A Positive approach to proactive wellbeing

Our mental health sits on a continuum. At one end of the scale is optimal psychological wellbeing, at the other, poor psychological health. We can also find ourselves at any point in between. This might seem obvious – we all know that it’s possible to survive without thriving. However, despite the existence of this continuum, the majority of mental health initiatives focus on awareness and treatment at one end only: that of poor psychological health. Whilst these efforts are undoubtedly vital, we know that our health services are overwhelmed and that the prevalence of poor psychological health is only increasing. So what’s the solution? One part of the answer is to increase efforts at the other end of the continuum: instead of waiting for people to become ill, to work on understanding what drives optimal wellbeing and actively promote protective strategies.

In our busy modern lives, it’s all too easy to overlook our health and wellbeing in favour of other priorities. We reach for the vitamin C tablets when we feel a cold coming on instead of eating a healthy, balanced diet each day. We ignore fatigue and push through jam-packed weekends instead of letting our bodies recuperate when they want to. At the same time, most of us know full well that prevention is better than cure – and it’s the same with our psychological health. The repercussions of poor psychological health can be devastating, affecting every aspect of our lives, and yet all too often we wait until we’re burned out or struggling with entrenched mental health issues before we attempt to make changes.

Although there has been increasing interest in a preventative approach to psychological wellbeing, both from a public health and scientific research perspective, the realisation of this approach is not simple. To shift the dial and achieve lasting results, a multidimensional approach is required. We need to design pathways towards the promotion of positive mental health and prevention of negative mental health which are multifactorial, multisystem and multilevel (Kia-Keating, Dowdy, Morgan & Noam, 2011). This is because the risk and protective factors associated with psychological wellbeing are complex: how they impact our wellbeing is influenced by many different individual, contextual and social factors throughout our lives.

Such complexity is why Positive takes a proactive approach which supports individual, social and organisational pathways towards optimal psychological wellbeing. The first element of this approach is normalisation and acceptance. We need to normalise the fact that we will all experience ups and downs in life. Linked to this, there has been a paradigm shift in psychological therapy in recent years towards the so-called ‘third wave of treatment’ which takes greater account of how we think and feel about what we think and feel. For example, Acceptance and Commitment Therapy (ACT) (Steven Hayes, 2004) emphasises the futility of trying to avoid psychological distress. In other words, if we think that all forms of negative emotions and feelings are detrimental, then we can become distressed when they occur. Accepting that these are part of everyday life can be protective, enabling us to notice them rather than avoid them, and work towards promoting good emotional awareness and regulation, and importantly build our distress tolerance and levels of resilience.

The second element of Positive’s approach is the incorporation of protective factors into our lives and the minimisation of risk factors – at least as far as possible. There are a number of factors which are known to be linked to positive wellbeing (e.g. exercise, nutrition, sleep, social support, self-esteem) along with other factors which science has linked to poor mental health (e.g. social isolation, rumination, exposure to difficult life events, stress and burnout). Whilst some of these factors will be out of our control, there will inevitably be places we can make changes for the better.

The third element is the recognition of the power of habits. Dr Richard Davidson (Professor of Psychology & Psychiatry at the University of Wisconsin–Madison) defines wellbeing as a skill – something we can practice and get better at. The neuroplasticity of the human brain means that we can change the way we think through repetition. We can develop a more resilient mindset, but in order to do this we must identify what works and stick with it, especially in the face of challenges.

The final element is the utilisation and nurturing of social connections. Uri Bronfenbrenner's (1979) work drew attention to the strong influence of environmental and societal factors on child development; it is argued that a similar lens must be used to understand the trajectory of adult psychological health. Research has demonstrated that social support has a protective influence on wellbeing, even in the context of high adversity, and that this effect is environmental in nature (Crush, Arseneault, Danese, Jaffee & Fisher, 2019). Therefore, our efforts to proactively manage wellbeing will be amplified when we work with those around us. However, often when we experience negative emotions we withdraw from our environment and from others, damaging our social connections – the very things which can nourish and protect our wellbeing. We must therefore consider risk and protection not only at the individual level, but also through a social and environmental lens. We need to consider what we can do to promote wellbeing at the team, school, community, family and organisational levels.

• Our mental health sits on a continuum
• Most efforts focus only on awareness and treatment of poor psychological health
• To make progress we need a multidimensional approach
• Positive takes a proactive approach built around the following:
  • Normalise and accept negative emotions
  • Boost protective factors and manage risk factors
  • Build positive habits
  • Nurture social connections

References

• Bronfenbrenner, U. (1979). The ecology of human development. Cambridge, Mass: Harvard University Press.
• Crush, E., Arseneault, L., Danese, A., Jaffee, S. R., & Fisher, H. L. (2019). Using discordant twin methods to investigate an environmentally mediated pathway between social support and the reduced likelihood of adolescent psychotic experiences. Psychological medicine, 1-8.
• Hayes S (2004) Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther 35: 639-665.
• Kia-Keating, M., Dowdy, E., Morgan, M. L., & Noam, G. G. (2011). Protecting and promoting: An integrative conceptual model for healthy development of adolescents. Journal of Adolescent Health, 48(3), 220-228