Chapter 9: Wellness
The many factors that go into deciding if a person is ill, including: general complaints about feeling ill, specific symptoms, identifiable damage to the body, impairment of daily activities, etc. But, one can feel fine but be full of germs, or free of germs but feel ill; one can life a long but impaired life or a short but vigorous one. This plurality should be included in our conception of health as well.
Three major eras in conception of health and illness in Western history:
- Beginning of man through mid-19th century: focus solely on disease treatment.
- Mid-19th century through late 20th century: germ theory (illness is caused by microscopic organisms, i.e. germs), focus on prevention.
- Last few decades to now: health promotion; good health can be promoted, and there is no upper limit to health. Our behavior affects our health. Opposite of illness is fitness and resilience, not just the absence of disease (Valliant, 2003).
Athenian Greeks such as Aristotle, Hippocrates, and Galen assumed that the mind and the body were intimately connected and that wellness was composed of physical and mental health.
Descartes proposed mind-body dualism, where the mind and body are separate. The body is physical while the mind is metaphysical. The body is controlled by mechanisms while the soul/mind is free.
This led to the mind-body problem, as biology and neurology sprang up to explain the body and psychology and psychiatry arose to deal with the mind.
However, we know that there are interactions between the body and the mind. For example, Oscar winners live almost four years longer than those that are nominated but do not win and actors and actresses that were in the same movies and around the same age, but not nominated. In 1996, the NBA celebrated its 50th anniversary and named the 50 greatest players in its history; of these 50 players, 49 were still alive. Psychological factors like stress and depression compromise immune functioning, while factors like social support, relaxation training, and confiding in others can boost immune functioning.
In the mind-body fields, health psychology applies psychological theories and research to physical well-being. Behavioral medicine includes the psychological context of health and illness in medical approaches. Psychoneuroimmunology takes into account the psychological, neurological, and immunological factors on health and disease. Experiment on immunosuppression with rats (Ader & Cohen, 1975), immune response can be conditioned, meaning that optimal functioning of the immune system may be brought on by avoiding negative stimuli and seeking out positive stimuli.
A few centuries ago, Western medicine held that the body could not heal itself. Now we know about the how the immune system can heal the body, not a mystical “will to live.” Health and wellness promotions have been successful in some instances, such as a California program increasing knowledge about health and illness and encouraging healthy behaviors. However, others have not been successful. Weinstein (1989) showed that people have unrealistic beliefs about their chances of developing a health problem. These programs must be “broad-based, changing people’s abstract knowledge as well as their personal beliefs and attitudes, their habits, and their social environments.” However, many wellness promotions still adopt a prevention approach rather than a true promotion of wellness.
Weight-loss may be the biggest topic in wellness in the U.S. Peterson’s generalizations about achieving a healthy weight: (1) Prevention is much more effective (the most effective way to never be overweight as an adult is to have avoided being overweight earlier in life). (2) Most forms of weight loss work in the short run, but fail in the long run (people tend to gain back the weight they have lost).
Peterson also mentions aging and physical decline as hot topics in health and wellness. He is of the opinion that while average life expectancy has increased in recent years, there is a maximum limit to our lifespan (about 120 years at most). He also mentions that the “Old Age” may have better advice and methods (don’t smoke, eat a balanced diet, exercise regularly) than the “New Age” (healing crystals, aromatherapy, aura enhancement); the “Old Age” certainly has more data to back it up.
Marie Jahoda’s book Current Concepts of Positive Mental Health (1958) outlines some states and traits that are associated with or identified as being psychologically healthy (although they were difficult to measure and did not stimulate further research): acceptance of oneself; accurate perception of reality; autonomy (freedom from social pressures); environmental mastery; growth, development, becoming; integration of personality.
Around the same time, William Scott was searching the literature on mental health (which was virtually all focused on disorder), and found that good social relationships was the most common correlate of mental health.
More recent work on correlates of mental health by Ryff and colleagues (1989, 1995, 1996, 1998) updated Jahoda’s list: autonomy; environmental mastery; personal growth; positive relations with others; purpose in life; self-acceptance. These have been backed up with valid and reliable measures. Using this scale, mental health shows a stronger correlation with physical health than does a hedonistic orientation; the role of the left prefrontal cortex is implicated in this association.
