above studies, the revised stress and coping theoretical model focused
the question about positive emotions on their role in the stress process. That positive emotions
might have something to do with the stress process is an idea that has intrigued me for many
years. I remember posing this possibility to Richard Lazarus when I was a new graduate
student at Berkeley in the 1970s. His first response was surprise, and perhaps puzzlement.
However, Dick Lazarus was always ready to explore ideas, and in 1980, Lazarus, Kanner,
and I published a chapter in which we speculated that positive emotions might serve as
‘‘sustainers’’ that help motivate coping, ‘‘breathers’’ that provide momentary respite from
distress, and ‘‘restorers’’ that replenish coping resources (Lazarus, Kanner, & Folkman,
1980). This long standing interest in positive emotions in the stress process led to the
inclusion of measures of positive affect in the longitudinal studies of caregivers that we
conducted at UCSF during the 1990s.
Positive emotions in the stress process   5

  Studies about the beneficial effects of positive emotion in the context of stress are still few
in number and found mainly in the resilience literature. Fredrickson and her colleagues
found that positive emotions buffered resilient people against depression and fuelled
thriving in the aftermath of 9/11 (Fredrickson, Tugade, Waugh, & Larkin, 2003),
accelerated cardiovascular recovery from laboratory-induced negative emotional arousal
in people high and low in trait resilience, and helped individuals find positive meaning in
negative situations (Tugade & Fredrickson, 2004). Bonanno and his colleagues (Bonanno &
Keltner, 1997; Keltner & Bonanno, 1997) found that bereaved individuals who showed
laughter at least once during a narration about their lost relationship also reported better
adjustment. Interestingly, when untrained observers viewed video tapes of the narrations
with the sound off, the observers experienced more positive emotion and less frustration in
response to bereaved participants who laughed compared with bereaved participants who
did not laugh.

Stress and Coping Model
The Cognitive Theory of Stress and Coping (Lazarus, 1966; Lazarus & Folkman, 1984)
has always been and continues to be an appraisal-based model. In its earlier formulation,
the appraisal process was most heavily implicated during the outset of an event in the
evaluation of its personal significance (primary appraisal) and the evaluation of options for
coping (secondary appraisal). Together, the two forms of appraisal were said to determine
the extent to which the transaction was appraised as a harm, threat, or challenge. Harm
appraisals were accompanied by negative emotions such as sadness or anger and threat
appraisals were accompanied by negative emotions such as anxiety or fear. Positive
emotions such as excitement, eagerness, and confidence appeared in relation to challenge
appraisals (Folkman & Lazarus, 1985). Coping processes were initiated in response to the
appraised demands of the specific situation. Ideally, instrumental kinds of problem-focused
coping were used more in situations where something could be done, and emotion-focused
coping to regulate distress was used more in situations that had to be accepted. Positive
emotions such as happiness, relief, or pride also appeared when a situation was resolved
favorably (Lazarus & Folkman, 1984).
   The original model had little to say about what happened when the outcome was
unfavorable except that the appraisalÁemotionÁcopingÁreappraisal process would repeat
itself, thus producing the conditions of chronic stress. It was at this unlikely point Á when
situations are not favorably resolved Á that the revised model introduced a new category of
coping, meaning-focused coping, and positive emotions. The model hypothesizes that
following a failed resolution, the need to try again triggers meaning-focused coping.
Meaning-focused coping is said in turn to generate positive emotions and their underlying
appraisals, and these emotions and appraisals influence the stress process by restoring
coping resources and providing motivation needed in order to sustain problem-focused
coping over the long term. In addition, positive emotions were hypothesized to provide
relief from distress. The original model is shown in Figure 1 and the revised model is shown
in Figure 2.
   How have these propositions fared since 1997? What evidence is there for meaning-
focused coping in terms of its content, its timing in the stress process, and its relation to
positive emotions; do these coping processes and emotions have salubrious effects on
resources, appraisal, and well-being during stressful periods? To the extent possible in a
6   S. Folkman
                              Appraisal       Coping         Event              Emotion
                                                            Outcome             Outcome
                Event

                                              Problem-      Favorable        Positive emotion
                                Harm          focused

                                Threat
                                              Emotion-
                              Challenge       focused
                                                             Unfavorable
                                                                                Distress

                          Person:        Situation:
                        Dispositions     Demands
                           Beliefs       Resources
                           Goals



                                                       Negative Emotion

Figure 1. Original stress and coping model (Lazarus & Folkman, 1984).


brief review that covers diverse topics, I try to highlight what has been found and some of
the key issues that need to be considered.

Coping and Positive Emotions
One of the first questions we addressed in our caregiver research asked whether positive
emotions were associated with the same coping strategies people use to regulate distress.
The first inkling that some of the coping processes associated with the generation of positive
emotion were different from those associated with the regulation of distress came from an
analysis of positive and negative moods before and after bereavement in our study of AIDS


                        Appraisal           Coping            Event                  Emotion
                                                             Outcome                 Outcome
          Event
                           Harm             Problem-         Favorable
                                                                                   Positive emotion
                                            focused
                          Threat
                                            Emotion-
                        Challenge           focused          Unfavorable    Distress



                                                                            Mean-          Positive
                    Restores                                                               Emotion
                    Resources
                                                                             ing
                                                      Sustains             focused
                                                       Coping               Coping


                                            POSITIVE EMOTION
                                                      Negative Emotion
Figure 2. Revised stress and coping model (adapted from Folkman, 1997).
Positive emotions in the stress process   7

caregivers. Moskowitz, Folkman, Collette, and Vittinghoff (1996) found that some kinds of
coping were associated with negative and positive moods pre and post-bereavement, but
other kinds were associated primarily with either positive mood or negative mood. Problem-
focused coping and positive reappraisal, for example, were consistently associated with
positive mood, but inconsistently and more weakly associated with negative mood. It was
our qualitative analyses of narratives of stressful events, however, that took us to the next
level of understanding about coping and positive emotion and to our decision to define a
category of ‘‘meaning-focused’’ coping.

