Towards A Balanced Model of Positive Mental Health
Paul T. P. Wong Ph.D. C.Psych
Tyndale University College
Toronto, Ontario

The pendulum has swung from an emphasis of positive aspects of behavior to negative psychology and then back to positive psychology.

We need to create a balanced model that integrates both positive and negative psychology. Such a model recognizes both positive and negative mental health conditions and incorporates a broad spectrum of positive intervention strategies.

Positive aspects of behaviors

1. Allport - maturity
2. Rogers and Maslow - personal growth and self-actualization
3. Fromm - the ability to love and create
4. Marie Jahoda - psychological resources and personal growth
5. Erickson -accomplishing the different developmental tasks
6. Jung - individuation
7. Frankl - meaning and responsibility
8. Wong - personal meaning (achievement, relationship, intimacy, self-acceptance,self-transcendence, religion, and fair treatment)
9. Peterson and Seligman - character strengths and virtues

Possible reasons for focus on mental illness

1. Second World War contributed to the growth of clinical psychology
2. Increasing influence of DSM as the basis for funding for managed care and third party insurance payment
3. The medical profession has a moral obligation to reduce human suffering caused by mental illnesses
4. Society has an moral obligation top care for the mental ill because they cannot take care of themselves
5. There appears to be a greater sense of urgency and responsibility to treat illness than promote health and there is no funding for health promotion
6. There is a lack of concern about positive mental health, because individuals are expected to actively maintain their own mental and physical health without the support of medical profession and Government funding

Definitions of positive mental health

1. Most experts agree that "mental health" and "mental illness" are not opposites. In other words, the absence of a mental disorder is not necessarily an indicator of mental health
2. The World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" [1]. In more recent years, this statement has been modified to include the ability to lead a "socially and economically productive life."
3. In general, mental health can be inferred from judging how effectively and successfully a person functions in living an independent and productive life. Another major indicator is whether he or she is able to maintain good relationships. Finally, we want to see whether this person is able to cope with daily stress and recover from traumatic life events

Ryff’s (1989) comprehensive model of positive mental health consists of psychological, social and emotional well-being

Social well-being consists of five components: social acceptance, social actualization, social contribution, social coherence and social integration

Emotional well-being consists of four components: presence of positive affect, absence of negative affect, life satisfaction and happiness

Psychological well-being is based on six components:

1. Self-acceptance - Feeling good about oneself and one’s life
2. Personal growth - Feeling confident about continued personal growth in knowledge and effectiveness
3. Purpose in life - Having a clear sense of purpose and goals and feeling that past life is also meaningful
4. Environmental mastery - Feeling competent to manage complex life situations (i.e., self-efficacy)
5. Autonomy - Feeling independent and having confidence in one’s own judgment
6. Positive relations with others - Having empathy and good relationships

Towards balanced conceptualizations in clinical and counselling psychology

1. Both negative and positive behaviors, emotions and situations
2. Both internal characteristics and external circumstances
3. Both current behavior and past histories
4. Both individual distinctiveness and cultural contexts
5. To facilitate behavior change, we also need to consider basic human need for meaning and purpose

What is abnormal?

1. Is it normal to be gay? (Homosexuality is no longer considered by the medical profession as abnormal; it is regarded as an alternative life style and one of several sexual orientations)
2. Is it normal for females to go topless the street?
3. Is it normal for men to have multiple wives?
4. Is it normal to have one’s body pierced?
5. What is considered abnormal depends on many factors, such as situational and cultural context, etc.
6. Abnormality is typically defined in terms of (a) statistics (b) societal or cultural norms, (c) adaptive functions, (d) effects of the behaviors and (e) reaction by influential people as way to ostracize someone (i.e., demonizing, and witch-hunting)
7. Abnormal behaviors may serve positive functions - some of the extreme behaviors of social and environmental activists

Beware of attributions biases

1. The fundamental attribution error - attributing other people’s behavior to internal causes, but one’s own behavior to situational causes
2. The fundamental negative bias - the tendency to consider a behavior negative, if it stands out (salience), generally regarded as negative, and in a vague context.

Beatrice Wright’s four-front approach

1. Deficiencies of the person
2. Strengths of the person
3. Lacks and negative factors in the environment
4. Resources and opportunities in the environment

Wong’s balanced model of positive psychology:

Table 1 Positive outcome (PO) in positive mental health

Table 2 Negative outcome (NO) in negative mental health and intervention strategies (in bracket)

Negative internal (NI) = negative personal characteristics, such as deficiencies, weaknesses, illness, disability, negative emotions and experiences

Positive internal (PI) = positive personal characteristics, such as strengths, virtues, health, positive emotions and experiences

Negative external (NE) = negative environmental characteristics, such as lack of opportunities and support coupled with the presence of a variety of negative factors such as discrimination, oppression and poverty

Positive external (PE) = positive environmental characteristics, such as social and environmental resources and opportunities for personal growth and success

Negative outcome (NE) = increase in negative affect, stress and conflict and decrease in the ability to function

Positive outcome (PO) = increase in positive affect and the ability to function, and a decrease in stress and conflict

Focus of intervention is inserted in bracket

Wong’s model includes 8 categories: Positive and negative personal characteristics, positive and negative environmental characteristics, and positive and negative outcomes (NO and PO)

This model recognizes that negatives and positives can co-exist, resulting in more complex combinations. In real life, most people experience all possible combinations PI-NI-PE-NE-PO-NO, although the degree of negativity and positivity in each category may vary from person to person and situation to situation.

Positive mental health does not mean the presence of positives and the absence of negatives, but (a) the ability to fully function in all kinds of negative and positive combinations and (b) the ability to effectively counteract negatives.

It is possible that under some conditions, some people only experience positives, e.g., PI-PE-PO. Such ideal conditions are rare and temporary.

Likewise, under some conditions, some individuals only experience negatives, e.g., NI-NE-NO. Such totally negative conditions can last longer than the ideal positives.

Even in this worse case scenario, effect therapy can reduce negatives and restore positives.

In terms applications, we always seek to reduce negatives and whenever possible transform negatives into positives through appropriate interventions. The suggested focuses (in bracket) are only part of positive interventions