Surprising Finding | Mental Illness vs. Mental Health: Continuum or Matrix?

A few days ago, I shared some research by Carol Ryff and Corey Keyes on the structure of psychological well-being. Today, I’d like to highlight more of Keyes’  work.

When we think about psychological health, we typically have a kind of continuum in mind. On the one end, there are states such as satisfaction and happiness, on the other end there’s (severe) mental illness, e.g., depression and anxiety disorders. And we’re also sure all people can be located on this single dimension at any given point in time. Additionally, the absence of one state is mostly equated to the presence of the other. Accordingly, an individual is perceived as being psychological healthy when there are no signs of mental illness.

Turns out this perspective may be flawed, or rather: incomplete. Using large-scale samples, Corey Keyes is able to show that we should probably see mental health and mental illness as two interrelated, yet clearly separable dimensions. The first one is about the presence or absence of mental health, the other about the presence or absence of mental illness (please take a look at his paper Mental Illness and/or Mental Health? Investigating Axioms of the Complete State Model of Health)

Keyes_Mental_Health_Matrix

When creating a matrix that is composed of these two continua, we’re able to understand psychological states on a much more nuanced level. By way of example, in his data, Keyes finds there are people who portray distinct signs of mental illness (e.g., depressive symptoms) while at the same time displaying a moderately high level of psychological health (e.g., perception of meaning in life). Conversely, there are quite a few people who are clearly neither mentally ill nor particularly healthy, a state that Keyes calls languishing. In the words of the researcher:

The current study confirms empirically that mental health and mental illness are not opposite ends of a single continuum; rather, they constitute distinct but correlated axes that suggest that mental health should be viewed as a complete state. Thus, the absence of mental illness does not equal the presence of mental health.

[…]

The diagnosis and measurement of mental health […] has provided some invaluable information. First, relatively few adults (i.e., about 2 in 10) who were free of any of the four 12-month mental disorders could be classified as flourishing or completely mentally healthy. Almost as many adults were mentally unhealthy (i.e., languishing) as were mentally healthy (i.e., flourishing), and most adults were moderately mentally healthy. Second, diagnoses less than flourishing were associated with greater levels of dysfunctions in terms of work reductions, health limitations, and psychosocial functioning. Moreover, pure languishing was as dysfunctional (sometimes more) than pure mental illness.

Especially the last sentence should give some food for thought to public health officials and corporate health executives alike. For decades, their focus has been on understanding, assessing, and mitigating mental illness. And while this certainly is an important endeavor, Keyes´ esearch clearly shows that it might be and equally pressing mission to help people find pathways from a state of low mental health (languishing) to high mental health (flourishing).

Enter Positive Psychology

Breathing Happiness: New TEDx Talk by Emma Seppälä

Emma Seppälä believes we already possess the tools we need to control our own happiness. She explores the science behind harnessing your state of mind and how it can ultimately lead to success.

Turns out, happiness is not as elusive as it once seemed. Using findings from cognitive psychology and neuroscience, Seppälä simplifies happiness so that anyone can enjoy it. She’s a frequent contributor to Harvard Business Review, Psychology Today and Scientific American Mind. She’s the founder and editor-in-chief of Fulfillment Daily, a news site dedicated to the science of happiness.

The Structure of Psychological Well-Being — before PERMA

Torbogen_Kirche_kleinWhen talking about the “grand design” of psychological wellbeing these days, most people (at least implicitly) refer to Seligman’s PERMA framework, comprised of the building blocks: positive emotions, engagement, relationships, meaning, and achievement. You might also find people who add another letter for vitality, resulting in PERMA-V.

Of course, Seligman’s outline wasn’t the first attempt at developing a “theory of everything” with regard to psychological well-being.

Between 15 to 20 years before the introduction of the PERMA framework, researchers Carol Ryff and Corey Keyes presented a data-driven model that is comprised of 6 dimensions (here’s the link to one of the original papers: The structure of psychological well-being revisited): self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth.

Quite obviously, there’s a lot of overlap between the two frameworks, but also subtle differences.

To me, one very interesting feature of the Ryff/Keyes model is the idea that well-being is a higher-order entity. They were able to show statistically there’s a kind of “the whole is greater than the sum of its parts”-effect in the data. The idea is that psychological well-being exists as a single factor on the meta-level, where the whole has more meaning than the parts – kind of like looking at a house creates more meaning than looking at bricks, a door, and windows separately.

Here are the six factors of the Ryff/Keyes model in the original words of the researchers:

Self-Acceptance

High scorer: possesses a positive attitude toward the self; acknowledges and accepts multiple aspects ofself, including good and bad qualities; feels positive about past life.

Low scorer: feels dissatisfied with self, is disappointed with what has occurred in past life, is troubled about certain personal qualities, wishes to be different than what he or she is.

Positive Relations With Others

High scorer: has warm, satisfying, trusting relationships with others; is concerned about the welfare of others; capable of strong empathy, affection, and intimacy; understands give and take of human relationships.

Low scorer: has few close, trusting relationships with others; finds it difficult to be warm, open, and concerned about others; is isolated and frustrated in interpersonal relationships; not willing to make compromises to sustain important ties with others. 

Autonomy

High scorer: is self-determining and independent, able to resist social pressures to think and act in certain ways, regulates behavior from within, evaluates self by personal standards.

Low scorer: is concerned about the expectations and evaluations of others, relies on judgments of others to make important decisions, conforms to social pressures to think and act in certain ways.

Environmental Mastery

High scorer: has a sense of mastery and competence in managing the environment, controls complex array of external activities, makes effective use of surrounding opportunities, able to choose or create contexts suitable to personal needs and values.