Meaning-focused Coping
Meaning-focused coping is, in its essence, appraisal-based coping in which the person
draws on his or her beliefs (e.g., religious, spiritual, or beliefs about justice), values (e.g.,
‘‘mattering’’), and existential goals (e.g., purpose in life or guiding principles) to motivate
and sustain coping and well-being during a difficult time (Park & Folkman, 1997; see also
Aldwin, 2007 for her discussion of transformational coping).
   In general, meaning-focused coping tends to be less situation-specific than both problem
and emotion-focused coping. In our first effort to distinguish among types of meaning-
focused coping, we identified four categories based on analyses of both quantitative data
from the Ways of Coping (Folkman & Lazarus, 1988) and qualitative data drawn from
nearly 2000 interviews about recently experienced stressful events. These categories were
positive reappraisal, revision of goals, spiritual beliefs, and the infusion of ordinary events
with positive meaning (Folkman, 1997; Folkman, Moskowitz, Ozer, & Park, 1997). We
later modified the list to include findings from reports in the rapidly expanding literature
and our own subsequent work, resulting in five categories: benefit finding, benefit
reminding, adaptive goal processes, reordering priorities, and infusing ordinary events
with positive meaning (Folkman & Moskowitz, 2007). Here, I briefly summarize what has
been learned by other researchers as well as our own research group about each of these
ways of generating positive emotion.

Benefit Finding
Affleck and Tennen’s seminal research on benefit finding (see Tennen & Affleck, 2002 for
review) and the growing interest of others in the related topic of stress-related growth
(Tedeschi, Park, & Calhoun, 1998; Park & Ai, 2006) has resulted in a substantial literature
(for reviews see Linley & Joseph, 2004; Helgeson, Reynolds, & Tomich, 2006). Benefit
finding is often assessed in terms of growth in wisdom, patience, and competence; greater
appreciation for life, greater clarity about what matters, strengthened faith or spirituality;
and improved quality of social relationships. It is by far the most commonly reported kind
of meaning-focused coping.
   Helgeson et al. (2006) published a meta-analysis of the relationship of benefit finding to
mental and physical health. Their definition of benefit finding was quite broad: ‘‘the
positive effects that result from a traumatic event’’ (p. 797). Within this broad definition
they make an important distinction between benefit finding as coping that reduces distress,
which refers to an ongoing difficult situation, and benefit finding as an outcome, which
refers to ‘‘actual change or growth’’ (p. 798).
   The meta-analysis showed that the only effect that approached a moderate size was the
relationship between benefit finding and positive well-being. At the level of small effect
size, benefit finding was associated with some negative states as well as some positive
8   S. Folkman

ones. This is consistent with other reports, indicating a consistent association with
positive affect and an inconsistent and usually weaker association with negative affect
(Linley & Joseph, 2004).
   Helgeson et al.’s (2006) review also provided intriguing findings regarding the timing of
benefit finding and its effects. The beneficial effects were greater when the time since the
traumatic event was more than 2 years. In contrast, when the event was less than 2 years in
the past, benefit finding was associated with increased distress. Based on this observation,
one could conclude that benefit finding caused distress. Another explanation suggested by
the revised stress and coping model is that meaning-focused coping such as benefit finding
comes into play when things are going badly. What we would expect to see when the
situation continues to be unresolved over time is a co-occurrence of positive emotions
generated by benefit finding and the negative emotions associated with the unwanted
outcome. In major stressful events, such as loss of a loved one, distress is likely to remain
elevated for several years (Carnelley, Wortman, Bolger, & Burke, 2006). Over time, we
would expect to see negative emotions decline and positive emotions get stronger.
   A clear sign that the literature on benefit finding is maturing is the controversies that are
appearing in the literature. Butler (2007) summarizes some of the key issues, namely,
whether to conceptualize the report of benefits as a means of coping as an adaptive
mechanism or a defensive, self-protective maneuver, as an outcome in and of itself
representing true change, or as something else altogether.
   Whether or not benefit finding is a defensive, self-protective maneuver is a question that
is asked more generally with respect to research on positive aspects of psychology. ‘‘Even
when positive aspects of human functioning are studied, negative motives are frequently
ascribed to them, resulting in some fundamental misunderstandings of positive phenom-
ena’’ (Aspinwall & MacNamara, 2005, p. 2549). Benefit finding could be maladaptive if it
impedes important problem-focused coping such as information gathering and evaluating,
decision-making, or relationship repair. However, research by Aspinwall and her colleagues
indicates that positive beliefs and states serve as resources that actually facilitate these
processes, allowing people to consider negative information appropriately, and further,
fostering greater selectivity in the allocation of effort to problems, based on whether the
problems are controllable (Aspinwall & MacNamara, 2005).
   The question about whether the benefits that are appraised at the outcome are actual also
seems to reflect many psychologists’ general suspicion about positive states of mind in
the stress process. Whether or not the benefits are actual, which is probably difficult to
determine in many instances, seems less important than whether the person believes
the benefits are actual, especially when such benefits relate to psychosocial resources. The
perception of benefit, for example, can restore self-confidence, which is an important
resource for both appraisal and coping. An inaccurate estimate of some perceived benefits,
however, such as the acquisition of skill, could prove detrimental in future outcomes. An
overestimation of one’s medical knowledge following extensive caregiving, for example,
could result in harm to another person.

Benefit Reminding
Tennen and Affleck (2002) distinguish benefit reminding from benefit finding as effortful
cognitions in which the individual reminds himself/herself of the possible benefits stemming
from the stressful experience. Benefit reminding is a form of meaning-focused coping that
occurs during the stressful situation. Tennen and Affleck’s research on benefit reminding
involved patients suffering from fibromyalgia who were asked to keep a daily diary and to
Positive emotions in the stress process   9

indicate how much that day they had reminded themselves of the benefits of their chronic
pain. On days when these patients made greater efforts to remind themselves of the benefits
that had come from their illness, they were more likely to experience pleasurable mood,
regardless of the pain they had experienced that day.
  The distinction between benefit reminding and benefit finding becomes blurred unless
benefit finding is labelled as an outcome. However, as noted above, the distinction may be
arbitrary and depends on where in the stress process the variable is measured.

