Optimal Mental Health_1_ by kqxarzawuiwpx

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									Optimal Mental
    Health
 Thriving and Complete Wellbeing
         by Cultivating the
 Positive Aspects of Mental Health




    By Jeremy Alan Herschler, MD
Dedication



       To all who suffer, to those who thirst for a better life, to my patients, my
teachers, my colleagues, my family and friends, my beautiful wife Alison and my
wonderful son Noah; this book is my love letter to you. May you believe in yourself,
be happy, strong, and healthy and live rich, long, satisfying, meaningful, exciting,
and fulfilling lives that are true to who you are on the inside. May you impose your
will on the opposition, excel at winning with ease, however you define victory, and
rise up this tall mountain to become more and more complete. People want more
than an end to their suffering, they hope to thrive and live the best things in life.
May you be humble and blessed with the magnificent grace of God. Come on, rise
up. Come on, rise up. Rise up.




                                            2
Acknowledgements


       I would like to thank the following individuals who reviewed this book and
provided feedback that helped guide its development: Michael Herschler PhD and
Anthony Umpierre MD. I also give thanks to the many contributors to this book. I
tried to find the spirit in their words in order to write the complete manual for fitness
and wellbeing.




                                            3
Contents
Dedication........................................................................................................................... 2
Acknowledgements ............................................................................................................. 3
Introduction........................................................................................................................ 7
   Positive Health Outcome Assessment .................................................................................... 12
Part One: What is Optimal Mental Health? .................................................................. 18
Part Two: Preventing Mental Illness ............................................................................. 28
Part Three: Biological Approaches to Optimal Mental Health .................................... 35
   Neurobiology and Optimal Health ........................................................................................ 37
   Optimal Nutrition ................................................................................................................... 41
   Healthy Weight........................................................................................................................ 45
   Exercise and Staying Fit ......................................................................................................... 54
   Obtaining Fully Refreshing Sleep .......................................................................................... 61
   Preventing Physical Illness and Disability ............................................................................ 63
   Long Life .................................................................................................................................. 69
Part Four: Psychological Approaches to Optimal Mental Health................................ 73
   Mental Growth ........................................................................................................................ 74
   Your Relationship with Yourself ........................................................................................... 82
   Emotional Security .................................................................................................................. 96
   Emotional Intelligence ............................................................................................................ 97
   Positive Emotions and a Joyous Engagement with the World .......................................... 103
   Coping, Resilience, and Mental Toughness ........................................................................ 104
   Ego Strength .......................................................................................................................... 138
   Psychological Insight: The Capacity for Understanding Self and Others ...................... 142
   Coherence of Personality ...................................................................................................... 143
   Practical Intelligence............................................................................................................. 145
   Mental Exercise ..................................................................................................................... 159
   Effort, Success, and Superior Functioning ......................................................................... 160
   Optimal Mental States: Flow, Mindfulness, Peak Experiences, Becoming Sure and
   Effectiveness States ............................................................................................................... 170
   Play and Work....................................................................................................................... 176
   Financial Health .................................................................................................................... 181
   Mental Balance and Homeostasis ........................................................................................ 183
   Clarity of Mind ...................................................................................................................... 186



                                                                       4
  Utilizing the Wisdom of the Unconscious............................................................................ 187
  Visualization .......................................................................................................................... 189
Part Five: Social Approaches to Optimal Mental Health ........................................... 190
  Social Support ....................................................................................................................... 191
  Pet Companionship ............................................................................................................... 194
  Altruism ................................................................................................................................. 195
  Social Intelligence .................................................................................................................. 198
  Storytelling............................................................................................................................. 223
  Touch ...................................................................................................................................... 224
  The Health Benefits of Sex ................................................................................................... 225
  Providing Effective Parenting .............................................................................................. 226
  On Being a Role Model ......................................................................................................... 242
  The Healing Relationship ..................................................................................................... 244
Part Six: Spiritual Approaches to Optimal Mental Health ......................................... 246
  Religious Coping ................................................................................................................... 248
  Gratitude ................................................................................................................................ 249
  Hope ....................................................................................................................................... 251
  Faith ....................................................................................................................................... 252
  Guidance ................................................................................................................................ 254
  Forgiveness ............................................................................................................................ 256
  Detachment ............................................................................................................................ 258
  Prayer ..................................................................................................................................... 259
  Grace ...................................................................................................................................... 260
  The All-Sufficient Spiritual Sacrifice .................................................................................. 262
  Being Centered ...................................................................................................................... 263
  Inner Strength ....................................................................................................................... 264
  Inner Peace ............................................................................................................................ 266
  Inner Joy ................................................................................................................................ 268
  Inner Beauty .......................................................................................................................... 269
  The Fruit of the Spirit ........................................................................................................... 270
  Spiritual Energy and the Life Force .................................................................................... 274
  Radiating Your Spiritual Light............................................................................................ 278
  Getting Grounded ................................................................................................................. 279
  Keeping Your Heart Open ................................................................................................... 280



                                                                       5
   Wonder and Awe................................................................................................................... 282
   Honoring the Sacredness of Life .......................................................................................... 283
   Enlightenment ....................................................................................................................... 284
   Spiritual Liberation .............................................................................................................. 288
   Spiritual Power...................................................................................................................... 289
   Authority and Mastery Over the Unseen Forces of Darkness .......................................... 290
   Self-Realization...................................................................................................................... 292
   Chutzpah ................................................................................................................................ 293
   Contentment and Bliss .......................................................................................................... 294
   Soulfulness ............................................................................................................................. 296
   Spiritual Growth and the Heights of Spiritual Achievement ............................................ 297
   Spiritual Issues in Success .................................................................................................... 298
   Made Complete ..................................................................................................................... 299
   Optimal Mental Health and Wholeness .............................................................................. 301
Part Seven: Environmental Approaches to Optimal Mental Health .......................... 304
Part Eight: Thriving...................................................................................................... 306
Part Nine: Complete Wellbeing .................................................................................... 308
Conclusions: ................................................................................................................... 309
   Positive Health Outcome Assessment .................................................................................. 317
References ...................................................................................................................... 323
About the Author............................................................................................................ 346




                                                                      6
Introduction

       Isaac Newton once wrote, ―If I have seen a little further, it is by standing on
the shoulders of giants.‖ Now, with our tremendous growth in knowledge, the
general interest in how to live optimally can be more fully satisfied today than at any
other time. The mind has tall mountains. People want to know how to find their
best quality of life, live long lives, and function at the highest possible levels.
Successful mental functioning makes these aims possible. Anything is possible. Our
success depends upon hard work and the bold spirit of adventure. There is nothing
so satisfying to the spirit than to give one‘s all to a difficult task and realize what one
hopes and dreams.     The opportunity to rise up the tall mountain before us exists at
this moment for every willing person.


       According to the Surgeon General David Satcher in the 1999 report of the
surgeon general on mental health, ―We know more today about how to treat mental
illness effectively and appropriately than we know with certainty how to prevent
mental illness and promote mental health. Common sense and respect for our fellow
humans tells us that a focus on the positive aspects of mental health demands our
immediate attention.‖ (U.S. Department of Health and Human Services, 1999) This
call for action has been answered with great interest worldwide in finding measures
to prevent mental illness and promote exceptional mental health and fitness.


       According to The World Health Organization and the Ottawa Charter of Health
Promotion, health promoting activities should be implemented at multiple levels. In
this model, mental health might be promoted by building healthy public policy,
creating supportive environments, strengthening community action, reorienting
health services to include health promotion, and by developing personal skills and
healthy lifestyles. (WHO 1986) This model appears appropriate for both physical
and mental health promotion. The goal of the health promotion field in general is to
develop evidence-based interventions that demonstrate effectiveness and
repeatability in groups of people outside of research conditions. Efforts aimed at the
promotion of mental health strive to create individual, social and environmental
conditions that allow for optimal psychological and psychophysiological development.
The goal is for people and the communities in which they live to thrive. This book
focuses on personal skills and healthy lifestyles that promote optimal mental health



                                             7
and fitness with the hope that it may offer guidance in your own pursuit of health
and fitness.


        Our understanding of the factors that promote mental health has been
informed by the categories of factors associated with illness. The prevalent view that
many factors interact to produce diseases in general can be credited to the seminal
work of George Engel, who in 1977 proposed the biopsychosocial model of disease.
According to this model, looking at biological factors or environmental factors alone
is not sufficient to explain the cause of disease. Rather, it suggests a general view
that several factors such as genes, parenting, or stressful events combine to produce
illness; whereas, a combination of specific biopsychosocial factors would also
combine to prevent illness and promote health. One single factor- biological,
psychological or social- may have tremendous weight on the health outcome or may
barely impact outcome at all. For mental illnesses, a biological predisposition to
illness is necessary but not sufficient to explain the occurrence of illness; while, a
psychological or social cause may be necessary but again not sufficient.      Similarly
we might expect that biological underpinnings are necessary for great mental fitness
while psychological and social factors would also play an important role. Theories of
brain plasticity suggest that the structure and function of brain tissue can change,
repair, and improve throughout life even despite damage to tissue and the body can
heal and become fit. Those who at one point suffer from physical or mental illness
may later achieve great health and wellbeing, sound body, sound mind and a shining
irrepressible spirit.


        The goal of both study of illness and health is to find out specifically which
different factors contribute to illness and which to health and how they in fact
produce their results. According to Engel‘s model, biopsychosocial factors are
involved in the causes, appearance, course and outcome of both illness and health.
Ultimately, the best interventions to treat disease, prevent illness and promote
higher health will combine biological, psychological and social aspects. Furthermore,
our understanding of the importance of spiritual approaches to health promotion is
growing. By embracing the diversity of human beings we increase our potential for
happiness, exceptional functioning and long life. A complex set of conditions, the
succession of conditions, results in the development of all we become and
experience. It is possible to disrupt the fundamental links to suffering and become
free and it is possible to create a set of conditions for optimal mental health and



                                            8
functioning. This book describes biological, psychological, social, spiritual and
environmental approaches that help to promote exceptional mental functioning and
health.



          The first step in promoting optimal mental health is taking measures to
prevent illness. Mental health problems are among the most common forms of
illness. It is estimated that 450 million people worldwide are affected by mental or
behavioral problems at any point in time. That translates to an estimated one is six
people, at any point in time, suffering from a diagnosable mental condition. One
fourth of the world‘s population will develop a mental or behavioral disorder at some
point in their lives. Mental health problems place a heavy burden on affected
individuals, their families and friends, and the community at large. There is a
tremendous financial burden with loss of productive work and health care expenses.
Mental disorders account for 25% of disability in the United States, Canada and
Western Europe and are a leading cause of premature death. A better understanding
of prevention of mental illness will help millions of people and the communities in
which they live avoid the immense suffering associated with these conditions.


          Ideally, known causes of illness should be avoided or if the causes are
unavoidable appropriate defensive measures should be taken. Unfortunately, it is
difficult to prove that particular events will cause mental conditions as research
designed to reproduce mental illnesses in people would be unethical. On the other
hand, certain biological, psychological and social risk factors have been correlated
with the occurrence of illness without a proven causal relationship. Similarly,
protective factors have been found that appear to reduce the occurrence of illness in
individuals at increased risk of becoming mentally ill due to risk factors.
Furthermore, the treatment of mental illness can also shed light on health promoting
factors. Healing factors that come from the patient have been found among healing
therapies that help thinking, emotions and behavior in general. Drug therapies
target symptoms with specific mechanisms of action but in research conditions some
people with mental illness respond to inactive placebos in the context of other
curative factors created by the research method.


          Achieving exceptional mental health means much more than just preventing
illness. Illness and health lie along a continuum between the extremes of severe



                                             9
illness and optimal functioning, health and fitness. Measures that merely treat or
prevent illness may only help people reach states of health that lie midway along the
continuum, while fitness implies higher degrees of health. The field of positive
psychology, initiated by Martin Seligman in the late 1990‘s, has helped begin to build
and refine our scientific understanding of the positive end of the mental health
spectrum or what makes people thrive. Positive psychology strives to answer
questions about how to live optimally with the highest possible quality of life and
happiness. The fields of clinical psychiatry and psychology‘s emphasis on alleviating
suffering has neglected both what makes life most worth living and our capacity to
achieve states of optimal mental health and functioning. Positive psychology is
founded on the belief that people hope for more than an end to suffering, they hope
to live the best things in life. People want to lead meaningful and fulfilling lives, to
find purpose, to nurture what is best within themselves, to strengthen areas of
weakness, and to improve their experiences of love, work, and leisure. Positive
psychology as a science strives to help individuals and communities build strengths
and develop virtues so that they might not only avoid suffering but also come to
flourish. (Seligman, 2006) We recognize optimal mental health in those people who
glow radiantly and function superbly; but, our understanding of the biological,
psychological, social and spiritual factors that enable people to thrive and live
optimally is still in early stages of scientific inquiry. Yet, a great effort has unearthed
many clues to help us thrive, find exceptionally healthy body, mind, heart and spirit
and optimal levels of functioning.


       This book will explore our present state of knowledge regarding health
promoting factors that have been associated with illness prevention and the
achievement of optimal mental health and functioning. A thorough discussion about
the treatment of mental illness is not included; however, measures which have been
shown to promote health and prevent illness may ultimately be shown to aid those
affected by mental illness in their recovery and realization of optimal health.
Because the field of mental health promotion and prevention of illness is young, the
following proposed positive health factors have not been proven effective by rigorous
scientific testing. The evidence supporting each factor however is included with
references. Therefore, the proposed factors should be viewed as areas of interest for
more rigorous testing and not necessarily prescriptive for optimal mental health.
Please read and enjoy with this caveat in mind.




                                            10
Strengthening the Evidence of Self- Help Literature’s Effectiveness


       The practice of modern medicine demands that treatment be based upon
evidence from research.    Before a drug is approved by the FDA its effectiveness
must be established. Unfortunately, the tremendously profitable self-help book
market lags behind medicine‘s sound scientific evidence-based approach. In order to
improve self-help medicine, research should be conducted in order to substantiate its
effectiveness and guide consumers. Common sense and respect for our fellow
humans requires that good government oversee the self-help market and make
determinations about the scope of benefit. Furthermore, a government based health
care system should promote self- help that is effective to save cost and expand
prevention and health promotion. This could mean more people enjoying longer
healthier lives. Some self- help may have universal benefit while other works may
be directed at specific target populations. Some self-help works may have good
intentions but show no positive effects in rigorous research studies. The potential for
growth in this area looks enormous.


       I am a psychiatrist and addictions specialist practicing in western Maryland
and have authored this self-help book thought to have universal benefit. The book
aims to prevent physical and mental illness and promote good health, fitness and
functioning. In the spirit of the above argument, I would like to study and prove or
disprove its effectiveness before submitting it for publication.   You can download the
free book online and participate in outcome research online if you wish as well at
www.OptimalMentalHealth.info


Best wishes, Jeremy




                                           11
Positive Health Outcome Assessment

       This questionnaire measures your level of positive health. It is recommended
that you complete this questionnaire before reading the book for a baseline assessment
and then return later at the conclusion of the book and see how far you have
progressed.

   -    Please mark your responses to the following questions about positive health. Scores
       range from 0-114.

   1. Quality of life:
      -   physical health:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
      - mental health:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
      - recreation/leisure:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
      - family/social life:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
      - housing/transportation:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
      - education/work/financial:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied




                                             12
-   legal issues:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   personal appearance:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   spiritual life:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   climate where you live:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   geography where you live (features of the earth’s surface):
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   degree of safety:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   political and personal freedom:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   crime level in your community:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied




                                       13
     -   traffic congestion:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
     -   quality of entertainment:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
     -   degree of gender and racial equality:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied

2. Subjective sense of wellbeing:
   - How happy am I in general?
           o 3. very happy
           o 2. fairly happy
           o 1. unhappy
           o 0. very unhappy
   - I feel mentally fit and healthy
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree
   - I feel physically fit and healthy
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree

3.   Resilience
             o    3.    I never feel ill
             o    2.   I rarely feel ill
             o    1.   I often feel ill
             o    0.   I always feel ill




                                            14
4. Accomplishment
         o 3. I have achieved much more than I hoped to accomplish
         o 2. I have achieved everything I hoped to accomplish
         o 1. I have achieved some of what I hoped to accomplish
         o 0. I haven’t achieved anything I hoped to accomplish
   - I hope to accomplish more
         o 3. Strongly agree
         o 2. Somewhat agree
         o 1. Disagree
         o 0. Strongly disagree

5.   Strength of character and beauty
            o 3. I have many positive qualities
            o 2. I have some positive qualities
            o 1. I have few positive qualities
            o 0. I have no positive qualities

6.    Social intelligence
     -    I am sought out by others because of my many positive qualities, warmth and
         integrity
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree
     - I have rich and satisfying relationships
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree
     - I work well with others
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree
     - I feel compassion for others, particularly when they suffer
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree




                                          15
7. Emotional intelligence
   - I often enjoy positive emotions
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree
   - I am able to keep a lid on my anger
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree
   - I understand my emotions
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree
   - I understand the emotions of other people
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree

8. Purpose and meaning
   -   I have enjoyed many valued experiences: love in a relationship, raising a child,
      experiencing beautiful art or music or others
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree
   - I have enjoyed creative deeds: creative art, music, dance, inventing, writing or
      others
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree
   - I have developed valued attitudes: bravery, forgiveness, responsibility or others
           o 3. Strongly agree
           o 2. Somewhat disagree
           o 1. Disagree
           o 0. Strongly disagree




                                          16
        -   I have contributed to my community
                o 3. Strongly agree
                o 2. Somewhat agree
                o 1. Disagree
                o 0. Strongly disagree

   9.    Maturity
        -   I am mature for my age
                o 3. Strongly agree
                o 2. Somewhat agree
                o 1. Disagree
                o 0. Strongly disagree

   10. Satisfaction, contentment and bliss
       -   All things considered, how satisfied are you with the life you lead these
            days?
               o    3.   very satisfied
               o    2.   fairly satisfied
               o    1.   not very satisfied
               o    0.   not at all satisfied




Total score:
               __________

   11. Longevity
       -   Age: years
              o _______
       - Quality of life adjusted age: how old do you feel? (Years)
              o _______

   12. Gender
       -   Male
       -   Female




                                                17
Part One: What is Optimal Mental Health?

       Henry Kissinger once said, ―If you don‘t know where you are headed, any
road will take you there.‖ When you have a clear concept of the goal, you are more
likely to get there. With this principle in mind, a clear objective will help guide
decisions and actions on the journey to optimal health. What, however, is optimal
mental health? On the continuum from mental illness to health, it has been
challenging to clearly define what constitutes exceptional health. Mental illnesses
have been thoroughly described in the literature with specific symptoms
characteristic of particular illnesses even though causes remain unclear; while,
descriptions of health have been vague. Many would agree that mental health is
more than the absence of illness.


       Aspects of positive mental health seem to differ between cultures with
differing value systems. Older people tend to define health as inner strength and the
ability to cope with life‘s challenges. Younger people tend to emphasize fitness,
energy and strength. People with comfortable living conditions tend to think of
health in terms of enjoying life; while, people who are not so well off tend to
conceive of health as just managing the essentials of daily life. In the Western world
we may emphasize rugged individualism while in the East there is more concern for
the wellbeing of the collective social group. The World Health Organization defines
mental health as ―a state of well-being in which the individual realizes his or her own
abilities, can cope with the normal stresses of life, can work productively and
fruitfully, and is able to make a contribution to his or her community.‖ According to
the U.S. Department of Health and Human Services, ―mental health is a state of
successful mental functioning, resulting in productive activities, fulfilling
relationships, and the ability to adapt to change and cope with adversity. Mental
health is indispensable to personal wellbeing, family and interpersonal relationships,
and one‘s contribution to society.‖


       According to the Canadian Institute for Health Information, ―mental health is
the capacity of each and all of us to feel, think and act in ways that enhance our
ability to enjoy life and deal with the challenges we face. It is a positive sense of
emotional and spiritual well-being that respects the importance of culture, equity,
social justice, interconnections and personal dignity.‖ Only 31% of Canadians in one



                                            18
survey rated their mental health as excellent. 22% of Canadians rated their overall
health as excellent. (Canadian Institute for Health Information 2009) The National
Aboriginal Health Strategy Working Party defines health as ―not just the physical
health well-being of the individual but the social, emotional, and cultural well-being
of the whole community.‖ (World Health Organization, 2004)


       George and Caroline Vaillant in the Comprehensive Textbook of Psychiatry,
Eighth Edition, discuss six approaches to a definition of positive (or optimal) mental
health: 1. above normal 2. positive psychology- or the presence of multiple human
strengths and virtues 3. maturity 4. socio-emotional intelligence 5. subjective
wellbeing and 6. resilience- the capacity for successful adaptation to life and
homeostasis. Positive mental health as above normal implies that there are no
grossly observable signs of illness. Health from this perspective would be a
reasonable, rather than optimal, state of functioning. Health as an absence of
pathology misses the realms of potential positive functioning. It is normal as an
adult to be able to drive an automobile, while greater mental fitness is required to
safely pilot a jet, and still greater mental fitness is required to be an astronaut.
Above normal mental health loosely defines health as fitness.


       Positive psychology conceives of mental health as best possible. Health is
comprised of a combination of character strengths and virtues that allow a person to
flourish. Some of these strengths and virtues include wisdom and knowledge,
creativity, curiosity, love of learning, open-mindedness, courage, bravery,
persistence, integrity, vitality, love, kindness, citizenship, fairness, leadership,
forgiveness and mercy, humility and modesty, self-regulation, appreciation of
beauty, gratitude, hope, humor, cleanliness, and spirituality. (Seligman and
Peterson, 2004)


       Mental health as maturity implies that adult mental health reflects a
continuing process of growth. This does not imply that younger individuals are less
healthy; but rather, levels of maturity appropriate for one‘s age or somewhat above
what is appropriate for one‘s age indicate mental health. Mental health as socio-
emotional intelligence involves the capacity to develop rich and satisfying, mutually
beneficial relationships and manage and understand one‘s own and others emotions.
It also includes the motivation to reach desired goals and delay gratification
cheerfully.


                                            19
       Subjective wellbeing as mental health is not a sufficient lone criterion of
mental health; yet it is an important aspect of health. An expert may determine
outward signs of mental health while the individual experiences health as internal
experience. One‘s degree of subjective wellbeing can only be determined by self
assessment. Satisfaction, pleasant emotions, and fewer unpleasant emotions all
contribute to one‘s sense of subjective wellbeing. Subjective wellbeing is not just
the absence of misery but also the presence of happiness and good spirits. Yet,
some people experience the illusion of happiness when denial prevents recognition of
important life problems in situations such as bipolar mania, being high on drugs, or
the excitement of risk taking, promiscuity, or binge eating. These maladaptive
routes to happiness may bring a temporary sense of pleasure but are typically short
lived. Life events have a relatively small impact overall on subjective wellbeing as
people tend to adapt to new situations and return to their baseline levels of
happiness. It is thought that one‘s degree of happiness or subjective wellbeing is
largely influenced by temperament, biology, and genetics. Other factors which
influence subjective wellbeing include patterns of thinking, one‘s degree of
satisfaction with important relationships or work and also deeper satisfactions such
as finding meaning in life or having a sense of purpose. While the impact of genetics
and life circumstance on happiness are more difficult to control, we can best affect
our levels of happiness with our actions.


       We can significantly impact our degree of happiness by involving ourselves in
present enjoyment that has the potential for future benefit, enjoying the journey as
we climb the mountain, by finding pleasure and by finding meaning in life.
Consistent with this finding, the most significant factor that distinguishes happy
people from those who are less happy is the presence of rich and satisfying social
relationships. In particular, the presence of a close, nurturing, intimate marriage is
considered the strongest predictor of happiness. According to Sonja Lyubomirsky,
twelve strategies whose effectiveness has been demonstrated in researched
samples, can help to increase happiness: expressing gratitude, cultivating optimism,
avoiding overthinking and social comparison, practicing acts of kindness, nurturing
relationships, developing strategies for coping, learning to forgive, increasing flow
experiences, savoring life‘s joys, committing to your goals, practicing religion and
spirituality, and taking care of your body. (Lyubormirsky, 2007) Martin Seligman




                                            20
has shown that we increase our happiness by using our strengths. With happiness
we can smile easily and enjoy life. Although feelings of happiness might seem to be
a basic ingredient of good mental health, it has yet to be determined what level of
subjective wellbeing is optimal for general functioning. On the other hand,
numerous studies have shown that happier people tend to be more successful in
multiple areas including marriage, friendship, work performance, income and health.
While success leads to greater happiness, happiness also leads to greater success.
(Ben-Shahar 2007)


       According to the Canadian Institute for Health Information, ―life enjoyment is
linked to various personality types or traits, such as extroversion, optimism,
hardiness, and hope. Life enjoyment is also dependent upon better self-perceived
health, higher levels of social support, having higher levels of trust in others, and
feeling in control of one‘s life. Higher levels of enjoyment have been linked to being
employed and being more satisfied with one‘s work. Income appears to be less of a
factor in subjective well-being once needs have been met. Better life enjoyment also
depends upon having high quality marital harmony, quality parenting skills, higher
levels of family stability and increased parental attachment. Life enjoyment is partly
a result of personality, but it can change over time because of life circumstances and
environments. Finally, devoting our time to meaningful causes can enhance life
enjoyment.‖ (Canadian Institute for Health Information 2009)


       Mental health as resilience involves one‘s capacity to adapt to stress. It
includes coping skills, both intentional and unconscious, and social support.
Resilience allows the individual to face difficulties head on without insult to health.
(Vaillant and Vaillant, 2005) According to Vaillant and Vaillant, ―Health is based on
an active, joyous, energetic engagement with the world.‖ Mental health also
includes positive emotions: spiritual emotions bind humans together with love,
hope, joy, forgiveness, compassion, faith, awe and gratitude; other positive
emotions do not require others such as excitement, interest, contentment, humor,
and sense of mastery. Environmental mastery is a component of optimal mental
health. According to Barbara Frederickson, positive emotions help us to broaden and
build; they make thought patterns more flexible, creative, integrative and efficient.
(Vaillant and Vaillant, 2009)




                                           21
       Positive mental health has also been conceived in other terms of functioning.
In the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV, an assessment
of functioning termed the Global Assessment of Functioning measures adaptive
behavior in terms of psychological, social and occupational functioning. At the top of
the scale is the highest adaptive level in which: 1. life‘s problems never seem to get
out of hand, 2. one is sought out by others because of his or her many positive
qualities, 3. there is superior functioning in a wide range of activities and 4. there are
no symptoms of mental illness. (American Psychiatric Association, 1994)


       Abraham Maslow described people who developed optimal mental health as
self- actualized. To be self-actualized is to become more and more of what one is
capable of becoming, the full realization of one‘s potential. According to Maslow, self
actualization is motivated by urges for growth rather than desires to correct
deficiency. In keeping with Maslow‘s hierarchy of needs theory, lower needs must be
satisfied before self actualization becomes possible.   Self-actualization is a level of
development. Maslow‘s hierarchy of needs begins with the most basic requirements
he termed ―the physiological needs‖ including food, water, breathing and sleeping.
Once these needs are met, a person can begin to fulfill the ―safety needs‖ including
security, shelter, physical comforts, employment and property. The next level is
―belongingness and love needs‖ in which people strive to meet needs for social
acceptance, a sense of belonging, connection, sexual intimacy and family. Next are
the ―esteem needs‖ where a person strives for competence, respect from others, and
recognition of achievement. Some theorists argue that an individual can begin to
self-actualize once these needs are met while others include two additional needs.
First, ―cognitive needs‖ are met by developing knowledge and understanding of the
surrounding world and then ―aesthetic needs‖ are satisfied when a person brings
about symmetry, order and beauty. Once all of these needs have been met, self-
actualization takes place.


       According to Maslow, common traits associated with self actualized people
include: embracing reality and facts rather than denying the truth, spontaneity,
having interest in solving other people‘s problems, acceptance of oneself and lacking
prejudice. Self actualized people have humility and respect for others. They are
independent and autonomous. They tend to form deep friendships with select few
people, they resist outside pressures, and they tend to transcend the environment as
opposed to merely coping with it. They also maintain a ―philosophical,‖ non-hostile,



                                           22
sense of humor, they have a need for privacy at times, they hold strong ethical
standards although they do not necessarily comply with conventional norms and they
experience ―peak experiences.‖ (Wikipedia.com, 2007)


        Other theorists have proposed alternative qualities for those with optimal
mental health including: strength of character, the capacity to deal with conflicting
emotions, the ability to experience pleasure without conflict, to be flexible and to
adapt to a changing environment, to adjust to the outside world with contentment,
to achieve insight into oneself, to live without fear, guilt, or anxiety, to face anxiety
with courage, emotional security resulting in flexibility and spontaneity in dealing
with others, and to take responsibility for one‘s own actions. One might equate
optimal mental health with the desirable characteristics of a mate including traits
such as ambition, dependable character, education and intelligence, emotional
stability, pleasing disposition, neatness, and sociability. (Seligman and Peterson,
2004)


        Optimal mental health also includes the capacity to attain optimal mental
states. Mental states are short lived experiences as opposed to long standing
patterns of behavior or traits. Authors have described optimal mental states such as
peak experiences, mindfulness, and ―flow‖ states. Peak experiences, as described by
Maslow, are exciting and joyous moments in life in which a person experiences
sudden feelings of intense happiness and wellbeing, wonder and awe, and for some
feelings of power, limitless horizons, a sense of transcendent unity, or knowledge of
a higher truth. They are usually brought about by intense feelings of love, great art
or music, or the beauty of nature. They can also come about in difficult situations
such as severe illness or confronting death. Mindfulness is a particular way of paying
attention that harnesses one‘s energy to look deeply into oneself and find insight,
create states of deep relaxation and calmness which nourish the body and mind, and
promote healing. In the state of ―flow,‖ experiences of mastery feel effortless. The
mind and body work smoothly in unison. A well practiced behavior becomes
effortless and there are no distractions from thoughts, emotions, or outside
disturbances. In such an optimal mental state one experiences a complete sense of
control.


        Optimal mental health can also be determined by the presence of a high
quality of life. In the medical field, outcomes of health care have been measured in



                                            23
terms of both longevity and quality of life. Because mental function strongly
influences the variables that affect these outcome measures, we can expect that
optimal mental health will result in optimal longevity and quality of life. From the
perspective of the individual, quality of life refers to one‘s degree of satisfaction or
happiness with life in general. A general measure of quality of life can be made by
answering the following question: All things considered, how satisfied are you with
the life you lead these days- very satisfied, fairly satisfied, not very satisfied or not
at all satisfied? A more thorough assessment of quality of life can be made by
determining a person‘s degree of satisfaction with the major domains of life including
the quality of general health, family and social life, spiritual life, quality of education,
work, and finances, the presence of legal issues, quality of housing and
transportation, recreation and leisure, and appearance. Other factors that can have
important influence on quality of life include climate and geography, degree of
safety, political and personal freedom, crime, traffic congestion, availability and
quality of entertainment, and the degree of gender and racial equality. With optimal
mental health, satisfaction or happiness should be high for each of the life quality
areas under the influence of mental function. According to the Complete Wellbeing
Magazine website, ―health is about having a fit body and living a life filled with joy
and fulfillment.‖ (completewellbeing.com 2011)


       While total positive mental health must be viewed as a utopian ideal, mental
illness and health lie on a continuum. As we will never reach the utopian ideal, we
can rather try realistically to find greater mental fitness and wellbeing by promoting
our mental health with gradual steps in a positive direction. We can become more
and more complete. We can live optimally by developing healthier lifestyles and
personal skills. It is the integration of healthy behaviors that brings about an
optimal lifestyle pattern. Adapting healthy lifestyles typically requires changes in
behavior. Such change takes place when sufficient leverage or personal reasons for
change move an individual to action. When the pros of change outweigh the pros of
keeping things as they are a person begins to think about making changes.
Information about the pros and cons of change must become available to an
individual in order for him or her to think about change.


       In one model of health-related behavior change, five progressive stages have
been described: pre-contemplation, contemplation, preparation, action and




                                             24
maintenance. These stages describe the thinking and behavior that takes place in
healthy behavior transformations. Pre-contemplation is characterized by no intent to
change, contemplation includes intent to change in the near future and awareness of
the consequences of current behavior. Preparation demonstrates an active intent to
change within a month or less as a particular strategy for change is selected. The
action stage involves undertaking the chosen strategy for change and the
maintenance stage occurs when the behavior change has been maintained for at
least 6 months. Throughout the change process, there is risk of back sliding or
relapse to past behavior. Sometimes people cycle through these stages of change
several times before they establish healthier behavior in the maintenance stage.
(Prochaska et al., 1994)


       In another model of behavior change, acquiring skills depends upon the
transition between four stages. In the first stage the individual is unaware that a
particular skill would be beneficial. In the second stage there is recognition of the
value of a skill without knowing how to perform it. The third stage is reached when
the individual can perform the skill competently but it requires focus and
concentration. Finally, in the fourth stage the skill is performed unconsciously with
little need for concentration and the capacity for talent. Some individuals progress
from this stage to a point where they may teach others to acquire the skill.


       In order to achieve optimal mental health a person will have to overcome
resistance. Resistance refers to all of the forces within an individual that oppose
efforts to change and improve. Resistance works to maintain the status quo. While
some aspects of resistance may be conscious, much of resistance is carried out
beyond conscious awareness. Every step forward is a compromise between the
forces that are striving for a better life and those that oppose progress. Resistance
may be demonstrated with emotions, attitudes, ideas, impulses, thoughts, fantasies,
or actions. Signs of resistance may include inappropriate emotional reactions to
situations, negative self-talk, behavior that is self- destructive or simply a failure to
change for the better.


       The underlying cause of resistance is always the avoidance of some painful
emotion. Sources of resistance include secondary gain of the status quo (perceived
benefits of things as they are), the repetition compulsion (the urge to relive the past




                                            25
in order to master it), feelings of guilt and the need for punishment, or memories of
past relationships that convey negative messages to a person (negative self-talk) in
the here and now.    Resistance can be overcome in several ways. One approach is
to uncover these motives for resistance which diminishes their power to influence us.
Another approach is to replace motives for resistance with more powerful motives
that inspire change. For example the expectancy of positive change makes such
change much more likely and the greater the degree of expectancy the more rapid
the rate of change. Sometimes approaching resistance with efforts to increase the
resistance will ultimately disarm the resistance so that a person can then turn the
momentum toward progress. Lastly, resistance can be overcome with persuasive
arguments. (Greenson, 1967) As Barack Obama has said, ―It is hope over fear and
it is the promise of change over the power of the status quo.‖


       While the cause of mental health problems is believed to stem from a
combination of biological, psychological, social and possibly spiritual factors, the
approaches involved in achieving optimal mental health also appear to fall into these
categories. Also, while any given factor in isolation may promote mental health
more or less than others, it seems that it is the synthesis of biological, psychological,
social, and spiritual health promoting activities that leads to optimal mental health.
This integration of various health promoting activities leads to a healthy lifestyle.
―Lifestyles‖ are long lasting patterns of behavior. They are stable over time. This
means that these lifestyle patterns are ingrained and unlikely to change. Changing
old behaviors may take some perseverance. It may take 6 months of practice in
order to adopt a new lifestyle pattern of behavior. When lifestyles change, a person
views themselves differently. It is the shift a smoker makes from viewing
themselves as a smoker to viewing themselves as a non-smoker. It is the shift a
person who is angry about other people‘s past behavior makes to view themselves as
a forgiving person. It appears that exceptional mental health is brought about with
the adoption of healthy lifestyles and personal skills that promote good physical,
mental, social, and spiritual health.


       It has been demonstrated that prevention and health promotion interventions
need to be long term with repeated booster interventions designed to reinforce the
original health promotion goals. In order to reach your potential for optimal mental
health, it will require a long term effort. It will be more of a marathon than a sprint.




                                           26
       With the adoption of healthier lifestyles and skills, people give themselves the
best opportunities to live long, to find happiness, and to prosper. Acquiring healthy
lifestyles and skills grows out of self-love and a love of life. Learning how best to
promote your mental and physical health means learning how best to live. Yet,
optimal health is not in itself a goal but rather the means to fulfilling your purpose,
living a meaningful life, and finding fulfillment and happiness in love, work and
leisure. With optimal health- physically, mentally, socially and spiritually- body,
mind, heart and spirit- your entire being shines radiantly. There is a sparkle in your
eyes. With optimum mental health you have the opportunity to find optimum quality
of life and long life. With the best states of health you are more able to contribute,
to contribute to your family, to your community, to your country, to the world.
Mental health promotion is important for the young and old and applies to those who
are sick or considered well. Hopefully, future research will establish sound reliable
methods of preventing mental illness and promoting exceptional mental health so
that future generations might more easily thrive during their lifetimes.    As new
research guides us in our efforts to reach our best states of health, our children and
our children‘s children might come to live happier, healthier, more fruitful,
meaningful, and fulfilling lives.




       The next section focuses on the prevention of mental illness, the first step in
promoting optimal mental health.




                                           27
Part Two: Preventing Mental Illness


       About 450 million people suffer from mental disorders throughout the world
according to the World Health Organization‘s World Health Report of 2001. At the
current rate, one person in four will develop one or more mental illnesses in their
lifetime. People become mentally ill in every region, country and society. Because of
the current limitations in effectiveness of treatment and the immense suffering and
disability associated with these conditions, prevention will hopefully play an
important role in reducing the burden of mental illness worldwide. In general, the
prevention of mental illness includes actions aimed at eradicating or eliminating
illnesses or minimizing the impact of illnesses when they occur. It also strives to
prevent the recurrence of illness and the time spent with symptoms.      Prevention of
mental illness is a young field and only in the past two decades have prevention
scientists been able to demonstrate the effectiveness of specific interventions. While
efforts to prevent mental illness have taken place for the past century, increasing
knowledge of risk and protective factors and the means to influence them has led to
the development of effective interventions. Preventive measures can be universal
and applied to everyone or they can be targeted at particular high –risk groups.
Some efforts have targeted predictors of illness or protective factors while other
interventions have aimed to identify the earliest stages of illness in order to provide
early treatment.   Interventions have been shown to reduce delinquent behavior,
depressive symptoms, psychotic disorders, bipolar disorder, anxiety disorders, eating
disorders and substance abuse and dependence. The scientific study of prevention
looks to uncover effective interventions that are demonstrated through randomized
controlled research trials to produce desired effects. This means that large groups of
individuals are studied using a particular intervention and then followed over time in
order to determine mental health outcomes for the whole group compared to those
who do not receive the intervention.


       While efforts aimed at prevention target outcomes shown to reduce the
occurrence of illness or symptoms, these measures may also enhance psychological
wellbeing. Similarly, efforts aimed at enhancing psychological wellbeing and fitness
rather than preventing illness may secondarily reduce the occurrence of illness as
positive health is a strong protective factor against illness. This chapter focuses on



                                           28
prevention while the remaining sections describe approaches aimed at promoting
optimal mental health and functioning. Therefore, the entire work will offer ideas
about what you can do to prevent the occurrence of mental illness for yourself and
those you love. While not entirely validated by research, clearly efforts to eliminate
risk factors for illness and support protective factors could help to protect you, your
family and others you care about. Risk factors are associated with an increased
probability of onset, greater severity and time spent ill. Protective factors increase
people‘s resistance to illness in situations of increased risk. The following table lists
risk factors and protective factors from The World Health Organization:


Risk and protective factors for mental disorders:

Risk factors

Biological risk factors
    -  Neurochemical imbalance
    -  Family history of mental illness
    -  Poor nutrition
    -  Medical illness
    -  Sensory disabilities or organic handicaps
    -  Chronic insomnia
    -  Chronic pain
    -  Early pregnancies
    -  Low birth weight
    -  Perinatal complications
    -  Substance use during pregnancy
    -  Access to drugs and alcohol
    -  Excessive substance use

Psychological risk factors
   -  Attention deficits
   -  Emotional immaturity and dyscontrol
   -  Personal loss
   -  Stressful life events
   -  Work stress

Social   risk factors
   -      Loneliness
   -      Isolation and alienation
   -      Displacement
   -      Bereavement
   -      Peer rejection
   -      Poor social circumstances
   -      Social incompetence
   -      Communication deviance



                                            29
   -    Social disadvantage
   -    Low social class
   -    Neighborhood disorganization
   -    Racial injustice and discrimination
   -    Parental mental illness
   -    Caring for chronically ill or dementia patients
   -    Family conflict or family disorganization
   -    Child abuse and neglect
   -    Elder abuse
   -    Exposure to aggression, violence or trauma
   -    Violence and delinquency
   -    War

Other   risk factors:
   -     Poverty
   -     Unemployment
   -     Poor works skills and habits
   -     Lack of education, transportation and housing
   -     Reading disabilities
   -     Academic failure and scholastic demoralization
   -     Urbanization


Protective factors:
   -   Ability to cope with stress
   -   Ability to face adversity
   -   Adaptability
   -   Autonomy
   -   Early cognitive stimulation
   -   Exercise
   -   Feelings of security
   -   Feelings of mastery and control
   -   Good parenting
   -   Literacy
   -   Positive attachment and early bonding
   -   Positive parent-child interaction
   -   Problem solving skills
   -   Pro-social behavior (acts such as helping, sharing, comforting, and
       cooperating)
   -   Self-esteem
   -   Skills for life
   -   Social and conflict management skills
   -   Socio-emotional growth
   -   Stress management
   -   Social support of family and friends
   -   Empowerment
   -   Ethnic minorities integration


                                            30
   -   Positive interpersonal interactions
   -   Social participation
   -   Social responsibility and tolerance
   -   Social services
   -   Social support and community networks

(World Health Organization, 2004)

       Other psychological factors that have been correlated with mental illness
include factors such as feelings of inadequacy and low self-esteem. Certain theories
have proposed psychological causes of mental illnesses. Psychodynamic theories
propose that unconscious conflict beyond one‘s awareness is associated with mental
illness. Behaviorism and social learning theory propose that mental illness is a
product of learning from the environment. Other social factors associated with
mental illness include trauma suffered as a child from divorce, neglect, or a
dysfunctional family life, and changing jobs or schools. Societal pressure that
associates beauty with thinness has been associated with the development of eating
disorders.