Low scorer, has difficulty managing everyday affairs, feels unable to change or improve surrounding context, is unaware of surrounding opportunities, lacks sense of control over external world.

Purpose in Life

High scorer: has goals in life and a sense of directedness, feels there is meaning to present and past life, holds beliefs that give life purpose, has aims and objectives for living.

Low scorer: lacks a sense of meaning in life; has few goals or aims, lacks sense of direction; does not see purpose in past life; has no outlooks or beliefs that give life meaning.

Personal Growth

High scorer: has a feeling of continued development, sees self as growing and expanding, is open to new experiences, has sense of realizing his or her potential, sees improvement in self and behavior over time, is changing in ways that reflect more self-knowledge and effectiveness.

Low scorer: has a sense of personal stagnation, lacks sense of improvement or expansion over time, feels bored and uninterested with life, feels unable to develop new attitudes or behaviors.

Positive Psychology News Digest on Mappalicious | No. 15/2016

My favorite pieces covering Positive Psychology and adjacent from (roughly) the last seven days:

Bakadesuyo: How To Be More Confident: 3 Secrets Backed By Research by Scott Barker


Fast Company: The Secret To Making Anxiety Work In Your Favor by Amy Cuddy


Sisu Lab: What’s Your 4-Minute Mile? by Emilia Lahti


Washington Post: Why this Wharton wunderkind wants leaders to replace their intuition with evidence by Jena McGregor


Fast Company: How to identify and get rid of the hidden beliefs that could be holding you back by Gwen Moran


Washington Post: The surprisingly easy way to reduce your anxiety by Amy Ellis Nutt


Guardian: Forget mindfulness, stop trying to find yourself and start faking it by Michael Puett & Christine Gross-Loh


New York Times: Angela Duckworth on Passion, Grit and Success by Julie Scelfo


Harvard Business Review: Good Bosses create more Wellness than Wellness plans do by Emma Seppälä


Forbes: Becoming The Kind Of Leader You Would Want To Follow by Brett Steenbarger


Science Daily: Can money buy happiness? maybe, if you spend it according to your personality type, no author

Mappalicious News Digest

10 fantastic Quotes by William James that preview Positive Psychology

Philosopher William James is often portrayed as being the founding father of modern (American) psychology. Here, I collected ten of his quotes that show he’s also been an influence for many theories and practices that are among the cornerstones of Positive Psychology.

On self-efficacy and solution-focused thinking

Action may not always bring happiness, but there is no happiness without action.

On creating habits

To change one’s life:
1. Start immediately.
2. Do it flamboyantly.
3. No exceptions.

On optimism, pessimism, and rumination

If you believe that feeling bad or worrying long enough will change a past or future event, then you are residing on another planet with a different reality system.

On the value of attention and mindfulness

Each of us literally chooses, by his way of attending to things, what sort of universe he shall appear to himself to inhabit.

On belief systems and disputation of negative thoughts

To perceive the world differently, we must be willing to change our belief system, let the past slip away, expand our sense of now, and dissolve the fear in our minds.

On perseverance, grit, and sisu

In exceptional cases we may find, beyond the very extremity of fatigue distress, amounts of ease and power that we never dreamed ourselves to own, sources of strength habitually not taxed at all, because habitually we never push through the obstruction, never pass those early critical points.

On finding purpose and vitality

Seek out that particular mental attribute which makes you feel most deeply and vitally alive, along with which comes the inner voice which says, ‘This is the real me,’ and when you have found that attitude, follow it.

On meaning, altruism, and the greater good

The great use of life is to spend it for something that will outlast it.

On the value of positive relationships

Wherever you are, it is your friends who make your world.

On hope, best future selves, and callings

Your hopes, dreams and aspirations are legitimate. They are trying to take you airborne, above the clouds, above the storms, if you only let them.
 William  James 

The Most Important Part of the Good Life | Jamie Gruman 

The good life. We all want it. We all want to know the secret formula for attaining it. But the simplistic, often misleading prescriptions for the good life that are tossed around in the popular media, books, and online, can push the good life further out of our reach. Psychologist, and Founding Chair of the Canadian Positive Psychology Association, Jamie Gruman, explains how a balanced viewpoint helps us properly understand the good life and make it a reality.

In his TEDx talk, Gruman describes the good life as a result of leading a balanced life, specifically, four different kinds of balance: Balance as a) mid-range, b) synthesis, c) tempered view, and d) sensitivity to context.

Share and enjoy!

Positive Psychology News Digest on Mappalicious | No. 14/2016

My favorite pieces covering Positive Psychology and adjacent from (roughly) the last seven days:

Center for Positive Organizations: Understanding positive business: Learning how to lead by Sue Ashford


Economist: Your employees wish you were emotionally intelligent by Natalie Baker


Center for Positive Organizations: Respectful engagement cultivates higher levels of creativity by Jane Dutton et al.


Psychology Today: The Shortcut to Finding Pleasure from Pain by Todd Kashdan


Huffington Post (Lifestyle): Simplicity, Free Time and Pursuing Your Passions by Taylor Kreiss


The Positive Organization: The Power of Self-Change via Robert Quinn


Vox: How scientists fell in and out of love with the hormone oxytocin by Brian Resnick


New York Times: The Keys to Happiness by Victoria Shannon


Forbes: Living Life With Renewed Energy: The Purpose Of Purpose by Brett Steenbarger


Huffington Post: 6 Quick Steps for Finding Your Company’s Authentic Purpose by Vic Strecher

News Digest - Mappalicious