Adaptive Goal Processes
Goals are involved in many meaning-focused functions. As noted in Folkman (1997), the
simple act of creating a to-do list when things feel completely out of control is not only
useful for instrumental coping, but it also creates a sense of mastery and control, even if
only for a few moments. Higher order goals provide a sense of meaning and purpose
(Baumeister, 1991; Park & Folkman, 1997) and structure and unity to people’s lives
(Baumeister, 1991; Emmons, Colby, & Kaiser, 1998). Goals motivate choices people make,
and reminding oneself of these higher order goals can help sustain efforts to achieve them,
even when those goals are threatened.
   Under ordinary circumstances, the pursuit of meaningful, realistic goals is a basis of
the appraisal of challenge, flavored with positive emotions. However, stressful situations
are often stressful precisely because they threaten or harm valued goals. Elsewhere we
have stated that a central tenet of effective coping is the ability to determine when a goal
is no longer tenable, relinquish that goal, and substitute a new goal that is both
meaningful and realistic (Stein, Folkman, Trabasso, & Richards, 1997). Carver and
Scheier (1998) and their colleagues speak of adaptive self-regulation, which they have
explored in a series of fascinating studies (e.g., Wrosch, Scheier, Miller, Schulz, &
Carver, 2003). Wrosch et al. proposed ‘‘that in situations in which people are confronted
with unattainable goals, benefits accrue from the capacities to abandon goal-directed
activities and to reengage in valued alternative goals. By having new goals available
and reengaging in those new goals, a person can reduce the distress that arises from the
desire to attain the unattainable while continuing to derive a sense of purpose in life by
finding other pursuits of value’’ (pp. 1494Á1495). In a series of studies, they found that
disengagement from unattainable goals was independently associated with high levels of
self-mastery and low levels of depressive symptoms, and the tendencies to reengage in
new goals predicted subjective well-being beyond what was explained by relinquishing
unattainable goals.
   Wrosch et al. (2003) stated that the key to maintaining well-being comes not just from
giving up goals that do not work, but in substituting new ones that are meaningful, or
‘‘valuable’’ to use their word, which closely parallels our concept of adaptive goal processes.
In both cases, the meaning attached to the new goal is motivational. Brunstein and
Gollwitzer (1996), for example, found that failure on tasks that involved a self-defining goal
led to enhanced performance on a subsequent task as long as that task also involved a self-
defining (i.e., meaningful or valued) goal, but if the goal was not self-defining (i.e., not
meaningful), the performance was inferior.
   While the concept of adaptive self-regulation is very pertinent to the discussion of coping
that sustains people when situations go badly, it does raise some interesting and provocative
questions. The focus on relinquishing untenable goals glosses over the often profoundly
difficult question: How do we know when to give up? Sometimes information is so clear that
there is no question about whether a goal is tenable: ‘‘You are fired’’ usually means that you
10   S. Folkman

need to give up the goal that you had with respect to having that particular job. However,
what about ‘‘You need to improve your work’’ or ‘‘I am not happy in this marriage.’’ The
evaluation of threats to goals involves a psychological calculus that weighs odds of success
and failure; the value attached to the goal (e.g., where threatened goal sits in the goal
hierarchy), which affects the costs of giving up or persisting; and the availability of goals that
can be substituted for the one that is threatened. Giving up a goal prematurely can be as
damaging as persisting too long.
   A rich and well-established literature on goals originally focused largely on the structure
of goal hierarchies, substitutability, and complexity (e.g., Miller, Galanter, & Pribram,
1960). Although more recently, goals have been examined in relation to their motivational
(e.g., Kruglanski, Shah, Fischbach, Friedman, & Chun, 2002) and self-regulatory proper-
ties (Carver & Scheier, 1998), the issue of when to give up a valued goal in real life involves
a complex calculus that probably eludes neat, structural models.
   A second issue has to do with what happens after a goal is in fact appraised as unrealistic
and the decision is made to relinquish it. Yielding goals that were previously valued is a
stressful process that involves loss and the distress associated with that loss (Klinger, 1977).
The process of disengaging is analogous to the process of coming to terms with the loss of a
loved one. In their dual process model of coping with bereavement, Stroebe and Schut
(2001) described a process of oscillation between loss-oriented coping and restoration-
oriented coping. The oscillatory pattern of coping is also consistent with Carver and
Scheier’s (1998) self-regulatory theory. The process of goal revision is obviously complex
and as a consequence we should expect it to generate a complex and dynamic picture of
positive and negative emotions. The oscillation described by Stroebe and Schut, as well as
Carver and Scheier can explain variability in the mix of positive and negative emotions while
the disengagement process is still underway.
   Sometimes goals are tied to fundamental beliefs that shape the person’s way of viewing
himself or herself and the world around. To give up a goal also means giving up the belief.
Consider decisions to emigrate from one’s country because one is no longer safe there, or
making the decision to stop seeking treatment for cancer. Relinquishing the goal of
remaining in one’s country or giving up the goal of finding an effective treatment for cancer
each involves changing beliefs about oneself and the world (Park & Folkman, 1997), and
this can be a shattering experience (Janoff-Bulman, 1992). Fascinating questions concern
how positive emotions help a person navigate the recovery from shattered beliefs and the
movement toward new goals.


Reordering Priorities
The recognition that priorities need to be reordered is one of the more common responses
to serious stressful events, both acute and chronic. Comments such as ‘‘my perspective
changed’’ or ‘‘I focused on what really matters’’ reflect the coping response to a changed
reality.
  The reordering of priorities is a value-based process. Things that now matter more move
up the ladder; things that now matter less move down. This reordering process can be
deliberate or it can seemingly ‘‘just happen.’’
  The reordering of priorities can be a very stressful process in itself. To acknowledge that
priorities need to be reordered involves an acceptance by the individual that his/her world
has changed, that things are not as they were or as they were expected to be. The person
appraises his or her world differently now than before.
Positive emotions in the stress process   11

   However, the process should also provide the basis for a renewed sense of purpose
(Stroebe & Schut, 2001). Knowing what matters most now, in this changed reality, is an
essential ingredient for formulating goals, allocating resources, and determining strategies
for moving forward.
   The reordering process can also lead to increased coping efficiency by narrowing the
person’s focus: ‘‘I decided that the most important thing in my life was to get better, and
that is what I am concentrating on.’’ For example, in a study of maternal caregivers of
children with chronic conditions, there was evidence of a major shift in priorities: 47% of
the maternal caregivers quit working outside the home in order to care for their child
(Wilson et al., 2005)
   Similar to the process of giving up meaningful goals, the reordering of priorities can exact
a toll. A decision to quit work in order to take care of a sick child, for example, can lead to
loss of income and increased financial strain. Thus, in real life, the reordering of priorities
may improve well-being because values and goals are aligned meaningfully for the
individual, but at the same time, the realignment process can lead to secondary stressors
and negative emotions. Accordingly, we would expect to see both negative and positive
emotions.