       Of particular importance, people with a family history of mental illness may
have an inherited risk to their own health but how big is the risk? Research into the
role of genetics in mental illness has uncovered the degree of risk posed by heritable
factors.   The majority of mental illnesses appear to have a relatively small
contribution from genetics in their causality. This means that other factors weigh
heavily in mental health outcomes. Nevertheless, it appears that genetic makeup
can predispose individuals to the development of mental illness. In other words,
while many individuals with a predisposing genetic makeup do not develop illness,
there must be an underlying genetic vulnerability to illness for illness to occur.


       It is most commonly believed that genetic predisposition toward mental
illness is complex with multiple numbers of genetic loci playing a role in most
conditions. Penetrance refers to the percentage of individuals with a particular
genotype known to cause illness who show signs and symptoms. Early onset
Alzheimer‘s disease shows complete penetrance resulting from mutations in the
amyloid precursor protein located on chromosome 21. Expressivity refers to the
extent to which a genotype is expressed. In variable expressivity, the trait may vary
in expression from mild to severe but is never completely unexpressed in individuals




                                           31
who have the gene. Most genotypes for psychiatric disorders are believed to show
incomplete penetrance or variable expressivity.


       From family and twin studies, mental disorders recognized as having a
genetic component related to their cause include psychotic disorders such as
schizophrenia and schizoaffective disorder; mood disorders such as bipolar disorder
and severe depression; personality disorders such as antisocial and schizotypal
personality disorders; anxiety disorders such as generalized anxiety disorder,
obsessive-compulsive disorder, panic disorder and phobia; substance use disorders
such as alcohol dependence; eating disorders such as anorexia nervosa and bulimia;
childhood disorders such as attention-deficit/ hyperactivity disorder, autism, and tic
disorders; and memory disorders such as Alzheimer‘s disease.


       The empiric risk to family members for heritability of illness is as follows:
Schizophrenia has an incidence rate of 1% for the general population. For siblings of
schizophrenic patients, the risk is 9-16%. For children with one schizophrenic parent
the risk is 5-13%; in cases where both parents have schizophrenia, the risk is 45%.
For those with a schizophrenic sibling and one parent the risk is 15%, an uncle or
aunt 1-4% and for a nephew or niece 2-4%. Bipolar disorder has an incidence rate
of .8-1.6% for the general population. Siblings of bipolar patients have an inherited
risk of 5-20%. Children of one bipolar parent have a risk of 15%. When one parent
and a sibling are affected with bipolar disorder the risk of illness is 20%. If both
parents are bipolar, the risk to their children is 50-75%. Major depressive disorder
has an incidence rate of 1-15% in the general population for men and 2-23% for
women. Siblings of those with major depression have a 5-30% risk. For children of
a depressed parent the risk is 7-19%. Schizoaffective disorder has an incidence rate
of .5% to less than 1% for the general population. First degree relatives of patients
with schizoaffective disorder have a 1-10% risk of illness. Obsessive- compulsive
disorder has an incidence rate of 1.5-3.5% for the general population. Siblings of
patients with OCD have a 25-35% risk and children with a parent having OCD also
have a 25-35% risk. Panic disorder has an incidence rate of 1.5-3.5% for the
general population. First degree relatives of affected individuals have a 15-25% risk
of illness. Generalized anxiety disorder has an incidence rate of 3.5% for the general
population. First degree relatives demonstrate a 20% risk of illness. Alcohol
dependence has an incidence rate of 14% for men and 3% for women in the general




                                           32
population. First degree relatives have an inherited risk of 27% for men and 5% for
women. Phobia has an incidence rate of 4-11% for the general population. First
degree relatives have a 12-31% risk of illness. Anorexia nervosa has a .1%
incidence rate in the general population. First degree relatives have a 5-10% risk of
anorexia. Attention deficit/ hyperactivity disorder has a 3-5% incidence rate in the
general population. Siblings of affected individuals have a 17-25% risk of ADHD.
(Hadley D, 2005)


       Other protective factors include an easy temperament (adjusting easily and
quickly to new situations and changes in one‘s routine, readily adapting to new
experiences, and generally displaying positive moods and emotions). Easy
temperament has been shown to protect against psychopathology including both
depression and bipolar disorder. Active coping by taking a direct and rational
approach to dealing with a problem and approach coping by attending to a stressor
by seeking information or closely monitoring the stressor are protective as opposed
to passive or avoidant coping.   Also problem focused coping or attempting to do
something constructive about a stressful situation is protective. (Borba C and Druss
B, 2010)


       Although multiple biological, psychological, and social risk factors are
associated with mental illness, only a fraction of affected people succumb to illness.
Therefore, protective factors appear to create resilience or prevent illness where risk
factors cannot be avoided. It would seem that biological, psychological, social and
possibly spiritual factors that contribute to the development of illness interact with
biological, psychological, social and spiritual protective factors. Our understanding of
such protective factors continues to grow and we can expect that an increasing
capacity to protect ourselves will translate to a tremendous decrease in the
occurrence of mental illness in the future. For those who develop symptoms, early
recognition of problems and early treatment can prevent the development of more
severe illness for affected individuals. Recent research in bipolar disorder and
schizophrenia has uncovered early phases of illness or prodromes which when
treated early can help affected individuals avoid the development of more severe
illness. So far effective prevention interventions reduce risk factors, strengthen
protective factors, start treatment in early stages and as a result decrease
psychiatric symptoms, disability and the occurrence of some mental illnesses. These




                                           33
interventions have also been shown to enhance positive mental health and contribute
to better physical health.


       The following sections describe biological, psychological, social, spiritual and
environmental approaches to help achieve optimal mental health.




                                           34
Part Three: Biological Approaches to Optimal Mental
Health


          In the field of psychiatry, biological approaches to mental illnesses and
disorders are now being emphasized. Treatment of mental illness is often
accomplished with the use of medications or other biological interventions.      This
trend is based upon positive results and the underlying assumption that we humans
are in fact chemical beings who respond to biological and chemical interventions for
illnesses and ultimately illnesses can be understood in biological terms. Many people
do respond positively to pharmacologic treatment of mental illnesses. Mental
functions are truly physical in the sense that they involve the biology of the brain
and body systems. Our emotions, thoughts and behavior are expressions of brain
biochemistry and physiology. There are biological underpinnings to who we are and
what we do. The biology of the brain in the course of mental illness and in health is
partly determined by psychological, social, environmental and possibly spiritual
factors which impact brain function. As more is understood about psychological,
social and spiritual factors that promote mental health, the underlying
neurophysiologic mechanisms by which these factors operate will hopefully be
uncovered. The human brain has plasticity which means that brain structure and
function can change under the impact of biological, psychological, social,
environmental and possibly spiritual influences. By creating positive influences on
brain plasticity we help to promote optimal health and functioning.


          Also, other biological factors such as nutrition, exercise and sleep and one‘s
physical state of health have an important impact on mental health. The body and
the mind are inextricably linked and therefore, physical factors impact mental health.
Therefore, promoting physical health is an important part of promoting mental
health.    Promoting good physical health brings about both physical and mental
vigor. This section on biological factors that promote mental health includes
methods of promoting optimal physical health which is thought in turn to promote
better mental health.




                                             35
        Good physical health comes about by efforts far beyond the treatment of
medical illnesses. It also includes optimal nutrition, regular exercise and staying fit,
maintenance of a healthy weight, refreshing sleep, and efforts to prevent the
occurrence of illness or limit their impact should illnesses occur. Good physical
health also stems in part from warm supportive relationships and a healthy mental
life, and possibly spiritual life. Making an effort to improve your physical health and
fitness and take measures to prevent illness and disability helps to give you the best
opportunity to realize exceptional mental health and increase your quality as well as
longevity of life.




                                           36
Neurobiology and Optimal Health




       It has been proposed that psychosocial spiritual wellbeing has a
neurobiological signature. The following section describes the neurobiological basis
of wellbeing.


Homeostasis and Allostasis


       Homeostasis is the tendency of a living system to regulate its internal
environment and maintain a stable, constant condition. There are feedback systems
that warn of problems and then the organism can take corrective action.
Homeostasis explains stability and balance but does not explain risk taking, growth
and development. Allostasis, on the other hand, is a process of maintaining stability
through change. While homeostasis achieves stability through resistance to change,
allostasis allows us to thrive by making positive changes.


Neuroadaptation


       A basic premise of science is that every action has a reaction, a stimulus has
a response. But how do positive biological changes in health take shape, how do
systems and behavior change? In the brain it has been found that at the level of
physiology, exposure to a drug like cocaine results in a compensatory release of
counteracting neurotransmitters. Over time repeated exposure to a drug of abuse
leads to tolerance, withdrawal and craving. Neuroadaption forces the drug user to
escalate the dose to maintain the euphoric drug effect. In the case of vision,
neuroadaptation has been harnessed in order to correct adult onset farsightedness or
presbyopia. The therapeutic use of multifocal intraocular lenses for presbyopia often
requires a period of 6-12 months for compensatory neuroadaptive brain changes to
take the multiple images from the lens of each eye and see them clearly with a
better image near and far.   It is as though the brain wants to see the clearer image
and learns to integrate the complex combination of images from each eye to make
an overall clearer picture. It seems that the underlying urge to survive and to thrive
pushes the brain to improve function. Neuroadaptation is also evident with the use
of psychiatric drugs. Some psychiatric medications such as antidepressants have a
delayed onset of action that takes months for a maximum effect.


                                          37
        Neuroadaptation means a change in neural circuitry. One goal of
neurobiology is to uncover the connection between neuroadaptive mechanisms and
cognition, emotion and behavior. In the area of optimal mental health the goal is to
create changing external and internal environments that produce desirable changes
in brain circuitry, changes which translate into higher quality of life, long life and
exceptional functioning.


Plasticity


        Plasticity is the adding or removal of connections between nerve cells and
adding of new cells. The central nervous system has the capacity to regenerate after
injury. New cells replace degenerated nerve cells after injury or disease. Also,
nerve cells can be recruited from other areas of the brain after injury such as stroke
to perform the functions of damaged neurons. Bach-y-Rita explained plasticity as
follows, ―If you are driving from here to Milwaukee and the main bridge goes out,
first you are paralyzed. Then you take old secondary roads through the farmland.
Then you use these roads more; you find shorter paths to use to get where you want
to go, and you start to get there faster. These ―secondary‖ neural pathways are
―unmasked‖ or exposed and strengthened as they are used. The ―unmasking‖
process is generally thought to be one of the principal ways in which the plastic brain
reorganizes itself.‖ (Wikipedia, 2009)    It also appears that developing new cells
play a role in learning and memory. After a stroke, physical therapy pushes the brain
to find ways to recreate function. With education and insight we push our brain
circuitry to function at new and higher levels. Plasticity allows the brain to change,
repair and grow.   ―According to the theory of neuroplasticity, thinking, learning, and
acting actually change both the brain's physical structure (anatomy) and functional
organization (physiology) from top to bottom.‖ (Wikipedia, 2009) Brain repair,
growth, maturation, and development depends both upon the processes of
neuroadaptation and neuroplasticity.




                                            38
Hormesis and eustress


       Hormesis is a beneficial biological process by which a low- intensity stressor
causes an adaptive reaction which produces increased stress resistance and defense
capacity.   Mild stress exposure has anti-aging effects. For example physical
exercise is well known to have beneficial effects.   While an absence of physical
activity is associated with increased incidence of disease, excessive exercise is also
harmful. Only moderate levels of exercise result in improved cardiovascular,
immune and neurologic function. Positive effects at an intermediate dose of a
stressor are characteristic of hormesis. Also, in animals, calorie restriction, as an
ongoing low-grade stressor, may prolong survival by enabling these animals to
better endure adversity. Along the same lines, Hans Selye proposed that persistent
stress that is not resolved through coping or adaptation is harmful, while other
eustress such as strength training or challenging work, enhances physical or mental
functioning.




Psychological wellbeing while treated with psychotropic medications


       When a person is faced with a mental disorder, treatment can often include
the use of psychotropic medication. These medications can provide relief of misery
and symptoms and allow for improved levels of functioning for those who are ill.
While some mental disorders are short lived, others are chronic conditions that
require maintenance treatment to prevent relapse or worsening of symptoms.
Psychiatric drugs have biological effects on brain function and the brain adapts to the
presence of drug bringing about the therapeutic effect. There is no reason to believe
that those who take psychotropic medications can‘t achieve exceptional health and
functioning. Even for those illnesses that result in tremendous impairment, anything
is possible. A time may come when we not only treat illness effectively but also
performance enhancing drugs become available that raise the level of functioning,
improve longevity and pose no threat from adverse effects. New treatments are
coming down the pike all the time, technology never stops progressing, and it is
ultimately up to the affected individual to do what he or she can to care for his or her
health while working with a professional.




                                            39
Optimal sensory capacity


       Vision, hearing, smell, taste and peripheral sensation are considered the
normal parts of human sensory capacity. We have the ability to discriminate and tell
things apart and we can process concurrent stimuli. An important psychological
function related to this biological sensory capacity is to correctly interpret stimuli.
With experimentation and training we can transcend normal sensory capacity and
perceive things that are ordinarily overlooked. A musician hopes to be the best
listener that he or she can be, just observing everything going on around them. The
majority of older adults will experience some changes in their sensory capacity and
there are unfortunately some extreme cases. Beethoven is well known for his ability
to write beautiful music even though he became deaf. An artist who learns to see
negative space sees more completely. A chef who can decipher by taste the
ingredients of a meal tastes more completely. A perfume designer might smell more
completely, a massage therapist feel more completely. Some have argued that
there are extrasensory perceptions as well including the capacity to read people or
the environment or foretell the future. Sensory neurons convert stimuli to brain
activity and we become sensitized or habituate to the stimulus. Optimal sensory
capacity helps to enable you to be the best you can be.




                                            40
Optimal Nutrition


       It is easy to eat a poor diet in today‘s world. People in some parts of the
world have difficulty obtaining proper nutrients because food is scarce; whereas,
people in developed parts of the world are flooded with temptations to eat diets that
please the pallet but provide poor nutrition. It is widely recognized that nutrition
plays an important role with respect to health and longevity of life; yet, questions
still remain concerning how specific nutrients promote health and the ideal amounts
of each that is needed. We are becoming more well informed about dietary factors
that pose risks to health, yet our environment is saturated with contributors to a
poor diet. Much research effort has led to current guidelines regarding optimal
nutrition for the general population. By following basic principles of healthy eating,
you can help prevent illness, promote your physical and mental health, and create
greater energy for living. The following section provides basic principles of healthy
nutrition.


   The first principle is to eat plenty of fruits, vegetables and whole grains. Women
need 21-25 grams of fiber per day. Men require 30-38 grams of fiber per day.
Soluble fiber sources include oats, barley, dried beans, chick peas and black-eyed
peas, apples, pears, prunes, bananas, oranges and vegetables such as Brussels
sprouts, carrots and broccoli.   Soluble fiber helps control blood sugar levels and
improves cholesterol. Insoluble fiber sources include vegetables such as carrots,
cucumbers, zucchini, celery, tomatoes, the edible skins of fruits, flaxseed, wheat
bran, and other whole grains. Insoluble fiber is important for the digestive system;
it helps bulk up stool and allows it to pass more easily. An association has been
found between regular consumption of a high-fiber diet and reports of better physical
as well as mental health. (Smith, 2005) Fruits and vegetables are also good
sources of essential vitamins and minerals. It has been found that deficiencies in
certain nutrients including folate, vitamin B12, iron, zinc and selenium tend to be
more common among depressed than non-depressed persons. (Bodnar and Wisner,
2005) Some vitamins are antioxidants which prevent damaging changes to cells and
reduce the risk of heart disease, some cancers, many of the effects of aging, and
Alzheimer‘s disease. You should try to get most of your needed nutrients from a
healthy well-balanced diet; but, it may be a good idea to supplement your diet with a
multivitamin in order to assure adequate intake of vitamins and minerals. Some


                                           41
nutritionists recommend adding additional vitamin C and E to a standard
multivitamin. Furthermore, a little evidence suggests that acetyl-L-carnitine, alpha-
lipoic acid and phophatidyl serine could also be added to our diet for better brain
health.


   The second principle is to reduce intake of saturated fat, trans fat and
cholesterol. Saturated fat comes from red meat, poultry, butter, whole milk, and
coconut, palm and other tropical oils. Trans fat is found in some commercially baked
goods such as crackers, cookies, cakes, doughnuts, as well as French fries,
shortening and some margarines. Dietary cholesterol is found in red meat, poultry,
seafood, eggs, dairy products, lard and butter. The USDA and Department of Health
and Human Services recommend that fat makes up no more than 35% of daily
calories, that saturated fat makes up less than 10% of total daily calories and that
dietary cholesterol totals less than 300 mg per day. The American Heart Association
updated the dietary recommendations in 2006 for saturated fat (less than 7% vs.
less than 10% of total daily calories in the 2000 guidelines) and less than 1% of total
calories for a goal for trans fatty acids. The American Medical Association in 2008
suggests that no more than 30% of your diet should come from fat, less than 7% of
calories from saturated fat, less than 200 mg of dietary cholesterol, and no trans fat.
The nutrition committee for the American Heart Association recommend limiting
intake of saturated fat, trans fat, and cholesterol by choosing lean meats and
vegetable alternatives, by using fat-free (skim) and low-fat (1% fat) dairy products
and by minimizing intake of partially hydrogenated fats. (Lichtenstein et. Al., 2006)


   Monounsaturated fats, including olive, canola and peanut oils, are the healthiest
fats. They lower total cholesterol, decrease harmful LDL cholesterol and increase
beneficial HDL cholesterol. Polyunsaturated fats such as corn, sunflower, flaxseed,
soybean oils, and the oils of fatty fish such as salmon, trout, herring, and tuna, lower
total cholesterol. It will help with daily fat intake if you sauté with olive oil instead of
butter, use olive oil instead of vegetable oil in salad dressing and marinades, use
canola oil when baking and eat salmon, trout, tuna or herring twice a week. Children
and pregnant women should avoid mercury-contaminated fish such as shark,
swordfish, king mackerel, and tilefish. Also farm raised fish are of lower quality than
wild supplies as over population of farm raised fish and the frequent use of
antibiotics in these farms result in some degree of contamination. Good control of
fat in your diet will help with heart health and the health of the circulatory system.



                                            42
It may be a good idea to take a fish oil supplement, to add omega-3 fatty acids, if
dietary intake of fish is limited.   Fish oil appears to be both cardio and neuro-
protective. Adequate dietary omega-3 fatty acids from fish or a supplement may
also prevent problems with mood. (Parker et al., 2006; Sublette et al., 2006;
Nemets et al. 2006) As a caution, some studies have shown that consuming more
than 3 grams of omega-3 fatty acids may increase the risk of bleeding problems.
Also fish oil supplements can produce gas and diarrhea after you first start taking
them, but these effects will quickly subside.


   The third principle is to limit sweets and salt. Excessive salt intake increases the
risk of high blood pressure while too many sweets increase the odds of weight gain
and obesity. It‘s important to control portion sizes at meals and the total number of
calories you consume. Total calorie intake must be balanced by physical activity in
order to prevent weight gain and obesity. It is important to include physical activity
in your daily routine.


   The fourth principle is to eat a variety of foods from each major food group in
order to ensure that you get the necessary nutrients including carbohydrates,
protein, fats, vitamins, minerals and fiber. The major food groups include fruits,
vegetables, carbohydrates, legumes-seeds-nuts, whole grains such as rice- noodles-
breads-corn, protein, dairy, fats, and sweets. It is suggested that 45-65% of daily
calories come from carbohydrates. Many people eat more protein than they need;
too much protein can be unhealthy by placing a burden on the kidneys. In general,
protein should make up 12-20% of daily calories. Fats should comprise 30% of daily
calories. Drink alcoholic beverages in moderation if at all; no more than one drink
per day for women and no more than two drinks per day for men.


   Lastly, handle food safely: wash your hands and all food contact surfaces, wash
fruits and vegetables but don‘t wash meats to avoid spread of bacteria to other
surfaces, cook foods to a safe temperature to kill microorganisms, refrigerate
perishable foods and avoid raw or partially cooked eggs and meat. Nearly anyone
can make changes in how they eat in order to get closer to recommended goals.
These dietary changes need to be maintained in order to promote good physical and
mental health. By following these recommendations, people will not have to give up
all of the things they enjoy; they will just need to make some adjustments in eating
habits in order to help establish optimal nutrition.


                                            43
   Dietary Guidelines from the Department of Health and Human Services and the
Department of Agriculture can be found at   www.healthierus.gov. Guidelines from the
American Heart Association can also be found at their website. Dietary Guidelines
from The American Medical Association can be found in the book American Medical
Association Complete Guide to Prevention and Wellness.




                                        44
Healthy Weight




         Overeating and obesity are common problems for people across the globe.
Obesity has reached epidemic proportions. 30% of United States adults are obese.
Among children and adolescents aged 6-19 years, 16% are considered overweight.
People who are obese are at increased risk for heart disease, high blood pressure,
diabetes, arthritis and some cancers. Obesity is also associated with emotional
suffering, depression, anxiety and interpersonal sensitivity. (Warschburger, 2005;
Mamplekou et al. 2005)    In order to develop goals for healthy weight, you should
consult a body weight table or calculate your body mass index (BMI). The following
tables describe healthy weight ranges for men and women based upon height and
build.




                                         45
Ideal Weight Table for Men and Women


Women
Height in Shoes      Small Frame        Medium Frame          Large Frame
6‘                   138-151 lb           148-162 lb           158-179 lb
5‘11‖                135-148 lb           145-159 lb           155-176 lb
5‘10‖                132-145 lb           142-156 lb           152-173 lb
5‘9‖                 129-142 lb           139-153 lb           149-170 lb
5‘8‖                 126-139 lb           136-150 lb           146-167 lb
5‘7‖                 123-136 lb           133-147 lb           143-163 lb
5‘6‖                 120-133 lb           130-144 lb           140-159 lb
5‘5‖                 117-130 lb           127-141 lb           137-155 lb
5‘4‖                 114-127 lb           124-138 lb           134-151 lb
5‘3‖                 111-124 lb           121-135 lb           131-147 lb
5‘2‖                 108-121 lb           118-132 lb           128-143 lb
5‘1‖                 106-118 lb           115-129 lb           125-140 lb
5‘                   104-115 lb           113-126 lb           122-137 lb
4‘11‖                103-113 lb           111-123 lb           120-134 lb
4‘10‖                102-111 lb           109-121 lb           118-131 lb


This table comes from height and weight tables of the Metropolitan Life Insurance
Company, 1983. The ideal weights given in these tables are for ages 25-59. The
weights assume that you are wearing shoes with 1-inch heels and indoor clothing
weighing 3 pounds.




                                         46
Men
Height in Shoes      Small Frame        Medium Frame          Large Frame
6‘4‖                 162-176 lb           171-187 lb           181-207 lb
6‘3‖                 158-172 lb           167-182 lb           176-202 lb
6‘2‖                 155-168 lb           164-178 lb           172-197 lb
6‘1‖                 152-164 lb           160-174 lb           168-192 lb
6‘                   149-160 lb           157-170 lb           164-188 lb
5‘11‖                146-157 lb           154-166 lb           161-184 lb
5‘10‖                144-154 lb           151-163 lb           158-180 lb
5‘9‖                 142-151 lb           148-160 lb           155-176 lb
5‘8‖                 140-148 lb           145-157 lb           152-172 lb
5‘7‖                 138-145 lb           142-154 lb           149-168 lb
5‘6‖                 136-142 lb           139-151 lb           146-164 lb
5‘5‖                 134-140 lb           137-148 lb           144-160 lb
5‘4‖                 132-138 lb           135-145 lb           142-156 lb
5‘3‖                 130-136 lb           133-143 lb           140-153 lb
5‘2‖                 128-134 lb           131-141 lb           138-150 lb




This table comes from height and weight tables of the Metropolitan Life Insurance
Company, 1983. The ideal weights given in these tables are for ages 25-59. The
weights assume that you are wearing shoes with 1-inch heels and indoor clothing
weighing 5 pounds.


Your frame size or body build is determined by the thickness of your bones. The
Metropolitan Life Insurance Company offers the following method for determining
your frame size: Extend your arm and bend your forearm upward at a 90 degree
angle. Measure the distance between the two prominent bones of your elbow with
your thumb and index finger of the other hand. Measure the space between your
finger and thumb with a ruler or tape measure. The following table shows the elbow
breadth for a medium frame and certain height ranges in 1‖ heels. Those below the
range of elbow breadth given for medium frames are considered small frames and
those above are large frames.




                                         47
Frame Size Tables


Women
Height in 1‖ Heels           Elbow Breadth for Medium Frame
4‘10‖ to 5‘3‖                       2 ¼‖ to 2 ½‖
5‘4‖ to 6‘                          2 3/8‖ to 2 5/8‖


Men
Height in 1‖ Heels           Elbow Breadth for Medium Frame
5‘2‖ to 5‘7‖                        2 ½‖ to 2 7/8‖
5‘8‖ to 6‘3‖                        2 3/4‖ to 3 ¼‖
6‘4‖                                2 7/8‖ to 3 ¼‖




       People with muscular builds who are athletic may fall above the
recommended weight range but still be trim. These guidelines do not take such
muscular people into consideration; however, other tests for body fat such as
skinfold thickness or underwater weight can determine the percentage of body fat.


       Desirable weight for height is also described in terms of body mass index
(BMI). This is one‘s weight in kilograms divided by height in meters squared. At all
adult ages, ideal BMI values are 22 kg/m2 for women and 23 kg/m2 for men. A
person whose BMI is > 25 kg/m2 is considered overweight, and a person whose BMI
is > 30 kg/m2 is considered obese. For conversion: 1 meter = 3.28 feet or
39.37 inches and 1 kg = 2.2 lbs. There are many BMI calculator websites; just
search for BMI calculator to convert height in feet and inches and weight in pounds
to your BMI.


       If you find that you need to lose weight based upon the data in these tables
or by calculating your BMI, you need a strategy to get your weight under control.
People choose to lose weight because of the health consequences, the loss of quality
of life, and the disability that is associated with excess body weight. Keeping the
reasons you have for losing weight fresh in your mind will help in the weight loss
process. Future mindedness facilitates self control. If you can envision a weight loss




                                          48
goal for the future, you will find that you might more easily assert control over
eating patterns. Some people set unrealistic goals however, which can lead to
frustration, temporary weight loss followed by rebound weight gain and unhealthy
overly aggressive dieting. Healthy weight loss should be a gradual process with
goals of losing 1-2 lbs per week.


       According to Judith Beck, author of the Beck Diet Solution, ―the reason so
many dieters have experienced difficulty in losing weight or keeping it off is that they
never learned how… (it will help if dieters will learn essential techniques) to help
motivate themselves every day, decatastrophize hunger, cope with cravings, eat
favorite foods in moderation, and get back on track immediately when they make a
mistake. When individuals learn these techniques, dieting- and then maintenance-
becomes much easier.‖


       According to Beck, common distortions in thinking that occur in overweight
individuals include: rationalization (―it‘s all right to eat this cake because…‖),
underestimation of consequences (―it doesn‘t matter too much if I eat this...‖), self-
deluded thinking (―I‘ve already cheated so it doesn‘t matter if I eat more‖), arbitrary
rules (―I should not waste food‖), mind reading (―my husband won‘t like it if I don‘t
share his food‖), and exaggeration (―I never feel really full‖). (Beck 2007) There
are also some common excuses that dieters use to sabotage their dieting: health
excuse (―I‘ll feel better if I eat‖), the blaming excuse (―my husband doesn‘t like it
when I diet‖), the giving up excuse (―I‘ll never be thin anyway‖), the celebration
excuse (―It‘s my birthday‖), and the victim excuse (―I have a slow metabolism‖).
(Helmering and Hales 2005) By learning to challenge these automatic thoughts that
sabotage dieting it will become easier to lose weight. Some triggers for excessive
eating can include mental triggers like thinking about or imagining food, emotional
triggers such as unpleasant feelings that lead to eating and social triggers that
include people or situations that lead to eating. (Beck 2007)     According to Beck, the
road to weight loss is not a straight one, but has peaks, valleys, plateaus, and wrong
turns, and most people getting on the road do so without a clear map. Hopefully,
this section will help provide a better map for weight loss for those who need to lose
weight. Beck also suggests that dieters write a list of reasons for wanting to lose
weight and refer to the list daily or as many times as necessary when tempted to
overeat.




                                            49
       An overweight person can get serious about losing weight and getting in
shape. You have to make being thinner and feeling good about yourself a higher
priority than eating what you want. Feelings of hunger can be viewed as an
opportunity to ―strengthen your resistance muscle.‖ If you feel hungry and don‘t
respond to it by eating the hunger will subside. Hunger comes and goes and you can
tolerate and withstand hunger. You can firmly decide to resist. For the overweight
individual, it can help to think through the situation and imagine how you will feel if
you give in to urges to overeat: disappointed, frustrated, and gaining more weight.
Imagine how happy you will be with yourself if you resist. You can learn to conquer
hunger which is so helpful in losing weight.    You gain pride and a sense of strength
with success tolerating hunger. (Beck 2007)


       Pay attention to the calories in your diet. The number of calories you require
depends upon your age and activity level. You can begin to avoid sweets, snack less
between meals, and cut down on portion sizes. The strength of our impulse to eat
comes from biology and heredity. Therefore, if you have a family history of obesity,
that puts you at increased risk of overeating. Those with a family history of obesity
appear to share a genetic predisposition for being overweight because of strong
biological impulses to eat regardless of weight. Also, some eating patterns are
learned such as eating comfort foods to soothe stress or overcome boredom. But,
you can learn to rein in impulses to overeat.


       There are many weight loss programs and plans available. In general though,
it is recommended that you eat fewer calories while maintaining a balanced diet and
exercise more. For good health and weight loss it is important to choose quality
foods while cutting calories and exercising daily. The less you exercise, the fewer
calories you should have in your diet. Overweight individuals need to learn to cut
out comfort foods, sweetened beverages, and favorite foods that contribute to
excessive calories. Daily self-monitoring with a bathroom scale is a crucial
component of any weight loss plan. For those who are overweight, if past attempts
to lose weight on your own have failed, I recommend that you seek an outside
source of guidance with a weight loss program.




                                           50
Reputable diet books, online weight-loss and support networks, and online diet
programs are available to provide helpful guidance in a weight loss plan. Some
reputable diet books include:


      Eat, Drink, and Be Healthy: The Harvard Medical School Guide to Healthy
       Eating by Walter C. Willett, MD, Free Press, a division of Simon & Schuster
       Inc.; 2001;


      No-Fad Diet: A Personal Plan for Healthy Weight Loss by the American Heart
       Association, Clarkson Potter/Publishers; 2005;


      The New American Plate: Recipes for a Healthy Weight and a Healthy Life by
       the American Institute for Cancer Research, University of California Press;
       2005


   In order to cut calories below what is needed to maintain current weight, an
estimate of required calories per day must be made. For someone who is
moderately active caloric needs can be calculated by multiplying body weight by 15
calories/lb. More accurate estimates can be made by using a table as follows:




                                         51
Estimated Calorie Requirements (in kilocalories) for Females and Males
Based Upon Age and Physical Activity (US Department of Health and Human
Services and the US Department of Agriculture, 2005)


                                             Activity Level†,‡,§

         Sex     Age (Years) Sedentary† Moderately Active‡            Active§

         Child       2-3          1000            1000-1400         1000-1400

         Female

                     4-8          1200            1400-1600         1400-1800

                    9-13          1600            1600-2000         1800-2200

                    14-18         1800               2000              2400

                    19-30         2000            2000-2200            2400

                    31-50         1800               2000              2200

                    51+           1600               1800           2000-2200

         Male

                     4-8          1400            1400-1600         1600-2000

                    9-13          1800            1800-2200         2000-2600

                    14-18         2200            2400-2800         2800-3200

                    19-30         2400            2600-2800            3000

                    31-50         2200            2400-2600         2800-3000

                    51+           2000            2200-2400         2400-2800




*These levels are based on estimated energy requirements from the Institute of
Medicine (IOM) Dietary Reference Intakes Macronutrient report (2002), calculated by
sex, age, and activity level for reference-sized individuals. "Reference size," as
determined by IOM, is based on median height and weight to 18 years of age and
median height and weight for that height to give a body mass index of 21.5 for
women and 22.5 for men.



                                           52
†
Sedentary means a lifestyle that includes only the light physical activity that is
associated with typical day-to-day life.
‡
Moderately active means a lifestyle that includes physical activity that is equivalent
to walking about 1.5- 3 miles/day at 3-4 miles/hour, in addition to the light physical
activity that is associated with typical day-to-day life.
§
Active means a lifestyle that includes physical activity that is equivalent to walking
more than 3 miles/day at 3-4 miles/hour, in addition to the light physical activity
that is associated with typical day-to-day life.




       In order to lose 1-2 lbs. per week, you need to cut 500 calories per day from
daily requirements. Choosing foods wisely and controlling portion sizes are the basic
ingredients to limiting caloric intake. In order to avoid overeating, it will help to
keep track of the calories in foods you eat, practice stopping before you feel stuffed,
be selective in food choices eating good quality foods, avoiding desserts, eating
smaller portions, slowing down so that your brain gets a chance to signal that you
have eaten enough, limiting the variety of foods at each meal (with more food
choices at a meal people tend to eat more), and minimize temptation by stocking
your pantry with healthy foods rather than junk foods and sweets. Ideally, you will
develop sufficient self control so that maintaining healthy weight will be possible
regardless of the types of foods around you.


       For people who are moderately to severely overweight, there are specifically
designed meal replacement shakes and entrees that can help cut down caloric intake
while maintaining appropriate nutrition. If meal replacements are not effective it
may be a good idea to join a weight loss program. Weight loss programs offer
counseling, educational classes, and record keeping of physical activity and regular
weight assessments. Commercial weight loss programs, such as Weight Watchers
and Jenny Craig, can help build motivation, and offer support, education and
structure. For the morbidly obese individual, if a weight loss program is ineffective,
it may be advisable to undergo minimally invasive gastric bypass surgery. If you are
overweight, make weight loss goals and maintain a spirited pursuit of your aims.
Make a list of advantages to losing weight in order to help increase your motivation
while dieting. Maintaining healthy weight contributes to better physical health,
mental health and quality of life.




                                            53
Exercise and Staying Fit




       An important aspect of promoting health includes exercise and staying fit.
There is growing research evidence of links between physical activity and mental
health benefits. Physical activity can enhance mood, improve cognitive function,
improve self-perception and self esteem and promotes feelings of self-efficacy.
Physical activity appears to relieve symptoms of depression and anxiety. It also
fosters resilience to stress. (Jones and O‘Beney, 2004) Higher levels of physical
activity are associated with lower rates of death for both older and younger adults.
Exercise reduces blood pressure and delays the onset of hypertension. Regular
physical activity lowers the risk of developing adult onset diabetes and cardio-
respiratory fitness decreases the risk of heart disease. The level of decreased risk of
heart disease with regular physical activity is roughly equivalent to not smoking
cigarettes.   Regular physical activity reduces the risk of colon cancer. Regular
exercise is necessary for the development of normal muscle strength, joint structure
and joint function. Weight- bearing physical activity is necessary for normal skeletal
development for children and adolescents and helps to maintain bone mass in adults.
In older adults, strength training and other forms of exercise preserve the ability to
live independently. Physical activity can favorably redistribute body fat. Quality of
life improves with physical activity by improving physical functioning and enhancing
psychological wellbeing. Many of the beneficial effects of exercise training from both
endurance (aerobic) and resistance (strength training) activities diminish within two
weeks if physical activity is substantially reduced, and effects disappear within two to
eight months if physical activity is not resumed.


       In the 1996 report of the surgeon general entitled Physical Activity and
Health, expert recommendations were made regarding physical activity.


1. a minimum of 30 minutes of physical activity of moderate intensity (such as brisk
walking) on most, if not all, days of the week


2. for most people greater health benefits can be obtained by engaging in physical
activity of more vigorous intensity or for longer duration




                                          54
3. previously sedentary people embarking on a physical activity program should
start with short durations of moderate intensity activity and gradually increase the
duration and /or intensity until the goal is reached


4. before beginning a new physical activity program people with chronic diseases
such as cardiovascular disease, obesity, or diabetes mellitus or those at high risk of
such diseases should consult a physician.


5. experts also advise men over age 40 or women over age 50 to consult a
physician before starting a vigorous activity program




   When you begin an exercise program, you must be careful to avoid adverse
effects. Most musculoskeletal injuries related to physical activity are believed to be
preventable by gradually working up to a desired level of activity and by avoiding
excessive amounts of activity. Serious cardiovascular events can occur with physical
exertion; but, for the majority of people, the net effect of regular physical activity is
a lower risk of death from cardiovascular disease. The pattern of physical activity for
most people changes with age. In general, participation in all types of physical
activity declines strikingly as age increases into adulthood. Therefore, a concerted
effort to increase physical activity or exercise regularly must be made by adults in
order to gain the physical and mental benefits.


   Starting and maintaining regular exercise requires getting motivated, overcoming
barriers, taking action and staying motivated. The motivation or leverage needed to
start exercising can come from external sources or internal ones. Personal goals for
weight loss, appearance, or health promotion with better physical fitness can bring
about intrinsic motivation to begin exercising regularly. External or extrinsic
motivators might include pressure from your doctor or family to get into shape for
health reasons. When the benefits of regular exercise outweigh any perceived
benefit of inactivity a person begins to think about getting started.


   Before a person gets started with regular exercise, however they often must
overcome barriers that stand in the way. Common barriers to exercise include:
insufficient time available to exercise, complaints that exercise is boring, lack of




                                            55
support from family or friends, beliefs that exercise is painful, fears of getting hurt,
embarrassment about one‘s appearance while exercising, fatigue after working all
day or laziness, not being athletic, past attempts to exercise regularly have failed,
being unable to afford exercise equipment or the expense of a health club, and
claiming that there is no suitable place to exercise.


   For those who feel that there isn‘t sufficient time to exercise, you can get up in
the morning a little earlier or sacrifice some time spent watching television in order
to get 30 minutes to an hour of needed exercise. You can overcome any tendency to
feel bored with exercise by finding things to do that you enjoy, by teaming up with a
family member, friend or co-worker, and by switching to different activities or places
to exercise to make things more interesting. If family or friends don‘t seem
supportive of your interest in fitness, you might consider educating them about the
health benefits of exercise and propose that they join you to see if they would like to
give it a try. If they continue to maintain an unsupportive attitude, you can ask
them to at least respect your personal wishes to get in shape.


   If you worry that exercise will be painful or that you might get hurt, you should
keep in mind that exercise should not be painful and precautions can be made to
protect yourself from accident or injury. After you first start exercising, a little
soreness is normal; but, there shouldn‘t be any pain. Pain is caused by overexertion
or a lack of sufficient warm up. If you experience pain, you are probably overdoing
it. Start slow with low intensity exercise such as walking and make gradual
increments of longer duration and higher intensity exercise. Also, remember to get
clearance from your doctor if you have any medical conditions or if you are over 40
for men or 50 for women. Remember to start your workout with about 10 minutes
of warm up with brisk walking or calisthenics, followed by some stretching once your
muscles are warm. When you are finished exercising you can cool down with lower
intensity activity until your heart rate returns to normal followed by some stretching
rather than an abrupt stop while your heart is racing to help prevent injury. If you
feel dizzy, faint, nauseated, very much out of breath, or in pain you should stop
exercising to prevent injury or other health problems.


   If you are worried about how you look while exercising, you might consider
exercising in the privacy or your home or in public early in the morning when few




                                            56
people are up. It is best if you can let go of concerns about your appearance
exercising; after all, getting in shape will only make you look better to others.
If fatigue after work or just a feeling of laziness stand in the way of exercise,
remember that exercise will give you more energy during the day. If you can just
get started with a small amount of activity like a short walk, you will gradually be
able to increase the intensity and duration of exercise and you should find that your
energy level is higher during the day. If not being athletic makes it hard for you to
get regular exercise, try not to put so much pressure on yourself. You don‘t have to
be a star athlete to gain the health benefits of exercise. If you feel awkward
exercising, you can get some pointers from a personal trainer or someone more
experienced. You can get help finding a trainer at The American Council on Exercise
website: www.acefitness.org. A greater degree of comfort comes with practice.
Also remember to start slow. Low intensity exercise such as walking can gradually
build to more challenging forms of exercise. You might not feel awkward if you don‘t
overdo it.


   If you tried to exercise in the past but failed to stick with it, try to learn from
your previous attempt or attempts. Did you make unrealistic goals or did you try to
do too much too quickly? Were there outside circumstances that distracted you from
regular exercise? Maybe you lacked motivation or sufficient leverage to keep you
going. It may help to remind yourself that with regular exercise you relieve stress,
build endurance and increase your energy, lose weight and maintain healthy body
weight, and prevent heart disease, stroke, osteoporosis, type 2 diabetes, arthritis,
some forms of cancer such as breast and colon cancer, depression and anxiety. (U.S.
Department of Health and Human Services, 1996) Try not to let yourself get
discouraged in the beginning. It can take weeks to months before you notice some
of the changes from regular exercise.


   If financial constraints prevent you from purchasing a health club membership or
home exercise equipment, you can still find inexpensive means to get in shape. You
can get aerobic exercise by walking, jogging or biking in a local park, neighborhood
high school or college campus. You can get exercise videos from your local library or
share videos with friends. For strength training exercise, you can rely on traditional
calisthenics such as push ups, pull ups, sit ups, crunches, squats and lunges.
Flexibility training also doesn‘t require any special facility or equipment. If finding a
suitable place to exercise has stood in the way of getting regular exercise, ask



                                            57
friends and family where they go, look into local community centers, public gyms
and colleges, and explore local parks and ball fields for places to go. Many people
are able to overcome the barriers they face to getting regular exercise and are able
to reap the health benefits of getting into shape. (Mayoclinic.com, 2006)


   After selecting the type of activity you want to get started with, the next step is
to take action. After the first couple exercise sessions you begin to develop some
momentum. By the third week of exercise you are forming a habit. At this point you
just have to stay motivated as you begin to increase the level of intensity and
duration. It will help you to stay motivated if you make a commitment to exercise,
have fun, start slow and don‘t overdo it, set goals and reward yourself for reaching
them, make exercise part of your daily routine, get support from friends and family,
and find a way to get variety into your exercise routine. It is also important to allow
yourself occasional breaks in the routine as long as you get right back to your habit
of regular exercise.


   While physical activity includes any activity that involves muscle movement and
energy expenditure, exercise involves specific types of physical activity that are
intended to improve and maintain physical fitness. Many research studies have
established the benefits of exercise; yet, it is also important to find the best kind of
exercise. An exercise program including aerobic exercise, strength training and
flexibility training provides greater benefit than simply increasing one‘s amount of
physical activity. Although, any increase in physical activity will offer health benefits.