We cannot exist in a psychological bubble; as such, how we respond to “bumps in the road” is also a part of mental health. The first studies on resilience involved young children, who seem to bounce back and even flourish after major stressors (Garmezy, 1983; Werner, 1982).
Bonnie Benard’s (1991) components of resilience: persistence; hardiness; goal-directedness; healthy success orientation; achievement motivation; educational aspirations; a belief in the future; a sense of anticipation; a sense of purpose; a sense of coherence.
Defense mechanisms are unconscious strategies people use to protect themselves against psychological threats (Freud); includes projection (people attribute their own undesirable characteristics to others), repression (actively keep upsetting memories out of our conscious minds), rationalization (we rewrite our personal history after a disappointment), denial (telling or convincing ourselves that it didn’t really happen), humor (reframing reality to make it more bearable), and sublimation (we channel our frustrations and disappointments into socially valued activities).
Holmes and Rahe (1967) looked at number of stressful life events and current health status; correlation was generally negative. Then, Mineka and Henderson (1985) included how people think about stressful events; exits (divorce) were more troublesome than entrances (beginning college), and events that were seen as unpredictable, uncontrollable, and/or meaningless more often lead to illness or death.
Now, we look at how individuals perceive stressful events as well:
- Primary appraisal: the individual asks what is at stake in the event (for instance, a speeding ticket is worse if you are driving on a suspended license vs. a current, valid license).
- Secondary appraisal: the individual takes stock of the resources at his or her disposal to deal with the event (the speeding ticket is not so bad if you have the money to pay the fine).
- Problem-focused coping: refers to attempts to meet the stressful event “head on” and remove its effects.
- Emotion-focused coping: refers to indirect attempts to cope, moderating one’s emotional response to the event. (Lazarus notes that no one style is preferred; one may be beneficial in one scenario but not another.)
- Hardiness: ability to find meaning and challenge in life’s demands; presence of hardiness reduces likeliness of becoming overwhelmed when challenged (Kobasa, 1979).
Erikson’s theory of psychological development (theory of psychosocial stages): (1) Trust vs. Mistrust (newborns); (2) Autonomy vs. Self-Doubt (18 months to about 3 years); (3) Initiative vs. Guilt (about 3 to 6); (4) Competence vs. Inferiority (about 6 to puberty); (5) Identity vs. Role Confusion (puberty to adolescence); (6) Intimacy vs. Isolation (leaving adolescence with an identity to adulthood); (7) Generativity vs. Stagnation (adulthood with identity and intimacy); (8) Ego Integrity vs. Despair (end of life)
However, there is little evidence to support a stage approach to social development; some may deal with these issues in a different order. But, Valliant (2004) found that maturity is strongly related to well-being. Peterson: “More generally, maturity means doing the psychosocial tasks well that are appropriate to one’s stage in life.”
Valliant’s study showed the factors associated with successful aging were as follows: not being a smoker (or quitting before age 45); not having a history of alcohol abuse; normal weight; regular exercise; years of education; stable marriage; use of mature defense mechanisms. Factors not strongly associated with successful aging: longevity of one’s ancestors; cholesterol level at age 50; social class of one’s parents; stressful life events before age 65.
Peterson’s note on years of education: wellness predicted by this factor not through higher IQ scores or higher income, but by greater future orientation and perseverance.
Chapter 10: Positive Interpersonal Relationships
Oxytocin is a hormone-like substance thought to be the biochemical basis of love. It increases during pregnancy and facilitates the production of milk and other “maternal behaviors.” The more time fathers spend with their infants, the more their oxytocin levels increase. It has been called the cuddle hormone and has been linked to the creation of a loving bond between two individuals and perhaps even to monogamy. It is associated with dopamine and can deactivate regions of the brain responsible for negative emotions when mothers view pictures of their children.
Zick Rubin (1970) is responsible for showing that love could be legitimately studied just as any other construct in psychology. He developed self-report measures that distinguished love from liking. His findings were: (1) The scale was associated with reports of being in love and with expectations of marriage. (2) Couples who mutually scored high on love scale were more likely to be together months later
Harry Harlow’s monkeys: Infants rhesus monkeys were provided with two faux mothers, one made of terry cloth, the other made of wire. The wire mother had a nipple protruding and provided the infant with its only source of food. However when startled, the infant ran to the comfort of the wire mother. Harlow concluded that infants form attachments with things that are easy to cuddle. Thus affection is more than the result of the satisfaction of physiological needs.
