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University of California Research Results
An interview with Professors Michael Levenson
and Carolyn Aldwin
by Raz Ingrasci, President (Edited
by Shawn McAndrew)
 In
the first quarter of 2003, Professors Michael Levenson and Carolyn
Aldwin of the University of California at Davis completed their
three-year grant research study of the Hoffman Quadrinity Process
(HQP). A summary of their scientific findings will be sent out soon
to all graduates. Briefly stated, however, the researchers
found that participants in the Hoffman Process experienced significant
and lasting reductions in negative affect (depression, anxiety,
interpersonal sensitivity, hostility, and obsessive-compulsive disorder),
coupled with significant and lasting increases in positive affect
(emotional intelligence, life satisfaction, spiritual experience,
mastery, empathy, and forgiveness.) Hoffman Process participants
were also found to have significantly increased physical energy
and vitality. In this interview, Drs. Levenson and Aldwin
share some of their perceptions about this research.
Raz Ingrasci: How important is independent, peer-review
research in determining the efficacy of a program like the Hoffman
Process?
Carolyn Aldwin: Scientific research is important
for a number of reasons. There is often a “halo effect”
when someone does something to try to improve themselves. Clinical
psychology wrestled for many years with the fact that often people
would say they benefited, but they actually hadn't changed by
standard and objective measures. Psychology spent decades trying
to come up with valid ways of determining whether or not an intervention
actually had an effect. Today's measures can show, for example,
that cognitive therapy is about as good as drug therapy in treating
depression. When it comes to alternative programs, like the Hoffman
Process, the value has been largely anecdotal. In this study, we
used the standard techniques of evaluation research to show whether
or not participating in the Hoffman Process had an effect.
RI: You had a control group, and you measured change
over time, so you can definitively say that positive change happened
and it was lasting.
CA: Right. We used the most conservative criteria.
We had a control group so we could show that change over time wasn't
due to change of the culture, like the effect of 9/11. We followed
people over time because it's easy to show short-term effects
for a couple of months. But they tend to peter out over the course
of a year. So we followed people a full year and showed that they
had lasting effects. The folks who participated in the Process generally
did much better than the control group.
RI: From a scientific perspective can you tell
us what it means when an effect reaches a level of significance?
Michael Levenson:There's more than one way
to address significance. First, these results were by and large,
quite statistically significant. That's an important thing to
show. Sometimes you'll see statisitical significance, but not
clinical significance. The results of this study were highly significant
in both senses – statistical and clinical significance.
CA: For most of our analyses you'd only get
these findings by chance one in a thousand times. So we're quite
certain of the effect. It is also important to note effect sizes.
Not only is there an effect, but how big is it?
ML: The affect sizes from Hoffman, for example,
on depression were better than what I found in the research literature
for drug therapies and equal to the best of the cognitive behavioral
therapy (CBT) results.
RI: CBT has been shown to reduce depression. Has
it been shown to reduce the other forms of negative affect that
were also reduced by the Hoffman Process?
ML: In general, the studies on CBT have only looked
at depression. Perhaps if researchers assessed other forms of negative
affectivity, for example anxiety, then CBT might have an effect
on them as well.
RI: So if depression goes down, we can expect that
anxiety and obsessive-compulsive symptoms also go down.
ML: I'm not sure about obsessive-compulsive
symptoms. In terms of the general cluster of negative affectivity
the two big ones are depression and anxiety. You would expect them
to go down together. Generally speaking the studies of CBT did not
employ broad-spectrum measures to look at all different forms of
negative affect like the ones we used to study the Hoffman Process.
CA: In our study on Hoffman, we also looked at
positive outcomes. Things like mastery, spirituality, forgiveness,
emotional intelligence. They all went up. In fact, emotional intelligence
kept going up over time.
RI: Is it unusual to see negative affect go down
and positive affect go up simultaneously? Are those two things typically
linked?
ML: It hasn't been studied until now, and
that was the aspect of this study that was unique. When studying
other interventions to improve a person's emotional well being,
whether it's a clinical approach, meditation, or whatever, they
haven't looked at both decrease in negative affect and increase
in positive affect. I won't say our study is absolutely unique
in that respect, but I believe that both in terms of completeness
of the measures used and the number of different measures looking
at both negative and positive functioning, our study stands apart.
RI: So there is no other intervention in the research
literature that shows both decrease in negative affect and increase
in positive affect occurring simultaneously. And, to some degree,
that may be because other studies haven't been designed that
way.
