Keys to Mental Health

07/07/14: When I trained to be a “metal health professional,” it became clear that I was really being trained to be a “mental illness professional.” There wasn’t a single lecture, book, or article geared toward what made someone “healthy.” Instead, everything was about how to identify illness and treat symptoms. Later I realized that across psychology and psychiatry, very few theories have ever been presented that capture what a healthy person is like, which to me is still shocking. So this post is about turning that on it’s head, and looking at the things that make us psychologically healthy. The best part is that they are available for each of us to achieve and improve, every moment of the day, regardless of what stresses we may be having.

Definition and Structure of Health
Defining health has been a tricky thing, which is part of what makes a model of a healthy person difficult to understand. The best definition I have seen, which is pretty widely cited, is from the World Health Organization (WHO), which defines health as: “…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (1948).” So to build a model of health with this in mind, we need to look beyond symptoms, and also focus on how to thrive.

On top of that, health has usually been seen as the opposite of illness, or pathology. If there is a big spectrum of wellness and illness, they would be on two opposing sides, with a lot of steps in between. However, some recent ideas on mental health include viewing mental health not just as the opposite of mental illness, but as a separate dimension altogether (Keyes, 2009). This means someone can have psychological problems and also have high levels of mental health. For example, someone could be clinically depressed, but still maintaining good relationships, having a sense of meaning in life, and working to accept themselves while trying to make life better.

Furthermore, as we understand more about the brain, human development, and culture, it is clear that mental health can look very different for each person. Previous attempts to articulate the things that make someone mentally health (by Ryff & Keyes; Deci & Ryan; McWilliams; Hattie, Myers, and Sweeney; etc) have produced some amazing insights. However, I have found these to be difficult to apply to everyday life, and they also have some cultural limitations. Furthermore, it is my belief that people of every personality style, value system, temperament, and cultural background can be mentally healthy, and the ways this is possible are in the next section.

Key Components Model
Given this context, I have developed what I call the Key Components of Model of Mental Health. You can think of the 6 key components as tasks, that when achieved, provide a solid foundation of mental health that can be built on and expanded. They are also not the only 6 things that matter, since each of us have unique parts of our lives that help us thrive and feel happy, but these are the 6 that we all need to do. Furthermore, They are things that are embraced in different ways by almost every society on Earth.

The key components are:

1. Adaptation: We need to find ways to manage our emotions, moods, thoughts, and behavior, and cope with stress. Ultimately this is about being able to handle surges in emotions and deal with our internal experience.

2. Competence: We need to find ways to get things done, and fulfill our roles and responsibilities. Being able to manage your life to keep things floating, even when under major stress, is a sign of health.

3. Formation: We need to forge an identity and find a way to be comfortable with who we are. Our identities are important for all types of social interactions, and the way we feel about ourselves sets the stage for living well.

4. Positivity: We need to find ways to enjoy life and be involved in things that we care about. Ultimately we need to find ways to make life worth living, by being a part of meaningful activities and relationships, and being able to experience positive emotions like joy, relaxation, pleasure, and fun.

5. Relatedness: We need to find ways to form and maintain harmonious relationships with other people. Social relationships are at the core of the human experience, and we need to be able to develop social skills that allow us to connect with other people and have secure and mutually satisfying relationships.

6. Vitality: We need to take good care of our bodies and physical health. Our minds and bodies are not separate entities as we like to think sometimes, but they are instead the same thing. Good self-care (moving your body, eating well, sleeping enough, and avoiding harmful things) is a life long task that is a key to mental health.

How to Use This
If this stuff sounds good to you, I think the main way to start using it is to first assess where you are at with each component. Some of them you may have down pat, whereas others need some work. I’d suggest step two would be to set some goals for improving one or two of them. If you need some help with that, check out “How to Set Goals.”

If you are struggling with mental health issues too, you may consider focusing more on these 6 tasks than in trying to reduce your symptoms. This may be especially helpful because the things above should also naturally reduce symptoms of every psychiatric condition.

If you are looking to read more about these components, there are a variety of article on this site that would be good next steps, including the revised Build a Coping System and Healthy Relationships.

Finally, I am actively developing a standardized assessment of these 6 components that I hope to introduce sometime in 2015. I will make that available here first.

Previous Models
Here are links to some of the other models that informed mine, and the main ideas they have popularized.

Ryff & Keyes
Psychological Well-Being, Social Well-Being

1. Self-acceptance
2. Social acceptance
3. Autonomy
4. Purpose in life
5. Personal growth
6. Environmental mastery
7. Social contribution
8. Social coherence
9. Positive relations
10. Social integration
11. Social actualization

McWilliams
Psychodynamic Mental Health

1. Capacity to Work
2. Capacity to Love
3. Capacity to Play
4. Movement Toward Secure Attachment Pattern
5. Sense of Agency
6. Self & Object Constancy
7. Ego Strength
8. Realistic and Reliable Self-Esteem
9. Enduring Values
10. Affect & Thought Tolerance and Regulation
11. Insight
12. Capacity to Mentalize
13. Flexibility of Coping and Defense Style
14. Balance of Relatedness and Separateness
15. Vitality
16. Acceptance

Hattie, Myers, and Sweeney
WEL Model

1. Creative Self
2. Coping Self
3. Social Self
4. Essential Self
5. Physical Self

Diener & Seligman
Subjective Well-Being, Positive Psychology

1. High positive affect
2. Low negative affect
3. High satisfaction with life

Deci & Ryan
Self-Determination Theory

1. Autonomy
2. Relatedness
3. Competence