   Aerobic exercise involves sustained activity of large muscle groups in order to
make the heart work harder and breathe more deeply to get oxygen and nutrients to
the tissues. Heart rate is widely accepted as a reliable measure of aerobic exercise
intensity. Examples of aerobic exercise include jogging, running, swimming,
bicycling, aerobic dance, cross country skiing, and any other activities that raise
heart rate. In order to obtain cardiovascular benefit from aerobic exercise you
should strive to reach your target heart rate for 20-30 minutes 4-6 days per week.
Exercise that doesn‘t raise your heart rate to its target level and keep it there for 20
minutes won‘t contribute significantly to cardiovascular fitness. One of the easiest
ways to calculate your target heart rate is maximum heart rate (220- age) x (.7 or
70%. When first beginning aerobic exercise your target rate should be more like
60% of the maximum rate and with higher degrees of fitness your target rate can



                                           58
approach 85%. You can calculate your heart rate by taking your pulse for 15
seconds and then multiply by 4 to arrive at beats per minute. A normal resting heart
rate for a 40 year old is about 70 beats per minute while his or her target heart rate
during aerobic exercise would be around 125. When you check your heart rate
during aerobic exercise, take your pulse within 5 seconds of stopping exercise in
order to get an accurate measure of heart rate before it begins to slow down with
rest. (Familydoctor.org, 2006) Some treadmills include electronic equipment that
will take your pulse while exercising to help guide you in choosing your exercise
intensity.


   Strength training is often associated with athletes but it is important for
everyone. Strength training helps to increase lean muscle mass, burn more calories
even at rest, reduce body fat, improve body image, confidence and self-esteem,
prevent depression, prevent injury, increase endurance and energy, help to get
refreshing sleep, and build strong bones. For older adults, strength training helps to
prevent osteoporosis, maintain independence and prevent loss of function. You can
use free weights, weight machines, other resistance machines, elastic bands, or you
can use your own body weight with push ups, sit ups, pull ups, squats and abdominal
crunches. You should be able to do 10-12 repetitions of each exercise for best
results. When it becomes easy to do 12 reps you can increase the weight or
resistance. It is normal to feel some muscle soreness following strength training but
you should not feel sharp pain or develop tissue swelling. If you feel pain, you are
trying to do too much. Lighten the load or cut back the resistance. You should give
your muscles a full day to recuperate to prevent injury. Only 2-3 half hour sessions
a week is needed to reap the benefits of strength training. Early improvements in
energy and strength can occur within a few weeks. (Mayoclinic.com, 2006)


   Most aerobic exercise and strength training causes muscles to contract; flexibility
training, on the other hand, makes muscles stretch and lengthen. Flexibility training
helps prevent injury during exercise, relieves stress by relaxing tight muscles,
improves posture, aids circulation, increases the range of motion around joints, and
improves balance and coordination. Even if you don‘t do strength training or aerobic
exercise, flexibility training can still be of benefit. Fundamental stretches in flexibility
training are directed at major muscle groups of the body including the calves, thighs,
hips, lower back, shoulders and neck. You should stretch briefly before strength
training and aerobic exercise after a 5-10 minute warm up with low intensity activity



                                            59
and then stretch more thoroughly while cooling down after a workout. Muscles
stretch best when they are warm. It takes time to lengthen muscles safely so you
should hold stretches for 30-60 seconds. You may want to use a watch to get a
sense of the proper amount of time for each stretch. It is important not to bounce
while stretching because bouncing can cause injury. You do not want to feel pain
while stretching. If you feel pain, ease up on the stretch until you are pain free and
then hold it. As yoga teaches, it helps to relax and breathe into your belly while
stretching. Stretch both sides of the body so that both right and left sides‘ flexibility
is close to equal. After an injury, stretching may cause further damage; it is best to
follow the advice of your doctor or a physical therapist regarding rehabilitation
following an injury. (Mayo Foundation for Medical Education and Research, 2006)


   Physical activity and exercise play an important role in one‘s degree of physical
and mental health. If you don‘t exercise regularly it is advisable to begin an exercise
routine. Develop a plan, team up with a buddy if you can, and start getting regular
exercise so that you can get fit and stay fit.




                                           60
Obtaining Fully Refreshing Sleep




       Sleep is a necessary biological process for all humans although the reason we
need sleep is not yet known. Insufficient sleep is associated with difficulty coping
and accomplishing tasks, problems with family and social relationships, and
worsening mood. (The Gallup Organization for the National Sleep Foundation, 1995)
Inadequate sleep is also associated with greater risk of developing psychiatric
disorders. (Breslau et al., 1996)   Insufficient sleep has been found to cause
impairments in performance, cognitive function, health and quality of life. Insomnia
is associated with impaired functioning in many areas; it leads to increased risk for
depression, anxiety, and possibly cardiovascular disorders. Therefore, obtaining fully
refreshing sleep is an important facet of good mental health.


       Sleep control is believed to take place in the hypothalamus located in the
base of the brain. The sleep drive accumulates while we are awake and dissipates
while we sleep. It is estimated that 8 hours of sleep are needed to fully discharge
the sleep drive. The human sleep-wake cycle is entrained into the light and dark
phases of the 24-hour day.    The hypothalamus triggers melatonin production by the
pineal gland during darkness while its production is inhibited by light.   The actions of
melatonin are thought to bring about sleep.


       Some people stay up late at night during the week and interrupt sleep in the
morning with an alarm clock. They may use caffeine in coffee or tea to raise their
level of arousal in the morning and then try to catch up with needs for sleep on
weekends when the schedule is not as demanding. Other people have ample time
for sleep but have difficulty falling asleep or maintaining sleep. The following tips
can help some people with insomnia get a better night‘s sleep.


   -   First, keep a routine schedule for sleep each night.
   -   Try to avoid a lifestyle of progressive sleep deprivation during the week
       followed by crashing on the weekends.
   -   Avoid napping during the day unless you are elderly or debilitated.
   -   Exercise daily, but exercise late in the evening may disturb sleep.
   -   Minimize caffeine intake within 8 hours of bedtime.



                                           61
   -   Don‘t eat heavy meals right before bedtime. A light snack on the other hand
       can be helpful.
   -   If something worries you when you lie down to sleep, write it down to look at
       in the morning.
   -   Make the bedroom comfortable. In general it is better to be slightly cool than
       too warm.


   If you continue to have problems getting adequate sleep, you may need to see a
physician. Breathing problems during sleep (sleep apnea) and restless leg syndrome
can interfere with sleep. Sometimes problems sleeping are related to underlying
mental health problems such as depression or anxiety. In these cases, treatment of
the mental health condition may correct problems with sleep. For others, treatment
of insomnia may require the use of sedating medication in order to function fully
during the day. Obtaining fully refreshing sleep appears to help promote better
mental health.




                                         62
Preventing Physical Illness and Disability


               Physical illness and disability are associated with mental health
problems. Therefore, preventing physical illness and disability will in turn also help
prevent mental illness. Preventive medicine is organized in three tiers: primary,
secondary and tertiary. Primary prevention measures remove or reduce disease risk
factors for example with immunization or not smoking. Secondary prevention aims
to detect diseases early such as the Pap smear for detection of cervical cancer in
women or the prostate specific antigen (PSA) blood test in men to detect prostate
cancer. Tertiary preventive measures strive to limit the impact of established
disease such as partial mastectomy and radiation therapy to control breast cancer.
Many physical illnesses are preventable and about ½ of all deaths can be accounted
for by preventable causes. The following table lists the leading preventable causes
of death in the United States in 1990. (McPhee & Pignone, 2004)




                                             63
Preventable Causes of Death (1990)


Cause                    Percentage of Total Deaths   Estimated Number of Deaths
Tobacco                               19                                 400,000
Dietary factors and                   14                                 300,000
activity patterns
Alcohol                               5                                  100,000
Microbial agents                      4                                  90,000
Toxic agents                          3                                  60,000
Firearms                              2                                  35,000
High-risk sexual behavior             1                                  30,000
Motor vehicle injuries                1                                  25,000
Illicit use of drugs                  <1                                 20,000


Total                                 50                                 1,060,000




          Cigarette smoking remains the most important preventable cause of illness
and early death in developed countries throughout the world. In the United States,
adult rates of smoking are about one in four people. Cigarettes are responsible for
one in every five deaths in the United States. Smokers have double the risk of fatal
heart disease, ten times the risk of lung cancer, and higher risk of cancers of the
mouth, throat, esophagus, pancreas, kidney, bladder, breast, prostate, colon, cervix
and blood. Smoking also increases the risk of stroke, peptic ulcers, fractures of the
hip, wrist and vertebrae, Alzheimer‘s disease and cataracts. It accounts for most of
the cases of chronic obstructive pulmonary disease. Nicotine constricts blood vessels
and is considered toxic to the brain. Nicotine is a habit forming chemical that results
in compulsive repeated use and dependence. Therefore, stopping smoking requires
steps to overcome physical withdrawal and psychological urges to continue to
smoke. There are various alternatives to assist with smoking cessation including
nicotine gum, patches, inhalers, lozenges and other medications available by
prescription from a doctor. Some people are able to stop smoking without
assistance. In a 50-year study of British doctors, it was found that smokers who quit
by age 35 could avoid most of the health consequences of smoking; those who quit




                                            64
by age 50 avoided 50% of the risks associated with smoking; while those who quit
by age 60 avoided approximately 33% of the risk. (Doll et al., 2004)


       Dietary factors and inadequate physical activity are associated with many
illnesses and they are the second most important preventable causes of death. A
sedentary lifestyle is an important modifiable risk factor. It is recommended that
adults should engage in 30 minutes or more of moderate-intensity physical activity
on most days of the week. Appropriate diet and maintenance of healthy body weight
reduce the risk of heart disease, diabetes, cancer and stroke. Prevention of cancer
appears to coincide with eating more fruit, vegetables and wholegrain foods. It is
believed that overindulgence in alcohol, smoking, obesity and lack of exercise may
interact with dietary factors to increase the risk of some cancers. (Holmes, 2006)


       Exposure to sunlight must be approached thoughtfully. Prudent sun exposure
may benefit mental health with improvements in mood and sleep but the best time
of exposure has not been found and clearly excessive sun exposure leads to health
problems.   Some scientists have recommended 15-20 minutes of sun exposure per
day. Morning exposure may help regulate the sleep-wake cycle.


       The lifetime prevalence of alcoholism is estimated to be between 12-16%.
Binge drinking among college students has increased. Alcohol-impaired driving
remains common, particularly among men aged 18-34, and is associated with a high
incidence of motor vehicle accidents, injuries and deaths. Alcohol dependence is
responsible for approximately 100,000 deaths each year. Heavy drinking is a leading
cause of cardiovascular illnesses, such as cardiomyopathy, coronary artery disease,
high blood pressure, dangerous heart rhythms, and stroke. It is a leading cause of
illness and death from liver disease.   Consuming 4 or more alcoholic beverages a
day increases the risk of developing cancer. Alcohol can be toxic to the brain in
excess.   Psychiatric disorders, such as depression, anxiety disorders, and antisocial
personality disorder, occur more often among alcoholics. Drinking alcohol is involved
in about one third of suicides, one half of homicides, and one third of child abuse
cases. (To, 2006) Respiratory problems can occur with inhalation of stomach
contents during alcohol- related vomiting. Heavy alcohol use is also associated with
poor nutrition and dietary deficiencies of essential vitamins and nutrients which can
lead to problems such as anemia or dementia.




                                           65
       Public health measures have decreased the incidence of infectious diseases
and the fatality rates associated with these diseases. These measures have included
immunization, better sanitation and better nutrition. Immunization of children in the
United States has nearly eliminated the occurrence of measles, mumps, rubella,
poliomyelitis, diphtheria, pertussis, and tetanus. In adults however, vaccine
preventable diseases such as hepatitis A and B, influenza, and pneumococcal
infections continue to account for more than 50,000 deaths annually in the United
States. Skin testing for tuberculosis and the treatment of selected patients reduces
the risk of reactivation of tuberculosis and its spread to unaffected individuals.
Unfortunately, it is estimated that as many as one-third of HIV-positive individuals
continue unprotected sexual practices after learning that they are HIV- infected.
Therefore, practicing ―safer sex‖ with the use of condoms will prevent the spread of
HIV and AIDS as well as other sexually transmitted diseases. Furthermore, use of
illicit drugs and sharing of equipment used for intravenous drug use has also
contributed to the spread of HIV and AIDS. Therefore, stopping illicit drug use or
use of sterile equipment by those who continue intravenous drug use can reduce the
spread of HIV. In 2005, the US Preventive Services Task Force recommended
screening for HIV in individuals at high risk, individuals requesting screening, and
pregnant women. (Prince, 2006) Oral health problems including cavities, gum
disease and cancer are almost always preventable. Good habits including proper
diet, brushing, flossing and keeping regular appointments with a dental hygienist and
dentist will help to maintain a healthy smile. You can get information about proper
brushing and flossing technique from your dental hygienist.


       Violence and injuries are also common preventable causes of disability and
death. Death from firearms in the United States has reached epidemic proportions.
Having a gun in the home increases the risk for both homicide and suicide. In
particular, males aged 16-35 are at the highest risk for serious injury or death from
accidents or violence. Alcohol and illicit drug use are associated with an increased
risk of violent death. Motor vehicle injuries remain the tenth leading cause of death.
It is estimated that one in four adults do not routinely wear seat belts. Furthermore,
a large percentage of motorcyclists do not wear helmets. It appears that young men
are at greatest risk to resist wearing helmets on motorcycles or bicycles. Other
factors associated with motor vehicle accidents and injuries include using cellular
telephones while driving, drinking alcohol and driving, or using other intoxicants




                                           66
while driving. It is estimated that 41% of highway fatalities are associated with
substance abuse.


       Together, nicotine, alcohol and illicit drug use account for 25% of all
preventable deaths. While illicit drug use accounts for less than 1% of all
preventable deaths such drug use leads to many physical and mental health
problems. It has been well established that sensation seeking behavior follows a
pattern of initial experimentation with a gateway drug such as alcohol, tobacco or
marijuana which can then lead to heavier drug use. Illicit drug use is associated with
a number of medical problems including infectious diseases related to intravenous
drug use and unprotected sex; heart problems and psychiatric illness associated with
stimulants such as cocaine and methamphetamine; respiratory failure associated
with opiate misuse; and brain damage as well as injury to the heart, kidneys and
liver associated with inhalant use. Street drugs are toxic to the brain and inhalants
are the most dangerous to the brain. Even caffeine in excess may be dangerous.
Substance use is often associated with mental health problems including depression,
anxiety, psychosis and antisocial personality disorder. It has been recently
established that even marijuana use is associated with the development of psychosis
and schizophrenia. Preventive measures designed to reduce the incidence of illicit
drug use include fostering supportive family and school environments and
recognizing problems early with those who are using drugs so that they can undergo
treatment and rehabilitation. In general, the greater the perception of risk related to
drug use, the less likelihood that an individual will use drugs. Other sources of toxic
exposure to the brain include monosodium glutamate (MSG- a food additive), paint
fumes and possibly even artificial sweeteners. More information about parents‘ role
in preventing substance use is discussed later in the effective parenting section.


       Secondary preventive measures have been developed in order to facilitate the
early recognition of cancers, high blood pressure and serum cholesterol problems.
Routine blood pressure monitoring with each encounter with a physician is standard
of care in order to help assure that patients have healthy blood pressure and receive
treatment for blood pressure abnormalities. Elevated blood pressure is associated
with heart disease, stroke and kidney damage if left untreated. Reductions in salt
and alcohol consumption, healthy weight and exercise can help to prevent high blood
pressure. Cholesterol screening is recommended for all middle aged and older adults




                                          67
and for those younger adults with risk factors for high cholesterol including a family
history, use of certain medications, or obesity. Elevated cholesterol is associated
with stroke and heart attack. Screening for early detection of cancers has been
shown to prevent death from breast, colon and cervical cancers. Screening for
breast cancer includes monthly breast self-examination for women over age 20, a
clinical breast exam every three years for women age 20-40 and then annually
thereafter and a mammogram age 40 and older. Screening for cervical cancer
includes a pap smear annually 3 years after first intercourse or age 21 whichever
comes first. After age 30, women with three normal tests may be screened every 2-
3 years. Screening for colon cancer includes a stool test for blood in the stool and
sigmoidoscopy or colonoscopy every one to two years after age 50. Screening for
prostate cancer includes a yearly PSA blood test and rectal exam for men aged 50
and older. (McPhee & Pignone, 2004)


       In situations where you become ill, you can help to promote your health
through your own effort in addition to any help you may receive. The range of
behaviors undertaken by people to restore their health when facing a medical
problem has been termed medical self-care. This includes self-initiated responses to
symptoms, getting help when needed, and appropriate follow through after seeing a
doctor. You can tend to your own wounds and tend to your life balance; but, you
should consult a doctor if symptoms are severe, if symptoms persist, or if you don‘t
know what to do. Some chronic conditions will require ongoing medical care over
long periods but a large part of recovery from illness will require that you take
responsibility for your own health and do your part. Good medical self-care requires
that you educate yourself about the illnesses you face and what you can do to
facilitate your recovery. Then it is up to you to make smart choices and take good
care of yourself.


       As many of today‘s diseases and causes of death are preventable, the above
preventive measures should be taken to promote both your physical and mental
health. Preventing physical illness helps to prevent mental health problems
associated with poor physical health. It is important to consult your physician and
keep abreast of new developments in preventive medicine so that you and your
family can take appropriate preventive measures to assure your best chances for a
healthy life.




                                           68
Long Life


       In developed regions of the world, life expectancy has increased by an
average of 30 years in the last century. More people are living to 100 and perhaps
by the time our children reach old age it will become common place. In fact, people
100 years and older are the fastest growing segment of the American population.
Improved longevity is a remarkable achievement and these added years can be a
wonderful gift for those who arrive at old age mentally sharp, physically fit and
financially secure. Today, more people than ever before are enjoying good health,
productivity and vitality well into old age.    Disability among America‘s elders has
declined over the past decade. Nevertheless, diseases of aging continue to affect
many older men and women. Osteoporosis and low bone mass, cardiovascular
disease, diabetes and Alzheimer‘s disease are common among older persons.           In
order to prolong life diagnostic methods that reliably detect disease and pathology
must improve, people must make healthy lifestyle choices and effective interventions
for disease and disability must be developed.


       According to Robert Butler, previous director of The Institute on Aging, a
branch of the National Institute of Health, and author of The Longevity Prescription,
there are eight proven strategies to a long, healthy life.
   1. Maintain mental vitality with physical and mental exercise
   2. Nurture your relationships
   3. Seek essential sleep
   4. Set stress aside
   5. Connect with your community
   6. Live the active life- build physical activity into your lifestyle, four types of
       exercise are important: endurance (aerobic), strength, flexibility and balance
   7. Eat your way to health
   8. Practice prevention

(Butler R, 2010)


       According to Andrew Weil from his website DrWeil.com, a study from the
University of Maryland published in January, 2011 investigating the diets of 2,500




                                               69
women and men ages 70-79 found that eating a diet that emphasized fruits,
vegetables, whole grains, poultry and fish and a limited quantity of meat, fried foods,
sweets and high-calorie drinks was correlated with better survival over a 10 year
period. The individuals who ate a diet of this type also were more active and
smoked less than other groups of individuals in the study. On the other hand, those
who ate diets that were high in fat, sweets, dairy products including ice cream and
cheese, and saturated and trans fatty acids had a 40% higher mortality rate. Weil
recommends an anti-inflammatory diet designed to reduce chronic low-level
inflammation that may lead to heart disease, cancer, Alzheimer‘s and Parkinson‘s
diseases, type-2 diabetes and many other illnesses. Such an anti-inflammatory diet
includes a healthy balance of omega-3 and omega-6 fatty acids, whole grains,
beans, sweet potatoes, winter squashes and other vegetables as well as fruits such
as berries, cherries, apples, and pears. It includes vegetable protein such as whole
soy foods, beans, lentils and other legumes and whole grains, seeds and nuts. He
recommends oily fish higher in omega-3‘s if you eat fish.


       Weil also argues that the happier and more positive you are, the healthier you
are likely to be and the longer you will live. Positive emotions and enjoyment of life
contribute to better health and long life. Positive emotions mean less stress and
better immune function. (Weil 2011) Also, maintaining a positive outlook on the
later years of life by expecting to gain greater maturity and wisdom, and emotionally
mellow to some degree with age may prolong life.


       Dan Buettner from the National Geographic Society sheds some light on the
secrets of healthy old age in his book The Blue Zones which describes the lifestyles
of four regions associated with the longest living people. The underlying theory is
that world‘s healthiest, longest-lived people can teach us about living longer, richer
lives. While there are things we can do to lead longer, healthier lives we must avoid
anti-aging quackery. Our current understanding of aging in medicine leaves us with
an inability to stop or reverse the aging process.   Yet, people throughout the world
and a greater percentage of people in particularly healthy cultures live to be 100 or
older. The four blue zone regions are as follows:


Sardinia, Italy-




                                          70
       In Sardinia men appear to retain their vigor and vitality longer than men
almost anywhere else. The area of extreme longevity is located in the mountainous
region. The lifestyle there hasn‘t changed much since the time of Christ. Every day
hikes taken by Sardinian shepherds burn 490 calories an hour. They drink red wine
high in flavonoids; brightly colored fruits and vegetables and dark chocolate also
contain them. Studies have shown that a diet high in flavonoids is associated with a
reduced incidence of certain cancers and heart disease. They drink goat‘s milk which
may help protect from atherosclerosis and Alzheimer‘s disease. Their family is their
purpose in life, they have a reverence for family. A genuine affection for elders
keeps them with their families until death. Grandparents stay involved in children‘s
lives. The Sardinian diet is lean and largely plant based with an emphasis on beans,
whole wheat, and garden vegetables. They eat pecorino cheese made from grass-
fed sheep that is high in omega- 3- fatty acids. Meat is largely reserved for Sundays
and special occasions. Lastly, they maintain a sardonic sense of humor.


Okinawa, Japan-


       In traditional Asian medicine, prevention is most honored. The Okinawan
culture of longevity has been disappearing with the encroaching American food
culture. The Okinawan centenarians (100 years old or older) traditionally ate meat,
usually pork, only during infrequent ceremonial occasions. They primarily ate meals
of stir-fried vegetables, sweet potatoes, and tofu. Okinawan families honor their
ancestors. They avoid eating too much by eating only until they are 80% full. They
grow gardens that provide a source of daily physical activity and healthy fresh
vegetables. They have a reason for waking up in the morning, a role, they feel
needed. They have strong social connections and meet regularly and they may
maintain lifelong friends. They enjoy the sunshine which increases vitamin D. They
stay active with walking and gardening. They consume medicinal herbs: mugwort,
ginger and turmeric which may offer prevention of disease. They learn to be likable
and keep younger people in their company well into old age.


Loma Linda, California (60 miles east of Los Angeles)-


       Seventh- day Adventists living in this community follow a faith that
discourages smoking, alcohol consumption, the consumption of meat, caffeinated




                                          71
drinks and even ―stimulating‖ condiments and spices. They eat a diet including nuts,
water, and vegetables; they get plenty of physical activity and maintain healthy
weight.   They eat a light dinner and pack more calories into the earlier part of the
day. As part of their religious beliefs they celebrate the Sabbath, a weekly break
from the demands of daily life, which allows them time to spend with the people who
are important to them and turn off the television and take a break from thinking
about work or business. They spend time with like-minded friends, other Adventists.
The Adventist Church encourages and provides opportunities for its members to
volunteer which gives a sense of purpose and altruism.


Costa Rica (Central America)-


       The centenarians in Costa Rica have a strong sense of purpose; they feel
needed and want to contribute. They drink hard water high in calcium. They live in
closely tied families which provide a sense of belonging and purpose. They visit with
neighbors and maintain a sense of humor. They eat a diet of fortified maize (corn)
and beans. They eat a light dinner early in the evening.    They do physical work all
of their lives and find joy in every day physical chores. They spend time in the
sunshine.


It seems that the lifestyles of these long lived people help to uncover the secrets of
not only a longer but also functional and productive lives. The field of aging and
longevity research will hopefully continue to uncover increasing knowledge that will
help people live longer and better lives. (Buettner D, 2008)




                                           72
Part Four: Psychological Approaches to Optimal Mental
Health

       The field of clinical psychology has concerned itself primarily with factors
associated with mental illness and its psychological treatment. The role of
psychological factors in the cause of mental illness was emphasized by Sigmund
Freud in his theory of ―intra-psychic‖ or unconscious conflict. Other psychological
explanations of illness have included failures in development, suggestibility and
binds, conditioning and social learning, stress and inadequate coping, and the
development of distorted reality testing. While the majority of psychological inquiry
has looked at illness, some investigations have found that certain psychological skills
and strengths appear to promote exceptional mental health and functioning and help
to prevent illness. The following section describes such strengths and skills. It will
also explore aspects of development associated with good mental health.




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Mental Growth




        For humans, growth takes place physically, mentally, socially and spiritually.
The result of growth is greater maturity. Human growth takes place naturally, as
Karen Horney has said, like the way an acorn develops into an oak tree. Most
aspects of growth occur automatically out of awareness while a portion of human
growth takes place under the direction of conscious thinking. Some may think that
thinking can get in the way of natural growth processes; but certain aspects of
healthy adaptation to life require use of conscious thinking. We grow in the direction
of our aims and we gain wisdom from life experiences. According to experts in the
field of psychology, during the process of growth as a human being, certain
developmental tasks must be successfully completed in order to achieve a positive
state of mental health. Erik Erikson, the most prominent developmental theorist
whose work included a focus on positive mental health, developed a model of
developmental crises which must be resolved successfully throughout life in order to
maintain health. The eight stages he described include: trust vs. mistrust (birth to
approximately 18 months), autonomy vs. shame and doubt (18 months to 3 years),
initiative vs. guilt (3 years to 5 years), industry vs. inferiority (5 years to 13 years),
identity vs. role confusion (13 years to 21 years), intimacy vs. isolation (21 years to
40 years), generativity vs. stagnation (40 years to 60 years) and ego integrity vs.
despair (60 years until death). Other theorists have described additional
developmental processes that contribute to the mental health of an individual.
Developmental stages through the life span include: infancy, toddler years,
childhood, adolescence, young adulthood, middle-age and late adulthood. Growth
through these stages leads to increasing maturity and ability to adapt successfully to
life.


Infancy (birth to 18 months)


        During infancy, a secure attachment with parents is the most important task.
In order for this to occur, parents need to provide predictable support and
nurturance. Bonding with mother and father strengthens with feeding, play, and
soothing when the infant is upset. From a foundation of secure attachment with
parents, the infant grows to explore his or her world and then eventually make


                                            74
attachments beyond the family. According to Erikson, from birth until approximately
18 months, if a mother is able to anticipate and to respond to the baby‘s needs in a
consistent and timely fashion, the baby will learn to tolerate the inevitable moments
of frustration and deprivation. Trust predominates over mistrust with the
consistency of a ―good enough‖ mother and father or primary caregiver.


Toddler (18 months to 3 years)


       The toddler continues to require a secure and dependable attachment with
parents. During this period of development, walking and talking enables the toddler
to explore his or her environment and form more complicated attachments to his or
her parents. Freud emphasized the importance of toilet training during this stage.
In general, parents should avoid pressuring the toddler during toilet training,
contests of will, creating anxiety about getting to the potty, or shame because of
failure. Ideally, parents should enlist the toddler‘s interest in toilet training, help the
toddler identify his or her need to go and teach him or her to signal when he or she
needs to go. Eventually, the toddler begins to get himself or herself to the potty on
his or her own. Typically, this process is learned throughout the second year of life
and into the third or fourth with lapses along the way. Success at bowel and bladder
control gives the toddler a sense of self-efficacy. Parents must allow the toddler to
explore his or her world in order to develop a sense of autonomy; however, an
ample amount of parental control is necessary so that the toddler is protected from
his or her own lack of self-control or judgment. According to Erikson, the stage of
autonomy vs. shame and doubt spans from approximately 18 months to
approximately 3 years of age.


Childhood (3 years to 13 years)


       During childhood, overcoming urges to compete with the same sex parent,
adjusting to school, and socialization become the major developmental tasks. The
child must give up urges to replace their same sex parent in competition for their
opposite sex parent and look outside the family for new places to compete without
feelings of guilt. Erikson felt that this stage of initiative vs. guilt takes place from
approximately 3 years of age until 5 years. As the child begins to acquire language,
he or she can begin to put feelings into words, handle conflicts with words, and learn




                                            75
to control impulses with the use of language. Eventually, any needs to discharge
aggression can be channeled into appropriate play. The ability to interact
appropriately with other children, to wait quietly for one‘s turn, and take on the task
of learning the basic skills and fundamentals of education including reading, writing,
math and other subjects takes place from approximately age 5 until 13 years of age.
The child learns about the pleasure of work completion by use of attention and
perseverance. From his or her accomplishments the child develops a sense of
industry. With a lack of success in this stage the child may develop a sense of
inferiority or inadequacy. At home, young children must be able to adjust to new
members of the family when parents have more children and they must learn to
control urges to misbehave. Children begin to develop friendships where support
and play are enjoyed with others outside the immediate family of origin.


       Characteristics of mentally healthy children include: the capacity to form
warm, trusting relationships with other children and adults; positive self-esteem
with a sense that they can be effective and make things happen in the world;
appropriate control of impulses; progressive ability to express needs, feelings and
ideas with words; beginnings of empathy and compassion; skills to concentrate,
focus and plan as a basis for learning; and the ability to deal in a developmentally
appropriate way with loss and limitations.


Adolescence (13 years to 21 years)


          From the age of 13 years until approximately 21 years of age, adolescents
experience the onset of puberty and its associated physiologic changes. Adolescents
become concerned with how they appear to others. An accrued confidence develops
that in the midst of life changes one maintains a sense of inner sameness and
continuity which others recognize. Adolescents form cliques in order to develop a
sense of belonging and differentiate themselves from other groups with which they
do not identify. Adolescents begin to fall in love and define their identities in terms
of companionships. When these tasks are not successfully undertaken, adolescents
can develop feelings of isolation, emptiness, anxiety and indecisiveness about career
choice. According to Erikson, role confusion can lead to delinquency, gender-related
identity problems and even psychotic episodes.




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Young Adult (21 years to 40 years)


       Erikson described the crisis for young adults from approximately 21 years of
age to 40 years as intimacy vs. isolation. He felt that intimacy takes precedence
over work as the most important task of young adulthood. Intimacy is closely tied to
fidelity with the ability to honor commitments in partnerships even when that
requires sacrifice and compromise. Intimacy includes the capacity to experience
others‘ needs and concerns as being as important as one‘s own. The experience of
intimacy for many leads to the desire for marriage. Therapists often encounter
disillusioned young men and women who concentrated their efforts on their careers
and did not marry or have children. These patients may feel accomplished at their
work but complain of loneliness, depression, and isolation.


       The transition from adolescence to young adulthood involves a separation
from the family of origin. Young adults let go of their family dependencies and
become a member of the society at large. Parents are no longer relied upon for such
high degrees of comfort, security and direction. Friendships shift to couples so that
young married couples may socialize with other couples without engendering feelings
of competition.


       When a young couple becomes parents for the first time new interdependent
roles as mother and father must be learned. Furthermore, the relationships of these
new parents with their own mother and father changes to more equal roles as they
assume the responsibilities that their parents once experienced: spouses, parents
and providers. Mentally healthy families are characterized by relationships in which
the adults are in charge. The parents must be leaders and models and make rules
which are kindly but firmly enforced. Children must feel valued and develop a sense
that they belong. Children should have an opportunity to contribute to and
participate in family life and share meaningful discussion time with their parents.
Communication in the family should be clear and negotiation fair. Members of the
family should be encouraged to express how they feel and say what they need. A
healthy family must be able to adjust to change and seek outside help when
necessary. A more thorough discussion of effective parenting is provided in the
social approaches to optimal mental health section.




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       Establishing a work identity is an important task for most young adults.
Hopefully, a smooth transition will take place from high school to on the job training
or from high school to college and possibly on to graduate school and then to on the
job training. In the age range from the late teens to twenties, the transition from
learning and play to work requires that the pleasures of learning and play become
subordinate to the demands of work. Young employees must develop solid
relationships with mentors where ideas and attitudes are learned. Work may
become a source of frustration or greater self-esteem. In addition to making a
living, work provides purpose and direction, helps to organize time and provides an
atmosphere where meaningful relationships can be established and maintained. As
Howard Thurman once said, ―Don‘t worry about what the world needs. Ask yourself
what makes you come alive, and do that. Because, what the world needs is people
who have come alive.‖ Finally, time for adult forms of play must be found in order to
develop a psychological balance.


Middle Age (40 years to 60 years)


       Coming to terms with the limits in time left in one‘s life and that eventually
one must face death is an important task of middle age. At some point, the adult
child is confronted with the task of caring for vulnerable, dependent parents who are
no longer able to function independently. Women face their loss of reproductive
potential at this time. Adults in middle age have to accept their aging bodies and
maintain intimacy and fidelity in the face of changes in physical appearance. Some
couples must adjust to changes in male sexual performance. Many couples have
established by this time a goodness of fit with an understanding of each others‘
needs, wishes and expectations. They find that they have established a safe place
for conflict and difference, care deeply for one another and are able to maintain a
satisfying sexual life. Eventually, middle aged parents have to let their children go
as they ―leave the nest.‖ Relationships with more equality develop with children who
in turn have their own children and provide for their families.


       In middle age, a new role as grandparent may be undertaken. Relationships
with in-laws and grandchildren enrich this period of adulthood. Middle aged adults
take on mentoring relationships at work and begin to plan for retirement. For many
during this period, physical health, emotional maturity, competence in the work




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situation and gratifying relationships with spouse, children, parents, friends and
colleagues contribute to a sense of wellbeing and satisfaction with life. Erikson
described the crisis of generativity vs. stagnation as the developmental situation for
middle aged adults from ages 40- 60. With generativity, a concern and caring for
the next generation is expressed through roles such as mentor, coach or teacher
with younger adults outside of the family. An interest in leaving a legacy, something
that endures beyond one‘s lifetime and perpetuates life may become important at
this stage.


Late Adulthood (60 years until death)


        In late adulthood, the aging body becomes a central concern. Losses of
ability in functioning, changes in physical appearance and increased incidence of
physical illness become more important. Protective measures can be taken to
preserve physical health such as regular exercise, proper diet, adequate rest and
preventive medical care. The realization that remaining time is limited and the loss
of friends and loved ones of similar age induce a personal examination of one‘s life.
According to Erikson, the result of this examination from age 60 until death may be
one of integrity or despair. Ego integrity results from the realization that one‘s life
was lived well with an overall purpose and meaning. Despair comes with the
realization that there had been a series of missed opportunities, bungled
relationships, or misfortune. In this period of late adulthood, loss of significant
others can be compensated for by intensifying relationships with existing friendships,
children, grandchildren and perhaps great-grandchildren. This process of deepening
remaining relationships in the face of loses is important to mental health at this
stage of life.


        Another task of this period is retirement. Retired adults must come to terms
with their increased separation from the younger generations with differences in age,
energy, knowledge and engagement with new technology. For some, retirement
results in a sense of relief, freedom, and pleasure which has been termed ―the
golden years.‖ When retirement is unwelcome, boredom, depression and physical
debilitation can result. For some, it is necessary to mourn unrealized ambitions or
goals. Diminished capacity for hearing or vision can result in an inability to drive and




                                           79
a sense of reduced competency in life. Possessions can be passed on to younger
significant relations as an emphasis on possessions shifts to generative relationships.


        The successful outcome of psychological development is maturity. While
maturity is viewed as an important component of mental health, the subjective
experience of happiness can be independent of maturity. Nevertheless, emotional
maturity supports self-esteem and allows the individual greater success in general.
Maturity has physical, mental, social and spiritual components. One may assess
their own perceived level of maturity while other people will also judge one‘s
maturity by how they feel about you. Maturity begins to form when a person learns
to control impulses, accept reality while also trying to tackle problems that are
amenable to change, maintain appropriate social behavior, hold high values, and
develop ambition to contribute to the world. Maturity includes the ability to form
lasting relationships and to work productively. Adult maturity stems from a world
view with knowledge of life and human existence, a sophisticated level of self-
awareness based upon an honest appraisal of one‘s own experience, and the
capacity to use this insight in a caring way toward oneself and others. The mature
adult must balance emotional needs, demands, and responsibilities by prioritizing
relationships and competing demands. According to Andrew Weil, aging adds
richness to life. We replace the shallowness and greenness of youth with depth and
maturity. With aging we come to develop and enhance desirable qualities of
personality while diminishing undesirable qualities; we smooth out roughness of
character. With age, we enhance the mental, emotional, and spiritual aspects of life
by the same processes that cause decline of the physical body. With age, we gain
the advantages and power of having survived and lastly Weil poses that with age one
develops one‘s voice of authority with the accrued experience of the past. (Weil,
2005)


        The maturing older adult recognizes that the body must be cared for
appropriately. The loss of significant others and realization of an impending end to
one‘s own life encourages the older adult to seek fulfillment in each moment, to
define what is truly important, and to plan for the future in the context of these
priorities. When mental and physical activity is maintained; a focus on the present
and the future is maintained; and involvement with the younger generations is
continued; then death can be met with feelings of satisfaction, fulfillment and




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acceptance. Mental health can be promoted throughout the life cycle in part by
finding ways to successfully adjust to these developmental stages and come to
develop full maturity. I believe that the process of learning, change and growth
never ends.




                                         81
Your Relationship with Yourself


       When you look in the mirror you see your physical appearance, but you can
also see much more deeply into yourself. Who have you been all of this time you
have lived? What do you think of yourself? How do you treat yourself? How is your
relationship with yourself? Exceptional mental health depends upon a healthy
relationship with self. The following section describes some of the important facets
of your optimal relationship with yourself.




Self- love


       According to Bernie Siegel a well known cancer surgeon and author, the
essential psychological problem most people who become ill deal with is an inability
to love themselves as a result of having been unloved by other people during some
key segment of their lives. He has found that this crucial period of being unloved is
almost always during childhood when immature patterns of coping are established.
Later, as adults, these patterns of coping are repeated making one vulnerable to
illness. Although Siegel focused primarily upon the development of cancer, he also
professed that the makeup of our personalities determines the specific makeup of
illness we experience. We may develop illness when illness serves a purpose. In
this model, true healing occurs when a person understands why they became ill.
(Siegel 1986) We may prevent illness by genuinely loving ourselves and we can
come to thrive when we not only love ourselves but also love life.


       When a person genuinely loves themselves, they will do their part to take
good care of themselves and promote their own wellbeing. They will stand up for
themselves and work hard to protect themselves from assault or injury. They will
heed the advice of health professionals and eat a better diet, exercise, maintain
healthy weight, and not smoke.


       Self-love is your birthright. Loving oneself doesn‘t mean loving everything
you‘ve ever done. You can love yourself for the good choices and actions you‘ve
made, and you can love yourself for learning from the mistakes. Loving yourself
means truly forgiving yourself for past mistakes and accepting all that has happened



                                          82
as reality. Some people may equate self-love with a conceited, boastful person, or a
selfish, self-centered person. But, those who genuinely love themselves are better
able to love others and need not convince others of their self-worth. Loving yourself
is not an egotistical thing; it doesn‘t mean setting yourself above others.


       Loving yourself means being kind and encouraging toward yourself. It means
getting your needs met, nourishing your strengths, forgiving your mistakes and
accepting your weaknesses. It means self- approval and self- acceptance. It means
encouraging yourself to make the effort to build a better life, to be a better person.
According to Oprah Winfrey, ―There is a difference, you know, between thinking you
deserve to be happy and knowing you are worthy of happiness... We often block our
own blessings because we don't feel inherently good enough or smart enough or
pretty enough or worthy enough… You're worthy because you are born and because
you are here. Your being here, your being alive makes worthiness your birthright.
You alone are enough."


        Getting into the habit of treating yourself with kindness will make it easier to
extend kindness to others as well.   With a willingness to do the necessary inner
work, you can enhance your acceptance and love of self. You need not only like
yourself, you can truly love yourself.   According to James Baraz, there is a presence
within each of us, ―a pure force that is the impulse inside us that wishes for our
happiness, that roots for our well-being. The process of learning to love ourselves
means accessing and then empowering this force, so that it directs our choices and
our life.‖ He also claims that ―as you stop focusing on what you don‘t appreciate and
start seeing yourself as a unique, mysterious, changing being, you allow your best
self to shine through. And the joy of that radiates out to the world.‖ (Baraz and
Alexander, 2010)




Self-esteem


       An important element of exceptional mental health is the ability to find your
beauty. Your beauty is made up of the positive qualities you possess. By
appreciating your beauty you develop higher self-esteem. Self-esteem comes
largely from a person‘s character. To be trustworthy, to show concern for others and




                                           83
to be committed to excellence are the foundations of strong character, self-respect
and high self-esteem. An individual‘s perception of personal worth or value impacts
self-esteem. Most importantly, the ability to appreciate one‘s own positive qualities
impacts self-esteem. People with low self-esteem generally lack confidence in
themselves. These people doubt themselves and therefore fear exposing themselves
to risk or chance of failure. They may blame others for their shortcomings rather
than taking responsibility for their behavior. Low self-esteem has been associated
with alcoholism and drug abuse, eating disorders, violence, school dropout, teenage
pregnancy, low academic achievement, and suicide. Low self-esteem does not
account for these problems alone but does appear to play a part in these problems
along with other contributing factors.


       Nathanial Brandon defines self-esteem as ―the disposition to experience
oneself as being competent to cope with the basic challenges of life and of being
worthy of happiness.‖ (Branden 1994) One‘s sense of competence is strengthened
by realistic self-assessment, meaningful accomplishments, overcoming adversity,
bouncing back from loss or failure, and maintaining integrity. The sense that one is
worthy of happiness is earned by living up to personal values.


