Mental Wellness?
I was a panelist at Morgan Stanley for an event called “Mental Health Awareness in 2019.”
This feels part of an overall Corporate American trend toward expanding the notion of health to include mental health (or “emotional wellness” -- a term I find far less charged in these highly-charged times). The hope being such efforts might make this notion less ominous to those in need.
Many questions were asked that day, but there was a fundamental question lurking behind the others:
“What does mental health actually look like (so that I might know if I’m not)?”
We speak increasingly freely about mental health, but do we really know what it is? If we don’t, then how can we judge this type of health with accuracy or objectivity or better, both? In other words, “What’s mental wellness?”
Everyone has a picture of mental health, but it’s likely incomplete (and being wrong carries a high price). I’d imagine most licensed clinicians don’t keep a checklist in hand; instead, they (we) diagnose based upon an ongoing assessment of the person we’re with.
Let’s try to add some clarity to what might become an ongoing attempt on my part to writing about things that might well add #mentalclarity to anyone who might want to know more about such things.
I’d like to start with a mildly edited, 23-point list of attributes from Jonathan Shedler’s “Shedler-Westen Assessment Procedure (SWAP)” that comprehensively captures what mentally healthy people exhibit.
A mentally healthy person:
Uses talents, abilities and energy effectively & productively.
Enjoys challenges and takes pleasure in accomplishments.
Sustains meaningful love relationships involving intimacy & care.
Finds meaning in belonging, and contributing to, a community.
Experiences purpose guiding, mentoring & nurturing others.
Is empathic: sensitive and responsive to other’s needs & feelings.
Is appropriately and (not or) effectively assertive.
Appreciates and responds to humor.
Is capable of tolerating emotionally-threatening criticism.
Grows from painful, negative past experiences.
Is articulate, expressing oneself via words.
Has a sufficiently active and satisfying sex life.
Appears comfortable and at ease in social situations.
Finds contentment and happiness in life’s activities.
Can express affect appropriately in quality and intensity .
Can recognize alternative viewpoints.
Possesses and strives to live up to morally and ethical standards.
Is creative, sees things and/or problems in novel ways.
Tends toward conscientiousness and responsibility.
Is energetic and outgoing.
Is psychologically insightful: understands self and others.
Finds mean and satisfaction pursuing long-term goals.
Forms close, lasting (mutually supportive & sharing) friendships.
When I first saw this list in a class, many years ago, I wondered aloud, “Yikes! How many of these attributes must be true to consider oneself mentally healthy?”
“All of them” my professor responded.
“All at once?” I asked, sheepishly.
“Uh huh” was the response.
“Uh oh” I gasped, audibly.
It’s a long list but it needs to be long because being mentally healthy is multi-faceted and multi-dimensional.
You might look at each attribute as binary. That is, you either possess each attribute or you don’t (in which case there’s a deficiency which might rightly strip you of your desired ‘mentally healthy’ mantle).
But another way of assessment could consider the frequency of each attribute being true with a quick analysis as to why and when not. This offers those brave enough to go there a greater tolerance for things existing on a continuum. That is, the answer can vary a bit depending on where you are, mentally, whilst contemplating your mentality. If, at the end of this self-evaluation, an attribute is more true than not, give yourself a check mark and move on.
As for whether or now you should (or might want to) talk to someone…
What if the answer to any - or many - of these attributes is not true or not true enough for you? For example, let’s say you are not typically ‘appropriately and effectively assertive (see #7)’ or that you’d like to be more typically ‘appropriately and effectively assertive’?
Well, then maybe you should talk to someone!
Before you begin considering your options, consider your context - your circumstance.
It could be you are in fact suffering from some type of disorder (e.g., depression). All disorders have symptoms that (also) include the converse of these aforementioned 23 attributes (e.g., not using talents, not enjoying challenges, etc.). If that’s the case or might be the case, going to a well-trained professional - a licensed psychotherapist or psychologist, or psychiatrist to be diagnosed and/or to be treated makes great sense.
It could, however, be that you’re experiencing grief due to a non-positive life event (e.g., dealing with disease, death, divorce) in which case having some or several attributes being not true might be a temporary thing. In 1917, Freud wrote “Mourning and Melancholia” noting the difference between feeling bad (and needing time) versus being depressed (and needing treatment).
So if you’re down, first consider giving yourself time; talk to friends, exercise, and soon you might feel better (remember: you don’t get over big losses; you get through them).
If, however, you’re down and unable to get up again after a reasonable amount of time, then schedule an appointment with a professional.
While many in therapy have a diagnosed or diagnosable disorder, others come because one (or more) of these attributes aren’t true enough for them. It’s not that anything’s wrong per se; it’s that things aren’t right enough. They want more. Nancy McWilliams, another beautiful mind in this field, wrote about why people seek therapy. The non-clinical reasons cited move me, weekly, from my own chair to my own analyst’s couch:
Development deeper Insight
Increasing one's sense of Agency
Securing/solidification one's Self-Identity
Growing of (realistic) Self-Esteem
Recognizing/handling one’s Feelings
Enhancing one's Ego Strength/Self-Cohesion
Expanding the capacity to Love, Work and Depend on Others
Experiencing greater Pleasure and Serenity
These 8 therapeutic gains are exquisite by-products of therapy and are compelling reasons to go - no matter why one goes. They, together and alone, deepen/widen the experience of those 23 attributes we began with.
So in closing, I’ll summarize by saying that mental wellness is a composite of many different attributes that will vary in terms of how true they are at any moment in time, but that they (all) need to be true enough, most of the time for wellness to be really real.
If one or more of these attributes aren’t true (or true enough) for you, consider the context. If it’s due to a short-term setback, give it time; if it doesn’t get better with time or if you think there’s something bigger (and diagnosable) at play - or if you just want to go deep for depth’s sake, then indeed talk to someone.
Clinicians are trained to help folks to get better - no matter where they’re starting from, no matter the reason.
There’s never been a better time to think about mental wellness as part of one’s overall health, especially now that its definition has expanded to make these questions just a little bit easier to answer..