Infusing Ordinary Events with Positive Meaning
We first observed this form of coping in the study of gay caregivers mentioned earlier.
Participants requested that we interview them about positive aspects of their lives as well as
the stressful aspects, and so we inserted a question in the interview that asked for an
account of a positive event that helped the person get through the day (Folkman et al.,
1997). What struck us was not the content of the events, which were just ordinary events
such as receiving a word of gratitude or praise, taking care of business, enjoying a good
movie, or watching a beautiful sunrise, but that these events were reported even under the
most dire circumstances. It was as if people took ordinary events and deliberately infused
them with positive meaning in order to experience a positive moment, providing the
‘‘breather’’ hypothesized by Lazarus et al. (1980).
   The creation of positive moments out of ordinary events is consistent with Tugade and
Fredrickson’s (2006) observation that people generally want to feel good. Tugade and
Fredrickson also pointed out that it is common for people to try to prolong pleasant feelings
by, for example, sharing their news with close friends and loved ones (for review, see Isen,
2000) or by savoring (Bryant, 1989). Our studies indicate that the same motive is operative
when times are difficult, and in fact I suggest that the desire to feel good takes on critical
importance for maintaining mental and physical well-being during difficult times.

Where We Are Now
The revised stress and coping model (Folkman, 1997) made a place for positive emotions in
the stress process. There is now substantial evidence that positive emotions are a normative
aspect of the stress process and that they help restore physiological and psychosocial coping
resources. Less is known about the full range of coping processes, including their content,
timing, and duration, which are associated with the regulation of positive as opposed to
negative emotions. However, what evidence we do have suggests that underlying beliefs,
values, and goals are heavily implicated in these coping processes and that the regulation of
meaning is the key common theme.
12    S. Folkman

   We have only begun the work of defining and systematizing meaning-focused coping. It
is important to be more comprehensive in its exploration than studies have been thus far.
For example, in addition to the types of coping summarized in this article, religious and
spiritual coping processes are involved in meaning-based coping, as are strategies related
to forgiveness and gratitude. Which of these are related primarily to positive emotions?
What coping processes have we overlooked? What is the best way to classify these
meaning-focused strategies? And, of course, what is the best way to measure them? The
difficulties in measuring coping are well known (for review, see Folkman & Moskowitz,
2004; Schwarzer & Schwarzer, 1996) and there is no reason to think the measurement of
meaning-based coping will be different.
   For both researchers and clinicians, it is important to maintain a balanced perspective
regarding the role of positive emotions in the stress process. This stress process is
strongly characterized by negative emotions and the inclusion of positive emotions in the
model is just that, inclusion. However, the evidence suggests that the positive emotions
have important adaptational significance and that these emotions are generated by
identifiable coping processes. Stress researchers need to include positive emotions in their
studies to learn more about how people generate and sustain them and to further explore
their adaptational significance in relation to physiological, psychological, and social
outcomes. Clinicians need to give attention to positive emotions with their clients, and
explore the sources of such emotions and how to generate and sustain them. This
attention to positive emotions will address the imbalance between stress research and
clinical practice that has resulted from decades of nearly exclusive concern with the
negative emotions.


Acknowledgements
The writing of this article was supported in part by NIH PO1 AT2024. I thank Judy
Moskowitz for her comments on a previous version of this article.


