Therapist Wellbeing: Beyond Clichés

I'm finding gems about wellbeing as I curate content for next year's learning community . (Finding gems, that is, once I reach past the cliché truisms and cautionary finger wagging for mental health care professionals of just-do-it lists: Eat right. Exercise more. Get enough sleep. Observe proper limits. If you don’t do self-care, you’ll burn out.)

It's a complicated literature.  But wellbeing objectively matters to health and longevity, productivity and performance (1).

The Organization for Economic Co-operation and Development's beautifully clear guidelines (2) say wellbeing has 3 components

  • Life evaluation - a reflective assessment on a person's life or some specific aspect of it.
  • Affect - a person's feelings or emotional states, typically measured with reference to a particular point in time.
  • Eudaimonia - a sense of meaning and purpose in life, or good psychological functioning.

What makes things complicated is that there is no one narrowly defined set of universal factors that create wellbeing. Instead, wellbeing is multifaceted and culturally determined (3).  What produces a high rating of wellbeing by a person in one country is different than in another (check out this cool explorable graphic, (4).

The wellbeing component of eudaimonia-the sense of meaning or purpose-brings to mind lines from David Whyte's poem Santiago:

the sense of having walked
from far inside yourself out into the revelation,
to have risked yourself for something that seemed
to stand both inside you and far beyond you,
that called you back in the end to the only road
you could follow, walking as you did, in your rags of love...

and Antonio Machado's poem Caminante:
Caminante, no hay camino,
se hace camino al andar.
Traveller, there is no path,
The path is made by walking.

Our subjective sense of wellbeing arises from the ways we align intentions and actions to meet ever changing circumstances. The supple way we make sense of life's twists and turns to become more effective and wiser.

To increase wellbeing it seems especially important to explore two questions .

1.    What is the role of mindfulness in wellbeing?  

Our minds have evolved to continually monitor threat, detecting the big and small mismatches between how things are and how we wish or fear they could be. We do things to close the gap, often in mindlessly habitual ways, like escaping momentary emotional discomfort that end up undermining overall wellbeing.

Repetitive negative thinking, be it worry or rumination, maladaptive perfectionism, the harsh self-criticism of shame-prone individuals, and so on, seem to be examples of this type of discrepancy processing gone awry.

Mindfulness practice may have therapeutic effects in part due to training the mind to shift away from the "Doing Mode" of constant discrepancy processing to a "Being Mode", a state of mind that meets experience as it is (5).

How to avoid making 2017 into yet another self-improvement project that gets co-opted by discrepancy processing and yields dissatisfaction? Exploring mindfulness practice could help.


2.    What are the implications of social baseline theory for wellbeing?

I heard Jim Coan give a fantastic plenary on social baseline theory and have been grappling with its implications ever since. Social baseline theory holds that the human brain and neural system incorporates others into the sense of self in the most fundamental of ways-as bioenergetics resources (6). If you and I stand looking at a steep hill, the longer we've been friends, the less steep we perceive the hill. If I stand there alone, anticipating I must solve the problem alone, my brain keeps more blood glucose onboard. In another series of studies, people received an electrical shock in three conditions-holding hands with a loved one, with a stranger, or alone empty-handed. Holding a loved one's hand or even the hand of the stranger decreases stress, while decreased access to relational partners increases cognitive and physiological effort (7).

It's interesting to think about this with findings about how including partners helps in PTSD.

Or how moms with substance abuse benefit from having their kids come to a session.   

What are the implications for wellbeing if our whole physiology is evolved to expect access to social relationships to decrease the risk and effort needed to meet a variety of goals?  At the most simple level, I'm looking at improving my wellbeing in 2017 and thinking,

Don't go it alone.

- Kelly Koerner, PhD

References

1. De Neve et al (2013) https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2306651
2. http://www.oecd.org/statistics/Guidelines%20on%20Measuring%20Subjective%20Well-being.pdf
3. Todd Kashdan https://www.psychologytoday.com/blog/curious/201608/10-discoveries-about-well-being-everyone-must-know
4. beautiful infographic lets you explore differences in wellbeing by country
http://www.oecdbetterlifeindex.org/#/11111111111
5. Zindel Segal http://www.mindful.org/difference-between-being-and-doing/
6. Coan, JA & Sbarra, DA (2015) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4375548/
7. Why We Hold Hands, Jim Coan https://www.youtube.com/watch?v=1UMHUPPQ96c