       The development of positive qualities raises self-esteem. There seem to be
many too many positive qualities associated with higher self esteem to list but some
qualities are the strengths and virtues included in Martin Seligman and Christopher
Peterson‘s book Character Strengths and Virtues. Wisdom involves the use of
knowledge in order to give good advice and display good judgment about important
facets of life while prudence involves the ability to make smart choices for oneself.
Courage involves a willingness to strive against opposition, to do what one aims
despite fear. Those with integrity take responsibility for their actions; their actions
support what they profess. Love and kindness involves the process of caring for the
welfare and growth of other people. Those who are loyal stand behind those with
whom they have ties. Fairness includes sound moral judgment and impartial
treatment of other people in life. Humility is letting one‘s accomplishments speak for
themselves; it is modesty in perception of oneself. (Peterson and Seligman, 2004)


       Self-esteem grows out of experiences of success. A person‘s ability to
positively challenge himself or herself will help bring about success. Individuals with




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a history of success are likely to have a sense of expectancy that they can control
their lives. For these people, success or failures are due to one‘s own efforts. These
people are described as having an internal locus of control. Whereas, those whose
efforts have been generally unsuccessful may come to believe that success, rewards,
and punishments are a matter of luck or largely determined by others in positions of
authority. These individuals are said to have an external locus of control. Those
who believe that their plans, goals and expectations of success are well founded will
have greater self-esteem and experience positive emotions. Development of an
internal locus of control has been associated with better mental health. (Rotter
1982)


        People also often associate high self-esteem with great accomplishments.
The capacity for excellence is learned. Coaches, leaders and administrators strive to
develop excellence in their following. Successful leaders possess a passion for their
visions and inspire the people around them to achieve great things by sharing a
common dream and by developing a positive attitude. In order to achieve
excellence, you must have a hunger to accomplish something. This hunger for
excellence is an infectious thing.


        A commitment to excellence will help you to avoid mediocrity and instill
higher self-esteem. What a person will attempt to do is determined by motivation.
George Patton is thought to have said, ―Always do more than is required of you.‖
The capabilities of a person are determined by learned ability and talent which has
been fostered by past motivation and work. The quality of what is done, however, is
determined by attitude. Successful people must be willing to tackle adversity.
Everyone faces setbacks, and the ability to react quickly and positively will help to
overcome the obstacles. With a vision and sense of purpose, you can avoid getting
side-tracked and stay focused on your aims. In order to achieve mastery and peaks
in performance, you will have to develop discipline and make sacrifices with
competing demands. In order to do the best of your ability you will have to set high
but realistic standards. Self doubt and feelings that you might fail derail motivation.
Positive results come from a determination to succeed.


        Failures and setbacks are a part of life. If you show character during tough
times you will be more likely to turn things around with perseverance. Perseverance




                                           85
stems from hope for better things down the road. In order to maintain positive self-
esteem, don‘t take out your frustrations on others. Don‘t blame others for your
mistakes. Don‘t become preoccupied with your losses, but rather, focus on your
positive attributes and resources and the work to be done. You can rely on
supportive friends and family, make new contacts and find help with the difficulties
you face, find the source of your problems and build your progress upon competent
performance of the basic fundamentals of your work.


       Excellence and mastery grow out of a spirit of determination and positive
attitude, but you must learn as much as possible about your particular domain in
order to find mastery. Masters of music, sports or martial arts are guided by
coaches or instructors who instill discipline and motivation to develop a thorough
fund of knowledge and a willingness and dedication to practice their art. Mastery of
a particular domain can require tremendous time and effort but for masters the joy
experienced in study and practice enables these individuals to put forth the required
effort. With increasing mastery experiences of ―flow‖ can occur. During these
experiences mastery feels effortless, attention is focused and the mind is relaxed.
Such high levels of performance certainly raise self-esteem.


       Manny Rosenberg has developed a self-esteem scale for measuring an
individual‘s degree of self-esteem for research purposes. The questionnaire consists
of ten statements with which a person rates their level of agreement. See the
following:


   1. I feel that I‘m a person of worth, at least on an equal plane with others.


   3   strongly agree
   2   agree
   1   disagree
   0   strongly disagree


   2. I feel I have a number of good qualities.


   3    strongly agree
   2    agree




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1   disagree
0   strongly disagree


3. All in all, I am inclined to feel that I am a failure.


0   strongly agree
1   agree
2   disagree
3   strongly disagree


4. I am able to do things as well as most other people.


3   strongly agree
2   agree
1   disagree
0   strongly disagree


5. I feel I do not have much to be proud of.


0   strongly agree
1   agree
2   disagree
3   strongly disagree


6. I take a positive attitude toward myself.


3   strongly agree
2   agree
1   disagree
0   strongly disagree


7. On the whole, I am satisfied with myself.


3   strongly agree
2   agree




                                         87
   1   disagree
   0   strongly disagree


   8. I wish I could have more respect for myself.


   0   strongly agree
   1   agree
   2   disagree
   3   strongly disagree


   9. I certainly feel useless at times.


   0   strongly agree
   1   agree
   2   disagree
   3   strongly disagree


   10. At times I think I am no good at all.


   0   strongly agree
   1   agree
   2   disagree
   3   strongly disagree


Scores range from 0-30. No interpretation of scores has yet been developed.
(Rosenberg 1989) It appears important to foster higher self-esteem in order to
promote optimal mental health. By learning to appreciate our positive qualities,
making goals, working hard to achieve our aims and by developing strong character,
we can build our self-esteem.




Healthy Values


       Who you have been has been strongly influenced by your values. Values
make up what is important to a person in his or her life. They create a foundation



                                           88
which helps an individual make decisions and shape priorities. Values are important
because they guide behavior. Values determine the way one lives his or her life;
they are the guiding principles in one‘s life. Values also help determine what a
person wants in life. Personal preferences play an important part in one‘s degree of
happiness. If you value a particular friendship or your family you will likely strive to
preserve their wellbeing. If you value your career, you will devote considerable time
and effort to your work. Some strongly held values are of extreme personal
importance to a person. If an opportunity opposes a strongly held value it is very
unlikely to be selected.


       Healthy values are positive and constructive while unhealthy values work to a
person‘s detriment or the detriment of others. Building a bed rock of healthy values
creates character strength as a person gains the courage to stand up for what he or
she believes in. Healthy behavior takes place when a person bases his or her actions
on healthy personal values. Other people‘s viewpoints may challenge one‘s healthy
values with peer pressure and threats of alienation; but it is strength of character
that enables a person to hold onto values in the face of opposition. For example, an
adolescent who considers illicit drug use dangerous may encounter other teens who
want him or her to try street drugs. A strong belief about the dangers of drugs will
help the adolescent resist any temptation to experiment with drugs.      Developing
strong values helps us make choices based upon reason as opposed to passion or
impulse. Healthy values can help prevent negative behaviors such as violence,
addictive behavior or others.


       Our values grow out of outside influences. Our parents, teachers, friends,
role models, religious background, and society influence our values. At a younger
age we tend to accept the values of our parents; whereas, with greater maturity we
come to develop a unique set of values out of the influence of personal experience
and the important people we encounter. Our values may follow the example of role
models with whom we identify. When a person lives in a manner contrary to
personal values he or she can develop internal conflict or a sense of shame. Life
may be filled with unhappiness or seem largely unfulfilled. We can regain positive
self-concept by realigning our behavior with our esteemed values. Building a
foundation of healthy values and living by them can allow a person to make good




                                           89
decisions, protect oneself from recklessness, achieve success in life, and maintain
self-worth.


       Many people have never thought about their values. Some people may value
seeking pleasure, excitement or novelty while others might value high morals or a
good work ethic. Clearly some values promote healthier behavior than others. The
following list provides examples of healthy values. You might want to take some
time and consider what is most important to you by defining your basic personal
values. Honoring healthy values appears to help promote exceptional mental health.
Foremost, you must value yourself.


Some common positive values:


Social values


Appearance


Authenticity


Cheerfulness


Citizenship: Doing your share to make your community better, cooperate, get
involved in community affairs, stay informed, vote, be a good neighbor, obey laws
and rules, respect authority, and protect the environment


Courteousness, being polite


Dependability


Diversity: respecting differences, valuing different backgrounds, ideas and input


Equality


Friendliness




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Friendship


Helpfulness


Influencing others


Integrity: Taking responsibility for oneself, living up to one‘s own standards


Justice


Kindness


Knowing right from wrong


Love, compassion, caring


Loyalty


Peace


Recognition


Redemption: To allow that those who break society‘s rules warrant the chance to
change, rehabilitate, and gain redemption


Respect for people: honoring their rights as individuals (life, liberty, pursuit of
happiness, freedom of speech, freedom of press); respect toward all people without
regard to race, religion, gender, or socioeconomic status, treating each individual
with human dignity


Status


Strong, healthy families


Supporting one‘s family financially




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Teamwork


To contribute


To not pursue one‘s own well-being to the detriment of other people


Tradition


Treating others fairly


Trustworthiness


Truth and honesty


Wisdom




Self- enhancing values


Bravery: The courage to meet the challenges and demands of one‘s life even in the
face of personal or professional adversity


Cleanliness


Commitment to continual self-improvement


Discipline, self-control


Education: To value learning as a lifelong process


Good work ethic, hard working


Happiness




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Health


Hope


Independence


Individual liberty


Perseverance


Self-reliance


Quality of life


Responsibility


Spiritual growth


Stability


Success


Taking responsibility for one‘s actions


The pursuit of excellence in everything one does


Wealth


Values for the general welfare


Earth awareness: to protect the environment


Faith in a better future


Freedom- the freedom to pursue goals and make choices




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Life as an invaluable precious gift


National unity


Patriotism


Safety and security


To promote the general welfare




Faith in yourself


       Do you follow your heart, trust your instincts, intuition, hunches, gut feelings
and judgment? Can you comfortably rely on your own strength, character, and
ability and trust that you can handle what life throws at you? Do the demons of
doubt plague you because you lack faith in yourself? Faith in yourself grows with
experience. Setbacks can shake your faith in yourself while success increases faith.
If you learn from mistakes and look for advantages to turn misfortune into gain, your
faith will grow. The ability to influence the events of your life will empower you with
a sense of strength. When we trust ourselves, we believe in our hearts that we will
make it through tough times. Faith in yourself grows like a muscle as you work
through the challenges of life and navigate your way forward.


       According to Mary Jane Ryan, self-trust is a combination of three qualities:
self-awareness, self-acceptance, and self-reliance. Everyone has unique attributes
and a lifetime of experiences to draw upon at any moment. Realizing this fact helps
people build their faith in themselves. We must accept that we learn through trial
and error and that everyone has unique experiences and skill sets. As your faith
grows you will feel confident in your ability to handle day to day demands and
unexpected problems.


       Sports psychologist Patrick Cohn says that ―confidence is how strongly you
believe you can perform well.‖ It is a feeling or consciousness of one‘s own powers;




                                          94
it is a reliance upon one‘s circumstances. It grows with trust in your preparation and
skill set. Positive experiences, an effective education, strong social and emotional
support, verbal persuasion, and good results also boost your confidence.        According
to Cohn, it helps performance if you don‘t over-coach yourself when you make a
mistake or over-control yourself because of fears of making mistakes. Whether you
struggle to succeed or perform well, a strong desire to improve moves you to work
harder, trust your skills more completely to perform effectively, spontaneously, and
intuitively and build confidence. Have an air of confidence about you.




        Norman Vincent Peale has said, ―Believe in yourself! Have faith in your
abilities!   Without a humble but reasonable confidence in your own powers you
cannot be successful or happy. Throw your heart over the fence and the rest will
follow.‖ From a spiritual standpoint, you can have faith in yourself as a vessel, an
instrument through which God can express his will. According to Leo Tolstoy, ―faith
is the force of life.‖   Developing self- confidence and a strong faith in oneself is likely
an important facet of exceptional mental health.




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Emotional Security


       Emotional security is related to one‘s relationships with other people in life,
how one feels about themselves and the capacity for optimism and hope. An
emotionally secure individual is not shaken by the turmoil of life; they stand firm in
the face of adversity. Emotional security results in flexibility and spontaneity in
dealing with others. Developing emotional security can mean healing the scars of
emotional, physical or sexual abuse. Developing a sense of injustice at others‘
abusive behavior, asserting oneself in the face of threats of abuse and leaving
abusive relationships can help build emotional security. People heal from the scars
of past traumatic events by working through troubling memories in order to free up
psychic energy and then shift the focus from the past to the present and future.
Emotional security is also built by obtaining emotional support from others, taking
risks and trying new things. With emotional security, people are bold in the face of
adversity and bold in relation to others.




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Emotional Intelligence


         Early concepts of intelligence proposed that it was an inborn feature which
could not be increased. More recent theorists have argued that intelligence can be
built and that intelligence is more complicated than originally conceived. Based upon
the work of Howard Gardner at Harvard University who developed nine intelligence
areas and other theorists, six primary intelligences have been described. These
primary intelligence areas include: abstract intelligence in which people make use of
symbolic reasoning; social intelligence which involves dealing with people; practical
intelligence which is the basis of getting things accomplished; emotional intelligence
which includes self-awareness and self-management; aesthetic intelligence which
involves a sense of form, design, music, art and literature; and kinesthetic
intelligence which includes whole body skills such as sports, dance or other
complicated physical feats. (Gardner 1983) Therefore, an intelligence based upon
emotion has been described. Emotional life can be handled with greater or lesser
skill. In cases where individuals are competent in managing their own emotional life
and the emotional life of others, such people appear to have greater emotional well-
being.


         The concept of emotional intelligence originated with the work of Wayne
Payne (1985). It became popularized by Daniel Goleman who authored a book on
the topic in 1995. Academic research in emotional intelligence began with the work
of Peter Salovey and John Mayer (1990). Emotional intelligence involves the ability
to apply knowledge from one‘s emotions and the emotions of others in order to be
more successful and lead a more fulfilling life. It involves an accurate, conscious
perception and monitoring of one‘s own emotions, management of one‘s emotions so
that their expression is appropriate, accurate recognition of and response to the
emotions in others, and the capacity to focus emotions toward a desired goal. It
includes the ability to make use of emotions to facilitate thinking and the ability to
understand emotions in ourselves and others. Emotionally intelligent people are
aware of the changing moods and emotions of other people. Our mental health is
dependent upon the ability to experience and express the full range of emotions;
yet, it also depends upon the ability to control expression of emotions at times when
social norms or other values might be endangered by unrestrained release of
feelings.


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       According to Jack Block from the University of California at Berkeley, men
who are high in emotional intelligence are socially poised, outgoing and cheerful, and
less prone to fearfulness or worry. They have been found to be committed to people
or particular causes, they take responsibility, have an ethical outlook, and are caring
in interpersonal relationships. Their emotional life is rich but they maintain
appropriateness in behavior. They are comfortable with themselves and others in
their social world. Emotionally intelligent women tend to be assertive and express
feelings directly. They feel positive about themselves and find that life has meaning
for them. They are outgoing and express their feelings appropriately. They adapt
well to stress. They rarely feel anxious or guilty or preoccupied with worries. They
have social poise that allows them to reach out to others with spontaneity and
comfort. (Goleman 1995)


       Emotional intelligence appears to be an essential factor responsible for
psychological well-being and success in life. The ability to effectively deal with
emotions in the workplace assists employees in coping with occupational stress.
(Oginska-Bulik 2005) People who have the capacity for emotional intelligence are
less depressed, healthier, more employable and have better relationships.
(www.eqtoday.com 2005) Empathic concern and attention to the feelings of others
are correlated with skill in communication. (Stratton 2005) Emotion regulation
abilities have been shown to correlate with the quality of individuals‘ interactions
with peers. (Lopes 2005) The development of several additional emotion skills is
helpful and adaptive in life. The capacity to self-soothe negative emotional states; to
endure frustration, loss and adapt to change; to delay gratification; to develop a love
of learning; to find cheerfulness, vigor, liveliness, zest and enthusiasm; to bring
curiosity and interest to situations; to have a sense of awe and wonder; to have an
openness to experience; to have a sense of inner sameness and continuity; to have
self- acceptance, empathy and courage; and to form a sense of gratitude for the
good things in life are all important adaptive emotional capacities.


       All emotions exist to assist in basic survival. Both positive and negative
emotions can be healthy. According to the theory of evolution, over the years of
existence of human kind, emotions have evolved and allowed for the continuation of
the human species. The emotional response is characteristic of other species of




                                           98
animals as well as humans. Several emotions can be discerned by characteristic
facial expressions in humans such as fear, anger, excitement, interest, happiness,
surprise, disgust, and sadness. The capacity to identify these emotions in ourselves
and others plays a vital role in mental health. The ability to pick up feelings in
others by their nonverbal cues leads to better emotional adjustment, popularity with
others, and an increased responsiveness to others based upon their emotional
states. Empathic children do better in school and become more popular with their
peers. (Vaillant and Vaillant, 2005)


         Emotional intelligence, as a facet of social intelligence, involves the ability
to monitor one‘s own and others‘ feelings and emotions, to discriminate among them
and understand their cause and use the information to guide one‘s thinking and
actions. It involves the capacity to stay open to the experience of emotions, both
positive and negative, in order to gain wisdom from them; but also, it is the capacity
to detach from emotions when highly charged emotional states interfere with the
realization of desired goals. It includes the capacity to maintain appropriate
responses to emotional experiences. Emotional intelligence allows someone to
understand how thoughts affect emotions and how emotions affect thought
processes.


       A fundamental element of emotional intelligence is emotional self-awareness
or an ability to recognize and understand one‘s own emotions. For example, when
one feels angry, it is a sign of emotional intelligence if you can recognize the
underlying frustration that has led to your anger. A primary emotion such as feeling
rejected, or disrespected, or disappointed, or embarrassed, or cheated, can lead to
excessive anger if not managed adequately. As Aristotle wrote in Nicomachean
Ethics, ―Anyone can become angry- that is easy. But to be angry with the right
person, to the right degree, at the right time, for the right purpose, and in the right
way- this is not easy.‖ A person can learn to notice their emotional states as though
observing them as they occur. By stepping back from involvement in emotional
experiences, you can learn to understand and manage emotions better. It is the
difference between being self aware and being engulfed in emotional experiences. It
is helpful to be able to label emotional states so that you can understand them.
Emotions help us to take priorities and make decisions; they are essential to sound
judgment. (Goleman 1995)




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       Emotional intelligence grows out of the capacity for empathy. Empathy
involves the ability to take another person‘s point of view and to project a sense of
understanding with the other person‘s experience. Empathy also involves
responding to another person‘s negative emotional state, helping them deal with
their emotions and demonstrating a true sense of caring. The ability to accurately
read another person‘s verbal and nonverbal cues is an essential part of empathic
behavior. Children learn empathy from experience and role models. If they can
learn how they make others feel when they misbehave or watch others show concern
for peoples‘ feelings they will develop a sense of empathy. The capacity for empathy
is gained over a long period of learning from experience. The combination of self-
control and empathy allow for improved social skill as one attunes to the feelings of
others in an appropriate manner. Popular people demonstrate high levels of
empathy and emotional intelligence so that others enjoy the experience of their
social skills on an emotional level.


       Another aspect of emotional intelligence is to understand the relationship
between thoughts and emotions. For example, specialists in cognition have found
that attitudes and beliefs typically precede emotions. It depends upon the inferred
meaning behind a situation or to what a person attributes a particular situation that
determines one‘s feelings about the situation. If your house burned down, when the
cause is attributed to lightning the resultant feelings are different than if the cause
were arson.


       Stress tolerance involves the capacity to endure frustration, loss and adapt to
change. This ability is dependent upon successful management of emotions and a
flexibility that allows one to adjust feelings and thinking in new situations. Coping
skills help to alleviate stress and frustration and keep a lid on strongly negative
emotional states. With good impulse control, emotions are controlled so that
behavior does not violate the boundaries of acceptable or appropriate behavior. A
mental set with openness to experience helps people adapt to change. Successful
stress tolerance includes the ability to maintain a cheerful disposition while
gratification of some aim is delayed. Long-range goals are most easily realized with
this capacity to delay gratification cheerfully.




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       An important emotional attribute is the ability to develop the drive,
motivation and perseverance to accomplish personal goals. The emotional tension
that arises when someone thinks about hopes for the future is vital to emotional
intelligence. The passion for a particular activity, a cause, a purpose, the resolve to
accomplish something and love is an important facet of mental health. With a fire in
the belly, tremendous achievements are possible and there is great joy in the
passion.


       Self-esteem and self-confidence arise out of a pattern of accomplishment of
desired aims. According to Sandor Rado, self-esteem is gained with positive
emotions and feelings of success; while, negative emotions are associated with
failure and can contribute to a loss of self-esteem. With experience reaching goals,
self-efficacy develops where a person will believe that they can reach new goals.
Self-efficacy also grows out of observation of others reaching goals that interest a
person. Even persuasive arguments can evoke self-efficacy.


       Other emotional attributes also seem to be important to optimal mental
health. A love of learning allows an individual a spirit of growth and development.
The capacity for cheerfulness, vigor, liveliness, zest and enthusiasm brings vitality
and passion to life. It is the ability to live from the heart as well as the head. This
aliveness is cognitive as well as emotional. Curiosity and interest spark an
investigation into the facets of life and the world unique to each individual. An awe
and wonder for the remarkable complexity of life and the universe open up an
individual to the prospects of something greater than oneself. An open attitude to
experience helps an individual learn, enjoy exciting new experiences, and develop
the capacity for graceful adaptation to change.


           As a person consolidates his or her personality and identity he or she
needs to develop a sense of inner sameness and continuity. A sense of peace with
oneself can develop from a self-accepting attitude. The ability to be aware of others‘
feelings, concerns and needs and to understand how others feel allows a person to
attune to others in an empathic way. A sense of courage enables a person to take
risks so that greater accomplishments can be realized and so that problems can be
faced. Finally, a sense of gratitude for the ―good‖ in life is an important emotional




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attribute of mature people. More will be said about the mental health benefits of
gratitude in the spiritual approaches to optimal mental health section.


       Developing emotional intelligence seems to make the process of living easier.
The goal is to integrate thinking and feeling so that you can live more effectively. It
means becoming more emotionally intuitive, responding to both inner and outer
worlds. Emotional intelligence grows out of self awareness, awareness of others‘
emotions, and a sense of empathy for the emotional lives of other people.




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Positive Emotions and a Joyous Engagement with the World


       According to George and Caroline Vaillant, ―Health is based on an active,
joyous, energetic engagement with the world.‖ Positive people have an enthusiasm
that is contagious and get others excited about what they are doing. A passion for
life grows out of experiences of positive emotions and these positive emotions are
derived from physical, mental, social and spiritual sources. We experience positive
emotions with the pleasures of the senses; with excitement, interest, inspiration,
contentment, serenity, amusement, humor, pride and sense of mastery; with the joy
of connecting socially, being lifted emotionally in the interchange and attachment of
beautiful relationships; with love, hope, forgiveness, compassion, faith, awe and
gratitude.    According to Barbara Fredrickson, positive emotions nourish us. She has
found in her research that cultivating positive emotions and maintaining at least a
3:1 ratio of positive to negative emotions helps us to flourish. Positive emotions
open up our minds and hearts. Deeply heartfelt positive emotions change our
neurochemistry. We do not need to eliminate negative emotions as they too are
important but rather balance negativity with positivity. Fredrickson argues that we
should not pressure ourselves to be positive as this can lead to toxic insincerity.
Rather she suggests that we lightly create the mindset of positivity, being open,
appreciative, kind and curious but also real. Fredrickson has found that positive
emotions bring us closer to others. We can strive to cultivate positivity in ourselves
and others. (Henly K, 2009)


       According to Martin Seligman, happiness is derived from three routes:
pleasure, engagement, and meaning.      When we are engaged in life, we are
absorbed fully in what we are doing. Time flies by and we are captivated fully. This
engagement may come with great conversation, reading a book, playing a musical
instrument, completing a challenging task at work or other events.     We can find
engagement in love, work and leisure. According to Seligman we become engaged
when we use our strengths. Some activities that are engaging and enjoyable may
not actually produce positive emotions. For example, the difficult training for a
sporting event or working out can be engaging but might be experienced as painful,
discouraging, or exhausting as well as enjoyable. Seligman argues that the greatest
satisfaction comes with a full life including all three routes to happiness: pleasures,
engagement, and meaning. (Seligman, et al., 2004) We can be happy and excited
about life.


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Coping, Resilience, and Mental Toughness


       We must all face adversity and stress in our lives. Some stress is good and
can promote higher functioning but severe or longstanding stress can harm mental
health as well as physical health. If you hold a glass of water out away from your
body with your arm fully extended it becomes heavier with time. Eventually, as you
hold the glass it gets too heavy and you have to put it down, let go of the glass.
After a rest you can easily pick the glass back up.   It seems that it is the same way
with stress. You need to let it go in order to pick it up again later. Therefore it is
important to learn how to let go of stress. We learn how to be tough and cope with
adversity through experience and hard knocks but also by observing role models or
by specific schooling.


       The development of good coping skills and resilience appear to protect people
from the negative effects of stress. These skills also help people regulate emotional
states and maintain poise under pressure. Some people learn to thrive on stress and
rise to occasions of increased stress with higher performance and vitality. The
strongest sense of emotional security comes with coping skills, resilience and mental
toughness. Very early in the course of life, infants encounter stresses and
frustrations which evoke the typical burst of tears. Later, toddlers can fall into
tantrums when things don‘t go their way. Gradually, as part of the developmental
process, a child learns self-soothing skills so that such extreme reactions to
frustrations and stress are no longer necessary. It is the capacity to self-soothe that
allows a child to let go, relax and fall asleep.


       Sigmund Freud coined the term ―mechanisms of defense‖ for the
psychological processes that individuals use to cope with the stress of socially
unacceptable urges. Freud‘s daughter Anna elaborated upon this theory of
psychological defenses and since that time, many theorists and researchers in the
field of psychology have developed a more complete understanding of healthy means
of coping with negative emotion and stress. Successfully coping with stress appears
to be important to the prevention of mental health problems. Furthermore, some
people appear to develop toughness and resilience which protects them in the face of
threatening events. People who learn to thrive on stress with mental toughness are
the focus of fields such as sports psychology. The following section describes



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psychological coping skills and factors associated with resilience and mental
toughness. Social aspects of coping including social support, assertiveness and
altruism will be discussed in the section on social approaches to optimal mental
health. Religious coping is discussed in the spiritual approaches section. The
capacity for physical activity to reduce stress has already been discussed.




Optimism


       Optimists look at life with zest. They have a sense of trust in themselves and
the process of life and live with a faith that things will work out. Problems are
viewed as challenges that can be diminished or solved. The ability to focus on
positive features of a situation is soothing under stress. For example, an ancient
Asian philosophy is to find opportunity in crisis. Rarely is a circumstance totally
negative. If one can find some positive aspects to focus on, the problems become
more bearable. In psychology, patients are taught to ―reframe‖ negative events in a
positive light. ―I lost my job but I have an opportunity to find one I would like
better.‖ A person can look for advantages in unfortunate situations. The ability to
remain optimistic is learned. Children who grow up in a family with an optimistic
atmosphere are more likely to remain optimistic when they reach adulthood. In
order to develop more of an optimistic attitude, one has to make a conscious effort
to reflect on the positive aspects of situations and allow himself or herself to
entertain the positives in light of the negatives while looking at the overall ―big
picture.‖


       If you face problems, you can ask yourself, ―what opportunities do these
problems afford me, how can they help me to grow as a person, who might be able
to help me with these problems?‖ Optimists see failure as something that can be
changed so that they might succeed the next time, while pessimists view failure as
something which cannot be changed. According to Martin Seligman, optimists learn
to attribute failures to external factors and limited specific situations rather than
looking at failure as a result of consistent internal characteristics and factors
occurring globally throughout one‘s life. Maintaining an optimistic view of life will
help prevent you from feeling overwhelmed by problems and stress.




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          Research has borne out that an optimistic attitude improves physical health,
protects against any tendency toward depression, protects adolescents from
substance use and leads to better quality of life. (Kivimaki M et al. 2005, Mayo Clin.
Womens Healthsource 2005; Harvard Men‘s Health Watch 2001; Kogan et al. 2005;
Carver et al. 2005; Friedman et al. 2005; Sears et al. 2005) Optimism has been
linked to positive mood states, life satisfaction and good morale. (Leung et al. 2005;
Hinton, 1997) It has also been associated with perseverance and effective problem
solving, longevity in life and success in a wide range of activities. (Harvard Men‘s
Health Watch 2001; Lightman 2005; Vaughan 2000) According to Andrew Weil,
―Being pessimistic can be more than just an emotional drain on yourself and those
around you - pessimism has been linked to a higher risk of dying before age 65. The
good news is that expressing positive emotions such as optimism is associated with a
variety of health benefits: lowered production of the stress hormone cortisol, better
immune function and reduced risk of chronic diseases.‖ (drweil.com 2011)


          You can learn to be more optimistic by taking time to explore the positive side
of life. You can look forward to the positive possibilities in negative situations and
keep a hopeful spirit in your life. Optimism grows stronger with positive results.
With experiences of success through the tests of time, you can respond to challenges
with an authoritative optimism. It appears that optimism is tied to good mental
health.




Humor


          The use of humor to cope with stress is enjoyable, socially graceful when it is
used in good taste and effective even in the most challenging of circumstances. A
happily married couple might say that their marriage has been good because they
have always been able to make each other laugh. In older people, there is a
correlation between humor and one‘s sense of wellbeing and morale. (Beullens,
2000) One‘s sense of humor is also related to quality of life, psychological health,
sense of optimism and self-esteem. (Thorson, 1997) Humor creates a sense of
rejuvenation under stress and facilitates communication and social interaction.
(Buxman, 1991)




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       There are fourteen general humor types: unexpected happenings, humorous
sounds, double meanings or plays on words, one word is said when another is
meant, exaggeration, twisting and distorting the truth, humorous opposites,
humorous contradictions, satire, sarcasm, irony, farce/slapstick or buffoonery,
parody or burlesque and finally mimicry. In order to increase one‘s capacity for
creating humor one must practice finding humor with these methods. There are
many books, audio recordings or videos of humorous subject matter. By studying
other people‘s methods of humor, one can learn how to find more humor in life.
When someone laughs, you can ask yourself, ―why was that funny?‖ This effort will
help you to get a sense of what makes humor work. Humor is a playful expression
of ideas and only works when it is expressed in a situation in which the listener
recognizes that it is ―in fun.‖ Sometimes attempts at humor fail when listeners don‘t
recognize that a comment is meant ―in fun‖ and feelings may be hurt. After learning
from examples, creativity and imagination can allow you to find humor in many
situations and particularly under times of stress.


Examples of humor:


Unexpected happening


       An unexpected happening can be humorous. For example, ―short walks can
be very romantic, especially when they are taken down the center isle of a church.‖
The surprise ending strikes the cord of humor.




Sounds


       Some sounds can be funny. Everyone has probably laughed at the sound of
unexpected flatulence. Animal noises can also be humorous to children.


Double meanings/Plays on words


       Double meaning and plays on words can be humorous. You would be very
surprised if the dentist told you that ―you don‘t grow your wisdom teeth until you
bite off more than you can chew.‖ Perhaps you can imagine a psychiatrist‘s patient




                                          107
exclaim, ―My head is clear as a bell; I can even hear a phone ringing in my ears.‖
Or, ―we don‘t get ulcers from what we eat, but what is eating us.‖


One word is said when another is meant


         Sometimes using one word when another is meant can be funny. For
example, an overweight man might say, ―I went on a three week diet and lost
twenty-one days.‖


Exaggeration


         Use of exaggeration can be quite amusing. Have you heard someone wearing
glasses say, ―I‘m so near-sighted that I can‘t even see my contact lenses when they
are on my eyes?‖


Twisting and distorting the truth


         Humor can be created by twisting and distorting the truth. For example, an
office worker‘s secretary might call and ask, ―Your boss is on the phone; do you want
me to tell him you‘re taking a nap or do you want to take the call?‖


Humorous opposites


         Opposites can be funny. Someone who doesn‘t exercise much might say,
―Every time I feel like exercising, I lie down until the feeling goes away.‖


Contradiction


         A contradiction can be used to produce humor. Jonathan Swift has said, ―May
you live all the days of your life.‖ Or as Mark Twain has said, ―I have been through
some terrible things in my life, some of which actually happened.‖


Satire




                                          108
        Satire deals with the evils and follies of mankind. ―When the price of prozac,
an antidepressant drug was increased, no one on prozac seemed to mind.‖


Sarcasm


        Sarcasm is another type of humor. ―Everyone wants instant gratification, no
matter how long it takes.‖


Irony


        The use of irony is another method of finding humor. In a famous story by
O‘Henry, the husband pawned his cherished watch to buy his wife a fancy comb for
her beautiful hair as a Christmas present. She on the other hand sold her hair to
buy him a watch fob for his watch.


Farce/Slapstick/Buffoonery


        Farce, slapstick and buffoonery are other forms of finding humor.   For
example, children often respond to silly faces.


Parody/Burlesque


        Another type of humor is parody and burlesque. With parody and burlesque
the humorist acts out a distorted representation of someone or something to poke
fun at them. For example, during my residency in psychiatry a group of friends and
I did a skit at an award dinner where one of the staff doctors was shown trying to
perform a psychiatric interview with a deceased patient.


Mimicry


        A mimic imitates someone in order to find humor. For example, Rich Little, a
comedian from the ‗70‘s and ‗80‘s, was known to imitate famous people by
mimicking their voices and behavior.




                                          109
Anthony Audrieth has proposed some other humor types. Some of these include the
following:


Anecdotes


       An anecdote is a brief account of an incident that illustrates a lesson through
an amusing situation. For example: a frustrated school teacher once said to his
class, ―if any of you are dumb stand up.‖ And he waited and nobody stood. Finally
one young man in the back rose to his feet. ―Are you dumb?‖ the teacher asked.
―No,‖ he said, ―but I hate to see you standing there by yourself.‖ In another story a
father once said to his son, ―it‘s time for us to talk about the facts of life.‖ ―What
would you like to know?‖ his son asked.




Antonymism


       An antonymism is a humor which uses two words or phrases of opposite
meaning. ―The more we think of some people the less we think of them.‖ Or, ―when
you are right, no one remembers; when you are wrong, no one forgets.‖


Blunder


       The humorous blunder makes fun of someone‘s mistake that makes them
look foolish. For example, a man at a party turns to another and asks, ―Who is that
awful-looking lady in the corner?‖ ―Why, that‘s my wife,‖ says the second man. In a
double blunder an attempt is made to correct or explain the first mistake and by
doing so makes it worse. ―Oh,‖ says the first man, ―I don‘t mean her,‖ his quick
avoidance, ―I mean the lady next to her.‖ ―That,‖ says the second man indignantly,
―is my daughter.‖


Bonehead


       The bonehead is a blunder in published writing. For example, an ad in the
classified section of the local paper reads, ―big dog, free to loving home, eats
anything, especially loves children.‖




                                           110
Bull


       A bull is a humorous statement based upon an absurd contradiction. For
example, ―The happiest man on earth is one who has never been born.‖


The Practical Joke


       A practical joke is a joke put into action or a prank. Examples include the
whoopy cushion or plastic dog turds.


(Audrieth 2005)


You might look for these humor types in others‘ humor and learn some formulas for
developing your own humor style. A good sense of humor appears to help one
achieve optimal mental health.




Sublimation


       Sublimation is a process by which stress and frustrations are channeled into
productive activities. According to the Diagnostic and Statistical Manual of Mental
Disorders, sublimation means that ―the individual deals with emotional conflict or
internal or external stressors by channeling potentially maladaptive feelings or
impulses into socially acceptable behavior.‖ (American Psychiatric Association 1994)
Examples of sources of sublimation include creative activities such as music, art,
writing, dance, sports, and hobbies. Some people term these activities outlets
because they serve as a means of letting out the tension felt under stress.


       The use of sublimation has been shown to improve adaptation for soldiers in
the military. (Dedic 2000) Sublimation has also been shown to predict better
outcomes in the lives of college students many years after school has ended along
with other adaptive mental mechanisms such as altruism, suppression, humor and
anticipation. (Vaillant 2000) Creative activities can be very rewarding as well as an
outlet for frustrations. Talent is honed by practice and at times with formal




                                         111
instruction. Artists, authors, or musicians learn to ―break out of the box,‖ and
develop beautiful new ideas that are enjoyed by others as much as themselves.
Many creative people find that travel helps to spawn creativity as they see new
things and meet new people.


       Sports help to decrease stress by physical exertion as well as a process by
which one loses oneself in the game or competition and then can forget about
frustrations that have been weighing on one‘s mind. With practice, developing skill
in a sport can be more rewarding as one learns to achieve greater excellence and for
some a sense of peak performance or flow.


       Hobbies are also a good source of sublimation in which one can lose
themselves in an enjoyable set of tasks such as learning about a particular domain,
sharing interests with others and developing a sense of pride because of developed
skills, knowledge or prize collectables. There are millions of hobbies that different
people enjoy and find soothing when they are under stress.


       It may be helpful to make an effort to develop enjoyable outlets in your life.
We may also help our children by fostering their development of emotional outlets.
Art or music lessons, sports teams, and dance instruction are all helpful for a child‘s
development of sublimation and flow.




Suppression and Compartmentalization


       Suppression is a skill in which one learns to keep a stiff upper lip during times
of stress or frustration. By holding down any tendency to complain, yell, or scream,
the situation is less likely to escalate into a more stressful situation. Suppression
involves blocking thoughts out of conscious awareness. Although people with
problems with obsessions and compulsions have difficulty suppressing intrusive
thoughts, a research group at Harvard University found that suppression is predictive
of good quality of life for many adults. (Vaillant 2001)


       Compartmentalization is similar to suppression but includes an organizational
feature. When you compartmentalize problems it means that you analyze and




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organize aspects of a problem first so that you can put things in the back of your
mind in a more advanced stage of problem solving. Just as we may forget
someone‘s name and then remember it later, our unconscious minds can incubate
and get to work on problems even though we are not thinking about them
consciously. By analyzing and organizing features of a problem before we set it in
the back of our mind, the solution we seek can come more easily.      Both suppression
and compartmentalization appear to promote good mental health. It appears that
while suppressing and compartmentalizing, emotions don‘t escalate and we need not
worry about problems continuously. With practice suppressing and
compartmentalizing problems, you will develop an accrued confidence in these
methods of stress relief.


Anticipation


        President Gerald Ford once said, ―Luck is a combination of opportunity and
preparedness.‖ Anticipation is an important skill that allows you to prepare for
possible problems and opportunities down the road. By looking forward you can
obtain information, resources or skills you might need later. This process reduces
stress by putting yourself in a more positive position when predicted difficulties or
new opportunities arise. People often live for the future in the hopes of shaping it
into something better than the present. We must adapt to the challenges we face
but we can look ahead with anticipation to direct the outcome of our days yet to
come.


        Some people live by the principle of ―one day at a time;‖ but, if you can learn
to look forward and anticipate the future you may find yourself better prepared and a
bit luckier. In a study conducted by a group at Harvard University, nearly two-
thirds of men before the age of 50 who were happy and well and only one-tenth of
sad and sick men made use of anticipation and other coping skills such as humor,
altruism, and suppression. (Vaillant 2001) Coping with life by the use of anticipation
appears to promote good mental health.


Reality Testing




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       Reality testing is the mental function in which one‘s relationship to the real
world is evaluated and understood. The breakdown of reality testing can lead to
delusional thinking and hallucinations. (Ventegodt 2005) More commonly, people
distort their perceptions of reality without a complete breakdown of reality testing.
In particular people can distort their views of themselves or the meaning behind
others‘ actions. At other times people distort their perceptions of a situation.
Distortions in thinking can cause tremendous stress and lead to inappropriate beliefs
and actions. Good ability to test reality has been strongly correlated with training
performance in the United States Navy. (Hartmann 2003)


       Cognitive-behavioral therapy helps to strengthen reality testing and resolve
distortions in thinking. (Turkington 2004) Skills taught in cognitive-behavioral
therapy can help maintain good reality testing long after therapy is over. A person
can learn to recognize and challenge distortions in perception so that he or she does
not suffer unnecessarily from poor reality testing. Reality testing means applying the
rules of scientific inquiry to everyday life. When we engage in reality testing, we
systematically doubt our initial perceptions or beliefs until we have scrutinized them
more carefully and checked them against further evidence. It is a process of seeking
the truth since we may have a tendency to distort our perceptions or beliefs. The
rules of reality testing include 1. asking what evidence supports the belief 2. asking
if there is any other way of interpreting the evidence and 3. determining how
consistent the belief is with other perceptions and beliefs that are known to be fact
or truth. With practice, these steps can be accomplished quickly and automatically.
According to cognitive theorists, some common distortions in thinking are as follows:


Filtering


   Taking the negative details and magnifying them while filtering out all of the
positive aspects of a situation, focusing on the negative and missing the ―big picture‖


Polarized thinking


   Seeing things as ―black or white,‖ good or bad, you are perfect or a failure, there
is no middle ground




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Overgeneralization


   Coming to a general conclusion by a single event or piece of evidence; if
something bad happens once, an overgeneralizer might expect it to happen
repeatedly, to see a single event as a never ending pattern


Mind reading


   Knowing what people think or feel without any outward expression of their
thoughts or feelings


Catastrophizing


   To expect disaster; when a few things go wrong the catastrophizer expects
disaster


Minimization


   To minimize or inappropriately shrink things e.g. your own desirable qualities


Personalization


   Thinking that other people‘s actions refer to you or is a reaction to you and not
multiply determined by many factors


Control fallacies


   To feel entirely externally controlled, to see oneself as a helpless victim, whereas,
to feel too much of a sense of internal control leads one to believe that they are
responsible for the pain and happiness of others


Blaming


   To hold others responsible for your pain, or to blame yourself for every problem




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Emotional reasoning


   To believe that what you feel must always be correct: if you feel helpless and
boring you must be helpless and boring


Fallacy of change


   To expect that others will change to suit you, to believe that you need to change
people because your hopes and happiness depends entirely upon others


Global labeling


   To generalize one or two qualities about a person into an entirely negative
judgment, ―He‘s a loser,‖ Mislabeling involves describing an event or person with
language that is highly colored and emotionally loaded.


You must be right


       One is continually on trial to prove that they are right, their opinions and
actions are always correct; these people will go to any length to prove that their
opinions must be right.