Additional research showed that isolated monkeys did not act normally around other monkeys. The effects of isolation can be reversed, but not if one has already progressed past critical developmental periods.
Two Perspectives on Love (Head vs. Heart)
(1) Equity theory: close relationships persist to the degree that both people believe that what they are getting out of the relationship is proportional to what they are putting in. Assumes people calculate the costs /benefits of interacting with each other, these include: goods, information, love, money, services, status. Another similar theory is the social support theory which refers to how other help us cope with stressful events (House, 1981), these include: appraisal support: constructive feedback, affirmation, and social comparison; emotional support: empathy trust, caring and nurturance; informational support: advice, suggestions, and solutions; instrumental support: tangible aid and service
Research in support of equity theory: people tend to pick romantic partners that are of equal attractiveness; friends also pick equally attractive friends; if mismatched, people need to be compensated on another dimension; men place more emphasis on their partners’ attractiveness, females place more importance on their partners industriousness and accumulation of resources (Buss et al. 1990). Couples are least likely to break up if they are satisfied with the relationship, if no suitable alternatives are present, and if a great deal of time has been invested in the relationship.
Limits of equity theory: it cannot account for selfless acts of altruism; volunteer work is associated with high life satisfaction and good health; giving social support is more beneficial than receiving it; there are various ways that people interpret their relationships that are at odds with their specific behaviors.
(2) Attachment theory: emphasizes the feelings that bind us together. Many young have evolved a predisposition to become attached to a care giver. This enhances an infant’s survival by regulating its relationship and proximity to a caregiver.
Developmental stages: (1) first hours: infants can trace objects, usually faces ; (2) few months: can discriminate caregiver from others; (3) 6-7 months infants shows a strong attachment to others
Strange Situation Test: infants are placed into a room and separated from their care giver. Their reactions are coded and categorized into three categories: avoidant, securely attached, and ambivalent. Securely attached children strike a balance between autonomy and dependency. They have more friends and are more popular in school. They tend to form better relationships with others and exhibit the qualities of well-being outlined in this book. Furthermore infant attachment styles tend to appear in adult romantic relationships, with securely attached individuals faring better than others. They are: more likely to practice safer sex, be more supportive of their partners, less upset in the wake of stress, more likely to compromise, more likely to have good self-esteem, less likely to divorce, and less likely to abuse their spouses.
Personal relationships around the world are becoming more similar to Western cultures (Rapson, 1993).
Affiliation: people want to be associated with other people; however, their specific identity is unimportant. This helps explain the basis of social comparison. It helps us evaluate ourselves.
Liking: when people have a positive attitude towards each other. Liking can be predicted by: proximity, similarity, complementarity of needs, high ability, attractiveness, and reciprocity.
Friendship: when liking is coupled with a mutual perception of similarity and expectations. Children develop friendships at the age of 3-4. Teenagers distinguish between best friends and good friends. Adult friends are often formed around work and mutual interests. The number of close friends that someone has is usually a low number. The number of friends one has usually decreases throughout life and older people tend to prefer friendships that have shared histories. Males and females tend to have same sex best friends. A best friend is one with whom someone has a reciprocated and sustained relationship marked by positive emotions.
Love: four types of love: agape(selfless love that approaches the divine), eros(desire), philia(friendship), and nomos (submission to god’s will).
Marriage based on love is a relatively modern invention and still uncommon in many parts of the world. Satisfaction with marriage is highest in the beginning, reaches an all-time low when couples have adolescent children, and increases once children leave the house. Married couples are physically and emotionally healthier than their non-married counterparts. The perception of higher divorce rate today may be a result of longer life spans. Marital satisfaction is not a strong predictor of divorce. Divorce is usually a combination of alternative mates, career decisions, and financial crises.
Relational efficacy is the belief that a couple can weather conflict together. Whining, defensiveness, and stubbornness during conflicts predict divorce. Humor, affection, and positive interpretations make marriage successful.
