In the last post I discussed mental health in general terms. As mentioned there, the World Health Organization defines mental health as a state of wellbeing.
But what exactly does our wellbeing depend on?
This is our topic for today. I’m gona be more specific about what mental health is, and talk about four pillars of wellbeing. I will also introduce a model that I call the Matrix of Wellbeing, which I use as guidance in my own clinical practice.
THE FOUR PILLARS OF WELLBEING
If we were to use a metaphor, wellbeing could be compared to an oil platform. Oil platforms appear to be solid structures protruding from the ocean like solid rocks. But actually, those big constructions rest on four pillars.
None of the pillars is more important than the other, but it is enough to damage just one of them to make the whole structure shake or even collapse.
The same applies to our wellbeing. It rests on four pillars and may collapse whenever any of them is weakened.
The four pillars of our wellbeing are:
- our body,
- our socio-economic status,
- our psychological processes,
- our interpersonal relationships
BIOLOGICAL UNDERPINNINGS OF WELLBEING
Human beings are biological organisms and our wellbeing depends – among others – on how well our bodies function.
So, the state of wellbeing can be undermined by:
- our genetics,
- level of hormones and neurotransmitters,
- ongoing diseases and infections,
- sleep disturbance,
- poor diet,
- certain medicines (like painkillers),
- drugs and alcohol,
- over- or underweight,
- inappropriate level of physical activity,
- a generally unhealthy lifestyle
SOCIO-ECONOMIC UNDERPINNINGS OF WELLBEING
Since humans are social species, it is the social status that determines our access to important resources and by that contributes to the state of wellbeing. In our culture, professional position and economic power are viewed as the most prominent signs of our social status.
Wellbeing may be undermined by:
- a permanent low rank in the social hierarchy or a sudden degradation,
- economic insecurity and poverty
Wellbeing can also be hit by:
- a perceived loss of social attractiveness,
- social alienation and lack of belonging
PSYCHOLOGICAL UNDERPINNINGS OF WELLBEING
Although heavily affected by physical and environmental factors, the state of wellbeing per se is a state of mind. This is probably why wellbeing is usually described in psychological terms, such as happiness or fulfilment.
And indeed, some psychological processes play a crucial role in strengthening or weakening the state of wellbeing. For example, among the biggest thieves of our happiness are such toxic psychological processes as:
- repetitive negative thinking,
- inflexible attention,
- exaggerated self-criticism,
- low self-esteem
RELATIONAL UNDERPINNINGS OF WELLBEING
As mentioned before, human beings are a social species and it would be impossible to overestimate the importance of interpersonal relations in our life.
The quality of our early relationships is crucial to our psychological development and to forming our adult personalities. The quality of our adult relationships is one of the pillars of our wellbeing throughout life.
Achieving and maintaining a good quality of interpersonal relationships is never entirely up to us as we can never fully control the way others treat us. What we CAN do is to terminate those relationships that are psychologically toxic to us.
Furthermore, although we CAN’T unilaterally fix bad relationships, we certainly CAN destroy the good ones by, for instance,
- dysfunctional interpersonal styles and schemes,
- interpersonal defensiveness (as opposed to assertiveness),
- the fear of intimacy,
- attachment problems
The truth is that we can’t dance solo and we can’t have a good relationship with someone who’s unwilling or unable to have one with us. But we can easily sabotage any relationship even when our counterparts do their best.
THE MATRIX OF WELLBEING
The four pillars of wellbeing – presented here as the four fields – form a model, which I call the Matrix of Wellbeing.
The two upper fields of the Matrix form an intrapersonal axis, which means that any problems in those two areas must be solved within you and not within anyone else. So, if your wellbeing requires any changes on the intrapersonal axis, the change must occur within your body, within your mind or within your own behavior, not within others.
The two lower fields of the Matrix form an interpersonal (or environmental) axis. This means that the quality of your functioning on this axis depends also on other people and is never entirely up to you.
Even when you’re aware of your own mistakes within these two domains and try to change your behavior, the final result depends on how your environment will respond to these changes.
For example, when you finally try to be more assertive in your relationships this move may be welcomed and positively reinforced by your friends or partner. But you may also be punished by them for the constructive change if they have benefited from the status quo, for instance your submissiveness.
We can also divide our model into (1) the psychological dimension of wellbeing, which consists of the two right-hand fields of the Matrix and (2) the non-psychological dimension of wellbeing, which consists of the two fields on the left-hand side of the Matrix.
Problems located within the psychological dimension may be targeted during psychotherapy – either individually, in therapeutic groups or couple therapy. You may even use self-help resources to solve them on your own.
But problems located on the left-hand side of the Matrix, within the non-psychological dimension, require other strategies.
For instance, somatic problems may be addressed by medical doctors, physiotherapists, dieticians or personal trainers. Socio-economic problems, in turn, may require some help from a lawyer, financial adviser or trade unions.
THE MATRIX AS YOUR LIFE COMPASS
Many brilliant psychological interventions have failed simply because they targeted the wrong pillar of wellbeing. They failed because there was a mismatch between applied solutions and the actual problem. In such cases, the Matrix may become a compass to help navigate unclear waters towards wellbeing.
Imagine, that you bought a car. One day you want to drive to work, but the engine doesn’t start. So, you call a car electrician who discovers that the ignition plugs do not work properly. So, he shifts the plugs but … the car still doesn’t start.
You then call a mechanic who discovers that the oil level is too low. So, he shifts the oil and the filter, but the car still doesn’t start. The third expert you call discovers that your tires are in a tragic condition and shifts these. The car still doesn’t start.
Finally, desperate you call a friend who’s a taxi driver. After inspecting your car, he says: well, I see that you shifted to high-quality oil, that you have new ignition plugs and that you bought brand new tires. Well, perhaps it’s time to fill some fuel and start driving?
Now, you realize that although all mechanics were absolutely right in their diagnosis, their solutions were totally irrelevant to your real problem: the lack of fuel.
This story shows why psychological interventions may sometimes fail. Even if delivered skillfully and based on right diagnoses, they may still be irrelevant to the real problems that undermine wellbeing, such as unemployment, poverty or social exclusion.
Take for example depression, which is a pathological state of mind. But depression may reflect a pathological state of your affairs. When the latter is the case, it will be difficult to fix the problem just within your head.
Thank you for staying with me to this point and welcome to my next blog-post.
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