CA: “Positive Psychology” is a relatively
new movement and there has been a huge increase in the past five
years in positive things that we can actually measure, like mastery,
emotional intelligence, spirituality, forgiveness, and gratitude.
So my guess is that the clinicians haven't hooked up with the
Positive Psychology people yet.
ML: When our article is published, it will probably
promote other similar studies. We've set the example: not only
have we researched Hoffman, but we've done, in effect, a new
kind of research, a more inclusive kind of research.
RI: Given that the Hoffman Process works so well
on depression, is it fair to conclude that depression is largely
a learned behavior?
CA: There are both biological propensities and
environmental propensities for depression. To a certain extent it's
learned but the other thing to remember is that just because you
have a genetic propensity doesn't mean you can't overcome
it.
ML: There's a tendency amongst the psychiatric
profession to think that if they're pretty sure there's
a genetic component to some mental health symptom then the only
treatment is drugs. And that's a completely wrong conclusion
to draw.
CA: For example, some fruit flies have a genetic
propensity to sit on their fruit, and others fly about as they eat.
In times of fruit shortage the fruit flies that typically fly about
will learn to sit on their fruit so it doesn't get stolen by
other fruit flies. Even fruit flies have choice and can learn. It
would be silly to think that people can't.
RI: So whatever the cause of depression, people
can, to some degree, learn their way out of it. Learning helps.
CA: Yes. You have to consider that many of the
people participating in the Hoffman Process were ready and really
motivated to change. That is important.
RI: I agree that to do the Hoffman Process requires
reasonably strong motivation and self-efficacy to begin with.
CA: About half the participants in this study met
the criteria for mild to moderate depression. But if one is severely
depressed, especially if suicidality is present, I think standard
clinical therapy, perhaps with medication, is the place to start.
RI: What does it means when Emotional Intelligence
increases?
CA: People who are emotionally intelligent are
better able to read emotions in other people and respond more sensitively
to them. They are also more aware of their own emotional processes,
and can control them better. Clearly the Hoffman Process focuses
on recognizing emotions, understanding their sources, and giving
people better tools for how to deal with negative emotions.
RI: We also saw that Spirituality goes up after
the Hoffman Process. What were you measuring?
ML: The scale we used was developed specifically
to look at spiritual experience as having to do with both a sense
of fellowship with other people and feelings of being in touch with
a higher reality. Both of those are assessed by this measure. That's
not something you would get by a simple measure of how often you
attend church or how strongly you believe in your religion. Its
much more about experience than it is about behavior or your belief
system.
CA: In fact, the scale we used didn't focus
on beliefs at all but rather things like a sense of timelessness,
connectedness, and luminosity.
RI: So when you say spirituality increases as a
result of the Hoffman Process and lasts, what you mean is feeling
more connected to life, to other people, feelings of peace, contentment,
joy, and things like that.
ML: Interestingly, we found that spiritual experience
had an effect. That is, change in spiritual experience across the
period of time we were assessing seemed to be what was driving the
increases in forgiveness and decreases in depression. That is one
mechanism we isolated and we think is a part of what's working
in the Process.
RI: Your research also shows a significant increase
in physical energy and vitality after a year. Do you believe the
overall psychological changes you measured may also be consistent
with long-term improvements in health?
ML: Well, we know that depression is a risk factor
for mortality/morbidity. That's well established. You could
draw the inference that if you decreased depression for the rest
of your life then you would probably be healthier and live longer.
RI: Is there any other research that shows people
who are more connected to life, happier, emotionally intelligent,
and so on?
CA: There's some research coming out that says
people who are happier have better immune responses to challenge.
There have only been a few studies on this so it doesn't make
a definitive finding. Some other research showed that emotional
stability is associated with longevity. To the extent that the Hoffman
Process increases emotional stability then that may also be beneficial
for health. But you'd need longer-term studies to evaluate all
of this.
RI: You both have a breadth of knowledge of your
field as well as having conducted lots of research. How did these
research results on the Hoffman Process compare to what you expected
to find?
CA: Truth be told, I wasn't certain what to
expect. The first thing that was encouraging to me about Hoffman
was the use of journaling, which research shows alleviates negative
affect around trauma. That was probably the reason that I agreed
to be involved in this. There is also a well-established association
between childhood stress and depression in later life. So the extent
to which the Hoffman Process was focusing on these two things was
a positive sign. I thought there might be some effect, but I was
surprised at how strong the effect was. Neither of us expected that.
In truth, we just weren't expecting to find the magnitude of
these results. But we're very glad that we did. ø
Click here to download the study (PDF 600KB). »
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