Gottman proposes a 5:1 model, which specifies the ratio of explicitly positive vs. explicitly negative interactions necessary for a relationships success.
Chapter 11: Positive Institutions
Positive is not an adjective sensibly applied to an institution as a whole. We have to ask positive for what purpose? Peterson replaced in his thinking the term positive institution with enabling institution. Some institutions can enable certain outcomes better than others can. Enable implies that pronouncements about what enables what should not be thought of as relentless laws of the universe. At the same time, a given institution can do a better or a worse job at its acknowledged purpose, and here comparisons across institutions and time are informative.
- An aggregation is an assembly of individuals physically in the same place – place may be the only thing they have in common. What is psychologically interesting about aggregations is that the mere presence of others influences how we act.
- A collectivity is simply a social category: two or more individuals who can be discussed as a whole. (e.g., Elvis impersonators)
- A group is a set of interacting individuals who mutually influence each other.
- An organization is an enduring and structured group. Usually an organization has a body of traditions and customs. Its members think of the organization as a whole, and their roles are differentiated and specialized. By this definition, many work groups qualify as organizations.
- An institution is a set of like organizations with especially sustained and pervasive influences within a society or even the world as a whole. Most societies have some form of religion, some form of marriage, and some form of education; we therefore speak of these as institutions.
Institutional-level virtues are the moral characteristics of the group as a whole, not simply summaries or composites of the characteristics of its individual members. They need to be an enduring part of the institutional culture. They serve the moral goals of an organization and not simply its bottom line, whether this be profit, power, or persistence. The fact that any institution has multiple goals challenges us as we attempt to separate Institutional-level virtues from characteristics that contribute to other desired goals. The problem with trying to describe what makes some organizations better than others is that the criteria used for deciding goodness conflate profitability, longevity, customer satisfaction, and notoriety with moral goodness, and debate ensues about the moral desirability of some of the critical features thereby identified. They contribute to fulfillments of its members rather than cause them directly. This ties to the concept of eudaimonia, which holds that well-being is not a consequence of virtuous action but rather an inherent aspect of such action. The need to influence actual conduct within the group in ways that people can recognize. Institutions, like individuals, can pay lip service to values that are ignored or even contradicted by their everyday practices. Virtues are cultivated and celebrated and serve as a source of identity and pride for the organization’s members.
Except for post-WWII burst between 1947 and 1957 (the baby boom) the birth rate in the US has steadily decreased throughout the 20th century. Families are becoming smaller. Because of birth control, most US adults become parents later in life than they did generations ago. Families are becoming older. With the increase in divorce and subsequent remarriage, there are a growing number of families that include stepparents. Families are becoming more complex.
Three major styles of parenting have been identified in the US: (1) Authoritarian parenting is firm, punitive, and emotionally cold. It values obedience and discourages independence. Children are not involved in decision-making. (2) Permissive parenting is loving but lax. Such parents exert little control over their children. (3) Authoritative parenting involves negotiating with children. Such parents set limits for a child, but explain why, and they encourage independence.
Parenting is both rewarding and stressful. The presence of children profoundly changes the relationship between husbands and wives. The vast majority of parents report that if given the chance to start their lives over, they would choose again to have babies.
School is sometimes called a life industry, which means that educational practices affect students not just in the here and now, but also across the lifespan in settings far removed from the classroom.
Discussions of excellent schools often focus just on achievement and not on the people who achieve, but we should not confuse graduation rates and test scores with the moral goals of education.
Positive attitudes and motives about school translate themselves into good academic performance but, more important, make students lifelong learners who reap psychological benefits long after graduation.