Suspicions of infidelity


       To continuously suspect lovers of infidelity even though there is little evidence
to substantiate such a belief


Threats to safety


       To feel that one‘s safety is threatened in situations in which there is actually
no true threat


Grandiosity




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       To develop beliefs that one is more important or famous than they actually
are in fact




       If you recognize one of these patterns of distorting reality it can be helpful to
challenge the validity of your beliefs. Raising questions such as: 1. Is there an
alternative explanation? 2. What is the evidence that this thought is true? 3. What
will be the effect of continuing to think this way? 4. What is the best possible
outcome; what is the worst possible outcome and what is the most realistic
outcome? 5. What is the likelihood that this will happen? After you learn to
challenge distortions in thinking, you will learn to find more rational responses. For
example, you might think that you have no control over a situation; yet, it‘s true
that you cannot change what has already occurred, but you can control how you
respond. Or with negative thinking such as, ―it‘s not fair that I am being treated this
way,‖ you might respond with a rational response such as ―life is not always fair but
sometimes things go my way and sometimes they do not.‖ Something that is
perceived as a threat can be instead viewed as a challenge, an obligation can be
instead viewed as a privilege, a test can be changed to an adventure. (Ben-
Shahar, 2009)    Sometimes people become preoccupied with negative thoughts. At
times people come to unfounded conclusions; you may want to watch your tendency
to distort truth or reality and make use of better reality testing. If distortions in
reality become persistent, it can be helpful to use the shamanic medicine technique
of imagery. You can imagine stomping on the head of the spirit responsible for your
distortion in thinking in order to destroy it or imagine the distortion getting smaller
and smaller as it fades off into the distance until it is completely gone. A psychiatrist
will prescribe medication to help a person with poor reality testing in severe cases.
Good skill in reality testing is protective so that false or distorted conclusions are not
wrongly accepted as facts. Good reality testing appears to prevent mental health
problems and helps to avoid unnecessary stress and inappropriate behavior.


       Experts in psychology have described other common patterns of distorted
thinking, or schemas, which are based upon experience. These schemas can lead to
troubling emotional states and dysfunctional behavior. Such schemas develop when
a person forms beliefs based upon experiences earlier in life that guide the
interpretation of events and influence emotional states and behavior. According to




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Jeffrey Young and colleagues (Young et al. 2003), learning to identify maladaptive
schemas and then systematically confronting and challenging the distortions inherent
to them can help a person change long-term life patterns.      The schemas they
described are as follows:


Emotional deprivation
   This schema refers to the belief that one‘s primary emotional needs will never be
met by others. These needs include nurturance, empathy, affection, protection,
guidance and caring from others. Often parents were emotionally depriving to the
child.


Abandonment/ instability
   This schema refers to the expectation that one will soon lose anyone with whom
an emotional attachment is formed. The person believes that, one way or another,
close relationships will end imminently. As children, these people may have
experienced the divorce or death of parents. This schema can also arise when
parents have been inconsistent in attending to the child‘s needs; for instance, there
may have been frequent occasions in which the child was left alone or unattended for
extended periods.


Mistrust/abuse
   This schema refers to the expectation that others will intentionally take
advantage in some way. People with this schema expect others to hurt, cheat, or
put them down. They often think in terms of attacking first or getting revenge
afterwards. In childhood, these clients were often abused or treated unfairly by
parents, siblings, or peers.


Social isolation/ alienation
   This schema refers to the belief that one is isolated from the world, different from
other people, and/or not part of any community. This belief is usually caused by
early experiences in which children see that either they, or their families, are
different from other people.


Defectiveness/shame




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   This schema refers to the belief that one is internally flawed, and that, if others
get close, they will realize this and withdraw from the relationship. This feeling of
being flawed and inadequate often leads to a strong sense of shame. Generally
parents were very critical of their children and made them feel as if they were not
worthy of being loved.


Social undesirability
   This schema refers to the belief that one is outwardly unattractive to others.
People with this schema see themselves as physically unattractive, socially inept, or
lacking in status. Usually there is a direct link to childhood experiences in which
children are made to feel, by family or peers, that they are not attractive.


Failure to achieve
   This schema refers to the belief that one is incapable of performing as well as
one‘s peers in areas such as career, school or sports. These people may feel stupid,
inept, untalented, or ignorant. People with this schema often do not try to achieve
because they believe that they will fail. This schema may develop if children are put
down and treated as if they are a failure in school and other spheres of
accomplishment. Usually the parents did not give enough support, discipline, and
encouragement for the child to persist and succeed in areas of achievement, such as
schoolwork or sports.


Functional dependence/ incompetence
   This schema refers to the belief that one is not capable of handling day-to-day
responsibilities competently and independently. People with this schema often rely
on others excessively for help in areas such as decision making and initiating new
tasks. Generally, parents did not encourage these children to act independently and
develop confidence in their ability to take care of themselves.


Vulnerability to harm and illness
   This schema refers to the belief that one is always on the verge of experiencing a
major catastrophe (financial, natural, medical, criminal, etc.). It may lead to taking
excessive precautions to protect oneself. Usually there was an extremely fearful
parent who passed on the idea that the world is a dangerous place.




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Enmeshment/ Undeveloped self
   This schema refers to the sense that one has too little individual identity or inner
direction. There is often a feeling of emptiness or of floundering. This schema is
often brought on by parents who are so controlling, abusive, or overprotective that
the child is discouraged from developing a separate sense of self.


Subjugation
   This schema refers to the belief that one must submit to the control of others in
order to avoid negative consequences. Often these individuals fear that, unless they
submit, others will get angry or reject them. People who subjugate ignore their own
desires and feelings. In childhood there was generally a very controlling parent.


Self-sacrifice
   This schema refers to the excessive sacrifice of one‘s own needs in order to help
others. When these people pay attention to their own needs, they often feel guilty.
To avoid this guilt, they put others‘ needs ahead of their own. Often, people who
self-sacrifice, gain feelings of increased self-esteem or an altruistic sense of meaning
from helping others. In childhood the person who makes excessive self-sacrifice
may have been made to feel overly responsible for the well-being of one or both
parents.


Approval-seeking/ recognition-seeking
       This schema refers to excessive tendencies to look for approval or attention
from others. Self-esteem relies on the behavior of others rather than upon internally
driven aims. People with this schema may have greater sensitivity to rejection.


Negativism/ pessimism
       This schema refers to a pattern of viewing the world in a negative light and
losing sight of positive aspects of life. People with this schema have a tendency to
catastrophize or exaggerate the negative aspects of a problem.


Emotional inhibition
   This schema refers to the belief that you must inhibit emotions and impulses,
especially anger, because any expression of feelings would harm others or lead to
loss of self-esteem, embarrassment, retaliation or abandonment. Someone with this




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schema may lack spontaneity, or be viewed as uptight. This schema is often brought
on by parents who discourage the expression of feelings.


Unrelenting/unbalanced standards/ hyper-criticalness
   This schema refers to two related beliefs. Either the person believes that
whatever they do is not good enough, that they must always strive harder; and/or
there is excessive emphasis on values such as status, wealth and power at the
expense of other values such as social interaction, health or happiness. Usually
these people‘s parents were never satisfied and gave their children love that was
conditional upon outstanding achievement.


Punitiveness
    This schema refers to the belief that people should be punished for mistakes. It
includes an impatient temperament with those who do not live up to one‘s
expectations, including oneself. People with this schema lack empathy and have
difficulty forgiving others or themselves.


Entitlement/self-centeredness
   This schema refers to the belief that you should be able to do, say, or have
whatever you want immediately regardless of whether that hurts others or seems
reasonable to them. You are not interested in what other people need, nor are you
aware of the long-term costs to you of alienating others. Parents who overindulge
their children and who do not set limits about what is socially appropriate may foster
the development of this schema. Alternatively, some children develop this schema
to compensate for feelings of emotional deprivation, defectiveness, or social
undesirability.


Insufficient self-control/self-discipline
   This schema refers to the inability to tolerate any frustration in reaching one‘s
goals, as well as an inability to restrain expression of one‘s impulses or feelings.
When lack of self-control is extreme, criminal or addictive behaviors rule one‘s life.
Parents who did not model self-control, or who did not adequately discipline their
children, may predispose them to have this schema as adults.




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       Schemas are maintained by continued distortions in thinking and self-
defeating behavior patterns. When a schema is imbedded, distortions will
exaggerate information obtained in life experiences in order to confirm the schema
and information that contradicts the schema will be minimized or denied. The
schema based patterns of thinking about oneself influence behavior. Some
opportunities might be avoided in order to avoid the pain that arises as a condition of
the implanted schema.


       The steps involved in overcoming maladaptive thinking schemas include:
identifying the major schemas in your life; developing an understanding of the early
developmental situation that created the schema; allowing for an emotional reaction
while creating distance by realizing that parents and siblings had their own
problems; and challenging distortions in thinking that perpetuate the schemas.
Distortions in thinking are made evident by looking for the evidence for and against
beliefs or perceptions of events. By challenging distorted thinking, new realistic
thoughts or beliefs are substituted.


       It appears that good reality testing helps to promote exceptional mental
health. In order to develop stronger reality testing, make an effort to examine your
beliefs, frustrations, and worries to see if there are distortions present in your
thinking. You can teach your children to challenge their distorted thinking by helping
them to recognize and challenge distortions that they express. One‘s impressions or
hypotheses of reality can be tested before they are believed or acted upon.      Good
reality testing may relieve much unnecessary suffering and stress.




Meditation/Relaxation Techniques


       Relaxation techniques and meditation can reduce stress and negative emotion
as well. Relaxation techniques such as deep belly breathing or systematic muscle
relaxation help to soothe tension. Relaxation training has been shown to increase
energy and vigor and reduce emotional problems. (Sutherland 2005) Meditation and
breath therapy have been shown to reduce pain and psychological distress
associated with lower back problems. (Carson 2005, Mehling 2005) Relaxation
training has also been shown to reduce anxiety and stress in pregnant women.




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(Bastani 2005) There is evidence that relaxation training can reduce the risk of
heart disease and death from heart attack. (VanDixhoorn 2005) Yoga and
meditation have been shown to improve sleep and reduce anxiety and depression.
(Kreitzer 2005) In one study, mindfulness-based meditation and Tai Chi were shown
to improve children‘s sense of well-being, calmness, relaxation, and improve sleep.
(Wall RB 2005) Transcendental Meditation has been claimed to reduce the likelihood
of death by 23%, with 49% reduction in death from cancer and 30% reduction in
death from cardiovascular causes. (Schneider 2005)


       With breath therapy, an effort is made to take deep abdominal breaths that
slow the breathing rate and help a person to develop a sense of relaxation. You can
learn to become aware of the breathing cycle by noticing when expiration stops and
inhalation begins and noticing when inhalation stops and expiration begins. By
forcing a bit more air out during expiration, you will naturally take deeper breaths in
order to fill your lungs as you allow your belly to expand. Such attention to
breathing brings about states of deep relaxation. Systematic muscle relaxation
involves a process of tensing and then relaxing major muscle groups. For example,
you would tighten up the grip of your left hand for a few seconds and then let the
hand relax noticing the loss of tension. Next, you tense and relax your forearm,
then your upper arm, then the opposite hand and arm, next, your face and neck,
then your torso, back, feet and legs. This process of tensing and relaxing
musculature is found quite relaxing but difficult to produce during day to day
activities. Therefore, an abbreviated method can be used by simply tensing and
relaxing a couple of muscle groups after having experience practicing the complete
process. The abbreviated version will remind you of the complete process by a
conditioned reflex and trigger a relaxation response.


       Stretching and meditative exercises such as yoga or tai chi can also reduce
tension. As the body becomes more relaxed so too does the mind. Yoga is a Hindu
practice that combines physical postures and breathing exercises in order for
individuals to achieve serenity. Yoga also increases flexibility and muscle tone. Tai
chi is a form of exercise that involves moving the body slowly in particular forms or
routines. Each movement flows gracefully into the next. Proper technique in tai chi
also includes breathing and meditation, to maintain focus on what one is doing. It
can bring about decreased stress, lower blood pressure, increased flexibility and




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better balance. Tai chi has been associated with improvements in mental well-being
including reduced stress, anxiety, depression and mood disturbance, and increased
self-esteem.




       Forms of meditation can allow a person to find a state of peace and relaxation
that creates comfort and soothes tensions and stress. There are many types of
meditation. The practice of meditation can increase physical relaxation, mental
calmness, heightened states of awareness, and psychological balance. Experiences
of mental clarity in which everything makes sense and feelings of bliss can occur
with meditation.   Styles of meditation differ; some practitioners will focus on the
breath or a sound (such as a mantra) or even loving kindness. Mindfulness
meditation helps one to step back from thinking and worries and merely observe the
process of thinking as it arises. While maintaining a sense of dignity like a majestic
mountain, sitting in a position that embodies dignity, in mindfulness one cultivates
patience, non-judging, letting go and trust. In mindfulness meditation the individual
narrows the focus of attention to a single object such as the breath or loving
kindness and simply redirects attention back to the object of focus when the mind
begins to stray. The mental habits that one finds as he or she strays from focused
attention are labeled with words in order to gain greater freedom. With practice at
mindfulness a state of balance can be achieved. Transcendental Meditation can be
learned in a seven step course. Massage is also a useful method of reducing stress
and developing a greater degree of relaxation.


Savoring life’s pleasures


       According to Sonja Lyubomirsky, ―the ability to savor the positive experiences
in life is one of the most important ingredients of happiness.‖ Savoring includes any
thoughts or behaviors that create, intensify and prolong enjoyment. You can savor
life‘s pleasures by reminiscing about the past, by relishing the present moment or by
fantasizing about or anticipating the future. Those who savor the past, looking back
at good times, are found to buffer stress. Those who savor the present moment are
less likely to experience depression, stress, guilt or shame. Those who look forward
to future pleasures are likely to be optimistic. In general, people who tend to savor
life‘s joys are inclined to be more self-confident, extraverted and gratified and also




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less neurotic. Savoring can mean relishing ordinary experiences, enjoying the
pleasures of the senses, reminiscing about the past with family or friends, or
appreciating beauty or excellence. There are always wonderful moments, beautiful
moments; we can savor those, let go and add to our happiness. The often quoted
phrase, stop and smell the roses, expresses the wisdom of savoring life‘s pleasures.
(Lyubormirsky, 2007)




Flexibility in the face of change


       Another psychological factor that may reduce stress and promote good
mental health is flexibility in the face of change. It is part of human nature to
develop set patterns of living and behaving. As a result of such patterns, there may
be resistance to change in the face of new events in the course of life. Such
resistances to change can evoke tremendous stress as the environment places
demands upon us that require new means of coping. A tendency toward flexibility in
the face of change and openness to new experiences appears to ease tension as life
places new demands upon us.


Acceptance


       The capacity for acceptance may also protect good mental health. When
people become unhappy with their place in life, they may develop a grudge, feeling
of resentment, bitterness, or a chip on their shoulder. Such tendencies toward
negative emotion over the circumstances of life create stress and the predisposition
to mental illness. A well known prayer and motto for Alcoholics Anonymous aptly
describes a healthy attitude toward negative life circumstances: ―God, grant me the
serenity to accept the things I cannot change, the courage to change the things that
I can and the wisdom to know the difference.‖ The realistic acceptance of your
destiny imposed by your time and place in the world will free you from tendencies
toward resentment and excessive stress and negative emotion. Acceptance also
includes self- acceptance which means accepting both the limitations and possibilities
one finds within himself or herself, accepting the weakness and evils of one‘s human
nature, and having a global benevolent view of the whole self. Self-acceptance
means taking on a non-judgmental, kind and compassionate attitude toward one‘s




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personal problems and inadequacies. Some people advise an unconditional
acceptance of oneself and others, that God gave you what is right for you. With
acceptance comes peace of mind.




Accepting Responsibility


         An important change that occurs during growth from childhood to adulthood
is the assumption of increasing responsibility for one‘s life. During the process of
emancipation, the adolescent or young adult separates from parental influence in
order to become a self-reliant individual. The separating young adult experiences
the freedom to select many more self-chosen decisions and actions; but with this
new found freedom comes a need for personal accountability. Everyone makes
mistakes along the way but some people rely heavily on excuses, justifications,
rationalizations or blaming; while, others learn to admit mistakes and shoulder the
blame.


         Accepting responsibility for one‘s life involves acknowledging that you choose
the direction of your life and that you are solely responsible for the consequences of
decisions made and actions taken. Those who accept responsibility are more likely
to take the bull by the horns, solve problems and find a path to success; whereas,
those who blame others and make excuses are more prone to failure. According to
James J. Messina, those who have difficulty accepting responsibility may be: overly
dependent on others for approval, acceptance, or recognition; chronically angry or
depressed over feeling unfairly treated; afraid of taking risks or making decisions;
overwhelmed by disabling fears; physically or emotionally unhealthy; unsuccessful in
personal relationships or other important enterprises in life; or abusing alcohol,
drugs, or food, or involved in unhealthy behaviors such as excessive gambling,
shopping, sex or other behaviors involving loss of control. (Messina, 2006)


         While accepting responsibility appears to be an important maturational
process, there are limits to the scope of what is appropriate for one to assume
responsibility. There is no disputing the claim that most people would be healthier if
they took better care of themselves, but it is erroneous to propose that individuals
are entirely responsible for staying healthy. (Wilker, 1987) Even holding people




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accountable for lifestyle choices in the context of health care is controversial.
(Cappelen and Norheim, 2005) The public in general lacks information about healthy
lifestyles, health care providers need to spend more time with patients discussing
healthier lifestyles, and government policy neglects to protect people from health
risks. Nevertheless, research has shown that people who take responsibility for
choosing nutrition options that are ―right‖ or ―better,‖ are willing and able to make
healthy dietary changes. (Eden et al., 1984)     It seems that accepting responsibility
for one‘s health will help to instill the motivation to educate oneself and adopt
healthier lifestyles; but, we should not expect that healthy choices will protect us
entirely from illness.


       When you reach the point where you acknowledge that your life is your
responsibility, you can take greater control of the outcome. No one can live your life
for you. You are in charge. While those who have not taken responsibility might
claim that life is unfair or that fate or luck has more impact on life than personal
choices, those who have accepted responsibility for their lives are willing to admit
mistakes, accept blame, tackle personal troubles and problems, take risks and
realize their goals and dreams. Those who accept responsibility for their health take
steps to protect themselves from illness or injury and may also make an effort to
create greater fitness and wellbeing.


Sense of Personal Control


       Personal control beliefs reflect a person‘s perception of the extent to which he
or she is capable of controlling or influencing the outcome of situations and
controlling the surrounding world. Personal control relates to the degree to which we
perceive that circumstances are controllable. One differentiation, termed locus of
control, has been made between perceived control residing primarily within oneself
versus external to the self. A person can exert control by directly influencing the
environment but also by altering oneself in order to adjust better to the
environment. Greater perception of personal control is associated with higher
income. A sense of personal control has also been linked to better psychological
health, better physical health and lower mortality risk; however, overestimates of
personal control in situations where control is limited by environmental factors has
been associated with increased stress and negative health outcomes. While a sense




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of personal control is important for good health we must remain realistic about
where control is possible by either changing the environment or changing ourselves.




Finding Meaning in Life


       Viktor Frankl, a psychiatrist who endured three years of imprisonment in Nazi
concentration camps, has proposed a theory that in life authentic happiness is found
when we find meaning in life. Meaning, according to Frankl, can be found in valued
experiences, valued creative deeds, or valued attitudes. Valued experiences include
experiencing love in a relationship, raising a child or experiencing beautiful art or
music. Valued creative deeds include creating art, music, dance, inventing, or
writing and valued attitudes include bravery, forgiveness, responsibility and other
attitudes. According to Martin Seligman, meaning is found by using your strengths
for something larger than yourself. With meaning, suffering can be endured more
easily. Finding meaning in life provides purpose for living. (Frankl V, 1963)


Life Balance


       In the face of stress, life balance may help a person maintain emotional
stability. Time and effort must be divided between responsibilities to your family,
your workplace or school, friends, and leisure. By creating a balance between the
competing demands and leisure when things get busy, you are less likely to become
stressed out or lose productivity. An exclusive devotion to work can lead to job
burnout and loss of satisfaction with life. It may be important to carve out time for
family, friends and leisure. If you remember to devote time to leisure, you will be
able to approach work or school with more energy and enthusiasm. By taking the
time to do what you love, you can create a sense of renewal. When things get
hectic, you can create things to do lists in order to establish priorities and manage
precious time well. Life balance appears to help one maintain stability when stressful
events occur.


       Life can be divided into eight major areas: health, family/social life,
recreation/leisure, housing/transportation, education/ work/ finances, legal matters,
appearance, and spiritual life. In a balanced life, a person will commit valuable time




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and effort to each of these areas as needed. An objective measure of a person‘s
quality of life might be determined by the quality of each of these areas while one‘s
own subjective quality of life is simply one‘s degree of personal happiness with life.
Life is a complex system in which the different areas interact. Changes in one area
of life are likely to affect other areas. Problems arise when areas in need are
neglected. A balanced approach to life may help to reduce problems and enhance
quality of life as well as emotional stability. With a balanced approach to life it is
easier to love and enjoy life.




Creating a calming home


          According to the Andrew Weil website, drweil.com, ―your home should be
your sanctuary where stress is left at the door and your soul is nurtured.‖ According
to his website, you can bring nature indoors with plants, cut flowers, wood, rocks, or
articles from the sea. You can paint certain rooms with warm and relaxing tones.
You can set aside an area or room for peace and calm, free of noise or distraction for
meditation, reading, or spiritual reflection. You can surround your senses with
beauty by cleaning out the clutter and using artwork, fragrance, stylish furnishings
and calming sounds to create an enjoyable environment. You can also create a
loving atmosphere with photos of family and friends and handmade or meaningful
gifts from loved ones. (drweil.com 2010)




          All of the above psychological methods of coping appear to help put a person
at ease and let go during times of stress. Rarely does a person use every method,
but developing skill at an assortment of coping skills may allow a person to endure
greater stress and negative emotion and protect them from mental and physical
problems. Better ability to cope with stress and to self-soothe may allow for better
quality and longevity of life. Successful coping creates emotional security and
comfort. Coping skills seem to be important to the development of optimal mental
health.




Resilience and hardiness




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       While purposeful efforts to cope with stress are important to mental health,
there are also automatic processes that can help us adjust to life as well. It has
been found in veterans of military combat that while some individuals develop a
syndrome of post-traumatic stress or war stress with recurrent nightmares and
intrusive memories, others exposed to very similar circumstances will survive
combat without persistent emotional difficulties.


       Resilience involves the capacity to ―bounce back‖ from stressors or setbacks.
Resilience corresponds to the accumulation of protective factors to cope with stress
and catastrophe. It is the capacity to avoid developing psychopathology in the face
of difficult circumstances. It is the ability to function competently despite stressors.
Efforts can be directed outward to change the environment, alloplastic change (eg.
solving problems), or efforts can be directed to change oneself or autoplastic change
(eg. managing emotions).


       There are some common characteristics that resilient people appear to share.
These characteristics begin to show during infancy and continue into adulthood.
Resilient infants are active, energetic, and easy going. They have an easy
temperament and readily elicit positive responses from other people. Resilient
infants are socially responsive with ability to elicit and receive attention. These
infants display more frustration tolerance, impulse control and ability to delay
gratification than other less resilient infants. In the toddler years, resilient children
display intelligence, autonomy, self assuredness and sociability. These toddlers tend
to display the abilities to cooperate and comply with external expectations. They are
friendly, socially responsive, emotionally sensitive, and display a positive sense of
self. Resilient male toddlers are more able to express emotion and demonstrate
social skills than other less resilient male toddlers while resilient toddler females are
more coordinated, less timid and they display more interest in exploring their
environment than non-resilient female toddlers.


       During middle childhood years, characteristics of resilient children build on
earlier foundations. Resilient children tend to have varied interests and hobbies that
are not gender specific. They tend to have more internal locus of control (the belief
that one largely influences the outcome of events rather than believing that luck or
external circumstances are responsible for successes, rewards or punishments),




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sense of personal efficacy (the belief that one can accomplish desired aims) and
better self-concept than their less resilient counterparts. They display motivation to
learn and understand and they take the initiative to question, suggest, observe, and
imitate in learning and problem solving. Resilient adolescents continue to build on
these foundations and spend more time on homework and cooperate with teachers.
They are less likely to commit delinquent acts and female resilient adolescents are
less likely to get pregnant. Young women who become pregnant during adolescence
display greater resilience if they continue their education, obtain social support, and
maintain high aspirations. Being outgoing also promotes resilience.


       There are five major characteristics related to resilience that tend to be
present across the life span. The five characteristics are cognitive superiority,
autonomy, flexibility concerning gender specific activities, social skills and internal
locus of control. It is believed that resilience can be fostered in children by fostering
development of these characteristics. Although cognitive skills have genetic or
biological underpinnings, cognitive superiority can be fostered by environmental
influences. Infants can be helped to develop cognitively by stimulating them
mentally with various objects with bright colors, patterns and contrasts. Similarly,
talking and reading to infants can help with cognitive development. When infants
begin to talk, you can expand upon their one or two word statements by explaining
more involved ways of expressing the same statements or questions. In the
preschool years, children can be exposed to reading, simple science and math
concepts such as counting and measuring and more advanced language. Later on,
children, adolescents and adults can develop cognition by academic pursuits and
hobbies.


       Autonomy of children can be fostered by providing them age- appropriate
projects to complete on their own. People who are autonomous think for themselves
and make their own decisions. Overly dependent children turn to others for advice
about most decisions. It is important to foster autonomous decision making. As
mentioned previously, it has also been found that the ability of children to transcend
traditional gender roles and participate in non sex- specific behaviors promotes
greater resilience. Children who learn to play with a greater variety of toys and
games tend to be more resilient. Boys can learn to cook and girls can do yard work.
Social skills can be fostered in children by exposing them to people of various




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backgrounds and providing opportunities for social activity. Children can be
encouraged to share, tell the truth and be sensitive to others‘ emotions. People with
an internal locus of control believe that they can influence their own fate. Children
can be provided opportunity to develop an internal locus of control by creating
activities where they have control over the outcome. For example, infants can learn
to feed themselves and toddlers can be encouraged to dress themselves.


       During childhood, family unity and a secure home environment promote
resilience. Development of a strong parent-infant bond helps to develop feelings of
security. Later, emotional support and adequate attention by parents help children
to be more resilient. Families that value education, loyalty, trust, a practical sense
of right and wrong, a frank communication style and mutual respect also foster
resilience in their children. Discipline should be fair and consistent. Parents can
foster self-esteem in their children by pointing out and developing their strengths.
Parents who maintain a warm, stable, and committed marriage with a sense of
equality foster resilience in their children. Routines of behavior in families such as
eating meals together also foster resilience. Spirituality and religion can also foster
resilience for children. The support of a caring adult aids tremendously in promoting
the resilience of children. Supportive adults help children develop a perception of
self-worth, positive feelings about the self, and a positive outlook on life. Supportive
adults also help children develop good feelings about their culture and ethnic group.


       Experiences in school can also promote resilience. Schools that provide an
inclusive and supportive atmosphere and recognize children as individuals help to
support resilience. Also, higher academic standards in schools can be protective.
Teachers who provide children with opportunities for positive social interactions with
peers help to foster resilience in the children. Discipline of students in school must
also be consistent and fair in order to teach children how to live in society. (Gorden-
Rouse 2005) As an outgrowth of education, children who develop a passion for an
interest or skill appear to show greater resilience in difficult circumstances.


       Even if upbringing has been inadequate in fostering resilience to mental
health problems, personal effort can be made to build resilience. According to the
American Psychological Association (APA Help Center, 2005) there are ten ways to
build resilience.




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1. Make connections: foster good relationships with close family members, friends
   or others. Accept help and support and participate in social or civic groups.
2. Avoid seeing crises as insurmountable problems: it is not possible to change the
   fact that highly stressful events occur; but, you can change how you interpret
   and respond to events. You can look toward the future with a sense of hope.
3. Accept that change is a part of living: Certain goals may no longer be obtainable
   as a result of negative events. Accepting circumstances that cannot be changed
   can help you focus on circumstances that you can alter.
4. Move toward your goals: Develop realistic goals. Take small steps toward goals
   regularly.
5. Take decisive actions: Don‘t just wish problems would go away. Act on adverse
   situations as much as you can.
6. Look for opportunities for self discovery: People find that they have grown in
   some respect as a result of their struggles. Many people who have experienced
   tragedies and hardship have reported better relationships, greater sense of
   strength even while feeling vulnerable, increased sense of self worth, a more
   developed spirituality and heightened appreciation for life.
7. Nurture a positive view of yourself: Developing confidence in your ability to solve
   problems and trusting your instincts helps build resilience.
8. Keep things in perspective: Try to consider the stressful situation in the broader
   context and keep a long term perspective. Avoid blowing the event out of
   proportion.
9. Maintain a hopeful outlook: An optimistic outlook enables you to expect that
   good things will happen in your life. It is helpful to visualize what you want
   rather than worrying about what you fear.
10. Take care of yourself: Pay attention to your own needs and feelings. It is helpful
   to engage in activities that you enjoy and find relaxing. Exercising regularly can
   be helpful. Taking care of your mind and body helps to keep you primed to deal
   with situations that require resilience.


       The American Psychological Association also includes writing or journaling,
meditation, and spiritual practices as resilience promoting activities. Resilience
doesn‘t mean that a person doesn‘t experience difficulties or distress. Resilience is
bolstered by relationships that include love and trust, provide role models and offer




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encouragement and reassurance. Your resilience is fostered by the capacity to make
realistic plans and take steps to carry them out, maintaining a positive view of
yourself and confidence in your strengths and abilities, development of skills in
communicating and problem solving and the capacity to manage strong feelings and
impulses. Resilient people tend to view problems as opportunities for learning and
development. Growth springs from challenges. (APA Help Center, 2005)


       Salvatore Maddi in his investigation of the hardiness of employees following
substantial downsizing of a company found three hardiness factors in resilient
employees. First, they had a sense of control that they can influence the outcomes
of events. Second, they had a sense of commitment while feeling worthwhile and
important and third, they viewed problems as a challenge for which they could work
to generate creative solutions. Other factors associated with psychological hardiness
include a tolerant and accepting attitude toward others, effectiveness handling
stress, good ability in managing moods, an even temperedness, a self-sufficient and
self-reliant nature, and good self-esteem. (Maddi 1987)


       A developing scientific interest has occurred in an area associated with
resilience termed posttraumatic growth or adversarial growth. This phenomenon is
described as a process of growth that often coexists with human suffering. Reports
of posttraumatic growth have been found in people who experience bereavement,
sexual assault or sexual abuse, combat, refugee experiences, being taken hostage,
rheumatoid arthritis, HIV infection, cancer, bone marrow transplantation, heart
attacks, coping with the medical problems of children, motor vehicle accidents, and
fires. Areas in which growth has been found include improved relationships, a
greater appreciation of life, new interests and priorities, a greater sense of personal
strength and spiritual development. Paradoxes occur such as impressions that losses
have produced valuable gains, or the victim is more vulnerable, yet stronger. Those
who suffer severe trauma may think that if they can survive the traumatic situation,
they can survive nearly anything. The traumatic experience becomes the standard
by which other difficult experiences are compared and as a result there is much less
anxiety or fear when faced with new challenges. Those who experience trauma may
become more comfortable with intimacy and develop a greater compassion for
others who suffer. They may appreciate family and friends more after the traumatic
experience threatened losing them.




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       They may have a greater appreciation for the value of their own life. They
may gain a better understanding of spiritual matters. They may develop a new path
in life. They may gain a greater sense of closeness with others and put more effort
into their relationships. New doorways may open and opportunities become
available which wouldn‘t have otherwise. They may discover that they are in fact
stronger than they thought they were.


       Out of the experience of suffering, individuals may explore fundamental
questions about death and the purpose of life. For those who report positive
changes in the context of trauma, it is common to value smaller things in life more
and rethink religious, spiritual and existential aspects of life. It is common for these
people to report that philosophies of life become more developed, satisfying and
meaningful; while, philosophies still differ from one person to another. It seems that
many who suffer establish a wiser perspective on living that incorporates the
negative experiences into their views about life. Despite the fact that positive
changes may take place as a result of suffering, this does not imply that trauma is
―good‖ or that growth is a goal in the context of suffering. (Tedeschi and Calhoun,
2004, Seligman 2011)


       According to Martin Seligman ―personal transformation is characterized by
renewed appreciation of being alive, enhanced personal strength, acting on new
possibilities, improved relationships, and spiritual deepening, all of which follow
tragedy.‖ In fact he points out that 61% of those in a group of prisoners of war in
Vietnam who were victims of torture, ―the more severe their treatment, the greater
the post- traumatic growth; they had benefited psychologically from their ordeal.‖
(Seligman 2011) Certain variables have been associated with the development of
posttraumatic growth including self-efficacy, hardiness, optimism, self-esteem,
extraversion, acceptance, religious coping, problem-focused coping, and positive
emotions. (Linley and Joseph, 2004) Constructively disclosing the story of the
traumatic experience in a comfortable place and creating a trauma narrative that
tells what has been gained as a result of the trauma also helps facilitate growth.


       Most people face significant adversity in their lives. Developing the ability to
bounce back from setbacks and even grow in the context of suffering appears to
contribute to exceptional mental health. Ann Landers once said, ―The single most




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useful bit of advice for all humanity that I can give is to expect trouble as an
inevitable part of life and when it comes, hold your head high, look it squarely in the
eye and say ―I will be bigger than you. You cannot defeat me.‖‖




Mental toughness


       In the field of sports psychology, top athletes‘ ability to thrive on stress,
perform in the upper ranges of their potential more consistently, and drive
relentlessly in pursuit of a goal, regardless of how long it takes or how much pain is
involved has been an area of great interest. This type of resilience in sports has
been termed ―mental toughness.‖ Mental toughness is an attitude that an athlete
takes with them into every situation. It is being driven by purpose, committed,
dedicated, courageous and filled with heart. It means persevering in the face of
fear. An athlete‘s mental set can be a model for any person who faces stress in life.
We do not hope for an easy life; but, rather we hope to be strong people and we can
strive hard to become mentally stronger.      The first step is simply to decide that you
want to become mentally tougher. One essential aspect of mental toughness is
being able to make a decision and then stick with it. You have to be able to take
control by narrowing your focus to the things within your control and then work hard
on those things by acquiring knowledge and developing greater competence. To be
mentally tough, you have to work hard on problems and if they persist, work harder.
Mental toughness includes learning from mistakes and not taking losses or criticism
personally. It means learning to stop any tendency toward a delicate emotional
sensitivity. Being mentally tough also includes taking pride in overcoming
difficulties; the greater the difficulty, the greater the pride.


       Controlling your thoughts is half the battle. You have to give yourself the
right messages during times of stress. You can learn how to respond effectively to
the voice in your head that gives you negative or distorted messages. If you have
sabotaging thoughts, you can learn how to answer them back. You can combat your
own suffering with positive self talk. A struggling athlete might tell himself or
herself, ―I can tough it out, I can dig a little deeper.‖ Distortions can be challenged
for their accuracy and irritating negative thoughts can be counteracted with an
authoritative optimism.    Finally, mental toughness means maintaining composure,




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maintaining poise under pressure. Both good physical fitness and relentless
confidence are associated with mental toughness. You have to believe in yourself to
be mentally tough.




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Ego Strength




          The ego is a theoretical mental structure of personality that is defined by its
functions. Originally, Freud had used the word ego to mean a sense of self;
however, he later revised it to mean a set of psychic functions such as judgment,
tolerance, reality-testing, control, planning, defense, synthesis of information,
intellectual functioning, and memory. Freud developed his concept of the ego along
with the id (the instinctual drives libido and aggression) and superego (ideals and
self-expectations). Many other theorists have made contributions to ego psychology
and the functions of the ego. The capacity for ego functions is natural and inborn.
Ego is responsible for negotiating between the inner needs of the individual and the
outside world. The ego mediates between the person and reality; it is the center
that integrates stimuli from both the unconscious and from conscious reality. It
develops on the basis of unsatisfied demands. In part, its functions include the
capacity to defend against anxiety and compromise when there is conflict. Ego
functions develop over the lifespan in response to social influences and the
environment. Ego functions develop in response to attachments to other people.
The ego is an active and changing force for coping with, adapting to and shaping the
external environment. According to ego psychology, the functions of the ego have
been divided into autonomous functions and strengths.


Autonomous ego functions
Sleep-wake cycle
Perception (5 senses)
Memory
Attention
Concentration
Orientation
Primary process thinking: condensation, symbolization (bizarre dream-like thoughts,
immediate gratification drive, the thinking seen in infants, seeks gratification of
wishes immediately)
Secondary process thinking: logic, time sense (reality oriented cognition, mediates
between the demands of the instinctual drives and the constraints of reality and
ethics)
Speech and language


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Judgment
Intelligence
Executive function (organizing, planning, decision making)
Psychomotor control
Adjustment to reality
Reality testing
Abstraction
Self-preservation
Self-care
Hygiene
Transition from play to work
Social skills (quality and patterns of interpersonal relationships)
Autoplastic adaptation (changing oneself to adjust to circumstances)
Anticipation
Observing ego (the capacity to reflect upon oneself or observe oneself)
Ego interests
Integration (synthesis)
Mastery: the ego seeks to master its environment and interactions




Ego strengths:
Stimulus barrier (how much stress one can handle and maintain ego functions)
Impulse control (oral, sexual, hostile)
Affect tolerance (ability to tolerate strong emotions)
Containment of primary process
Resistance to regression (regression occurs when skills of the ego stop working to
protect unpleasant emotions)
Delay of drive gratification
Frustration tolerance
Pain tolerance
Tension tolerance
Capacity for drive and affect discharge (ability to discharge strong emotions or
instinctual drives such as urges for sex or aggression)
Sublimatory channel (channeling stress into healthy outlets)




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Mentation over somatic discharge (thinking as opposed to channeling stress into
physical symptoms)
Development
Fantasy as trial action
Regression in the service of the ego (capacity to relax one‘s hold on reality, to
experience aspects of self that are ordinarily inaccessible, and to emerge with
increased adaptive capacity as a result of creative integrations)


        Ego strength is the effectiveness with which the ego undergoes its range of
functions. Ego strength involves the capacity to cope despite adversity. A strong
ego means that the person does not deny or distort tough realities but finds ways of
prevailing while taking reality into account. Ego strength also includes the capacity
to manage emotions, wishes, and impulses without melting down or becoming
excessively defensive. A person with high ego strength is self-confident, strong-
willed, and steadfast in response to frustration. They have a strong positive sense of
self.


        In Freud‘s psychoanalytic theory of personality, ego strength is the ability of
the ego to effectively deal with the demands of the id, the superego, and reality. A
strong ego will not only mediate between id, superego and the realities of life and
integrate these functions, but it will also do so with enough flexibility so that energy
will remain for creativity and other various needs. In the case of a rigid personality,
ego functions are maintained only at the cost of impoverishment of the personality. A
strong ego maintains its functions even in the face of wide variations in the supply of
energy to the ego. Those with little ego strength may feel torn between the
competing demands of id, ego and reality. Ego strength helps us maintain emotional
stability and cope with internal and external stress.


        According to theorists, the ego stands for reason and caution, developing with
age. Freud used an analogy which compared the ego to a rider on horseback; the
ego being the rider while the id (instinctual drives of libido and aggression) being the
horse. The horse provides the energy while the rider ultimately controls the
direction. However, in unfavorable circumstances, at times the horse makes its own
decisions over rocky landscape.




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       Ego strength includes the various internal psychological capacities that an
individual brings to his or her social interactions. Ego strengths tend to fluctuate
from one situation to another and variations in the social environment can evoke
better or worse functioning. Furthermore, in situations of illness, crisis, role
transitions or social upheaval some regression in selected aspects of ego functioning
is normal. In social situations, ego strength can be reinforced, supported, built and
even shared with another person.     Those who model strong egos can share their
strength with others who are lower functioning and then can incorporate greater
strength. Ego strength is learned from influences such as a parent, teacher, sibling,
therapist, coach or friend; ego function can change with new social influences.
(Bjorklund, 2000)


       According to Hartman and Zimboroff building ego strength includes release of
shame and reclaiming worthiness and release of helplessness and reclaiming
personal power. When a child is traumatized as the victim of someone else‘s rage,
or treated as an object or a thing, the surviving adult can re-nurture, comfort, and
re-parent their inner child so that he or she can say that the traumatic experience
was wrong and that he or she is now supported, nurtured, and kept safe. This is
possible because the adult has inner strength to offer the traumatized inner child
having grown stronger with age and positive experiences of coping, resilience and
mental toughness.    The shame is the abuser‘s not the victim‘s. The victim is no
longer a child and subject to the unconscious patterns put in place at that time. The
adult can discriminate between the past and the present situation and he or she is no
longer helpless. He or she can assert himself or herself in the face of others in
positions of authority.   The adult is no longer a child facing an omnipotent parent.
The self of today strengthens the fragile inner child, the regressed ego state. The
current ego is called on to ―be there‖ for the child ego and is strengthened as the
process brings growth to any developmental arrest of the child state and
empowerment to the underdeveloped adult. (Hartman and Zimboroff 2004) Ego
strength grows by overcoming challenges like the muscles of the body. If you use
the muscles in your body they start to get bigger and stronger. The more you use
your ego strength the stronger it gets




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Psychological Insight: The Capacity for Understanding Self and Others


       Throughout a person‘s lifetime, the ability to understand oneself and other
people plays an important part in quality of life. Psychological insight involves
understanding why people think, feel, and do what they do. The capacity to
―mentalize‖ allows a person to understand the mental states which underlie
behavior.   It is a form of imagination that enables a person to consider the needs,
desires, feelings, beliefs, goals, purposes, and reasons for the behavior of oneself
and others. It includes understanding the content of thought, what is communicated
by others, and the process by which things happen in people‘s lives.


       People often think of insight in situations where a person makes sense out of
a personal problem or symptom they are experiencing. Understanding the reason
something bad has happened allows a person to develop a sense of control as they
gain the ability to prevent it from happening again.   Insight can help to remove any
obstacles to growth. By gaining insight the individual gains greater freedom of
choice so that he or she does not have to fall into the traps of past patterns of
behavior. The best predictor of a person‘s future behavior is his or her past
behavior; but, insight is the key to breaking out of past patterns of behavior by
understanding why things happen as they do.


       Through much investigation, the field of psychology has found that the
majority of problems have multiple causes. The brain is incredibly complex and no
single explanation tells the entire story. Therefore, the cause of human problems
and psychological symptoms are multi-factorial; yet, the more we can unearth the
hidden causal factors, the greater comfort and control we obtain. This can mean
making what is unconscious or hidden from awareness, conscious. One important
means of gaining psychological insight is to work with a therapist in psychotherapy.
A therapist can help uncover the reason for a client‘s thoughts, feelings, and
behavior and make clear the source of emotional difficulty. For example, a therapist
might help a person recognize how past relationships affect current relationships.
Understanding these relationships can shed light on and help solve a personal
problem. With insight, people run their lives more effectively. Self-understanding is
crucial for personal growth. Developing psychological insight appears to be an
important component of optimal mental health.