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  Personality, 73, 1Á28.
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  • 1. Anxiety, Stress, & Coping, January 2008; 21(1): 3Á14 STAR 2006 CONFERENCEÁINVITED ARTICLE The case for positive emotions in the stress process* SUSAN FOLKMAN UCSF Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, USA Abstract For many decades, the stress process was described primarily in terms of negative emotions. However, robust evidence that positive emotions co-occurred with negative emotions during intensely stressful situations suggested the need to consider the possible roles of positive emotions in the stress process. About 10 years ago, these possibilities were incorporated into a revision of stress and coping theory (Folkman, 1997). This article summarizes the research reported during the intervening 10 years that pertains to the revised model. Evidence has accumulated regarding the co-occurrence of positive and negative emotions during stressful periods; the restorative function of positive emotions with respect to physiological, psychological, and social coping resources; and the kinds of coping processes that generate positive emotions including benefit finding and reminding, adaptive goal processes, reordering priorities, and infusing ordinary events with positive meaning. Overall, the evidence supports the propositions set forth in the revised model. Contrary to earlier tendencies to dismiss positive emotions, the evidence indicates they have important functions in the stress process and are related to coping processes that are distinct from those that regulate distress. Including positive emotions in future studies will help address an imbalance between research and clinical practice due to decades of nearly exclusive concern with the negative emotions. Keywords: Stress, meaning-focused coping, positive emotion, coping theory, benefit finding, adaptive goal processes, reordering priorities, positive meaningful events One of the most exhilarating aspects of research is coming upon an unexpected finding that prompts a new direction in thinking. In my case, the unexpected finding was the observation that positive emotions and negative emotions co-occurred during the intensely stressful experiences of caring for a dying loved one and then actually losing that person. This finding first appeared in our longitudinal study of gay men who were the caregivers of life partners dying of AIDS. The study took place in the 1990s, when AIDS was basically an untreatable terminal illness with a horrific clinical course. I published these findings in 1997 (Folkman, 1997) and suggested revisions to the stress and coping theoretical model to *This article was invited by the editors following Professor Folkman’s address at the 27th Stress and Anxiety Research Conference held in July 2006 in Rethymnon, Crete, Greece Correspondence: Susan Folkman, UCSF Osher Center for Integrative Medicine, Box 1726, UCSF, San Francisco, CA 94143, USA. Tel: '1 415 353 7719. Fax: '1 415 353 7554. E-mail: folkman@ocim.ucsf.edu ISSN 1061-5806 print/ISSN 1477-2205 online # 2008 Taylor & Francis DOI: 10.1080/10615800701740457
  • 2. 4 S. Folkman incorporate positive emotions. In the interim, a number of studies produced findings that are relevant to the revised model. In this article, I revisit the propositions set forth in the model in light of these findings. My overall goal in this is to advance stress and coping theory and help establish directions for research and clinical care. Positive and Negative Emotions Co-occur During Stressful Periods Some may still question whether our observation that positive emotions co-occur with negative ones during intensely stressful periods was anomalous. It was not. As noted in Folkman (1997), positive emotions during stressful periods were observed in earlier studies (Viney, 1986; Wortman & Silver, 1987), and others have since observed the same phenomenon (e.g., Bonanno & Keltner, 1997; Larsen, McGraw, & Cacioppo, 2001; Zautra, Affleck, Tennen, Reich, & Davis, 2005). Stress researchers’ lack of attention to the occurrence of positive emotions may have stemmed from an assumption that positive emotions do not have adaptational significance, as opposed to negative emotions, which are well known for mobilizing the fight/flight response (Cannon, 1939) and focusing attention on the problem at hand (Frijda, 1988). Interest in negative emotions has also been motivated by the accumulating body of research showing their deleterious effects on health and well-being over the life span. Fredrickson’s (1998) ground-breaking ‘‘Broaden and Build Model’’ of positive emotions has done a great deal to stimulate interest in the positive emotions. Her model provided the framework for studies showing that positive emotions broaden the individual’s attentional focus and behavioral repertoire, thereby replenishing the person’s social, intellectual, and physical resources. The recent interest in positive psychology (e.g., Seligman & Csikszentmihalyi, 2000) has also fuelled interest in positive emotions, with many reports about their benefits now in the literature. A major review by Pressman and Cohen (2005) shows that positive emotions matter with respect to morbidity, independent of negative affect. Positive emotions also matter with respect to risk of mortality with several studies showing positive affect, and not negative affect, predicting survival (e.g., Moskowitz, 2003; Ostir, Markides, Black, & Goodwin, 2000). In a series of six studies, King, Hicks, Krull, and Del Gaiso (2006) demonstrated that positive moods may predispose people to feel that life is meaningful and increase their sensitivity to the meaning relevance of a situation. Steptoe, Gibson, Hamer, and Wardle (2007) found that positive affect is related to biological responses, including diurnal cortisol patterns and systolic pressure. They concluded that ‘‘positive affect is related to biological responses in the laboratory and everyday life that may be health protective’’ (p. 56). In contrast to the above studies, the revised stress and coping theoretical model focused the question about positive emotions on their role in the stress process. That positive emotions might have something to do with the stress process is an idea that has intrigued me for many years. I remember posing this possibility to Richard Lazarus when I was a new graduate student at Berkeley in the 1970s. His first response was surprise, and perhaps puzzlement. However, Dick Lazarus was always ready to explore ideas, and in 1980, Lazarus, Kanner, and I published a chapter in which we speculated that positive emotions might serve as ‘‘sustainers’’ that help motivate coping, ‘‘breathers’’ that provide momentary respite from distress, and ‘‘restorers’’ that replenish coping resources (Lazarus, Kanner, & Folkman, 1980). This long standing interest in positive emotions in the stress process led to the inclusion of measures of positive affect in the longitudinal studies of caregivers that we conducted at UCSF during the 1990s.
  • 3. Positive emotions in the stress process 5 Studies about the beneficial effects of positive emotion in the context of stress are still few in number and found mainly in the resilience literature. Fredrickson and her colleagues found that positive emotions buffered resilient people against depression and fuelled thriving in the aftermath of 9/11 (Fredrickson, Tugade, Waugh, & Larkin, 2003), accelerated cardiovascular recovery from laboratory-induced negative emotional arousal in people high and low in trait resilience, and helped individuals find positive meaning in negative situations (Tugade & Fredrickson, 2004). Bonanno and his colleagues (Bonanno & Keltner, 1997; Keltner & Bonanno, 1997) found that bereaved individuals who showed laughter at least once during a narration about their lost relationship also reported better adjustment. Interestingly, when untrained observers viewed video tapes of the narrations with the sound off, the observers experienced more positive emotion and less frustration in response to bereaved participants who laughed compared with bereaved participants who did not laugh. Stress and Coping Model The Cognitive Theory of Stress and Coping (Lazarus, 1966; Lazarus & Folkman, 1984) has always been and continues to be an appraisal-based model. In its earlier formulation, the appraisal process was most heavily implicated during the outset of an event in the evaluation of its personal significance (primary appraisal) and the evaluation of options for coping (secondary appraisal). Together, the two forms of appraisal were said to determine the