The features of good schools (based on Maehr, et.al.): (1) Students perceive courses to be relevant; (2) Students perceive that they have control over what happens to them at school; (3) Students perceive school discipline policies to be firm, fair, clear, and consistently enforced, with a focus on correction and skills building rather than punishment; (4) Students see the school reward system as rational: the school recognizes students for their achievement and rewards their positive behavior; (5) There exists a strong and effective school governance; (6) The school principal displays strong leadership; (6) Practices are in place which decrease the impersonality of the school and increase contact between students and teachers, which in turn increase students’ feeling of belonging and connectedness
A typology of workers in terms of work’s meaning (from England and Whitely, 1990): (1) Alienated worker – work is not central to life; it is pursued for neither economic nor expressive reasons; it is not seen as fulfilling any obligation to the larger society. Alienated workers tend to be young and female in low-paying jobs with little variety or responsibility. (2) Economic worker – meaning of work revolves solely around good pay and high security. Economic workers tend to be less educated, are somewhat more likely to be male, and tend to be in low-paying jobs with low job satisfaction. (3) Duty-oriented worker – work is highly central to life, is undertaken for expressive reasons, and is regarded as a societal obligation. The duty-oriented worker tends to be older, is somewhat more likely to be female, tend to be managers or in sales, and tend to be in jobs with high variety and responsibility, earning good salaries. (4) Balanced worker – highly central to life; both economic and expressive goals are satisfied. The balanced worker tends to be older, tends to be well-educated males, has high autonomy, works the longest hours, has the highest salaries, and high work satisfaction.
Excellent work organizations have an articulated moral goal or vision that can be embraced by workers and customers alike. Workers are treated fairly in moral work organizations, which have reward structures both explicit and equitable. The organization must treat people as individuals and not just as a pair of hands, and it follows through on commitments – to workers and to customers. Promises and contracts, even implied ones, are honored.
Roman municipal virtues recurring in contemporary characterizations of good institutions: Gravitas (a sense of the importance of the matter at hand), Veritas (honesty), Concordia (harmony), Pax (peace), Equity (fair dealing within society), Good fortune (remembrance of important positive events), Justice (sensible laws and governance), Patience (the ability to weather crises), Providence (the sense that the society has a destiny), and Safety (public health and welfare).
Confucius valued social order and stressed explicit role expectations and identified six crucial relationships: (1) Ruler and subject; (2) Parents and children; (3) Husband and wife; (4) Older sibling and younger sibling; (5) Teacher and student; (6) Friend and friend. Each (except for #6 sometimes) has a superior and subordinate member. The subordinate has the responsibility of obedience to the superior, but only when the superior displays benevolence and care.
In studies of religion, Allport distinguished between extrinsic religiosity (religion as a means to other ends) and intrinsic religiosity (religion as an end in itself). Extrinsically religious people are the most likely to be prejudiced. Intrinsically are the least likely.
Psychologists distinguish between religiosity and spirituality.
The psychoanalytical school draws upon the work of Freud and emphasizes the role of unconscious motives for religious beliefs. The object relations school draws on more contemporary psychodynamic theorizing and often emphasizes maternal influences. The transpersonal school assumes that religious phenomena (although immaterial) are nonetheless real and can be studied directly. The phenomenological school attempts to describe religion as the individual experiences it.
Positive psychology has increased the interest in character strengths and virtues, including the explicitly theological (faith, hope, and charity) and the more secular but still religiously linked (gratitude and forgiveness).
The psychology of religion today is a moving target, and as analytic questions begin to be answered, the field may be increasingly embraced by the larger discipline.
Widely valued institutional-level virtues: (1) Purpose – a shared vision of the moral goals of the organization, which are reinforced by remembrances and celebrations; (2) Safety – protection against threat, danger, and exploitation; (3) Fairness – equitable rules governing reward and punishment and the means for consistently enforcing them; (4) Humanity – mutual care and concern; (5) Dignity – the treatment of all people in the organization as individuals regardless of their position.
A worthy future goal of positive psychology is to turn its attention to how institutional practices can be engineered so that moral excellence and personal fulfillment on the part of all institutional members are enabled.
From Good Work (Gardner, Csikszentmihalyi, Damon, 2001): When there is alignment between the abstract values of a field and what people in the field actually do at work, individual practitioners are free to operate at their best, morale is high, and the professional realm flourishes.
Such alignment is rare and easily threatened. (1) Promethean technology and the unanticipated problems it can bring in its wake; (2) Intrusion of the profit motive into professions; (3) Dumbing down of what the profession does in order to appeal to the lowest common denominator among its various stakeholders.
To facilitate good work create institutions that promote good work: expand functions, reconfigure memberships, reaffirm traditional values, and prominent practitioners can take personal stands in favor of excellence.