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Coherence of Personality


       According to C. Robert Cloninger coherence of personality involves the
development and integration of three character dimensions or aspects of personality.
The first dimension is self-directedness which involves being reliable and purposeful
as opposed to blaming or being aimless. Letting go of fighting and worrying can help
to increase hope and self-directedness. The second dimension is cooperativeness:
being tolerant and helpful as opposed to prejudiced or revengeful. Working in the
service of others increases love and cooperativeness. The third dimension is self-
transcendence which involves being self-forgetful and spiritual as opposed to self-
conscious or materialistic. Self-transcendence can become evident with an intuitive
understanding of elevated aspects of humanity such as ethics, art and culture. For
others it may be the awareness of a divine presence, feelings of boundlessness or
inseparability. Some people lose their sense of separateness when absorbed in what
they find moving or love to do. Feelings of boundlessness and self-forgetfulness
have been called ―oceanic feelings‖ by Freud. These three dimensions of character
have been found to have about 50% heritability in twin studies but character and
personality develops by a complex interaction between genetic and environmental
variables.   Cloninger has argued that self-transcendence is essential to the process
of integration and maturation of personality. He has found that people who score
high on all three character dimensions have the highest levels of positive emotions,
absence of negative emotions, satisfaction with life, and virtuous conduct.   At the
highest level according to Cloninger: wisdom comes with a coherent understanding
of faith, hope and charity; well-being occurs with a full range of positive emotions
and no negative emotions; there are creative acts of compassionate service,
unshakable confidence and love of truth. (Cloninger, 2004; Wikipedia, 2010)


       It has been argued that on the path to coherence and wellbeing one must
develop self-awareness. These stages of awareness spiral upward as a person
matures or increases in coherence of personality. Each transition in stage of
awareness requires that a person accept the limitations about what he or she
believed was satisfying or valuable in order to begin adapting in ways that are more
coherent and flexible. With little self awareness people act on immediate likes and
dislikes. At the next stage people can let go of negative emotions and accept reality.
At the next stage of awareness people act like good parents and consider the
perspective of other people in a balanced way. This is possible by observing one‘s


                                          143
own thoughts and motives. The person at this stage of awareness can observe
himself or herself and others for understanding without judging or blaming. At the
highest stage termed contemplation there is effortless calm, impartial awareness,
wisdom, and creativity. The person is more loving and is able to access what was
previously unconscious as needed without effort or distress. (Cloninger, Svrakic,
2009)




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Practical Intelligence


       One facet of optimal mental health is learning to navigate your way through
the trials of everyday life. Robert Sternberg has developed a theory of the kind of
intelligence needed to succeed in everyday life which he termed, practical
intelligence. Sternberg described practical intelligence as ―the ability to find a more
optimal fit between the individual and the demands of the environment through
adapting to the environment, shaping and changing it, or selecting a new
environment in the pursuit of personally valued goals.‖ Sternberg‘s formulation of
this sort of intelligence includes knowledge gained from everyday experience.       It is
what may be commonly referred to as ―street smarts‖ or ―common sense,‖ as
opposed to ―book smarts‖ or academic intelligence. Many people would agree that
experience is the best teacher. Much of the ability to solve everyday problems
comes from the wisdom gained from experience. (Sternberg 1986, 2000)


       Knowledge increases with experience. This sort of knowledge is termed tacit
knowledge. Tacit knowledge guides action or how one behaves. It is knowledge
about what to do in a given situation or class of situations. Tacit knowledge has
been shown to correlate with prestige in business, salary, grades in school and
adjustment to college. (Sternberg 2001) Some important cognitive abilities that aid
in the development of practical intelligence include the capacity to observe oneself,
to observe and appraise the outside world, to learn, to solve problems, to reason
effectively, to use good judgment and make decisions, to be creative and
demonstrate ingenuity, to manage time, and to think of the future and establish
appropriate goals and expectations for oneself.


Self-observation


       Practical intelligence grows out of the capacity to observe oneself and the
outside world. At some early point in life, we begin to think about ourselves. We
learn to step back and consider how we appear to others. We become aware of our
thoughts, our emotions and our behavior. Out of social influences and learning we
observe ourselves and speculate upon how others see us. Later we observe
ourselves in the hopes of making adjustments in order to live better lives.




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       Self-esteem arises out of our personal view of ourselves. During early stages
a person learns to view oneself as his or her parents view him or her. Later, as we
individuate, we gain the capacity to form a self- concept separate from parental
influence. When we observe our own behavior we compare our assessment of
ourselves to our hopes and expectations of how we would like to be. Self-esteem
drops if we find fault in how we act; however, efforts to improve behavior regain
self-worth.


       If a person fails to monitor his or her own behavior, he or she will also fail to
make important changes. At the other extreme, tremendous self-preoccupation can
paralyze a person and therefore it is important to forget oneself in the course of
action while later reviewing the events and the outcome. The conduct of one‘s
behavior is viewed personally in the context of values stemming from one‘s society,
culture, work or school environment, friends, and family. We learn about the values
of these groups so that we can conduct ourselves accordingly. Self-observation is
shaped by our perception of others who are important to us.


       When you are learning a new skill, a scrutiny of your thoughts is necessary to
help you adjust thinking so that you can find greater mastery. Coaches guide
athletes in a process of self-observation by pointing things out to them. They
facilitate change by promoting continual self-observation and adjustment with
practice. Therapists guide their clients in a process of self-observation in order to
break the cycle of problems through insight. If a person repeatedly finds himself or
herself in problematic situations such as dysfunctional relationships, getting fired
from work, developing financial problems or getting into trouble with the law, self-
observation can help to uncover its cause and enable the individual to live life
differently. Once a pattern is recognized, it must be anticipated that it will try to
creep up again. Therapists work with clients to develop greater self knowledge so
that the onset of a repeated pattern can be recognized.     With a deeper
understanding of what causes a problem, thinking and behavior changes so that
repetition of the pattern is avoided providing much needed relief. Through self-
observation with the help of a therapist, clients develop the freedom to function
differently.




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Appraising the outside world


       When we observe the outside world, we must sort relevant information from
the irrelevant.   Through every sensory modality, we learn to attend to meaningful
events based upon past experience. Remembering experiences throughout life
enables us to appraise the events around us. Memories of past stimuli serve as a
context of comparison for new stimuli. New information is integrated into one‘s
understanding of the way things are around them. We constantly reformulate our
understanding of the world.


Learning


       The capacity to learn appears to be vital to successful adaptation and good
mental health. With a great desire to learn some people strive to improve
continuously.     On the other hand, some mental health problems appear to be
learned. Eric Kandel, a Nobel Prize winner, demonstrated learning processes at the
primitive level. He described two processes termed sensitization and habituation
which shape the learning process. Sensitization involves attuning to stimuli while
habituation is a process of ignoring certain stimuli. This filtering of stimuli allows us
to sort the relevant from the irrelevant and helps to focus our thinking so that
productive learning can occur. We must integrate information into a meaningful
interpretation and relate our new understandings to existing knowledge.


       Learning also occurs by a process termed conditioning. In one type of
conditioning, the repeated association of one event with another evokes responses
simply by producing the associated event. For example, the classically conditioned
response is for a dog to salivate in response to the presentation of a steak while a
bell chimes. Eventually, just the chiming of the bell triggers salivation. Thus, the
association of events can lead to a classically conditioned response. It is believed
that anxiety disorders may come about because of classically conditioned responses
to particular events. Another form of conditioning, termed operant conditioning,
occurs with shaping of behavior based upon reward or punishment. We learn to
repeat rewarded behaviors while those behaviors that are not rewarded or punished
decrease or stop altogether in a process termed ―extinction‖ of the behavior. We
hope that operant conditioning throughout the course of life will foster greater




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adaptive skill; but, for some people, punishments and rewards seem arbitrary and
they learn that they are victims of other people‘s whims. This situation is associated
with mental health problems. Over time, a person develops an idea of what the
important people in his or her life would reinforce. These internal messages carry
tremendous weight in the outcome of our lives. When things go awry, it can be
helpful to consider how the important people experienced in one‘s life might reinforce
the difficult situation from within us at an unconscious level. By uncovering the
nature of such negative influences, a person gains freedom from their negative
impact. Conditioning that promotes mental health comes from predictable, stable
and healthier environments.


       With the use of language, complex ideas are processed and remembered by
assimilating them into one‘s view of the world. This type of learning is termed
constructivism, where we fit the meanings of events into our world view. With this
type of learning we construct meanings in order to develop concepts or mental
models in order to understand the world.


       Historical events are remembered by learning the story or sequence of events
which helps one construct a timeline of events. We learn about ―cause and effect‖ in
this manner. With learning, a fund of knowledge grows so that complex problems
can be solved, skills can be developed, and new ideas can be formulated.


       Experiential learning is the process of finding meaning from direct experience.
It is learning through reflection on doing and interacting with the environment. One
experiments with knowledge firsthand and makes discoveries rather than hearing or
reading about others‘ experiences. Experience is a ―living textbook‖ to which a
person can refer for needed information. Experiential learning engages the learner
at a more personal level by addressing needs and wants. Confucius is believed to
have said, ―tell me and I will forget, show me and I may remember, involve me and
I will understand.‖ Experience produces greater practical intelligence as we learn
from the environment. (Wikipedia.com, 2008) In the best of circumstances,
learning results in profound knowledge and understanding, and also strong skill at
discernment and perception.


Reasoning




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       The development of practical intelligence also depends upon good reasoning.
Good reasoning involves the ability to provide true or probable evidence that
sufficiently supports one‘s beliefs. It also means that one can refute others‘
arguments with sufficient evidence. Good reasoning makes use of logic so that facts
are integrated into reasonable conclusions. We learn from experience how to
assimilate facts into conclusions about ourselves and the world. When new
information becomes available, we can integrate our new understandings into past
knowledge so that new conclusions can be made. Reasoning is dependent upon
memory and knowledge as well as logic. Problems with reasoning arise from
mistakes in determining what is true or jumping to conclusions supported by
inadequate or misleading information. Good reasoning supports problem solving,
decision making and judgment. Reasoning also plays an important role in how we
view ourselves and others. Therefore, faulty reasoning has a detrimental impact on
people‘s quality and longevity of life.


Problem solving


       Most people have problems that need to be solved and burdens that need to
be lifted. But, many people believe that their problems can‘t be solved, that there is
no answer. A key element of practical intelligence is skill at problem solving.
Problem solving skills in general are important stress reducers. Some people are
proficient problem solvers who can figure out what is wrong and resolve it. Those
who develop better problem solving skills benefit in several ways. First, these
individuals become better able to anticipate problems and make plans to avoid them.
Secondly, these people are able to cope with setbacks more effectively. Problems
solving skills are useful to others and marketable. The cognitive capacity to solve
problems appears to be vital to successful adjustment and happiness in life. Skills in
problem solving are not inborn and must be developed. Problems come in many
varieties and there are often several positive solutions to a problem.


       People learn to solve problems from life experience; but, many of the
problems people face are not unique to them. People share many similarities
including the various sorts of problems they may face in the course of life.
Therefore, you can learn from the wisdom gained by others‘ experience, mistakes




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and successes, and take their advice about how to solve a particular problem. You
can benefit from the wisdom of friends, family, or colleagues at work. There might
be published solutions to a particular problem in the available literature. In
situations when a problem seems new to you and others, adaptations from similar
problems and their solutions might be helpful.


       There are stages to the problem solving process. First, you must recognize
that there is a problem. Practically intelligent people do not wait until the problem
hits them over the head before they recognize that it exists. Next, you must define
the problem. What are the features of the problem? It can help to become curious
about the challenges you face, not just focused on getting rid of problems or
avoiding them.   Sometimes it may help to uncover the cause of the problem
although this is not always necessary to solve a problem. Next, you can formulate a
strategy for solving the problem. What approach will you use to face this problem?
Who can help you solve this problem? There is a phase in which you collect
information, allocate resources to help solve the problem and finally you must track
your progress. Once a solution to a problem is found and the necessary actions are
taken, it is important to review the outcome. Is the outcome satisfactory or are their
still remaining problems to be solved? Finally, it is important to maintain solutions to
problems so that old problems do not reemerge.


       Problem solving can be viewed in phases. You start at an initial problem state
and hope to strive to a successful goal state. The area between the initial state and
the goal state is termed the problem space. A workable solution gets you through
the problem space to the goal state. In order to generate possible solutions to a
problem, a process termed brainstorming can be helpful. Brainstorming for solutions
to problems involves generating a wide range of alternative solutions which helps to
improve the quality of ideas. (Munoz 2005) The rules of brainstorming help to guide
you in finding solutions: 1. You should offer as many possible solutions as you can.
2. No criticism is allowed even if a given solution seems implausible initially.
3. There should be an attempt to combine and borrow from the group of generated
solutions in order to find the best possible solution to a problem. Brainstorming
helps to prevent premature negative judgments about possible solutions to problems
and facilitates the process of finding solutions. Once a list of possible solutions has
been created, each solution can be weighed by its pros and cons.




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Decision making and judgment


       Another important aspect of practical intelligence is decision making and
sound judgment. We are empowered by our ability to make choices and control our
destiny. The ability to effectively govern oneself and act autonomously depends
upon sound decision making ability. Decision making involves weighing the pros and
cons of a given set of choices and selecting the best option. Phases of decision
making include: problem identification, acquiring information, formulating
hypotheses about consequences of decision options, weighing options, and selecting
a choice. In the medical field, decisions are made based upon the evidence of prior
research and an evaluation of potential risks versus the benefits of a given treatment
alternative. In a court of law, judgments are based upon certain standards of proof
such as: clear and convincing evidence, preponderance of the evidence or beyond a
reasonable doubt.


       Good judgment implies that a person is able to foresee the consequences of
his or her decisions and choose prudently. Such wisdom in decision making includes
an open mindedness about possible new alternatives as opposed to a rigid adherence
to traditions. It is not unusual for people to repeat faulty decisions as though
expecting a different result. Our judgment is limited by the available information.
When mistakes are made we must look for new information in order to make better
decisions. Good judgment protects an individual from risks to mental health and it
helps to direct the individual in the process of successful adjustment to life‘s
challenges. One of the most important things a person can do to promote his or her
health and happiness is to make smart choices. By using foresight and overcoming
urges for immediate gratification, risks and self-defeating behavior can be avoided
and choices can be made to better prepare for the future. Good judgment appears
to help people find happiness and long life.


Intuition


       Intuition is a knowing, a sensing that is beyond conscious understanding, a
gut feeling. Some scientists have contended that intuition is associated with
innovation or scientific discovery. Intuition may elicit solutions to problems or guide




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decision making. A broad knowledge base contributes to a greater intuitive sense.
Someone with more experience will have better intuition due to tacit knowledge.
Intuition is experienced as flashes of insight or gut feelings.


Creativity


         At times, negotiating your way through day to day problems and
opportunities will require creativity. Developments in science, technology, research
and the arts and even the development of specific new methods of promoting mental
health will be made possible by the means of creative thinking and ingenuity.
Creativity is a skill that can be developed. It is said that creative thinkers learn to
―break out of the box‖ of standard assumptions and ideas. Creativity is sparked by
travel where new and different people, places and things are seen and experienced.
Creativity occurs in the context of one‘s society and culture. Therefore, traveling
promotes creativity by finding new contexts in which to think and conceive of ideas.
Exposure to new ideas can also be encountered in literature, television, the internet,
music, movies, theater, etc. Meeting new people and sharing ideas can also help the
creative process. By exploring areas outside one‘s area of interest, a cross-
fertilization of ideas can stimulate the creative process.


       Learning and collecting information allows a person to understand a particular
domain better so that new connections can be formed. Creativity is typically based
upon others‘ work. Great creators and inventors ―stand on the shoulders of giants.‖
Other creators have made previous discoveries which have established the
knowledge of a particular field. Creativity works to change an existing domain of
knowledge or establish an offshoot of previous knowledge to a new area. Creativity
is not the efforts of one person alone but rather the combined effort of a system
which promotes new ideas.


       Creative people enjoy the process of creating. They find enjoyment in
combining adjacent areas of knowledge and approach their work in a playful manner.
They are able to kick ideas around with others or by themselves with a sense of
curiosity and enjoyment. Being creative involves luck: to be in the right place at the
right time. As creative people work they must sift good ideas from trash; but,
creative people must allow a generation of many ideas, good and bad. Creativity




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involves divergent thinking where fluency allows for the generation of a large
quantity of ideas, flexibility enables the creator to switch perspectives and originality
enables the creator to find unusual ideas.


       The first step in the creative process is to become immersed in the area of
interest. The second step involves incubation where there is no immediate effort to
get to work as associations flow and connections are made in the back of the mind.
The next step is the ―eureka‖ experience when the pieces of the puzzle fall together.
The next step involves evaluation of new insights to determine if they are worth
pursuing and the last step is the development of the idea(s).


        Creativity is spawned by stimulating people, stimulating surroundings, a wide
source of information and ideas to draw from, and a comfortable work space.
Creative thinking enables people to solve new problems which helps reduce stress
and raises self-esteem. It can help to stimulate creativity by thinking of areas of
need, where there are problems and room for improvement. Creativity enables
people to add beauty to their world and to make headway in the pursuit of
happiness.




Improvisation


       Improvisation is art, any form of art made up on the spot. It is straight from
the heart, extemporaneous productions, spontaneous creation, shooting from the
hip. Improvisation is most often associated with the field of jazz. According to
Stephen Nachmanovitch, author of Free Play- Improvisation in Life and Art,
improvisation comes from the spontaneous and intuitive promptings of the
unconscious, improvisation tells a spiritual and psychological story. It is a free play
of consciousness as it communicates messages emerging from the raw material of
the unconscious. What we have to express is already with us. It is us. The creative
work comes alive by unblocking the obstacles to its natural flow. Improvisation
entails an element of risk but we can develop it more fully with a bold sense of
adventure. It requires competent technique, skill in the use of one‘s chosen medium
of expression; but it goes beyond technique, even virtuosity. We practice until the
skill becomes unconscious; but, improvisation in life goes from competence to




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presence. With training, experimentation, practice, patience, letting go, and trust we
can get to the point where we overcome the critic who says there is ―something
lacking‖ in our art. We don‘t want to become overly technical and lose freshness and
aliveness. Technique is merely the tool by which we draw, write, paint, sing or play
spontaneous creations of our deepest selves.


       As Nachmanovitch says, ―The most common form of improvisation is ordinary
speech. Every conversation is a form of jazz. The activity of instant creation is as
ordinary to us a breathing.‖ In psychoanalysis, the client learns to free associate,
simply saying whatever comes to mind. When it becomes difficult to associate freely
the therapist analyzes the resistances and defenses present in order to disarm them
from impeding progress. The resistances and defenses are always created by the
anticipation and avoidance of unpleasant emotion. Beneath the unpleasant emotion
is freedom and joy, if you can surrender spiritually and let go of grasping. We can
also cope with toughness and thrive despite unpleasant circumstances. The goal of
analysis is not only to create insight about the workings of the unconscious but to
teach improvisational speech. When people improvise together, they entrain into
each other‘s rhythms, weaving in and out of one another‘s rhythms, pushing and
pulling, creating harmonies. They think together; they coordinate in a self-
organizing whole.


       According to Nachmanovitch, ―When you let go of some impediment or fear,
boom- in whooshes the muse. You feel clarity, power, freedom, as something
unforeseeable jumps out of you…In this journey there is no endpoint, because it is
the journey into the soul…Improvisation is inherently a mystery. It cannot be fully
expressed in words, because it concerns the deep preverbal levels of spirit.‖ The
ultimate goal of improvised art is to reach the divine, divine beauty, divine play,
divine communication. It flows with our evolving consciousness. Memory, intention
and intuition are fused. There is no script or recipe.   The stream of consciousness is
always with us. It is energy, information and pattern. It can be enhanced through
practice and any discipline that unblocks our sense of intuition. When our intuition
and inspiration of any kind are unblocked or liberated we can express our authentic
voice. Intuitive knowledge proceeds from everything we know and with it comes a
feeling of absolute certainty.




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         Nachmanovitch suggests that ―For improvisation to appear we have to
disappear. We let go of self-consciousness, we are fully in the moment.        Your
focused concentration and involvement maintains and augments itself, your physical
needs decrease, your gaze narrows, your sense of time stops. You feel alert and
alive. Effort becomes effortless. You lose yourself in your own voice, in the handling
of your tools, in your feeling for the rules. Absorbed in the pure fascination of the
game, the textures and resistances and nuances and limitations of that particular
medium, you forget time and place and who you are. This flashpoint of creation in
the present moment is where work and play merge. When the self-clinging
personality somehow drops away, we are both entranced and alert at the same
time.‖


         Nachmanovitch is a musician. He says that ―When I first found myself
improvising, I felt with great excitement that I was onto something, a kind of
spiritual connectedness that went far beyond the scope of music making. At the
same time, improvisation extended the scope and relevance of music making until
the artificial boundary between art and life disintegrated. I had found a freedom that
was both exhilarating and exacting.     Looking into the moment of improvisation, I
was uncovering patterns related to every kind of creativity, uncovering clues as well
to living a life that is self-creating, self-organizing, and authentic. I came to see
improvisation as a master key to creativity… In a sense all art is improvisation.
Some are presented whole at once while others are doctored improvisations that
have been revised over a period of time before the public enjoys the work.‖ It is
rare that a musician will create totally spontaneous, finished performances for the
public; but to listen to agile, free, imaginative, improvised music, we can appreciate
the vast scope of an artist‘s genius. Nachmanovitch says that ―Improvisation applies
across the board to all fields of creative activity. Any action can be practiced as an
art, as a craft, or as drudgery.‖   In a sense, ―everything we do is art‖. It‘s a gift
that comes from a place of joy, discovery and inner knowing. It is the heart‘s voice.


         Martha Graham has said that ―There is a vitality, a life force, an energy, a
quickening, that is translated through you into action, and because there is only one
of you in all time, this expression is unique. And if you block it, it will never exist
through any other medium and will be lost.‖ Nachmanovitch suggests that it is
surrender that opens us up and lets spontaneous expression come forth. According




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to Carl Jung, ―The creation of something new is not accomplished by the intellect but
by the play instinct acting from inner necessity. The creative mind plays with the
objects it loves.‖ Donald Winnicott says, ―It is in playing and only in playing that the
individual child or adult is able to be creative and to use the whole personality, and it
is only in being creative that the individual discovers the self.‖


       Michelangelo claimed that there was an ―intelleto,‖ a form of intelligence that
enabled him to see within the marble he carved and simply remove the excess stone
to reveal or liberate his magnificent sculptures. According to Nachmanovitch, ―The
inner critic can bring creativity to a standstill. There are two kinds of judgment,
constructive and obstructive. Constructive judgment facilitates action, it helps guide
the quality of the improvisation… When a mistake occurs, we can go with it, we
become, then, no longer the victims of circumstance, but able to use circumstance
as the vehicle of creativity. Creativity is not reserved for a time and place when
everything is perfect.‖ He also assured us that ―The fruits of improvising,
composing, writing, inventing, and discovering may flower spontaneously, but they
arise from soil that we have prepared, fertilized, and tended in the faith that they will
ripen in nature‘s own time.‖


       Improvisation is the fundamental ability that allows us to create beautiful
works of art, both formal art and the art of life. When we capture that mysterious
something and our audience is moved to tears or filled with awe, nothing is lacking;
it is as though we are gods. According to Henry Miller, ―My life itself became a work
of art. I had found a voice, I was whole again.― (Nachmanovitch 1990)




Reflecting


       Reflecting is the considering or re-examining of experience, prior
understandings or ideas that allows for growth, new insights and deeper
understanding. By reflecting we turn experience into learning. We can revisit
experience, think things through, mull it over, and arrive at new conclusions. At
times reflecting is beyond thinking, imagination, or reasoning; it might involve
―grokking‖ and intuition. In our current levels of stimulation and constant




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bombardment in today‘s society we need to be sure to take time and reflect on our
own and others lives and ideas.




Time management


       Another aspect of practical intelligence is good time management.
Organization and good use of time appears to help reduce stress and promote
mental health. Anticipating deadlines and tackling projects in advance reduces job
or school stress. Balancing work and family demands with leisure activities appears
important for one‘s mental health. Projects in need of completion can be organized
in ―things to do‖ lists so that nothing is left undone or found overwhelming in light of
its state of disorganization. Robert McKain is thought to have said, ―Set priorities for
your goals…A major part of successful living lies in the ability to put first things first.‖
All time management requires planning. Successful time management allows an
individual to accomplish more and live more fully.


Future orientation


       Practically intelligent people think of their futures. Hopes for the future and
anticipation of potential problems down the road allow an individual to prepare and
guide himself or herself in changing times and challenging circumstances. By
thinking of the future, one can develop and make use of resources in order to realize
aspirations. In difficult times, hoping for better days down the road makes the pain
more bearable. By developing future goals, one can strive forward and build self-
esteem with the realization of desired aims. High school students with lower levels
of future orientation have higher incidence of substance use. (Peters 2005) Loss of
future orientation is associated with depression and thoughts of suicide.




Setting appropriate goals and expectations for oneself


       In order to protect oneself from mental strain and disappointment, future
goals and expectations must be appropriate. Working toward goals is a tremendous
source of happiness; but, not everyone can be a professional baseball player, a




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movie star, or an astronaut. Projected goals and expectations of oneself must be
based upon past performance. It is unreasonable to expect yourself to accomplish
tremendous things without a track record. Reaching big goals is a gradual process.
As you build a track record of accomplishments expectations can get a little tougher.
Establishing a pattern of accomplishments is encouraging so that you can strive
confidently toward a very difficult goal. Furthermore, a person is more likely to put
forth the required effort to reach their goal if he or she believes that he or she can
accomplish it. Research has shown that positive emotions play a key role in the
pursuit of goals. Positive emotions serve to motivate us toward our aims. (Custers
2005) It has also been shown that setting higher expectations for oneself and
feeling self- confident lead to resilience despite environmental stressors in at-risk
youth. (Aronowitz 2005)




       Practical intelligence, street smarts, or common sense appears to be an
important facet of optimal mental health. The ability to learn from experience and
make use of tacit knowledge in order to live wisely can protect people from stress,
help with the accomplishment of goals, and help to promote optimal mental health
and fitness. It is helpful to place yourself in environments where you can learn the
most from your experiences. With the accumulation of practical intelligence a person
develops wisdom. Such wisdom is knowledge of how to live well; it concerns the
individual‘s own good and it also considers the good of the community.




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Mental Exercise


       The human brain can continue to grow and improve with exercise. Recent
brain research has shown that the plasticity of brain neuronal structures allows for
development at all ages. The combination of an enriching environment and
purposeful mental stimulation helps to increase our mental capacity. Therefore, we
can prevent the frequent decline in cognitive capacity with older age and enhance
our ability to think well and stay mentally sharp at any age by exercising the mind.


       Mental exercise means pushing your brain to learn new things, to do new
things, and to develop greater mastery at skills you already have. You can dedicate
yourself to learn and acquire new knowledge and be willing to do things you‘ve not
done before. Mental exercise can include such things as taking a class, learning to
play an instrument, playing scrabble or working crossword puzzles, starting a new
hobby, learning a foreign language, reading, writing, and socializing. Television and
video games are inadequate stimulation for mental exercise in most cases. Research
of specific mental exercise tasks has shown benefit in preventing cognitive decline in
older individuals; but, it is difficult to recommend specific mental exercises for the
general population. Nevertheless, there is strong argument for the viewpoint that by
pushing our brains to know more and to do more we can come closer to optimal
functioning.


Lifelong education:


       We improve our capacity to adapt successfully to life with the acquisition of
knowledge through a lifelong education. Education is any experience or act that
helps a person develop physically, mentally, socially or spiritually. Knowledge is
transmitted from one generation to the next through informal instruction or more
structured schooling.   Learning can occur by observation, by listening and by
engaging in activities. Each individual may learn most effectively by one preferred
modality. Teachers must understand a subject well enough to convey its
fundamental nature to students. A lifelong education allows for the betterment of
individuals and the societies in which we live.




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Effort, Success, and Superior Functioning




       Motivation is the driving force that moves a person to action. It involves the
formation of desire, want, or urge to fulfill a need. Avolition or low motivation
interferes with a person‘s adjustment to life; motivation is adaptive. Motivation is
necessary to meet needs and reach goals. Creating higher levels of motivation helps
a person answer questions, solve problems, achieve success and obtain cherished
rewards. The accomplishments realized as a product of motivation also play an
important part in the development of self-esteem. Therefore, developing strong
motivation is important to one‘s mental health.


       There are basic physiologic processes that underlie motivation: the search for
pleasure and the avoidance of pain. In the past decade the physiology and brain
chemistry of reward or pleasure has been uncovered. The neurotransmitter
dopamine in an area of the brain termed the nucleus accumbens plays an important
role. The experience of pleasure is associated with increases in dopamine in the
shell of the nucleus accumbens. The physiology and chemistry of the counter-
regulatory process that produces aversion or emotional pain has not yet been found.
Some evidence points to the neurotransmitter dynorphin as the primary mediator of
emotional pain. In an evolutionary sense, our most primitive neurologic structures
should include basic pathways for pleasure and pain, joy and suffering. If we block
the primitive neurologic pathway to pain and suffering we shall finally be released,
freedom from negative emotion when much unpleasantness becomes too much. The
day may come when psychiatric disorders are treated by blocking the effects of
dynorphin. (In animal models, kappa opiate receptor antagonists- drugs that block
the effects of dynorphin- reduce stress and anxiety, decrease helplessness in models
of depression, appear to block the emergence of psychosis, and reduce self-
administration of drugs of abuse). We are impelled by our emotions to avoid pain
and to seek pleasure; yet, with maturity we come to tolerate pain in anticipation of
delayed gratification and find pleasure in healthy and constructive rather than self-
defeating ways.


       Basic physiologic drives create the motivation to satisfy hunger, thirst, needs
for sleep, and urges for sex. With abstinence the drive to satisfy these needs
accumulates and then when the urge is satisfied the drive dissipates. Some theorists


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have proposed that the motivation to achieve success is in fact brought about by the
basic drive for sex in the sense that achievement makes a person a better candidate
for reproduction. Freud proposed that all behavior was ultimately motivated by basic
drives for libido or aggression. Whether urges for sex, libido, or aggression play a
role in achievement, achievement alone is rewarding and appears to be important to
a person‘s self-esteem and confidence. Other theorists have proposed that
psychological needs bring about motivation. According to Abraham Maslow, human
needs can be arranged in a hierarchy. Once lower level needs are satisfied, a person
moves on to the next tier of needs. Needs range from physiologic needs for food
and water, to needs for safety, needs for love and a sense of belonging, needs for
self-esteem, and finally needs for self-actualization or growth. (Maslow, 1943)
Others have claimed that people appear to have psychological needs for relatedness,
intimacy, autonomy, competence, achievement, and power. While research has yet
to validate the role of psychological needs in motivation, it is widely accepted that
such needs are important determinants of behavior.


       Motivation includes a state of emotional arousal or mental energy that gives
rise to goal-directed behavior. It is an integration of cognition and emotion; the
cognitive aspects produce goal orientation while emotion supplies the driving force
behind actions. Sources of motivation can be divided into intrinsic or internal
sources and extrinsic or external sources. Intrinsic motivation comes from what is
considered important to a person. To reduce pain and to experience sheer
enjoyment; short term and long term goals; personal values; beliefs about how one
ought to behave; to overcome challenges; as well as urges to understand something,
solve a problem, make a decision, or take control of one‘s life; or maintain a sense of
purpose or a sense of meaning can underlie intrinsic motivation. Intrinsic motivation
to change behavior comes from the discrepancy between how things are at present
and the way a person would like things to be. Discrepancies between one‘s actions
and values will lead to a change in values or behavior in order to eliminate the
discrepancy.


       Extrinsic motivation, on the other hand, comes from anticipated reward or
punishment. Anticipated acquisition of money, material goods, and motivation
through fear are extrinsic sources of motivation. Social influences on motivation
including the prospect of receiving others‘ love, social comparison, urges to be like




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someone else, desires to belong to a group, being empowered by others, having to
do something because of social pressure, or building one‘s reputation are extrinsic
motivators as opposed to wanting to do something because of internal influences.
You can affect the impact of extrinsic sources of motivation by choosing
environments that will provide a positive influence. People try to choose good
neighborhoods and schools for their children, positive places of worship, good jobs,
good friends and good partners in marriage. Negative influences on motivation like
getting in with the wrong crowd, working at a job you hate, or staying in an abusive
relationship can have devastating effects upon a person‘s health and quality of life.


       You can also influence your intrinsic motivation by clarifying what is important
to you and what you hope to achieve. The purpose of making goals is to actively
plan your life. In order to formulate goals you must decide what you value and what
you want. If you ask yourself questions like: What do I want to do? What do I want
to have? Where do I want to go? What do I want to be like? What do I want to
know? What do I want to do for money and how much do I want to earn? What
kind of contribution do I want to make to my community? What do I want to do for
fun? What do I want to do for my spouse or family? What do I want to do for my
health? The answers to these questions can help you formulate goals that inspire
you to shape your life. Without goals, motivation drops. People who strive for
personally significant goals find happiness along the way to achieving their aims.
Therefore, it is advisable to make goals for a better life in order to build the fire in
your belly, instill motivation, take action, find happiness and achieve success.


       Success is a process in which goals are realized that bring you closer to your
dreams. You do not know the upper limits of your capacity for success, to grow and
change. No one knows. Those who have the unquenchable desire for a better life
learn to find their passion and make their dreams a reality. You may ask, ―how do I
make life the best possible?‖ What do you hope to accomplish? What could you do
that would make you look back at your life with pride? What would give you a
greater sense of purpose? What could you do that would make others look at you
with great respect? How could you live life in the way that you would like to be
remembered? What moves your heart into a state of excitement and joy? You must
listen to your heart and uncover the dreams that are deeply rooted within you there.




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To be truly successful, you must listen to your own heart, find your passion, and
make your dreams reality.


       It has been said that a life without dreams is like a garden without flowers.
You have to dream to make a dream come true. Henry David Thoreau advised to ―go
confidently in the direction of your dreams. Live the life you‘ve imagined.‖     It
appears that we grow great by dreams. As Mark Twain has said, ―the really great
make you feel that you too can become great.‖ According to Carl Sandburg,
―Nothing happens unless first we dream.‖


       With a dream, the unconscious can manifest a path toward its realization. As
Gloria Steinem has said, ―Without leaps of imagination, or dreaming, we lose the
excitement of possibilities. Dreaming, after all, is a form of planning.‖ In order to
live your dream, an action plan will guide the journey, and then as it has been said,
―a journey of a thousand miles starts from beneath one‘s feet.‖ There may be great
challenges in the pursuit of a dream. The dream may have strong opposition.
According to Albert Einstein, ―Great spirits have always encountered violent
opposition from mediocre minds. The latter cannot understand it when a man does
not thoughtlessly submit to hereditary prejudices but honestly and courageously
uses his intelligence.‖   As Jonas Salk has said, ―I have had dreams and I have had
nightmares, but I have conquered my nightmares because of my dreams.‖


       In the enduring words of John Lennon, ―you may say I‘m a dreamer, but I‘m
not the only one…‖ In the words of Edward Kennedy ―the work goes on, the cause
endures, the hope still lives and the dreams shall never die.‖ Robert Kennedy
paraphrased the words of George Bernard Shaw in a speech saying, ―Some men see
things as they are and say, ―Why?‖ I dream of things that never were and say, ―Why
not?‖‖ So keep dreaming… According to Abraham Lincoln, ―and in the end, it‘s not
the years in your life that count, it‘s the life in your years.‖


       According to Oprah Winfrey, ―We are all called. Everybody has a calling, and
your real job in life is to figure out what that is and get about the business of doing
it. Every time we have seen a person on this stage who is a success in their life,
they spoke of the job, and they spoke of the juice that they receive from doing what
they knew they were meant to be doing… They lit up the stage with their passion.




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Because that is what a calling is. It lights you up and it lets you know that you are
exactly where you're supposed to be, doing exactly what you're supposed to be
doing. And that is what I want for all of you and hope that you will take from this
show, to live from the heart of yourself. You have to make a living; I understand
that. But you also have to know what sparks the light in you so that you, in your own
way, can illuminate the world… Carry whatever you're supposed to be doing, carry
that forward and don't waste any more time. Start embracing the life that is calling
you and use your life to serve the world."


       Although some people may want to compare themselves to others in order to
determine if they are successful, what really matters is how you view your own
degree of success. In order to be successful, you must take total responsibility for
your life. Next, you must decide what you truly want from life. You should do what
you love and make demanding goals and commit to your goals. You must believe
that your goals are possible and you must believe in yourself. You must have drive
and confidence. You must expect a grand outcome. Success comes more easily if
you keep asking questions and develop a network of support. You can find a wise
coach or mentor and learn from role models.


       Success comes more often to those who show strong character. Be a class
act. Try to show poise and always remain positive. Cooperate with other people and
be likable. Try to break bad habits and establish good habits instead. Regain control
of your emotions, your thoughts and your behavior. You can rise above any
negative self-talk, limiting thoughts and self-defeating behavior.


       Success depends partly upon how you respond to events in your life. In order
to achieve success, you will have to overcome adversity. Some people may face
great misfortune or terrible mistakes. But you can view adversity as a challenge.
Don‘t back down, throw yourself into the effort. You can learn from adversity and
never give up. You can welcome and thrive on pressure. There can be peace in the
midst of turmoil. Success comes with passion and enthusiasm. You can become
intensely persistent. You can become empowered by empowering others and ignite
the fire in your belly. With passion, you put your heart and soul into your efforts to
achieve.




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       Success is a choice. It is making a decision to accomplish something and
becoming dedicated. The height of success is deciding to become the best you can
be and committing to excellence. According to Bindya Singh, ―We should strive at
excellence not perfection. By striving for excellence, we are trying to do our best
without pressurizing ourselves to be perfect.‖ (Singh 2003) There may be missteps
or setbacks in progress but success comes with hard work. No meaningful
accomplishments come without working hard. By putting in the effort, you come to
believe that you deserve success. You can make a tremendous contribution to
society through grit and determination.


       Realizing that effort plays the biggest role in success will help instill hope and
motivation. Expecting to achieve a goal and the value of reaching the goal both
influence your degree of motivation. With resolve, the motivation to reach personal
goals is strong. It is a firmness of purpose that sustains your motivation in the face
of obstacles. It is perseverance that wins out in order to make you successful.
People often enjoy the pursuit of their aims as much as the final realization of a goal.
Striving for positive things is in itself rewarding. As you strive to reach important
goals, you must remain patient. Reaching great goals takes time.


       Self-discipline is essential to success at any endeavor. Self-discipline is the
assertion of willpower in order to commit to a task as long as it takes to learn,
perfect, or complete it. It means to find closure or finish what you start, it means
taking responsibility for the outcome of a task, and it means refusing to give in to
distractions that interfere with completion of the task.   It involves making choices in
which short-term pleasure is sacrificed for long-term gain. Self-discipline comes
naturally from the love and passion one has for their work; yet, a person will find
greater willpower and self-discipline when focusing on the goal or the rewards rather
than the difficulty of the job to be done. When your view of the future goal is clear,
you can impose your will on the distractions and opposition and conquer the task at
hand. According to Angela L. Duckworth and Martin E.P. Seligman, self-discipline is
a better predictor of school success than intelligence. (Mathews J, 2006) President
Harry S. Truman has said, ―In reading the lives of great men, I found that the first
victory they won was over themselves… self-discipline with all of them came first.‖
Self-discipline is a key ingredient in winning success. The ability to develop
ambition, willpower and self-discipline is not reserved for a few special people. It




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develops with training much like the development of muscle strength. Such strength
can be built with practice, by striving hard, narrowing one‘s focus, and reaching
goals, and by gaining greater and greater self-control in the process. Finally, with
strong character, when we realize our aims we should express gratitude. With the
help of self discipline, the fulfillment of one‘s hopes and dreams is a strong predictor
of happiness in life.




The following poem helps to characterize success:


Success


To laugh often and much;
To win the respect of
intelligent people and
the affection of children;
To earn the appreciation
of honest critics and
endure the betrayal of false friends;
To appreciate beauty;
To find the best in others;
To leave the world a bit better
whether by a healthy child,
a redeemed social condition,
or a job well done;
To know even one life has
breathed easier because
you have lived --
This is to have succeeded.


- Author unknown (sometimes attributed to Ralph Waldo Emerson)


       The greatest successes come with superior levels of functioning. According to
the Global Assessment of Functioning, the highest level is present when there is
superior functioning in a wide range of activities, life‘s problems never seem to get
out of hand and one is sought out by others because of his or her many positive



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qualities. (American Psychiatric Association, 1994). Superior functioning may also
mean making highly creative contributions to society; developing a strong knowledge
base, wisdom and expertise in any given field; or extraordinary achievements or
performances. Superior functioning occurs in love, work and leisure.


         Some have argued that superior functioning and high talent is possible only
with natural ability or giftedness. Thus, we hear, ―he‘s a natural athlete, she‘s a
born musician.‖ Gifted children learn more quickly, deeply, and broadly than others
their age and may operate at the same level as normal children who are considerably
older. Yet, while some gifted children advance early, others are late bloomers.
According to Howard Gardner, there are eight different intelligences or areas in
which people learn and show talent: intrapersonal, logical-mathematical, spatial-
visual, musical, linguistic, bodily-kinesthetic, interpersonal, and naturalistic. Gardner
gave examples of people who demonstrated exceptional skill in each of these
intelligences: Sigmund Freud (intrapersonal), Albert Einstein (logical-mathematical),
Pablo Picasso (spatial-visual), Igor Stravinsky (musical), T.S. Eliot (linguistic),
Martha Graham (bodily-kinesthetic), Mohandas Gandhi (interpersonal), and Charles
Darwin (naturalistic). (Gardner, 1983) Furthermore, fluid intelligence is the ability
to find meaning in confusion, to understand the relationships of various concepts and
solve problems independent of acquired knowledge; while crystallized intelligence is
the ability to use experience, knowledge and skills. It seems that when people are
using talents or gifts the abilities come naturally; it is as though something is given
without effort or merit. Intuitive and creative leaps occur spontaneously in states of
flow and experiences of wonder, awe and ecstasy. Creativity can be stimulated by
intense feelings, memories or images. It seems that giftedness comes with intuition.