extent to which the transaction was appraised as a harm, threat, or challenge. Harm appraisals were accompanied by negative emotions such as sadness or anger and threat appraisals were accompanied by negative emotions such as anxiety or fear. Positive emotions such as excitement, eagerness, and confidence appeared in relation to challenge appraisals (Folkman & Lazarus, 1985). Coping processes were initiated in response to the appraised demands of the specific situation. Ideally, instrumental kinds of problem-focused coping were used more in situations where something could be done, and emotion-focused coping to regulate distress was used more in situations that had to be accepted. Positive emotions such as happiness, relief, or pride also appeared when a situation was resolved favorably (Lazarus & Folkman, 1984). The original model had little to say about what happened when the outcome was unfavorable except that the appraisalÁemotionÁcopingÁreappraisal process would repeat itself, thus producing the conditions of chronic stress. It was at this unlikely point Á when situations are not favorably resolved Á that the revised model introduced a new category of coping, meaning-focused coping, and positive emotions. The model hypothesizes that following a failed resolution, the need to try again triggers meaning-focused coping. Meaning-focused coping is said in turn to generate positive emotions and their underlying appraisals, and these emotions and appraisals influence the stress process by restoring coping resources and providing motivation needed in order to sustain problem-focused coping over the long term. In addition, positive emotions were hypothesized to provide relief from distress. The original model is shown in Figure 1 and the revised model is shown in Figure 2. How have these propositions fared since 1997? What evidence is there for meaning- focused coping in terms of its content, its timing in the stress process, and its relation to positive emotions; do these coping processes and emotions have salubrious effects on resources, appraisal, and well-being during stressful periods? To the extent possible in a
  • 4. 6 S. Folkman Appraisal Coping Event Emotion Outcome Outcome Event Problem- Favorable Positive emotion Harm focused Threat Emotion- Challenge focused Unfavorable Distress Person: Situation: Dispositions Demands Beliefs Resources Goals Negative Emotion Figure 1. Original stress and coping model (Lazarus & Folkman, 1984). brief review that covers diverse topics, I try to highlight what has been found and some of the key issues that need to be considered. Coping and Positive Emotions One of the first questions we addressed in our caregiver research asked whether positive emotions were associated with the same coping strategies people use to regulate distress. The first inkling that some of the coping processes associated with the generation of positive emotion were different from those associated with the regulation of distress came from an analysis of positive and negative moods before and after bereavement in our study of AIDS Appraisal Coping Event Emotion Outcome Outcome Event Harm Problem- Favorable Positive emotion focused Threat Emotion- Challenge focused Unfavorable Distress Mean- Positive Restores Emotion Resources ing Sustains focused Coping Coping POSITIVE EMOTION Negative Emotion Figure 2. Revised stress and coping model (adapted from Folkman, 1997).
  • 5. Positive emotions in the stress process 7 caregivers. Moskowitz, Folkman, Collette, and Vittinghoff (1996) found that some kinds of coping were associated with negative and positive moods pre and post-bereavement, but other kinds were associated primarily with either positive mood or negative mood. Problem- focused coping and positive reappraisal, for example, were consistently associated with positive mood, but inconsistently and more weakly associated with negative mood. It was our qualitative analyses of narratives of stressful events, however, that took us to the next level of understanding about coping and positive emotion and to our decision to define a category of ‘‘meaning-focused’’ coping. Meaning-focused Coping Meaning-focused coping is, in its essence, appraisal-based coping in which the person draws on his or her beliefs (e.g., religious, spiritual, or beliefs about justice), values (e.g., ‘‘mattering’’), and existential goals (e.g., purpose in life or guiding principles) to motivate and sustain coping and well-being during a difficult time (Park & Folkman, 1997; see also Aldwin, 2007 for her discussion of transformational coping). In general, meaning-focused coping tends to be less situation-specific than both problem and emotion-focused coping. In our first effort to distinguish among types of meaning- focused coping, we identified four categories based on analyses of both quantitative data from the Ways of Coping (Folkman & Lazarus, 1988) and qualitative data drawn from nearly 2000 interviews about recently experienced stressful events. These categories were positive reappraisal, revision of goals, spiritual beliefs, and the infusion of ordinary events with positive meaning (Folkman, 1997; Folkman, Moskowitz, Ozer, & Park, 1997). We later modified the list to include findings from reports in the rapidly expanding literature and our own subsequent work, resulting in five categories: benefit finding, benefit reminding, adaptive goal processes, reordering priorities, and infusing ordinary events with positive meaning (Folkman & Moskowitz, 2007). Here, I briefly summarize what has been learned by other researchers as well as our own research group about each of these ways of generating positive emotion. Benefit Finding Affleck and Tennen’s seminal research on benefit finding (see Tennen & Affleck, 2002 for review) and the growing interest of others in the related topic of stress-related growth (Tedeschi, Park, & Calhoun, 1998; Park & Ai, 2006) has resulted in a substantial literature (for reviews see Linley & Joseph, 2004; Helgeson, Reynolds, & Tomich, 2006). Benefit finding is often assessed in terms of growth in wisdom, patience, and competence; greater appreciation for life, greater clarity about what matters, strengthened faith or spirituality; and improved quality of social relationships. It is by far the most commonly reported kind of meaning-focused coping. Helgeson et al. (2006) published a meta-analysis of the relationship of benefit finding to mental and physical health. Their definition of benefit finding was quite broad: ‘‘the positive effects that result from a traumatic event’’ (p. 797). Within this broad definition they make an important distinction between benefit finding as coping that reduces distress, which refers to an ongoing difficult situation, and benefit finding as an outcome, which refers to ‘‘actual change or growth’’ (p. 798). The meta-analysis showed that the only effect that approached a moderate size was the relationship between benefit finding and positive well-being. At the level of small effect size, benefit finding was associated with some negative states as well as some positive
  • 6. 8 S. Folkman ones. This is consistent with other reports, indicating a consistent association with positive affect and an inconsistent and usually weaker association with negative affect (Linley & Joseph, 2004). Helgeson et al.’s (2006) review also provided intriguing findings regarding the timing of benefit finding and its effects. The beneficial effects were greater when the time since the traumatic event was more than 2 years. In contrast, when the event was less than 2 years in the past, benefit finding was associated with increased distress. Based on this observation, one could conclude that benefit finding caused distress. Another explanation suggested by the revised stress and coping model is that meaning-focused coping such as benefit finding comes into play when things are going badly. What we would expect to see when the situation continues to be unresolved over time is a co-occurrence of positive emotions generated by benefit finding and the negative emotions associated with the unwanted outcome. In major stressful events, such as loss of a loved one, distress is likely to remain elevated for several years (Carnelley, Wortman, Bolger, & Burke, 2006). Over time, we would expect to see negative emotions decline and positive emotions get stronger. A clear sign that the literature on benefit finding is maturing is the controversies that are appearing in the literature. Butler (2007) summarizes some of the key issues, namely, whether to conceptualize the report of benefits as a means of coping as an adaptive mechanism or a defensive, self-protective