27 May Psychological Health: The Path From Surviving to Thriving – Part II
It has now been more than a year since we published the first of what was going to be a three-part blog series on well-being. Little did we know that we were about to enter into a pandemic that would dramatically change the global landscape. I had much of the three parts written but found myself questioning some of the very notions of well-being amidst all the suffering. It also seemed strange to be writing about thriving while we were all moving back into surviving. While there is still progress to be made, it does feel like spring has finally arrived.
I have never been more aware of the blooming of plants and trees in spring as I am this year. I hear more of the people I work with in therapy, colleagues, and friends talking about their plants than ever before. There was something very symbolic about the once in a generation freeze here in Texas that brought so much devastation. As spring arrives I am encouraged and excited to see each plant that seemingly made it through the freeze and now emerges and grows. We’re all coming out of a very long winter in which many of us were frozen and our normal expected resources were not available to us. As we consider well-being, the concepts of struggle, resilience, and growth in the face of adversity have taken on much more meaning.
This post attempts to build on the previous one and provide a high-level overview of the various models of well-being.
The Question of Well-being
So, what does psychological well-being look like? Unfortunately, it has often been thought of as the lack of pathology or disorder. In other words, being healthy is not being sick. This isn’t how we measure physical health, though. Think about the markers of physical health. You might measure your cardiovascular endurance by how far you can run or how quickly you can do it. How healthy a person is can be measured in many ways. The World Health Organization (WHO) recognizes this when it states that well-being is, “not merely the absence of disease or infirmity but a state of complete physical, mental and social well-being.” As one example, paraphrasing the psychophysiologist Stephen Porges: the absence of fear is not the same as the presence of safety. So, if it’s not the lack of something what is the presence of well-being?
This has been debated for millennia by philosophers, spiritual leaders, psychologists, and physicians. As an example, Aristotle took the position that the good life was not the search for immediate pleasure but the pursuit of deep purpose and meaning. Freud famously defined well-being as the ability to love, work, and play. Of course, he also suggested that one could only aspire to transform neurotic misery into ordinary unhappiness, which doesn’t sound very hopeful!
Different Models of Well-Being
There have been many psychological pioneers since Freud and, depending on their focus, their definitions of well-being differ. Many theorists ranging from Freud to Klein, to Bion, and now more contemporary theorists and practitioners have provided different models for psychological development or health even if they didn’t use the term “well-being”. These models included concepts like autonomy (the ability to function independently), agency and efficacy (or the feeling that you have some power and control in your life), sufficient coping mechanisms to manage life’s challenges, an ability to wrestle with difficult truths and contradictions, a positive and solid sense of identity, and deep and meaningful relationships with others. Some of my favorite analysts and researchers were Winnicott, Bion, and Bowlby who all had ways of describing how our individual development takes place within the context of growth promoting relationships.
Other psychological traditions had different models as well. The behavioral tradition that was most prominent in the 1960’s was less interested in the subjective or personal experience of the individual in relation to well-being but more so on the environment’s capacity to produce an outcome of well-being for the individual and society. The humanistic-existential tradition, as its name would imply, is deeply interested in the individual experience of living, making meaning, finding purpose, and growth towards self-actualization. Some of its well-known contributors are Abraham Maslow, Carl Rogers, and Rollo May. Their many contributions to the idea of well-being have to do with a meaningful life and contain the paradoxes we face, such as living/dying and freedom/responsibility.
More recently we have traditions such as positive psychology that have attempted to focus on psychological health over pathology. They have focused on positive emotions, engagement, relationships, finding purpose and meaning, and feeling accomplished in life. As the field has grown there is now more value given to all emotional states (rather than just pleasant ones) and how they might actually be in necessary tension with one another (e.g., sadness at the loss of a loved one allowing for greater gratitude and emotional intimacy in ongoing relationships). Also, it’s helpful to realize that there might not be a single definition of the “good life” or well-being; it might be culturally and individually determined. For example, in our Western world we tend to have an individualistic lens that leads to telling people to pull themselves up by their bootstraps. However, our historical and current experiences are different, and some people are asked to endure more and with less. Some emotions, like anger or fear, might be very important and adaptive if you experience systemic oppressions.
There are many other traditions and lines of research that are beyond what I can cover in a (relatively 😊) brief blog post.
Summing it all up
Whew, so what does all this mean? The short answer is that it’s complicated and contextual. It’s also worth trying to make sense of. The type of plant, the soil it’s growing in, the general climate and specific weather events surrounding it, and other factors will all impact what and how it grows. Sometimes we are just trying to make it through the freeze but hopefully we will all have the chance to shift from surviving to thriving.
In part III (which I promise won’t be a year from now!), we’ll get into how we’ve come to think about well-being at Chrysalis.