         Some evidence suggests that superior functioning and achievement depends
upon chance. Factors such as timing, opportunity, cultural influences and family
legacy can play an important role in personal achievement. Mentors, coaches and a
matrix of support can serve as catalysts to help people find what they love to do and
accelerate learning.    Different personalities favor certain skills and different people
possess particular natural strengths.


         Exceptional ability, talent and excellence are cultivated through disciplined
study.    At first the individual is unaware that they lack a skill, next they become




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aware that the skill is lacking. Then through strong motivation, the ability to delay
gratification, and hard work, the skill is learned but may still require much
concentration and effort. Eventually with practice the skill becomes natural, smooth,
and unconscious. It has been demonstrated over time that purposeful practice over
long periods, perhaps 10 years time, is the essential ingredient of expertise. Rather
than inborn talent, years of practice can form expertise for any willing person. By
setting a high standard of excellence, the quality of what is done can be honed
toward perfection. Excellence demands a strong command of skills and superior
execution. Truly extraordinary achievements are created by people who understand
the relationship between effort and reward, who have a compelling view of the future
that impels them to action, and a bedrock of clear personal values that guide
behavior. Mastery is a never ending path that requires instruction, practice,
visualization and a dedicated push to the edge of the limits in accomplishment and
performance. There are plateaus in skill that are followed by elevations in the level
of skill. These developments come with a love for the discipline.


       According to Abraham Maslow, people who have realized an unusually high
degree of their potential may have a childlike quality, a wise innocence. They
approach life with a second naivete or hold the world with an ―innocent eye.‖ They
possess both maturity and a healthy childishness. Superior functioning is an
important reality of optimal mental health.


       Superior functioning includes the highest forms of love, work, and significance
and it includes the highest forms of leisure and play. Superior functioning is the
state of excelling; it is the gradual result of always striving to do better. It means
finding flow, doing what you do best, and making a difference. It is doing what you
were meant to do and realizing your dreams, providing a great source of joy and
meaning. It means teamwork with high morale and passion, empowering each other
and believing in the reason behind the effort. It means developing a felt sense of
one‘s place in the universe and a clearly articulated vision of something better. It
means a commitment of emotion, discipline, foresight and sacrifice.      It means
having a strong impulse or inclination, a call or summons. We love to observe the
superior functioning of others as it makes us believe that even more is possible in
the future. You may recognize the air of confidence and swagger in the walk or
conduct of those who function at the highest levels; nevertheless, remain humble.




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According to former president Bill Clinton, when you embark on your remarkable life
after graduation you should do what you love, work hard at it, and don‘t quit in order
to make a little something of your life.




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Optimal Mental States: Flow, Mindfulness, Peak Experiences, Becoming Sure and
Effectiveness States


       Mental states are relatively short lived phenomena as opposed to long
standing traits. Optimal mental states are exceptional mental experiences. They
include high levels of performance or flow states, mindfulness, peak experiences,
becoming sure and effectiveness states. Exceptional performances, becoming sure
and mindfulness are brought about with conditioning and practice while peak
experiences tend to occur unexpectedly. Effectiveness states come from the
development of positive artistically impacting experiences.



       Peak performance situations can be experienced when skills are fine tuned.
They can be reached during any well practiced activity. It is to experience a state of
mastery that feels effortless. The mind and body work smoothly in unison. These
high performance states come about during a state of relaxation. Best performances
occur when a person is just slightly above the normal state of arousal and physically
relaxed. During these heightened performance experiences a person exudes
confidence. There is a steadfast determination to succeed and it is displayed in one‘s
behavior. The individual is totally absorbed in the moment and completely focused.
Concentration is directed at the task at hand. Having the ability to stay in the
moment is a gift that all peak performers have. The experience is automatic. There
is no interference from outside distractions, thoughts, or emotions, and one feels
completely in control. These experiences produce a sense of satisfaction and
fulfillment. When athletes function in exceptional ways they often refer to a process
termed ―entering the zone.‖ Such high achievement is made possible by practice
and more practice and then at the time of performance forgetting everything he or
she has been taught in order to get himself or herself out of the way and let the
sport take over. When the athlete is in the zone, he or she moves effortlessly,
beautifully, and faultlessly.


       A psychologist, Mihaly Csikszentmihalyi, has developed and investigated a
related concept termed ―flow.‖ Flow involves a focused attention and absorption that
resembles meditation; but, unlike meditation, during flow experiences, high levels of
ability take place. During experiences of flow, time seems to stop and you lose self-
consciousness. You feel more alive. Emotions, thoughts and actions are merged
together and directed at the task at hand. In flow situations where complicated skills



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or talents are involved, prior practice is necessary so that much of the required effort
has become second nature. People access flow states with repetition and practice.
―The best moments usually occur when a person‘s body and mind is stretched to its
limits in a voluntary effort to accomplish something difficult and worthwhile.‖ It is a
state of losing oneself and finding oneself in the course of a loved activity.
(Csikszentmihalyi, 1990)




       Mindfulness or mindful awareness is attuning to oneself with a friendly,
openhearted interest. It involves becoming aware of what is happening moment to
moment; it is paying attention intentionally and non-judgmentally. Attention is
focused on immediate experiences (such as the cycle of the breath) so that a person
can notice his or her mental events in the present moment; noticing whatever arises
as it arises. According to Daniel Siegel, mindful awareness includes an orientation
toward one‘s experiences characterized by curiosity, openness, acceptance and love.
It is a manner of relating to oneself. While focusing attention on the chosen object,
the individual describes and labels the events putting them into words as they occur.
Being non-judgmental means not grasping onto judgments, being aware of
judgments and disengaging from them, and perceiving feelings without having to
react to them. Mindfulness allows us to become aware of our automatic mental
habits. The benefits of mindfulness can include the development of patience, non-
reactivity, compassion for self, caring and empathy for others, and wisdom. Life
becomes more enriched by filling the senses, living in each moment and developing
a general sense of wellbeing. (Siegel, 2007)


       According to Jon Kabat- Zinn, ―Mindfulness is moment to moment awareness.
It is cultivated by purposely paying attention to things we ordinarily never give a
moment‘s thought to. It is a systematic approach to developing new kinds of control
and wisdom in our lives, based on our inner capacities for relaxation, paying
attention, awareness and insight…


       All of us have the capacity to be mindful. All it involves is cultivating our
ability to pay attention in the present moment. Mindfulness is a lens, taking the
scattered and reactive energies of your mind and focusing them into a coherent
source of energy for living, for problem solving, and for healing… Cultivating




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mindfulness means learning to tap and focus energies that are typically wasted in
reacting automatically and unconsciously to the outside world and tapping our own
inner experiences… It is learning to dwell in states of deep relaxation which
nourishes and restores body and mind. It also makes it easier for us to see with
greater clarity the way we actually live and therefore how to make changes to
enhance our health and quality of life… It helps us to channel our energy more
effectively in stressful situations, or when we are feeling threatened or helpless…
This energy comes from inside us and is therefore always within our reach and
potential control. Cultivating mindfulness can lead to the discovery of deep realms of
relaxation, calmness, and insight within…     It is as if you were to come upon a new
territory, previously unknown to you or only vaguely suspected, which contains a
veritable wellspring of positive energy for self-understanding and healing. It is easy
to get to this territory it is always accessible…   The path to it in any moment lies no
farther than your own body and mind and your own breathing. Its energies can be
of great value to you…


       The systematic cultivation of mindfulness has been called the heart of
Buddhist meditation. It has flourished over the past 2,500 years in many Asian
countries. In recent years the practice of this kind of meditation has become
widespread in the world… Mindfulness is basically just a particular way of paying
attention. It is a way of looking deeply into oneself in the spirit of self-inquiry and
self-understanding… It is not dependent on any belief system or ideology, so that its
benefits are therefore accessible for anyone to test for himself or herself…     there is
a way of being, a way of looking at problems, a way of coming to terms with the ―full
catastrophe‖ that can make life more joyful and rich than it otherwise might be, and
a sense also of being somehow more in control.‖ (Kabat-Zinn, 1990)


       According to Mark Epstein, ―It is possible to learn a new way to be with one‘s
feelings. The Buddha taught a method of holding thoughts, feelings and sensations
in the balance of meditative equipoise so that they can be seen in a clear light…
Training in this attitude of mind is why meditation is practiced… As a person learns
to be with his or her own feelings with the combination of courage and patience that
bare attention requires, he or she can become more humble and more forthcoming,
more capable of the intimacy that he or she may have both feared and craved.‖
Epstein also proposes that ―by not identifying with, not holding on to, and not being




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embarrassed by whatever arises, the meditator moves inexorably from a narrow
focus on the content of his or her experience to an ever-widening focus on the
process itself. Thoughts and feelings, stripped of their associated pride or shame,
gradually lose their charge and come to be seen as ―just‖ thoughts or ―just‖
feelings… While not denying the immediate reality of the feeling, one can
nevertheless begin to smile at oneself and at one‘s habitual reactions.‖ (Epstein
1995)


        Peak experiences have been most thoroughly investigated by Abraham
Maslow. According to Maslow, these experiences are unexpected joyous and deeply
moving times in life with sudden feelings of intense happiness, wellbeing, wonder,
and awe. At times these experiences involve a diminished sense of self with a
greater sense of transcendental unity. The individual feels more interconnected and
integrated, in harmony and at one with the world and all things. At other times one
experiences an awareness of profound knowledge or higher truth. Great insights and
revelations are deeply felt as the individual experiences a perspective on things as
though looking across the horizon from a mountain peak. Such experiences are
brought about by intense feelings of love, enjoying great art, music, or the beauty of
nature. Alternatively, they can occur in the setting of typically negative situations
such as serious illness or facing death. Maslow believed that peak experiences help
people to become less conflicted, more loving, more accepting, more creative and
more empowered. With these changes people also become more honest and
trustworthy and more spontaneous. According to Maslow, all people are capable of
experiencing these exceptional mental states. He argued that peak experiences
should be studied and cultivated in order to help people realize personal growth,
fulfillment, and integration. (Wikipedia 2007) Peak experiences might be among
those experiences that were the best moments of your life, those experiences that
you would most like to live again.


        Samadhi is a Sanskrit term for the highest accomplishment in the discipline of
yoga. Features of Samadhi may also occur during peak experiences, meditation,
certain physical feats such as dancing or running, or reveling at the beauty of
something like a sunset. Different forms of Samadhi can take place. It is described
as a state of consciousness with equilibrium and stillness, a sense of general
wellbeing, bliss and joy. It can be viewed as complete control of the functions of




                                          173
consciousness or an effortless and continual state of perfection. It is the sense that
nothing is lacking to take away from wholeness and perfection. It has been
described as the pure love of God, everlasting peace and happiness. For people who
achieve this state of consciousness miraculous happenings may occur and they no
longer fear death. As a result of Samadhi experiences people also become instilled
with a holistic and compassionate world view.     (Wikipedia.com, 2008)


       Sureness is a mental state that comes with knowledge and practice. It is a
state of confidence and freedom from doubt. By integrating the lessons of the past
at an unconscious level, the conscious mind is made sure by the unconscious. In
order for the integration to be successful the proper information must be acquired by
the unconscious. Now, in this age of information our integrations may become more
and more complete. Intuitive knowledge proceeds from everything we know,
consciously and unconsciously, and with it there arises an inner compass and feeling
of absolute certainty. Gut feelings are substantiated by fact. Decisions come
rationally and easily. The integration of knowledge from life experience results in
sureness of purpose and a well thought out vision for tomorrow. Becoming sure
means right thought, right emotion, and right action.


       Effectiveness states have been described by Jeffrey Zeig. According to Zeig,
if you want to experience ways in which you can be different you have to change
your state. You can elicit a change in state with the development of an experiential
impact. An experiential impact as in art, all forms of art, can elicit effective ―states‖
that can bring about healing, change, and growth. Such states can be states like
attentiveness, curiosity or love. The following are some ways to develop an
experiential impact in order to access effectiveness states:


          1.   Art: music, literature, drama, film and photography, sculpture, paint
               and drawing, etc.
          2.   Tasks
          3.   Metaphors
          4.   Allusions
          5.   Poems
          6.   Hypnosis
          7.   Directives




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       As a therapist, an artist, a politician, a parent or a friend you can use
effectiveness states to help people to be different. You can use experiences to help
elicit effectiveness states in yourself.   It can be applied naturalistically. When
someone induces a change in your state they can help you evolve from the inside
out rather than teaching didactically, they can use experiences artistically to elicit
and evoke change.


       Milton Erickson was a master of this method of change in psychotherapy.
According to Jeffrey Zeig, ―when patients felt locked into some kind of symptom
state, Dr. Erickson would elicit a flexible, effectiveness state that could be useful to
them and enable them to help themselves make the transition from being stuck in an
ineffective place into a more flexible, effective way of being.‖ Erickson worked with
patients struggling with symptoms and people who wished to enhance functioning.
He was involved in the training of Olympic athletes as well as treating patients. Zeig
believes that ―the flexibility of the therapist to enter effectiveness states such as
utilization (response ready to use constructively whatever exists in the therapy
situation) is a vehicle that helps patients to flexibly change their symptomatic
―states.‖‖


       The potential of effectiveness states is not known, but the potential impact of
experiences seems unlimited. Overall, with all of the optimal mental states we are
finding an optimal way to be in this moment.




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Play and Work




       Play is a state of mind while also an activity. We put ourselves in a playful
emotional state to play; yet, an activity can induce the emotional state of play.
Anyone can play. Play brings a lightness and ease to the rest of the day.         It has
been proposed that making play part of daily life is critical to happiness, creating
moments in which we feel most alive and being fulfilled as a person. We don‘t need
to play all of the time in order to be fulfilled. The sheer joy of a little bit of play
enlivens us and spreads to other areas of life such as marriage, family, friendships,
work or school, making us happier and more productive. As children we learn to
play quite naturally, we simply do what we enjoy. Later in life, responsibilities and
demands can rob us of play time.      Some may think that play is a waste of time, that
we should leave ―childish‖ things behind. But play energizes us, it lifts the spirit, it
eases one‘s burdens, it brings a sense of excitement and adventure to life, it fosters
creativity and innovation and it often promotes social interaction. Play makes life
beautiful, joyful and fun.


       Play is vital to interpersonal relationships. It is difficult to sustain intimacy in
marriage or friendship without play. Playfulness in interactions creates a climate for
easy connection which allows for emotional closeness and deeper, more rewarding
relationships. Those who are domineering or harm others psychologically or
physically have lost the sense of fair play. Even in competitive sports there are rules
of the game and a tradition of fair play.


       According to Stuart Brown, while play is difficult to define because it is so
varied, there are certain properties of play:
   1. Apparently purposeless- done for its own sake
   2. Voluntary- not obligatory or required by duty
   3. Inherent attraction- it makes you feel good, cure for boredom
   4. Freedom from time- lose sense of passage of time
   5. Diminished consciousness of self- we stop worrying about whether we look
       good or awkward, smart or stupid; being in the moment, in the zone, flow
   6. Improvisational potential- we are open to serendipity, chance
   7. Continuation desire- the pleasure of the experience drives the desire, we find
       ways to keep it going, play is its own reward, its own reason for being


                                            176
Brown also describes play personalities which for most of us are a mix of the
following categories:
   1.   The joker
   2. The kinesthete- people who like to move
   3. The explorer
   4. The competitor
   5. The director- planning and executing scenes and events
   6. The collector
   7. The artist/creator
   8. The storyteller



        Play is found widely throughout the animal kingdom. In rats it has been
found that an environment with more ―rats and rat toys‖ to play with resulted in
greater brain growth.   This led to the argument for providing an ―enriching‖
environment for babies and young children to promote brain growth. In other words
fostering opportunities for play and socialization should lead to greater development
in humans.


        Play is not the opposite of work. Play at work is essential. We can enjoy our
work; it can be fun. Work that is devoid of play is either boring or a grind. We need
the purpose of work, the sense that we are contributing, doing service for others,
that we are needed in our world. We need to be constructive and productive. We
also need the economic stability that work provides and we need to feel competent
as technicians or managers. We may earn respect with our work and we may gain
status. With pride in one‘s work, job satisfaction comes from work well done. One
hopes to establish a place of work where he or she can feel the joy of solid
performance and good results, be aware of one‘s mission to society and do what he
or she loves to do. We hope to find work where we are eager to go to work each day.
We need security in income and employment as well as family, community and
health. With good training, quality leadership, belief in the value and purpose of
one‘s work, that one‘s contribution is valuable, work that has variety and is
engaging, and that victory can be won in one‘s work, having a record of success,
loyalty and pride in belonging to one‘s organization, camaraderie and friendship with
fellow employees, job security, a safe working environment, a work environment



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that respects and appreciates diversity, and opportunities for promotion and higher
status, it is easy to have good morale.


                According to Tom Rath and Jim Harter in their book Wellbeing: The
Five Essential Elements, ―People who thrive in their careers love their work so much
that it is closely aligned with—and can‘t help but spill over into—their personal
lives…For those who are engaged during their work day, happiness and interest
throughout the day are significantly higher. Conversely, stress levels are higher for
those who are disengaged… If your supervisor or boss pays attention to you and
focuses on your strengths it is very unlikely that you will be disengaged at work… If
you are able to use your strengths at work you are more likely to be engaged at
work and have excellent quality of life… Those who have a best friend at work are
more likely to be engaged at their work, better at engaging customers, produce
higher quality work, have higher wellbeing and are less likely to get injured on the
job… and people who have three or four close friendships are healthier, have higher
wellbeing, and are more engaged in their jobs.‖ (Rath and Harter 2010)


         The work that is most fulfilling is really an extension of play that comes from
our own inner needs. Such work is done for pure enjoyment and those who achieve
expertise at work do so because of the drive created by meaning, by love, by fun
and by play. According to Brown, when we lose that feeling of lightness in what we
do, we should take it as a warning sign. When we take a play vacation from work we
can return to work renewed and energized with fresh ideas. When we get bogged
down in work, breaks for play can lead to creativity and important epiphanies about
work. According to James Michener, ―The master in the art of living makes little
distinction between his work and his play, his labor and his leisure, his mind and his
body, his information and his recreation, his love and his religion. He hardly knows
which is which. He simply pursues his vision of excellence at whatever he does,
leaving others to decide whether he is working or playing. To him, he‘s always doing
both.‖


         Play may prolong life. In a study conducted by the National Geographic
Society, the long life expectancy of Okinawans in Japan was explained as much by
engaging in activities like playing with young children as diet and exercise. Others
have pointed out that play can become pathological as some video gamers become




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addicted to play with consequences in important facets of life. Therefore, we need to
maintain balance in life, meeting the needs for health, recreation, family and social
life, finances and work or school.   When looking for the best play for you, do what
you harmonize with, what‘s fun. (Brown S. and Vaughan C. 2010)


          For the competitor, whether a participant or a fan, winning is an important
part of play. The thrill of victory in competitive play is cherished by game players of
every sort. When it comes to winning, the goal is not just to win but to excel at
winning with ease. Some might suggest that it comes from a commitment to
excellence. According to Gary Player, ―The mind is what makes you a superstar, and
what your mind feeds on is what determines the outcome." Vince Lombardi said that
―the price of success is hard work, dedication to the job at hand, and the
determination that whether we win or lose, we have applied the best of ourselves to
the task at hand.‖ Winning means survival of the fittest. Charles Darwin said, ―In
the struggle for survival, the fittest win out at the expense of their rivals because
they succeed in adapting themselves best to their environment.‖


          The aggressive pursuit of victory is a mental set, a way of approaching
games. Vince Lombardi once said, ―winning isn‘t everything, but the will to win is
everything.‖ You must welcome pressure. Winston Churchill‘s inspiring words
describe such a mental set: ―As long as we have faith in our cause and an
unconquerable will to win, victory will not be denied us.‖ It is possible in some
instances to impose one‘s will on the will of the opposition with such force that one
robs them of their spirit. In these instances the efforts of the opposition seem
ineffectual. As Lombardi said, ―the spirit, the will to win, and the will to excel are the
things that endure. These qualities are so much more important that the events that
occur.‖


          In games much like warfare, it is important to develop strategy. According to
Sun Tzu, ―The expert in battle seeks his victory from strategic advantage and does
not demand it from his men.‖ But, the players in a game or the soldiers in battle
must execute their plan well. The strategy grows out of self understanding and a
solid scouting of the opposition. In order to perform with flow and talent, players
must be well practiced at their art. There must be thorough conditioning and a
culture of confidence. Coaches and players can inspire the team, boost morale, and




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share the strength of their egos. There can be muses who inspire peak performance
in whatever creative way they might develop. Muses may be family or friends, fans
or hired hands. Innovation and creativity can bring magic to the competition.
Training the best and the worst players alike, depends upon corrective emotional
experiences that solve problems in performance and bring about inspired play. In
team play victory comes with a collective determination and by each player finding a
way to contribute.


       No one likes to lose, but in a curious way, losing is winning depending upon
how one loses, what is learned from the loss, and how one changes as a result. It
has been said that a difficult defeat can be all that it takes, much like a tremendous
victory, to bring the glory out. Winning becomes a habit; but for some losing
becomes a habit too. In the instances of habitual loss, leaders must rise up and turn
despair into hope, faith, and discipline. Habitual winning leads to championship
seasons and in the best of circumstances, the fittest of teams and organizations
become dynasties with winning seasons year after year. In order to excel at winning
with ease you must feed your mind with a healthy diet of inspired words and ideas.




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Financial Health


         Financial security and health depends upon good sense and hard work. For
some it comes easily with a little basic information. What can you do financially to
make yourself happier and better off in the next year? According to
investorwords.com, ―Someone with good financial health usually deals well with their
finances, makes their payments on time, and knows how to manage their money.
Someone in poor financial health usually owes a lot of money and isn‘t making their
payments on time.‖     Financial health can also mean finding the best way to finance
what you want out of life.


         The balance of finances depends upon money earned, money saved and
money spent. Money is earned with work (as a manager or technician), with sales,
investments, business ownership (goods and services), income generating hobbies,
gifts, fundraising, pensions, social security benefits, welfare and gambling (many
would agree that income from gambling is not healthy and definitely any type of
crime is not healthy). Money saved is working capital. Money is spent on daily
needs (health, recreation/leisure, housing, transportation, legal, appearance,
technology resources, gifts to others, losses, and taxes) and investing in the future
(education, business investments, equity, insurance).


         Sound financial management means avoiding risky investment or
overspending that could jeopardize the financial health of your future. You must
eliminate those things that endanger your financial health. Good debt such as
student loans and a mortgage are prudent use of borrowed money.        Reducing debt
burden and maintaining a good credit score by paying bills on time is good debt
management. It is wise to protect yourself from financial ruin due to illness,
accident, disaster or death with insurance. It is also wise to do a financial health
check.


         One measure of financial health is your net worth. To calculate your net
worth, simply subtract what you owe (your liabilities) from what you own (your
assets). If you track your net worth progression over time you can see if you are
living within your means, saving money, and more likely to reach your financial
goals. Increasing debts over time are o.k. if you are advancing your education,
investing in real estate, or starting a business, but accumulated debt from keeping


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up with the Joneses is not prudent. Other measures of financial health include your
debt-to-income ratio, your rate of savings and emergency funds.        Your monthly debt
load should not exceed 42% of your monthly income according to Fannie Mae. It
has been proposed that younger people should dedicate no more than 30 percent of
gross income to pay for all debt (car payments, mortgage, student loans, personal
loans, credit cards) and that percentage should decline to zero by retirement age.
You don‘t want to spend more than you earn.       In fact, some advise that you should
save about 20 percent of your income. It helps to keep abreast of what has changed
in your life that may change your financial plan. You may need more or less
insurance, a different investment philosophy or put away more or less for retirement.
You can raise deductibles on insurance to lower your premiums. (Bernard T, 2010)


       Many people never organize their financial data in an easy format so that they
can know at any time exactly where they stand. Developing a strategy of financial
responsibility that transforms dire straits into financial health, restores financial
health after a down turn, or bolsters financial strengths can create a strong
performance that outshines your peers. The goal is to create a state of financial
security where you can sleep peacefully, be healthy and life is fulfilling and fun.




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Mental Balance and Homeostasis


       Stability is the quality of a person when disrupted from a condition of
equilibrium to take corrective action and restore the original condition. Stability
depends upon the degree of emotionality or lability of a person. The emotions of
stable people arouse slowly and return quickly to baseline; in contrast unstable
individuals have intense, rapidly arising, changing and unpredictable emotions that
return slowly to baseline. Unstable introverts are moody, anxious, rigid and
unsociable. Unstable extroverts are touchy, aggressive, excitable and impulsive.
Stable introverts are thoughtful, careful, peaceful, even-tempered and calm while
stable extroverts are outgoing, talkative, responsive, easy going and carefree.
Stability means that a person has strength, sturdiness, firmness and soundness.


       An essential function of living organisms including human beings is to
regulate the internal environment in order to maintain a stable condition which
sustains life. This process referred to as homeostasis includes the balance of
temperature, salinity, acidity, nutrients and waste. This important balance is
regulated with homeostatic control mechanisms which include a receptor that detects
any changes and a control center that produces an appropriate response to any
detected change in order to reproduce the balanced state. For example, in humans
body temperature is regulated with perspiration when the temperature rises above a
certain point and shivering when temperature falls below a certain point.
Furthermore, capillaries expand below the skin to cool the blood when hot and
constrict to conserve heat when too cool. Such homeostatic balancing mechanisms
are essential to wellbeing.


       It has been proposed that mental wellbeing also depends upon homeostatic
control or balance. It seems that our stability must depend upon such balance and
control systems. In line with this theory, optimal mental health depends upon an
exceptional regulatory system that monitors mental states and institutes corrective
responses to any imbalances that may occur. A better balance can be established by
learning to recognize the beginnings of imbalanced situations and by making
adjustments in order to bring oneself back into balance. According to B. Alan
Wallace, who embraces a Buddhist psychological approach to optimal mental health,
exceptional mental health comes with the cultivation of four types of mental balance:



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conative, attentional, cognitive, and emotional. One of the fundamental Buddhist
principles is that mental suffering is largely the result of imbalances of the mind and
we can recognize mental imbalance when feelings of dissatisfaction occur. In
Buddhism, these imbalances are corrected with mental training. Balance occurs by
keeping hyperactivity in check, increasing deficiencies and correcting inappropriate
function. According to Wallace, with development of these four types of mental
balance one discovers serenity, bliss and peace.


        Conative balance refers to the balance of desires for happiness. Deficiencies
in conative balance involve apathy or lack of desire for happiness. Hyperactivity of
desires for happiness can be found in obsessions that interfere with functioning.
Dysfunctional desires for happiness occur when an individual desires self-destructive
things or something harmful to others such as addictions to drugs, alcohol, sex,
shopping or overeating. A person can bring desire into balance by learning to notice
such imbalances and by developing greater wisdom in the choice of goals. A healthy
conative balance comes with wholesome goals that promote one‘s own or others‘
wellbeing rather than a complete absence of desire often associated with Buddhist
thinking. Apathy is overcome by reflecting on the lives of other people who have
flourished, obsessions and unwholesome aspirations are kept in check by reflecting
on the effects of particular desires upon one‘s life.


        Attentional balance must also keep deficits, hyperactivity, and dysfunction in
check. An attentional deficit occurs when a person is unable to focus vividly on an
object of attention because of dullness or boredom. Attentional hyperactivity takes
place with high levels of arousal, agitation and distraction. Dysfunction of attention
is characterized by a focus on things that are detrimental to one‘s own or others‘
wellbeing. According to Wallace, attentional balance comes with the ability to
recognize such imbalances with mindfulness and meta-attention. Mindfulness is the
ability to sustain voluntary focus on a single object while meta-attention is the
capacity to monitor one‘s own state of attention.       According to Wallace, optimal
functioning and wellbeing comes with relaxation, vivid attention and engagement in
activity.


        Cognitive balance occurs when one views the world without cognitive
hyperactivity, deficit or dysfunction. Cognitive deficit is present when a person




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becomes absent minded or fails to perceive things clearly. Cognitive hyperactivity
occurs when a person fails to distinguish between reality and one‘s fantasies.
Cognitive dysfunction is the misapprehension of events. We can learn to recognize
such imbalances with meta-cognition or an attention to one‘s cognition. With close
attention to other people and the environment, cognitive deficits are corrected. By
learning to attend carefully to the things we perceive with our senses, we can better
distinguish between reality and any tendency to superimpose personal distortions on
our experiences.


        Finally, emotional balance or freedom from excessive emotional upheaval can
occur with emotional regulation skills. Emotional deficits are characterized by
emotional deadness or cold indifference toward others. Emotional hyperactivity
takes place with interpersonal hypersensitivity, excessive delight and depression,
hope and fear, admiration and contempt, and infatuation and intense dislike.
Emotional dysfunction refers to inappropriate emotional responses such as finding
joy in another‘s misfortune or feeling angry with another‘s success.   According to
Wallace, Buddhism offers meditative practice to counter emotional imbalance by
cultivating loving-kindness, compassion, empathetic joy, and equanimity. Loving-
kindness is a heartfelt desire that one self and others will experience wellbeing.
Compassion means that one wishes others be free of suffering. Empathetic joy is a
delight in one‘s own and others‘ happiness and virtues. Equanimity involves an
impartial caring for others‘ wellbeing despite one‘s own self-centered likes and
dislikes.


        According to Buddhism, people‘s minds are imbalanced by habit, not by
nature, and these imbalances can be rectified with skillful effort. According to
Wallace, mental balance results in a state of wellbeing and optimal mental health
that is independent of pleasurable stimuli. (Wallace 2006)




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Clarity of Mind


       We think of clarity of mind like air or water clarity that allows one to see
things from great distance. Clarity of mind is freedom from mistakes, errors in
judgment or wrong choices. It is waking up from delusion; clarity of mind comes
with a dedication to reality. Clarity allows us to see the truth. It may be that
forgetfulness obscures a person‘s clear view. Clarity comes with good focus,
concentration and attention. Clarity of mind includes understanding the path that
leads to where you are at present and a clear direction or vision of the future, but it
also means getting gut feelings and dependable intuition. Some have argued that
mindfulness meditation brings clarity of mind. According to John P. Milton, ―the
cutting through event that brings clarity, may be powerful, like a thunderbolt; or it
may be very subtle, like the sound of a leaf falling to touch the earth.‖




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Utilizing the Wisdom of the Unconscious




       Nobody knows his potential or her capacities. It is the hidden potential of the
unconscious that we must turn to for optimal health, fitness and functioning. Unlike
the conscious mind, the unconscious mind is hidden from awareness. Yet, we can
see that so much occurs beyond awareness in day to day functioning. The
unconscious has so much more wisdom than the conscious mind as it has access to
the vast reservoir of memories. It has been said that there is both a personal
unconscious and a collective unconscious. The unconscious has more abilities than
we ever dreamed of and we can facilitate, activate, cultivate and, to some extent
utilize the back of our minds to optimize health, healing, fitness and functioning. We
can make suggestions to the unconscious but it will only permit what is acceptable to
the self. We can ask it questions and gain a fresh perspective or even solve a
problem.


       When we let go of preconceived notions about what is possible the
unconscious can surprise us with our potential to be more ourselves, more whole and
complete, optimizing health, fitness and functioning, complete wellbeing… physically,
mentally, socially and spiritually. It may happen with moments of inner reverie,
meditation or waking from a dream; it may happen in ways unimagined by the
conscious mind. We can piggy back unconscious processes that facilitate
psychological development and mastery of the environment on every day moments
of relaxation, exercise, love, work, leisure and play, experiencing consciously or
doing nothing consciously.   It is helpful to outgrow learned limitations so that inner
potentials can be realized to achieve magnificent goals. We can creatively use and
develop what we already have and we can ask many questions, find many answers
and learn many new things in any creative way the unconscious desires. We don‘t
have to recognize how this happens and we don‘t have to control or direct what is
happening as the unconscious does its work. We can relax the habitual sets of
consciousness, the usual modes of thinking, to break out of learned limitations and
let autonomous processes create new combinations of associations and mental skills
for creative problem solving, healing, discovery, invention and optimal health and
functioning.




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       It is important to relate optimally to the unconscious. You develop rapport
with the unconscious by allowing it an opportunity to do its own work. (Erickson,
Rossi and Rossi, 1976)




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Visualization


       Visualization is a mental technique using one‘s imagination to create images
in the mind of what one hopes to achieve. By developing a detailed view of what
you desire: imagining what you feel, what you see, what you hear, and by
repetition, higher levels of health, fitness and success are possible. Images in the
mind result in effects at an unconscious level that bring about changes and make
dreams come true.      By using visualization we appear to take advantage of the
language of the unconscious and facilitate the realization of our innate potential.
Some people use this technique naturally in their lives, imagining that their aims are
already achieved. In a Russian study of the training of Olympic athletes, devoting
75% of their time to mental training and visualization and only 25% of their time to
physical training resulted in the best levels of performance.


       Now it is possible to conceive of many possible selves, a wise self, a mature
self, a sure self, a curious self, a playful self, a serious self, a cooperative self, a
relationally connected self, a tremendously creative self, a physically and mentally fit
self, a right-minded self, a complete self that grows more and more complete. If
there are any weaknesses in your life, you can develop a visualization of growth,
even excelling in that problem area with ease. You can see yourself being good at
managing the responsibilities of daily life and having something valuable to give to
the world. You need not limit the scope of your visualizations as the imagination is
pregnant with possibility; a truly enjoyable, happy and fulfilling life has infinite
forms. Take a moment now to envision your own optimal mental health and fitness,
healing from any illness or injury, fully thriving in life, complete wellbeing. Imagine
your best state of health, your best self, your personal best. What do you feel?
What do you see? What do you hear? Let that image become vivid in your
imagination... Make use of repetition. We need not experience ourselves as victims
of reality but rather creative participants in the unfolding journey of self-realization.
Your path has many more milestones yet to come of which to be proud. Your
unconscious mind can act on your visualization and attune consciousness to align
with that image and arrive there and truly flourish.




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Part Five: Social Approaches to Optimal Mental Health

       Human beings are social creatures. We are drawn together. According to
Irvin Yalom, ―In an evolutionary sense, without deep, positive, reciprocal
interpersonal bonds, neither individual nor species survival would have been
possible.‖ The need to be close to others is necessary for survival. People need
people also for socialization and satisfaction. ―No one- not the dying, not the
outcast, not the mighty- transcends the need for human contact.‖ (Yalom 1995)
Few people can tolerate prolonged periods of isolation and such deprivation of social
interaction is associated with mental health problems. Loneliness is painful. Other
social factors also appear to predispose people to mental illness including child
abuse, early losses such as a parent or sibling, neglect, a dysfunctional family life, or
being the child of divorced parents. On the other hand certain social factors appear
to help promote good mental health including supportive relationships, altruism,
effective parenting, and the development of social intelligence. Even the support of
a companion pet can help to promote good mental health. The presence of rich and
satisfying social relationships is the strongest predictor of happiness. As Lisa Oz
suggests in her book Us, ―embrace them (these relationships) and cherish them and
know that your relationships are your true home.‖ This section will describe social
factors associated with optimal mental health and functioning.




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Social Support


       Social support is generally defined as access to networks of friends and
relatives who are available to provide aid and comfort during difficult times. These
are relationships which an individual can count on for various kinds of support.
According to the Canadian Institute for Health Information, ―having available
emotional support and a high level of community belonging are consistently
associated with psychological well-being and life satisfaction. Emotional support is
defined as having someone available to listen, give advice in a crisis, and confide in,
who understands problems and whose advice the person needing support really
wants.‖ (Canadian Institute for Health Information 2009)


        Healthy coping through social support may include pooling resources and
mobilizing together to confront adversity. Emotional support provided through
camaraderie and talk reduces stress and helps a person in a difficult situation work
through problems and start feeling better. When someone is overwhelmed or in
times of need, help completing tasks or fulfilling responsibilities such as errands or
caring for children is termed instrumental support. Support in the form of advice
and practical information is considered information support and sharing time
enjoying leisure, visiting or just relaxing is a form of social support through
companionship.


       Support is usually provided by friends or relatives but can also come from
work colleagues, peers, and members of support groups or religious institutions.
The social bonds in which people find support require a period of time before mutual
affection holds the relationships together. Social relationships have been found to
decrease the incidence of chronic disease, disability, mental illness, and death. The
negative impact of stress on health is substantially reduced for people with high
levels of social support. (George, 2006) Animal models of social support have
shown reduced levels of stress hormones in response to stressors. (Schirber, 2004)
Social support has been shown to affect illness outcome in medical disorders and
quality of life. (Kelly 1999; Shyu 2005, Moraes, 2005) Also, the tendency of people
to give social support to others has been correlated with better health. (Brown 2005)
A support group for terminal breast cancer patients was found to prolong their life
expectancy. (Spiegel et al. 1989) In one study of 10,000 twin subjects, women who


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had low levels of social support had greater risk of developing depression than those
women with higher levels of support. (Kendler et al. 2005)


         A process termed ―universality,‖ initially described by Irvin Yalom, can help
alleviate tension when someone under stress realizes by meeting others that he or
she is not alone in his or her difficulties.   In addition, even though a supportive
friend may not share a stressful experience, a sense of compassion can help to
soothe feelings of stress. It may not be necessary to actually lean on others for
support in order to reap the benefits of social connections. Just knowing that others
are there for a person appears to help in avoiding unhealthy reactions to stressful
situations. Social support increases one‘s sense of belonging, security, and self-
worth.


         One barrier to finding social support is fear of confiding in others or difficulty
with trust, but emotional support can be gained merely by venting feelings without
divulging risky personal details. A person can maintain a sense of trust by sharing
only what they are comfortable sharing. It is better to forge supportive relationships
before they are needed but social support can be found at any time and any age.
These relationships can be fostered by offering support to others; support is often
reciprocated. A solid social support network will include enough different people to
provide the various skills, backgrounds and information needed without burdening
anyone too heavily.


         If you don‘t have a support network you may wonder how to establish one.
Some people find it difficult to meet new people because they are quiet or shy.
There are several ways to help meet new people in order to establish supportive
relationships. Classes and hobbies are a good way to meet others who share similar
interests. Exercising in a health club is another way of meeting people. Taking
yoga, aerobics, martial arts or other health club classes may make meeting others
easier since the setting is more intimate and classes may include interaction between
people rather than merely working out in the same area. Playing team sports such
as volleyball, softball or basketball can facilitate interaction with others and aid in
developing relationships. Volunteering some time toward a community activity and
getting involved in group projects at work can also help in the process of getting to
know other people. Volunteers are needed at hospitals, places of worship,




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museums, community centers or other organizations. People meet while working for
a cause such as political campaigns or a community cleanup effort. People also meet
in religious institutions or spiritual groups. People can meet while getting involved in
activities in a senior center. Sometimes new people meet while walking their dog,
taking their dog to obedience class, at pet shops, or organized meetings for people
who share interest in a particular type of pet. People can meet while walking in their
neighborhood which provides exercise as well as opportunity to meet new people.
New people also meet at parties where friends bring along their friends which can
widen one‘s radius of social contacts. People also meet at coffeehouses, parks,
museums, or sporting events.


       You can learn to take risks and talk to other people first. You can look for
something to start a conversation. Developing a variety of interests can allow you to
create new opportunities to meet people and also become more interesting to others.
It is important to remember to stay in touch with family and friends who aren‘t a
part of your day to day life with phone calls or emails when visits aren‘t possible.
It‘s important to keep updated about the events of your close friends and relatives
lives in order to maintain the bonds necessary for solid social support. With social
support you can feel close to other people in your community and develop the sense
that your community is a source of comfort. As Oprah Winfrey advises, ―be that safe
harbor for somebody else- their safe place to fall.‖




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Pet Companionship




       The majority of American households include a pet. Some pets such as dogs,
cats, monkeys, miniature horses and goats can offer unconditional love and
companionship to their owners. Just as pet owners would say, increasing research
evidence indicates that companion pets offer people strong social and psychological
support. Having a pet is not always a good idea however. Allergies, other medical
reasons, or financial limitations can exclude pets as an option for some people. The
potential pet owner must also consider the long term responsibility for the animal
and pets must never be used as an outlet for frustration or aggression. On the other
hand, for the appropriate owner, the emotional support provided by certain pets can
help to promote good mental health.




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Altruism


       Altruism involves selfless acts in which one puts the needs of others before
their own. Kindness shows concern for others. It usually means helping another
person without expecting anything in return, although it may produce benefit by
improving self-esteem, one‘s sense of satisfaction, or creating a sense of fulfilled
duty. We build character through altruistic living, living for others. People can be
altruistic toward family members and friends or toward people they don‘t know and
may never meet. Some people donate to charities or volunteer to help the less
fortunate of society. Heroic altruism involves great risk to the helper, whereas
conventional altruism poses no threat.


       One aspect of altruistic love is being of service to others. Serving others
means helping them get what they want. According to John Gloster-Smith there are
five measures that show the depth of one‘s service: the attitude with which you
offered your service, the intention behind your service, your expectation of reward,
your willingness to offer your service and the way you performed your service.
(Gloster-Smith 2008)


       Many authors have written eloquently about service to others. As Thomas
Jefferson has said, ―I believe… that every human mind feels pleasure in doing good
to another.‖ According to Sue Pattom Thoele, ―An essential part of a happy, healthy
life is being of service to others.‖ Robert Green Ingersoll says that ―you will rise by
lifting others.‖ According to Martin Luther King, Jr., ―Everybody can be great
because anybody can serve. You only need a heart full of grace, a soul generated by
love.‖ He also said, ―We are prone to judge success by the index of our salaries or
the size of our automobiles, rather than by the quality of our service and relationship
to humanity.‖ As the Dalai Lama says, ―Our greatest duty and our main
responsibility is to help others. But please, if you can‘t help them, would you please
not hurt them.‖ Mahatma Gandhi has said, ―I shall pass through this world but once.
Any good therefore that I can do or any kindness that I can show to any human
being, let me do it now. Let me not defer or neglect it, for I shall not pass this way
again.― According to Pema Chodron, ―We work on ourselves in order to help others,
but also we help others in order to work on ourselves.‖ Thich Nhat Hanh, a Buddhist
teacher and author says, ―contemplate to see that awakened people, while not being


                                          195
enslaved by the work of serving living beings, never abandon their work of serving
living beings.‖ And finally, according to Denzel Washington, ―It‘s not about what you
have or what you‘ve accomplished. It‘s about who you‘ve lifted up and made better.
It‘s about what you‘ve given back.‖ Altruism and works of service grow out of
compassion for others, both sympathy for others‘ distress and the desire to ease it.