maneuver, as an outcome in and of itself representing true change, or as something else altogether. Whether or not benefit finding is a defensive, self-protective maneuver is a question that is asked more generally with respect to research on positive aspects of psychology. ‘‘Even when positive aspects of human functioning are studied, negative motives are frequently ascribed to them, resulting in some fundamental misunderstandings of positive phenom- ena’’ (Aspinwall & MacNamara, 2005, p. 2549). Benefit finding could be maladaptive if it impedes important problem-focused coping such as information gathering and evaluating, decision-making, or relationship repair. However, research by Aspinwall and her colleagues indicates that positive beliefs and states serve as resources that actually facilitate these processes, allowing people to consider negative information appropriately, and further, fostering greater selectivity in the allocation of effort to problems, based on whether the problems are controllable (Aspinwall & MacNamara, 2005). The question about whether the benefits that are appraised at the outcome are actual also seems to reflect many psychologists’ general suspicion about positive states of mind in the stress process. Whether or not the benefits are actual, which is probably difficult to determine in many instances, seems less important than whether the person believes the benefits are actual, especially when such benefits relate to psychosocial resources. The perception of benefit, for example, can restore self-confidence, which is an important resource for both appraisal and coping. An inaccurate estimate of some perceived benefits, however, such as the acquisition of skill, could prove detrimental in future outcomes. An overestimation of one’s medical knowledge following extensive caregiving, for example, could result in harm to another person. Benefit Reminding Tennen and Affleck (2002) distinguish benefit reminding from benefit finding as effortful cognitions in which the individual reminds himself/herself of the possible benefits stemming from the stressful experience. Benefit reminding is a form of meaning-focused coping that occurs during the stressful situation. Tennen and Affleck’s research on benefit reminding involved patients suffering from fibromyalgia who were asked to keep a daily diary and to
  • 7. Positive emotions in the stress process 9 indicate how much that day they had reminded themselves of the benefits of their chronic pain. On days when these patients made greater efforts to remind themselves of the benefits that had come from their illness, they were more likely to experience pleasurable mood, regardless of the pain they had experienced that day. The distinction between benefit reminding and benefit finding becomes blurred unless benefit finding is labelled as an outcome. However, as noted above, the distinction may be arbitrary and depends on where in the stress process the variable is measured. Adaptive Goal Processes Goals are involved in many meaning-focused functions. As noted in Folkman (1997), the simple act of creating a to-do list when things feel completely out of control is not only useful for instrumental coping, but it also creates a sense of mastery and control, even if only for a few moments. Higher order goals provide a sense of meaning and purpose (Baumeister, 1991; Park & Folkman, 1997) and structure and unity to people’s lives (Baumeister, 1991; Emmons, Colby, & Kaiser, 1998). Goals motivate choices people make, and reminding oneself of these higher order goals can help sustain efforts to achieve them, even when those goals are threatened. Under ordinary circumstances, the pursuit of meaningful, realistic goals is a basis of the appraisal of challenge, flavored with positive emotions. However, stressful situations are often stressful precisely because they threaten or harm valued goals. Elsewhere we have stated that a central tenet of effective coping is the ability to determine when a goal is no longer tenable, relinquish that goal, and substitute a new goal that is both meaningful and realistic (Stein, Folkman, Trabasso, & Richards, 1997). Carver and Scheier (1998) and their colleagues speak of adaptive self-regulation, which they have explored in a series of fascinating studies (e.g., Wrosch, Scheier, Miller, Schulz, & Carver, 2003). Wrosch et al. proposed ‘‘that in situations in which people are confronted with unattainable goals, benefits accrue from the capacities to abandon goal-directed activities and to reengage in valued alternative goals. By having new goals available and reengaging in those new goals, a person can reduce the distress that arises from the desire to attain the unattainable while continuing to derive a sense of purpose in life by finding other pursuits of value’’ (pp. 1494Á1495). In a series of studies, they found that disengagement from unattainable goals was independently associated with high levels of self-mastery and low levels of depressive symptoms, and the tendencies to reengage in new goals predicted subjective well-being beyond what was explained by relinquishing unattainable goals. Wrosch et al. (2003) stated that the key to maintaining well-being comes not just from giving up goals that do not work, but in substituting new ones that are meaningful, or ‘‘valuable’’ to use their word, which closely parallels our concept of adaptive goal processes. In both cases, the meaning attached to the new goal is motivational. Brunstein and Gollwitzer (1996), for example, found that failure on tasks that involved a self-defining goal led to enhanced performance on a subsequent task as long as that task also involved a self- defining (i.e., meaningful or valued) goal, but if the goal was not self-defining (i.e., not meaningful), the performance was inferior. While the concept of adaptive self-regulation is very pertinent to the discussion of coping that sustains people when situations go badly, it does raise some interesting and provocative questions. The focus on relinquishing untenable goals glosses over the often profoundly difficult question: How do we know when to give up? Sometimes information is so clear that there is no question about whether a goal is tenable: ‘‘You are fired’’ usually means that you
  • 8. 10 S. Folkman need to give up the goal that you had with respect to having that particular job. However, what about ‘‘You need to improve your work’’ or ‘‘I am not happy in this marriage.’’ The evaluation of threats to goals involves a psychological calculus that weighs odds of success and failure; the value attached to the goal (e.g., where threatened goal sits in the goal hierarchy), which affects the costs of giving up or persisting; and the availability of goals that can be substituted for the one that is threatened. Giving up a goal prematurely can be as damaging as persisting too long. A rich and well-established literature on goals originally focused largely on the structure of goal hierarchies, substitutability, and complexity (e.g., Miller, Galanter, & Pribram, 1960). Although more recently, goals have been examined in relation to their motivational (e.g., Kruglanski, Shah, Fischbach, Friedman, & Chun, 2002) and self-regulatory proper- ties (Carver & Scheier, 1998), the issue of when to give up a valued goal in real life involves a complex calculus that probably eludes neat, structural models. A second issue has to do with what happens after a goal is in fact appraised as unrealistic and the decision is made to relinquish it. Yielding goals that were previously valued is a stressful process that involves loss and the distress associated with that loss (Klinger, 1977). The process of disengaging is analogous to the process of coming to terms with the loss of a loved one. In their dual process model of coping with bereavement, Stroebe and Schut (2001) described a process of oscillation between loss-oriented coping and restoration- oriented coping. The oscillatory pattern of coping is also consistent with Carver and Scheier’s (1998) self-regulatory theory. The process of goal revision is obviously complex and as a consequence we should expect it to generate a complex and dynamic picture of positive and negative emotions. The oscillation described by Stroebe and Schut, as well as Carver and Scheier can explain variability in the mix of positive and negative emotions while the disengagement process is still underway. Sometimes goals are tied to fundamental beliefs that shape the person’s way of viewing himself or herself and the world around. To give up a goal also means giving up the belief. Consider decisions to emigrate from one’s country because one is no longer safe there, or making the decision to stop seeking treatment for cancer. Relinquishing the goal of remaining in one’s country or giving up the goal of finding an effective treatment for cancer each involves changing beliefs about oneself and the world (Park & Folkman, 1997), and this can be a shattering experience (Janoff-Bulman, 1992). Fascinating questions concern how positive emotions help a person navigate the recovery from shattered beliefs and the movement toward new goals. Reordering Priorities The recognition that priorities need to be reordered is one of the more common responses to serious stressful events, both acute and chronic. Comments such as ‘‘my perspective changed’’ or ‘‘I focused on what really matters’’ reflect the coping response to a changed reality. The reordering of priorities is a value-based process. Things that now matter more move up the ladder; things that now matter less move down. This reordering process can be deliberate or it can seemingly ‘‘just happen.’’ The reordering of priorities can be a very stressful process in itself. To acknowledge that priorities need to be reordered involves an acceptance by the individual that his/her world has changed, that things are not as they were or as they were expected to be. The person appraises his or her world differently now than before.
  • 9. Positive emotions in the stress process 11 However, the process should also provide the basis for a renewed sense of purpose (Stroebe & Schut, 2001). Knowing what matters most now, in this changed reality, is an essential ingredient for formulating goals, allocating resources, and determining strategies for moving forward. The reordering process can also lead to increased coping efficiency by narrowing the person’s focus: ‘‘I decided that the most important thing in my life was to get better, and that is what I am concentrating on.’’ For example, in a study of maternal caregivers of children with chronic conditions, there was evidence of a major shift in priorities: 47% of the maternal caregivers quit working outside the home in order to care for their child (Wilson et al., 2005) Similar to the process of giving up meaningful goals, the reordering of priorities can exact a toll. A decision to quit work in order to take care of a sick child, for example, can lead to loss of income and increased financial strain. Thus, in real life, the reordering of priorities may improve well-being because values and goals are aligned meaningfully for the individual, but at the same time, the realignment process can lead to secondary stressors and negative emotions. Accordingly, we would expect to see both negative and positive emotions. Infusing Ordinary Events with Positive Meaning We first observed this form of coping in the study of gay caregivers mentioned earlier. Participants requested that we interview them about positive aspects of their lives as well as the stressful aspects, and so we inserted a question in the interview that asked for an account of a positive event that helped the person get through the day (Folkman et al., 1997). What struck us was not the content of the events, which were just ordinary events such as receiving a word of gratitude or praise, taking care of business, enjoying a good movie, or watching a beautiful sunrise, but that these events were reported even under the most dire circumstances. It was as if people took ordinary events and deliberately infused them with positive meaning in order to experience a positive moment, providing the ‘‘breather’’ hypothesized by Lazarus et al. (1980). The creation of positive moments out of ordinary events is consistent with Tugade and Fredrickson’s (2006) observation that people generally want to feel good. Tugade and Fredrickson also pointed out that it is common for people to try to prolong pleasant feelings by, for example, sharing their news with close friends and loved ones (for review, see Isen, 2000) or by savoring (Bryant, 1989). Our studies indicate that the same motive is operative when times are difficult, and in fact I suggest that the desire to feel good takes on critical importance for maintaining mental and physical well-being during difficult times. Where We Are Now The revised stress and coping model (Folkman, 1997) made a place for positive emotions in the stress process. There is now substantial evidence that positive emotions are a normative aspect of the stress process and that they help restore physiological and psychosocial coping resources. Less is known about the full range of coping processes, including their content, timing, and duration, which are associated with the regulation of positive as opposed to negative emotions. However, what evidence we do have suggests that underlying beliefs, values, and goals are heavily implicated in these coping processes and that the regulation of meaning is the key common theme.
  • 10. 12 S. Folkman We have only begun the work of defining and systematizing meaning-focused coping. It is important to be more comprehensive in its exploration than studies have been thus far. For example, in addition to the types of coping summarized in this article, religious and spiritual coping processes are involved in meaning-based coping, as are strategies related to forgiveness and gratitude. Which of these are related primarily to positive emotions? What coping processes have we overlooked? What is the best way to classify these meaning-focused strategies? And, of course, what is the best way to measure them? The difficulties in measuring coping are well known (for review, see Folkman & Moskowitz, 2004; Schwarzer & Schwarzer, 1996) and there is no reason to think the measurement of meaning-based coping will be different. For both researchers and clinicians, it is important to maintain a balanced perspective regarding the role of positive emotions in the stress process. This stress process is strongly characterized by negative emotions and the inclusion of positive emotions in the model is just that, inclusion. However, the evidence suggests that the positive emotions have important adaptational significance and that these emotions are generated by identifiable coping processes. Stress researchers need to include positive emotions in their studies to learn more about how people generate and sustain them and to further explore their adaptational significance in relation to physiological, psychological, and social outcomes. Clinicians need to give attention to positive emotions with their clients, and explore the sources of such emotions and how to generate and sustain them. This attention to positive emotions will address the imbalance between stress research and clinical practice that has resulted from decades of nearly exclusive concern with the negative emotions. Acknowledgements The writing of this article was supported in part by NIH PO1 AT2024. I thank Judy Moskowitz for her comments on a previous version of this article. References Aldwin, C. M. (2007). Stress, coping, and development (2nd edn). New York: Guilford. Aspinwall, L. G., & MacNamara, A. (2005). Taking positive changes seriously. Cancer, 104(11 Suppl.), 2549Á2556. Baumeister, R. F. (1991). Meaning of life. New York: Guilford. Bonanno, G. A., & Keltner, D. (1997). Facial expressions of emotion and the course of conjugal bereavement. Journal of Abnormal Psychology, 106, 126Á137. Brunstein, J. C., & Gollwitzer, P. M. (1996). Effects of failure on subsequent performance: the importance of self- defining goals. Journal of Personality and Social Psychology, 70, 395Á407. Bryant, F. B. (1989). A four-factor model of perceived control: Avoiding, coping, obtaining, and savoring. Journal of Personality, 57, 773Á797. Butler, L. D. (2007). Growing pains: Commentary on the field of posttraumatic growth and Hobfoll and colleagues’ recent contributions to it. Applied Psychology, 56, 367Á378. Cannon, W. B. (1939). The wisdom of the body (2nd edn). New York: W.W. Norton. Carnelley, K. B., Wortman, C. B., Bolger, N., & Burke, C. T. (2006). The time course of grief reactions to spousal loss: evidence from a national probability sample. Journal of Personality and Social Psychology, 91, 476Á492. Carver, C. S., & Scheier, M. F. (1998). On the self-regulation of behavior. New York: Cambridge University Press. Emmons, R. A., Colby, P. M., & Kaiser, H. A. (1998). When losses lead to gains: Personal goals and the recovery of meaning. In P. T. P. Wong, & P. S. Fry (Eds.), The human quest for meaning (pp. 163Á178). Mahwah, NJ: Lawrence Erlbaum Associates. Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207Á1221.
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