       Altruistic helping behavior has been found as early as toddler age. It is
believed that altruism stems from empathy and pro-social motivation or the desire to
be part of one‘s community. Those who exhibit altruistic love find life more
meaningful and tend to be happier than selfish counterparts. Conventional wisdom
has taught that when we help others, some of the good done flows back to us. This
is the law of karma. Those people with a kindly, charitable interest in others may
experience both better physical and mental health. Altruistic behaviors are strongly
correlated with greater well-being, happiness, health, and longevity. (Post 2005)
Numerous scientific studies show that acts of kindness result in both physical and
mental health benefits including the joy and calm that comes with such acts, reduced
stress and stress-related illness, resilience and increased emotional vigor, a
reduction in physical pain with the release of endorphins, a sense of wellbeing when
one remembers such kind acts, an increased sense of self-worth and optimism, and
better immune function and healing.


       Altruists see a fellow human being where others see a stranger. Altruism
may be inspired by a spiritual feeling of closeness to others or a sense that all
humans are part of a large family. It seems that those who exhibit altruistic love
take into account the inherent value of humans in general, that each person is linked
to all others and that everyone is entitled to humane treatment merely by virtue of
being alive.


       It is important not to make so much self- sacrifice in the service of others that
you suffer unnecessarily from self-neglect. As altruism appears to promote health, it
may be a good idea to make an effort to volunteer your time for others in need or
make donations. You can encourage others. You might find such acts very
rewarding. In fact, altruistic and philanthropic acts create more lasting happiness
than many other pleasures. It may also be advisable to teach your children to offer
help to others in need without overdoing it with excessive self-sacrifice. According to




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The Random Acts of Kindness Foundation, ―As people tap into their own generous
human spirit and share kindness with one another, they discover for themselves the
power of kindness to effect positive change in their lives and the lives around them.
When kindness is expressed, healthy relationships are created, community
connections are nourished, and people are inspired to pass kindness on.‖
(actsofkindness .org 2010) According to Martin Luther King, "Life's most persistent
and urgent question is: 'What are you doing for others?‖ Michelle Obama says, ―All
of us have something to contribute, and all of us can make a meaningful difference
in someone's life. It's a great way to remind others that they are not forgotten, and
to remind ourselves that there are always things we can do.‖




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Social Intelligence


       Because so many of the activities of life involve social interaction, social skills
are an important determinant of life‘s quality. Wholesome social connections are
emotionally satisfying, good for one‘s general health and provide a secure base from
which a person can meet life‘s challenges. In general, the ability to connect with
others in a way that is beneficial to all can play an important role in our happiness.
The best predictor of happiness in older age is a propensity for extroversion. (Baltes
1999) Extroversion is an interest in things outside of the self or the outer, objective
world. The extrovert‘s preferred focus is on people and things; whereas, the
introvert prefers thoughts and ideas. Resilience to stress and illness has been
correlated with social competence, extroversion, agreeableness, social skills and
conscientiousness. (Friborg 2005) Poor social skills lead to missed opportunities,
estrangement from others, and failures in important tasks of life. If a nurturing
environment is provided for us, we are more likely to learn to attune and connect
smoothly with others. With good social skills, isolation and social tensions can be
avoided and personal aims involving other people can be more easily reached. To be
socially intelligent means to use social skills in order to establish and maintain
cooperative, constructive, mutually beneficial and satisfying relationships.


       The term social intelligence was originally coined by Edward Thorndike
(1920). He described the ability to understand and manage other people, and to act
wisely is social situations. The field of social intelligence has grown to include not
only social cognition and the individual‘s fund of knowledge about the social world,
but also, the development of unconscious processes that underlie solid social
connections. These unconscious underpinnings of social intelligence include an
empathic appreciation of other people‘s feelings, nonverbal signals and tone of voice,
the ability to attune to others by paying close attention, and the capacity to discern
others‘ thoughts, feelings and intentions. The unconscious aspects of social
intelligence also include the ability to communicate nonverbally with others in
synchrony. Higher up in consciousness socially intelligent people have the ability to
steer social interactions according to their wishes and to meet the needs of others
during social interaction. (Goleman, 2006)




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       Social intelligence becomes important even at an early age. It has been
found that early school success for young children was achieved not by standard ―IQ‖
intelligence but rather by knowing what kind of behavior is expected in school, how
to restrain the impulse to misbehave, being able to wait, and how to get along with
other children. In addition, the child must be able to communicate his or her own
needs and turn to teachers for help. (Goleman 1995) Social intelligence typically
grows out of experiences early in development; but, it seems that we can build social
intelligence later in life as well by developing our social capacities through
experience.


       Social intelligence develops with a process termed social learning. As a part
of social interaction, we observe the behavior of others and we can model our
behavior after that which we have seen or purposely avoid a particular behavior we
observed because of an undesirable outcome. Through experience, a child develops
a reservoir of knowledge about outcomes of social interaction. Adults have a much
larger supply of social experiences to draw from in social settings. We shape our
behavior based upon the appraisals of others, reproduce those aspects of self that
are shown approval and diminish or eliminate those that are shown disapproval.


       There are certain steps to the modeling process in social learning. The first
step is attention. Your attention is drawn to models of behavior that appear
attractive, colorful, dramatic, prestigious or competent at a particular endeavor of
interest. If a model seems to resemble yourself you pay more attention to him or
her. If a particular behavior being observed results in a desired outcome for that
individual, this will draw your attention to that individual and increase the likelihood
that you will adopt that person‘s behavior.


       The second step in social learning is retention. You must be able to
remember what you paid attention to so that you can repeat or avoid repeating the
particular behavior. The memories are stored in the form of images and verbal
descriptions so that later the memories can be brought up in order to reproduce the
behavior. The third step in the modeling process is reproduction of the desired
behavior. The memories of the behavior have to translate into actual behavior.
Sometimes there is a particular skill set needed in order to repeat the behavior which
can be acquired with knowledge and practice.




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       In the process of social learning, a person must believe that they are capable
of ultimately reproducing a modeled behavior or efforts to adopt a desired behavior
will be short lived. One‘s confidence that he or she might adopt a particular skill
develops as a result of a history of past achievement, observation of the success or
failure of others in acquiring the skill, or under the influence of verbal persuasion.
Finally, any degree of physical or emotional discomfort experienced in the process of
developing a modeled behavior inhibits the tendency to persevere in pursuit of a new
skill. On the other hand, a highly valued skill is more likely to be pursued with
steadfast perseverance.


       As skills develop people look at their behavior and compare what they see to
their hopes and expectations. Self- esteem grows out of the capacity to meet one‘s
expectations. It also grows out of rewards earned by performing adopted behaviors.
In the pursuit of a career, social learning helps young students learn from mentors.
People select their environments, they shape their environments, and the
environment partly shapes their behavior. The interaction between the environment
and one‘s values determines which forms of behavior are developed. It is important
therefore, to choose environments wisely so that one‘s behavior is positively shaped
by his or her social context. (Bandura 1976, 1985)


       Social intelligence depends upon the ability to communicate clearly. Clear
communication requires an accurate perception of others as well as the ability to
deliver messages. Our perception of others‘ behavior is influenced by the things to
which we turn our attention. We learn to ignore irrelevant stimuli and focus our
attention on things that are important.   Some people have difficulty filtering out
irrelevant stimuli during social interactions and may infer erroneous meanings behind
these stimuli. Ordinarily, social experiences teach us the significance of others‘
actions. We observe and engage in millions of social interactions and learn what
messages are intended by various behaviors through repetition. People could not
convey messages clearly if we did not share common verbal and nonverbal language.
Socially active people are more adept at appreciating the meaning behind subtle
social cues simply because they have spent more time learning in social situations.
Therefore, you may be able to improve your ability to infer appropriate meaning
behind others‘ behavior by getting yourself into more social situations and by




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comparing your assessments to those of friends or family. You can also learn to
deliver subtle messages with a powerful impact.


       Social intelligence requires human beings to respond to each other with facial
expression, voice, and gesture as tools. In order to achieve social aims, you must be
able to listen and convey clear messages both verbally and nonverbally. Verbal
messages must be straightforward and concise. Good social skill includes looking the
other person squarely in the eye while delivering a clear message that can be easily
understood. We learn patterns of communication from the people in our lives so it
can help to associate with other people who communicate clearly. According to
Donald Clifton, ―People with good communication skills find it easy to put their
thoughts into words. They are good conversationalists and presenters.‖


       Social intelligence requires good memory. We need to remember names and
faces, experiences of previous social situations, and maintain a fund of knowledge
that allows us to connect with others on a number of different topics. It is common
for people to remember faces better than names; but, developing skill at
remembering others‘ names will help social life. Often, people don‘t concentrate
during introductions and fail to remember the other person‘s name. Later, they may
avoid situations where they need to know a person‘s name. By making an effort to
listen carefully for names during introductions, you can avoid this problem. If you
don‘t catch the person‘s name the first time, you can ask them to repeat it. You can
use the person‘s name during the conversation to aid your memory.


       Memory of previous social situations is an automatic, unpracticed, aspect of
memory. Early in development we begin to put together that social situations are
important to our lives and we start to build an understanding of social dynamics
through memory of social encounters. The general fund of knowledge that allows us
to connect with others by discussing a broad array of topics, however, can be
increased with purposeful effort to expand one‘s knowledge base.


       Socially intelligent people have empathy for others. Empathic attunement
enables a person to feel what another person is feeling, but empathy also helps us to
understand others‘ thoughts, wishes, and intentions. Empathy comes from an ability
to place oneself in someone else‘s shoes and imagine how they must think and feel




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with the situation they face. It is the ability to see into the other person. A lack of
empathy in social situations makes a person appear superficial, self-serving, and
cold. Those who lack empathy view others as an object rather than a person, ―it‖
versus ―you.‖ Without an empathic appreciation of others, no consideration can be
made for how others feel. For those without empathy, life is shallow. Some consider
the experience of empathy an experience of the divine. With empathy an
unconditional positive regard develops for others who are accepted without negative
judgment of their basic worth. Empathy is learned during childhood by gaining an
appreciation of how one makes others feel and by witnessing the empathy of others.


Social judgment


       An important aspect of social intelligence is sound social judgment.
Experience with interpersonal interaction helps us develop better judgment in social
situations. Many people learn how to achieve their interpersonal aims and respond
to others in a shrewd manner. Sound judgment in social situations is acquired
through social learning and fostered early on by parental guidance. Errors in
judgment lead to hurt feelings, missed opportunities, estrangement, or even being
singled out as a scapegoat. The emotionally intelligent capacity to manage impulses
and attune to others empathically helps with social judgment.     Good social judgment
also includes etiquette, authenticity and genuineness, responsibility, respect, and
dependability. Sound social judgment leads to mutually beneficial relationships.


       Good social judgment requires that we keep a lid on strong emotions. By
honestly appraising one‘s own behavior, by carefully assessing the reactions of
others, and by stepping back from emotions in order not to get engulfed in emotion,
we can manage our emotions and maintain self-control. Skill at self-regulation helps
us avoid interpersonal conflict and mistakes.


       When we become charged with powerful emotions during conflict, our
behavior may have a tendency to break out of accepted social norms. Socially
intelligent people learn to control their impulses and maintain appropriate boundaries
in behavior. A child must learn that certain behaviors just aren‘t acceptable and
must be avoided. Adult behavior is built upon this foundation. Therefore, successful




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parenting and schooling must include lessons in appropriate social behavior and
impulse control.


       Knowledge about social etiquette is learned at home, at school, and in other
social situations. It is important to know about etiquette so that you do not offend
others. Socially intelligent people maintain appropriate etiquette because
inappropriate behavior turns people off and interferes with efforts to reach goals.
Appropriate etiquette is perceived as mature and classy and helps to avoid
unnecessary negative social tension.


       It has been said that ―honesty is the best policy.‖ An important aspect of
social judgment and social intelligence is a dedication to truth and honesty. Deceit in
social situations often leads to problems later. When someone is caught being
dishonest, respect is lost. If you adhere to a policy of honesty there will be no
difficulty remembering what stories were told and relationships will feel more
authentic. Authentic relationships are characterized by open communication and a
willingness to listen to each participant in the relationship. Authenticity is conveyed
when one‘s behavior is congruent with one‘s espoused value system. It is a process
of allowing people to know your real self as you truly are.


       Some people conceal their thoughts and feelings holding their cards close to
their vest. However, an honest display of emotions will feel more authentic to other
people. You don‘t have to wear your emotions on your sleeve; but, it is helpful to
share your emotional life with others without losing control. Social intelligence
includes authenticity in relationships.


       Good social judgment must include responsibility. Social responsibility
involves one‘s responsibility to society. It includes recognizing the basic human
rights of others, respect for other people, acceptance of individual differences and
cultural diversity, accountability for decisions and actions, and a willingness to
contribute to social and community activities. Morality is an important facet of social
responsibility. The issue of morality raises the questions: how can I have a sense of
individual responsibility and prudent judgment and how can I evaluate my options
and determine which ones are right or good and conversely which ones are wrong or
bad? Those who believe that a moral life is the proper way to live espouse that right




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action promotes human happiness. ―A well-lived life is a happy life.‖ A basic feature
of human life is that in terms of our behavior, we can reflect on our options, evaluate
them, and choose our actions accordingly. We have free will.


       Morals relate to the relationship between an individual‘s action and social
conduct. The goal of social responsibility is to adhere to principles of goodness and
justice. Human beings share certain basic rights which obligate us to treat one
another in certain ways and refrain from treating one another in other unacceptable
ways. We try to determine what is right or wrong according to the consequences of
actions but also according to principles of conduct. Such principles include the
―Golden Rule,‖ to treat others as you would have them treat you; or the principle to
never treat others in a way that you would not want to be treated; or that justice
demands a fair and impartial outlook. Morals are primarily based upon concerns
about harm and fairness.


       According to Lawrence Kohlberg, a person‘s morality develops over the life
span. Early evidence of morality according to Kohlberg can be found in the child who
believes that what feels good or what the child likes is right. Later a child believes
that right or wrong is determined by parental punishment or reward. Next a child
learns the values of family, church or school and lives by those values of right and
wrong. Later in development right action tends to be defined in terms of standards
set by the whole society, such as The United States Constitution; individually, right is
a matter of personal values and opinions. In the highest developmental level, right
is defined by self-chosen ethical principles that adhere to logic, universality and
consistency. Such principles as the ―Golden Rule‖ include reciprocity, equality,
fairness and respect for the dignity of all persons. (Barger 2000)


       Conscience is an important part of the mature mind. Conscience rewards
good behavior and in these instances increases self-esteem. Conscience also
punishes bad behavior with guilt. Feelings of guilt lower self-esteem. Because
conscience reminds a person of responsibility it is constructive and adaptive. Those
who struggle with a guilty conscience can repair self-esteem by learning from
mistakes, by making amends where possible, and by choosing to live more
responsibly. We may turn from sinner toward saint by recognizing that it is our
responsibility to treat each other well, by recognizing that the divine is in everyone.




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       Finally, good social judgment includes dependability. By keeping your word
and shouldering responsibilities, others will learn that they can rely on you. There
may be instances in which you need to break an ill advised promise; but you can
redouble your efforts to use better judgment and keep your word. While errors in
judgment cause us stress, sound social judgment will help to promote our health and
wellbeing.




Social problem solving


       One of the most important aspects of social intelligence is attention to the
relational climate. This involves being alert to cues that signal that there are
problems in relationships and working out any difficulties. Your own feelings are a
good barometer of the quality of relationships. For example, if you feel frustration or
a lack of empathy, this should signal to you that there are problems in the
relationship that need to be addressed. Problems in relationships are often an
outgrowth of past relationships and their conflicts. It is generally accepted that we
can bring the baggage of past relationships into current ones. Skill at social problem
solving will enable us to address the difficulties we may bring to the table as well as
the problems arising from the other person in a relationship. The following section
will address common relationship problems including resistance or defensiveness,
interpersonal conflicts, holding expectation of others too high, handling others‘
anger, criticism or rigidity, power struggles, having to choose between two people,
boundaries in relationships, and assertiveness.


       The reluctance of another person to participate in a social encounter can be
approached with warmth and self-disclosure. If you can pinpoint a specific reason
for the other person‘s resistance or defensiveness the underlying cause can be
addressed directly. Disagreements between people can best be negotiated with
active listening and direct communication. Active listening means that you restate
the other person‘s point in order to make sure that everything is understood clearly.
Direct communication means addressing differences in a calm and appropriate
manner without avoiding points of disagreement. This prevents a person from
sweeping problems under the rug only to find that they resurface later. It is




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important to respect one another‘s differences and minimize frustration by not
allowing your expectations of others to get too high.


       Another important social skill is the ability to defuse others‘ anger. Anger can
be dealt with by hearing the angry person out before you respond, by taking
responsibility for yourself, and by keeping a lid on your own emotions so that you
don‘t feed into the emotional tension. If you feel yourself starting to escalate along
with the other person, it might be better to walk away in order to prevent emotion
driven mistakes. You can revisit the issue after you have both calmed down.


       Social intelligence also means being able to deal with criticism. It is
important not to take criticism personally. When another person‘s criticism of you is
well founded and constructive it can be the catalyst that helps bring about growth.
We must learn to welcome others‘ feedback so that we can address our weaknesses.
When criticizing someone else, your comments are more likely to be heard if you
balance the negative feedback with some praise for what is good. You may
encounter other people who are rigid in their ways despite a pattern of problems.
Sometimes you can destabilize others‘ rigidity by helping them see a better way in
someone who they admire. Just pointing out the negative aspects of someone‘s rigid
pattern will often fail to break the cycle.


       Another aspect of social intelligence is the ability to avoid power struggles.
Power struggles arise when people compete for a position of greater influence. It
has been said that ―knowledge is power,‖ but if you refuse to allow others to
influence you they will be less likely to follow your suggestions. If you can create an
exchange of power where you allow other people to influence you while also
influencing them, you will avoid power struggles. In situations of triangulation where
you are being forced to choose between two people, it may require particular social
skill to sidestep the situation.


       In some social situations, other people may try to overstep boundaries in
acceptable behavior. An important part of social intelligence is the capacity to stop
others from violating your boundaries by ―setting limits‖ on their behavior. When
someone makes an undesired sexual overture you must be able to say ―no.‖ If
someone tries to get you to do work for them that you do not wish to do, you must




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be able to say ―no.‖ If someone demands constant attention when you have
important competing demands, you must be able to set limits and tell them to wait
until another time. If someone violates your privacy, you must be able to get them
to leave. Skill at setting limits is a component of assertiveness and it will help you to
protect your self- esteem and also help you to meet your own important needs.


        Self-assertion is the act of standing up for oneself. Everyone should insist on
being treated fairly and stand up for their rights. If you can learn to avoid getting
stepped on you protect yourself from unwanted stress and negative emotion.
Assertive people are not aggressive. Aggressive people cause others pain by
violating rights or by disrespecting other people while those who assert themselves
tactfully and effectively get their needs met and express their feelings and
preferences without hurting other people. By standing up for yourself, you protect
yourself from others‘ aggressive behavior. Some unassertive people may want to
―be nice‖ or ―not cause trouble‖ when their rights are violated.


   Several kinds of behavior are associated with self-assertion:
   1. To speak up, make requests, ask for favors and insist that your rights be
        respected as a significant, equal human being
   2. To express negative emotions and to refuse requests
   3. To show positive emotions and accept compliments appropriately
   4. To ask why and question authority or tradition
   5. To initiate, carry on, change and terminate conversations comfortably. Share
        your feelings, opinions and experiences with others.
   6. To deal with minor irritations before things escalate.


(Schimmel 1976)


        Assertiveness is healthy for everyone. It prevents feelings of personal
powerlessness and results in a sense of empowerment. (Kilkus 1993) Research has
shown that improved self-assertion may help patients with eating disorders and
sexual disorders, and is often correlated with the success of psychotherapy in
general. (Carter 2003, Schwartz 1983, Payk 1987, Crowe 2005) It has been shown
that assertiveness training fosters greater self-esteem as well as assertiveness. (Lin,
2004)




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       Evidence that you lack self-assertion includes: loss of self-respect because
you are dominated by others, you conceal your true feelings, your feelings of
submissiveness make it difficult to feel loving, or you may make use of passive-
aggressive subtle manipulations since it is hard for you to be direct in your
interactions with others. It is possible to change your behavior so that you protect
your rights more carefully. You can explain your view of situations to others
involved in a tactful way so that your feelings are heard and your needs are met.
You can ease into a pattern of greater self-assertion by making small changes first
with less stressful situations. Then, with an accrued confidence, you can begin to
tackle bigger problem areas. (mentalhelp.net 2005) Making an effort to stand up
for yourself appears to help promote optimal mental health. You may also teach
your children to assert themselves at school and at home without becoming
aggressive or inappropriate in their behavior.


Influence


       Having social intelligence means that you can readily influence others. This
means that you can steer social situations toward what you want, that you can get
others to cooperate with you, that you can lead others, that you can empower
others, and that you can promote loyalty and teamwork. We learn to steer social
situations by example from others and our own personal experience. Skills in
persuasion can allow you to change other people‘s minds and get desired outcomes
in social situations. Most importantly, others must cooperate with you. The first
step in this process is to cooperate with others. If you work well with other people
when they direct the action it is much more likely that they will reciprocate when you
wish to direct them. If you want others to cooperate with you, you must share
common goals. You must communicate your ideas clearly. Other factors such as a
willingness to listen fully to other people, making use of proper etiquette, and being
open to differences of opinion will help in getting people to cooperate with you.


       People are brought together by a common cause. Behavior in groups and
teamwork are built upon the foundation of childhood experiences of family life.
Successful groups are comprised of loyal members who devote themselves to the
cause of the group and protect their membership. Functioning together as a group




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requires teamwork. Teamwork involves organization and cooperation so that tasks
can be completed successfully. In a functioning team, roles are divided among its
members so that the work can be completed without redundancy of effort. Teams
require leadership where leaders define the roles and responsibilities of team
members. The team must share the vision of the team leader. Larger groups
include the membership of a country, where citizenship grants the individual member
protection, but also certain roles and obligations to the country. Social intelligence
includes successful team membership with a spirit of cooperation and loyalty to the
groups to which one belongs.


       Social intelligence also includes the ability to lead others. Henry Kissinger,
secretary of state, once said, ―If you don‘t know where you are headed, any road will
take you there.‖ Leaders must have a vision, in its absence there is no purpose to
leadership. They must be inspired by their view of what could be. With a view of
the future, a leader can rally support in order to realize the envisioned goals.
Leaders must also be motivators who inspire group members to overcome obstacles
in the pursuit of aims. This motivation can arise in response to a clear discrepancy
between how things are at present and how the group would like things to be; but
also, group members must believe that they can in fact accomplish the desired aims
in order for there to be sufficient motivation to do the work required to reach goals.
A sense that goals are possible to reach comes from a track record reaching previous
goals, having witnessed others accomplish similar goals or sometimes merely with
convincing verbal persuasion.


       Leaders must delegate responsibilities to members of their group in order for
the team to function efficiently. Successful leadership must include a consistent
respect for group members, effective communication that allows the leader to
convey clear and memorable messages and organizational skills that help to divide
the work into sensible responsibilities for the membership. Effective leaders often
have inspirational ability, decisiveness, ability to manage conflict effectively,
administrative skills, and integrity. In times of crises, good leaders can command
with presence and take control of a situation. As we together face an enormous
number of problems in life, leaders naturally come to the forefront to help join our
efforts to solve the problems at work, at home and in our communities.




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       Empowering others means sharing your power, passing on your positive
energy and positive attitude. It means motivating and inspiring others, and building
a sense of personal power and self-efficacy in others. It involves helping others
achieve their goals, encouraging them to be their best, to reach their full potential.
It means recognizing and cultivating others‘ potential. When you empower others
you look for ways to build their self-esteem, build confidence, and make them feel
important, valuable and worthwhile. You can strengthen others beliefs in their own
abilities and help them become successful and feel stronger. Empowering others
means encouraging growth, bringing out people‘s best, and helping them develop a
dedication to improvement and the work to be done.       It means giving others
support to help create opportunities for them to exercise their own power. According
to Brian Tracy, empowering others also means that you avoid doing things that
disempower them by robbing them of their energy and enthusiasm. You can
challenge others, collaborate with them, nurture talent and express appreciation.


       Authority is the legitimate right to exercise power. Subject matter experts in
a given field exercise the authority to make decisions, give advice or express
opinions. In order to speak with a voice of authority you must be competent,
believable, clear, consistent and correct. Authority and wisdom is tested in life‘s
laboratory and preeminent or undisputed authority depends upon an exceptional
track record.


       We influence the next generation through our interactions with them.
Generativity involves caring for and guiding the next generation. True generativity
has as its goal enrichment of the lives of others; it involves a direct concern for the
welfare of others and an absence of self-interest. Generativity can mean serving as
a consultant, guide, mentor, or coach to young adults in the larger community. It
means to be part of a caring relationship; good mentors learn to hold loosely and
share responsibility. With generativity a person can foster growth of the next
generation. According to Erik Erikson, generativity is an important part of
psychological development typically occurring between ages 40-60. This passing of
the baton to the next generation appears to promote good mental health.


       Over generations, the meaning of life for groups of people can be found in the
established traditions. Customs, rituals, beliefs and folklore can be passed into the




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future by successive generations in order to share wisdom and keep the meaning of
life for these groups of people in society. In the traditions of groups is the wisdom
passed along from generation to generation. Social intelligence includes the passing
on of the wisdom learned by one‘s ancestors before them. Some traditions,
however, need to be challenged as successive generations of people change with
advances in technology and understanding of the world.


Respect and status


        Earning respect and status are additional components of social intelligence.
Respect is the feeling of esteem for another person.    Respect has to be earned or
deserved. You may be regarded positively for certain qualities you possess. Respect
can be applied to someone who has done something well. Someone can earn
respect by adhering to moral and ethical principles despite pressure from others.
Being dependable and trustworthy also helps to build respect. Displaying self-
confidence, being polite and remembering what others have said will help earn
respect. Contempt is the opposite of respect. Rude conduct usually indicates that
there is disrespect, while actions that honor another indicate respect. In many
societies, children are expected to be respectful of their parents, or people in general
respectful of elders. In the military, subordinates must respect their superiors in
rank.   Many countries expect citizens to be patriotic and show respect to their
nation. Earning respect from others evokes happiness and wellbeing.


        Status, or the rank, honor, or prestige of a person within a group or society,
may be based upon achievements or inherited at birth. Status indicates one‘s
degree of relative worth to others. Status can be achieved with knowledge, ability or
perseverance. It is based upon one‘s individual merits or accomplishments. Society
judges success, whether occupational, financial, academic, political or other aspect of
achievement. In many societies, occupation is considered the major determinant of
status, but other social roles within groups may indicate status.    Socioeconomic
status is based upon income, education and occupational prestige. With status come
certain rights, duties and particular lifestyles of the social hierarchy. It has been
shown that people who achieve high social status will show confidence, intelligence,
mental and emotional stability, generosity and happiness. (Wikipidea.com, 2010)




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Social comfort


       When social interaction works at its best, a felt connection develops where
participants feel heard and understood and come out of the interaction lifted
emotionally. These optimal social connections are formed by establishing good
rapport. Good rapport is established through emotional involvement,
complementary transaction of behavior and personalities, attentive listening,
responsiveness, respect, warmth and mutual liking, and a sense of support or
collaboration. In order for two people to establish good rapport, they have to get in
synch. With a flexible relational style that can accommodate to others, participants
in a relationship can interact beneath the words at the nonverbal level in a
coordinated and harmonious dance. In this dance there is coordination of pace,
timing, rhythm, and body movement. Getting in synch at this level establishes
comfort and rapport even when spoken discussion points create tension. Good
rapport also comes when people get on the same wavelength by sharing the same
attitudes, perspectives or understandings. Rapport is built between people where
there is active participation and low distrust or hostility. A good rapport between
people involves a climate of trust and safety.   Non-possessive warmth and caring
helps to create such a favorable climate. With good rapport, a connection feels
pleasant, engaged and smooth. Some people love the challenge of meeting new
people and winning them over with rapport.


       We are able to find rapport with others as an outgrowth of experiences being
well loved and developing a sense of security. Often, children experience a secure
base at home when their parents are responsive, understanding, respectful, and act
with empathy. These children learn that they can count on their parents when they
are upset and need love and comfort. Other parents who are anxious, abusive or
avoidant don‘t provide their children needed emotional nourishment and these kids
can grow up having difficulty with social connections. Fortunately, those who were
deprived of a secure base by their parents can find reparative relationships as
children or adults where a surrogate secure relationship builds their capacity for
connection. We need a secure base with rapport and trust that provides a supportive




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emotional atmosphere from which we gain our capacity to connect securely with
others. (Goleman 2006)


       It is easier to initiate and maintain social interaction with another person if
you have a sense of comfort in social situations. Comfort can be found in common
ground or shared interests to discuss. Ideally, you can share your views and
interests and listen to the views and interests of others. The exchange of ideas
requires a sense of balance so that you do not dominate the conversation or fail to
listen to the other person. Some people become riddled with anxiety in social
situations because of the appearance or status of another person. This problem
stems from low ego strength or lack of self-love. When a person genuinely loves
himself or herself, it is easier to engage in social interactions with comfort. While
self-esteem comes with success, self-love is your birthright.


       The degree of social comfort a person experiences is also related to
appearance. By choosing attire that is appropriate to each situation, you will be
received more warmly and more likely get across a good impression. Caring for your
appearance is an important ingredient of social comfort.


       Social comfort also includes openness to new people and ideas. In order to
relate freely to new and different people, one must be open to new experiences.
Different people have different ideas and values which may challenge you to examine
your own thinking. It is difficult to develop meaningful relationships with new people
if you cannot accept people for their differences. This is only possible by maintaining
an open attitude to that which is new. New and different people should be treated
with respect for their differences as long as no one is getting hurt. Furthermore,
socially intelligent people are able to solve problems posed by new people and new
ideas. When someone confronts you about your opinions or beliefs you must be able
to tactfully discuss your differences so that both of you learn about the basis of each
other‘s opinions. With openness to others, we can live in harmony with one another.
By strengthening the bonds of affection between ourselves and others, we can live
together in harmony, peace and mutual trust.


       With social comfort it is easier for a person to present themselves with
confidence and poise. The way a person carries themselves says a lot about them.




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The attitude about yourself that you project to other people has a tremendous
impact on others‘ assumptions about you as a person. If you feel a sense of self-
worth and self-respect, other people will pick up on your assuredness and candor.
You will find that people treat you differently if you project a sense of confidence to
them in your interactions.


         With a secure base and a wealth of experience in social settings a person can
develop a sense of social ease. Conversation comes easily and social problems are
handled smoothly. An accrued confidence in one‘s social effectiveness develops.
With every successful social encounter, you develop greater self-efficacy with a
sense that you can accomplish what you hope to in new social situations. This sense
of social effectiveness brings comfort and feelings of wellbeing. It builds self-esteem
and better quality of life. With social comfort and affection for others we can live in
harmony with one another.




Intimate relationships


         According to Abraham Maslow, a basic need for humans in general is the
social capacity to love others and be loved. This need, according to Maslow, is
second only to physiologic needs such as food and water and safety needs such as
shelter, protection and security. Early in development, an infant learns about
interpersonal love in his or her relationship with parents or primary care givers. Adult
love is built on the foundation of loving relationships in childhood.


         Love stems from one person caring for another. A person‘s lovability stems
from characteristics such as kindness, optimism, appearance, strong character and
sense of humor. During development, the capacity to love matures so that children
not only seek to meet their own needs for love but also to meet the needs of others.
Love is very important to us all. It has been said that ―learning to love is learning to
live.‖


         Interpersonal love generally involves the emotion of intense attraction to
another person and may also include caring for the other person as well as
identifying with them. A person may have love for the soul or mind of another




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person or simply love another person‘s body. With interpersonal love comes
intimacy in which secrets are shared and emotional risks are taken. To love another
and to be loved is to find an unconscious fit with another person. Some consider
love a spiritual experience in which there is recognition of a soul that completes
one‘s own soul, or that complements it. According to Erich Fromm, the presence of
love is evident by ―the depth of the relationship, and the aliveness and strength in
each person concerned.‖ (Fromm, 1956) The quality of intimacy can be great; it
can have poetry and a godliness to it.


       Interpersonal love can be divided into several types. Erotic love is affection
based upon sexual desires. ―Philia‖ or brotherly love is affectionate regard or
friendliness that takes place between one‘s friends, family members, or work
relationships. ―Agape‖ love is love without condition; it means to love someone
simply for the sake of loving them. In the Bible, agape love is described as follows:
long suffering, patience, kindness, not envious, not jealous, not vain or boastful, not
condescending, not conceited or arrogant, not inflated with pride, not rude, does not
act unbecomingly, does not insist on its own rights or its own way, not self-seeking,
not irritating or resentful, forgiving, does not rejoice at injustice and
unrighteousness, but rejoices when right and truth prevail, bears all things, believes
the best of every person, its hopes are fadeless under all circumstances and it
endures everything without weakening, it never fails. (1 Corinthians 13: 1-8) It is
easy to love family, friends, those who admire us, or those who help us but do we
love strangers, those who bear ill will toward us, those who condemn us or speak
poorly of us?


       Socially intelligent people possess skill at developing and maintaining close
relationships with others. Closeness comes with being interested in one another,
respecting one another and doing things to make one another happy. For some
people, it can be difficult to maintain intimacy in the midst of the trials and
tribulations of life. These challenging times require an optimistic atmosphere in
family relationships or those of friends. Separate roles for each person must be
developed. Healthy committed relationships involve mutual respect and an interest
in the growth of the other person. Hearts can harden when people are injured in
loving relationships. You cannot lose that part of you that believes in love. One has
to have courage, choose wisely and take risks so that they can open their hearts to




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other people after they have been hurt. Loving relationships require personal
sacrifice and an attitude of forgiveness when others cause pain. We must trust and
do positive things for others in order for our relationships to flourish.


       In young adults romance and erotic love grows out of sexual maturity and
urges for reproduction that are instinctive. The desire for emotional involvement in
the context of a sexual relationship leads to a merging of goals between partners.
Couples begin to look toward the future together with urges for children and
mutually beneficial career ambitions. For most individuals, the experience of
intimacy leads to the desire for marriage and commitment. According to Robert
Sternberg, the most durable and satisfying relationships include passion (physical
attraction and romantic drives), intimacy (feeling close and connected), and
commitment.


       Romance is a pleasurable feeling of excitement, wonder and bliss that comes
with deep desires to connect with another person. There is a soulful connection, a
force of romantic attraction: ―I give my love to her as she does to me. I was made
for her and she for me.‖ We may look for romantic partners who share interests and
tastes but also complement or complete us.       Romance offers us adventure and
intense emotions; emotional closeness and romance coexist. We think of intimacy in
terms of friendship, deep connection, and long lasting sharing while romance draws
us to find the perfect mate with powerful affinity, appreciation and love. Some have
estimated that romantic love typically lasts for about one year while some couples
keep romantic feelings alive much longer. Within an established relationship,
romantic love thrives by optimizing intimacy with freedom, security, and
opportunities for growth and self- realization. An immature person in an intimate
relationship is more likely to overestimate love and romance, become disillusioned,
and split up or have an affair; while a mature partner is more likely to see the
relationship more realistically and act constructively to correct problems and build a
healthy romance that lasts a lifetime.


       According to Mark Epstein, ―The ego seeks to unburden itself through its love
relations, freeing itself from inner tensions and inhibitions by ―making use‖ of
another person in sex or love. When there is no unburdening and no rhythm of
tension and relaxation, there can be no freedom to bond, no surrender of ego




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boundaries, and no merging of the kind that characterizes all forms of love‖ With
this unburdening the person in relationship is more available to emotional, and
especially sexual, experience. (Epstein 1995)


       The capacity to maintain loving relationships in marriage is correlated with
mental health. In a study conducted at Harvard, there was probably no single
longitudinal variable that predicted a man‘s mental health as clearly as his capacity
to remain happily married over time. How a man described his marriage over the
years predicted his career success, the relative maturity of his defenses, and his own
perception of his happiness. Research studies over long periods of time have shown
that no single variable predicts mental health in adulthood as clearly as the gift to
remain happily married over time. (Vaillant 2005)


       Healthy marriages have common characteristics. A soothing steady warmth
exists in the relationship with a strong bond that creates feelings of comfort and
peace. Each partner knows the other‘s idiosyncrasies. Each partner likes more of
the other‘s traits than he or she dislikes. Each partner feels concern for the
happiness and growth of the other person. Each partner demonstrates love of the
other person by behaving in ways that promote the happiness and growth of the
other person. Each partner can communicate effectively and fully disclose himself or
herself to the other person. Each partner imposes feasible demands and
expectations on the other person and each partner respects the autonomy and
individuality of the other person. Today in the United States, the divorce rate has
surpassed 50% of all marriages. Despite the frequency of problems with marriage,
many couples continue to maintain long happy, healthy, and flourishing marriages.


   John Gottman in his book The Seven Principles of Making Marriage Work,
discussed his findings after conducting years of research on marriage. He found that
happily married couples can have loud arguments; but, happy couples make use of
―repair attempts‖ that help prevent the escalation of negativity during
disagreements. He found that you don‘t have to resolve your marital conflicts for
your marriage to thrive; but, you have to be open to considering your partners
opinions and positions. Happier couples don‘t blame when they complain. They
don‘t store things up and they can be clear, polite and appreciative. They are also
able to put on the brakes when discussing problems with their partner. They can




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accept apologies and they are able to say that they are wrong. They are able to
maintain a sense of humor and listen to their partner. They are able to be
affectionate even when they are disagreeing.    They are tolerant of each other‘s
imperfections and faults and compromise with each other. They develop a sense of
solidarity and side with each other when conflicts arise with outsiders.


   According to Gottman, successful couples in marriage are familiar with each
other‘s worlds and what makes their spouse tick. This includes knowledge of their
spouse‘s everyday life, hopes, fears and dreams. Gottman found that couples who
put a positive spin on the marriage‘s history are likely to be happier down the road.
Happier couples stay emotionally engaged and keep each other informed about what
they are doing and how the day went. They make decisions together and yield to
their partner‘s wishes at times. They work as a team on financial issues and plan
together for their financial future. They create a sense of fairness and teamwork
concerning housework.


   Gottman also found that the quality of a couple‘s friendship is the determining
factor in their satisfaction with romance, sex and passion. Happy couples realize
that one of the goals of marriage is to help their partner realize his or her dreams.
Happier marriages have a spiritual dimension with a culture rich with symbols and
rituals that enable couples to understand what it means to be a part of the family
they have become. (Gottman 1999) According to Gottman, with an emotional
attunement through trust, respect, connection, and affection, relationships can be
enduring and resilient despite the inevitable struggles.   One of the strongest
predictive factors in maintaining long happy, flourishing marriages is an investment
in finding ways to increase your spouse‘s happiness, to enjoy time together, and
strengthen the intimacy between the two of you.


   Family relationships are also important determinants of the quality of our lives.
The ties of family relationships are held together by a joined effort to support family
members‘ growth and success. Growing up together, brothers and sisters often
share similar interests which help build bonds. Merely spending the formative years
of development together- eating meals together, watching television together,
enjoying holidays, enduring family problems, and playing together- helps to forge a
special tie with a sibling. Siblings have to overcome rivalries for parental attention




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and love in order to maintain a healthy connection. Parents play a critical role in
family relationships. The quality of parents‘ relationships with their children figures
prominently in development and later health and quality of life of children. More will
be said about effective parenting in a following section.


   The bonds of friendship are different from family relationships in that we choose
our friends. Friendships develop when we connect with like-minded people who
share interests, viewpoints or problems we have. Friendships grow out of warmth
and conversation. When you offer love, acceptance, kindness, respect and
encouragement you foster good friendship. Friendship often includes giving and
reciprocity. These relationships grow deeper with self-disclosure. When you feel
safe with another person and trust you can let your guard down, become vulnerable
and express yourself fully. Being in the company of good friends means that you can
let go and be yourself, share secrets, laugh and cry and get support. You may have
friends with whom you have instant rapport; for example, even if you haven‘t seen a
friend in years, you pick up right where you left off. In order to maintain long-term
friendships disappointments and disagreements will have to be overcome.
Friendships can be very rewarding, rich and satisfying, and they typically offer
emotional support which also promotes good health.      Some people may either have
insufficient relationships or poor quality relationships which cause them psychic pain.
People feel lonely when the friendship they crave is not available to them. Yet, even
healthy friendships have uncomfortable moments of tension or conflict.      Those who
maintain rich and satisfying friendships do so with good social skills. With friendship
you have someone to spend time with and do things with, you get support when you
need it, you feel wanted, included and cared for, and you have a place to confide
your problems and secrets. You can initiate friendship by doing things for other
people and then see if they reciprocate. You can share some intimate things slowly
and see if they do so also. Good friendship, rich and satisfying relationships, have to
have give and take.


   According to Sreelata Yellamrazu, ―the whole concept of friendship involves the
acceptance of another individual - for their imperfections, their mysteries and their
flaws, and helping shape one another's lives.‖ Friendship falls into place with an
unconscious fit like the pieces of a puzzle. Sreelata advises to ―Choose friends
wisely. The pleasure of the journey called life banks significantly on the company we




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keep and take along the road.‖ (Yellamrazu 2006) Friendship can bring about
greater happiness, offer support with life‘s burdens, and prolong your lifespan. We
can cultivate meaningful friendship by seizing opportunities for friendship, nourishing
those relationships we have, turning away from toxic relationships, and trusting our
natural instincts.




Social appeal, presence and colorful personality


       Those with social intelligence recognize the value of personal appearance. It
is essential to take some pride in how you look. Don‘t underestimate the power of
your appearance on your psyche, it is a boost to look in the mirror and feel that you
look your best. Barbers, beauticians, manicurists and cosmetologists make their
living meeting our needs for social appeal through appearance.       We live in a society
where people are assessed based upon the way that they look and social norms of
acceptability often dictate what we wear or our hair style. Women may use
cosmetics: prudent use of eye shadows, blushers, and lipsticks can go a long way.
Some prefer to go ―au natural‖ and that can also be quite attractive.


       According to Mark Twain, ―clothes make the man. Naked people have little or
no influence on society.‖ Your clothing makes up the majority of your physical
appearance. You don‘t want to seem out of place. People will size you up by your
appearance in the first few seconds of meeting them. They are going to form their
first impressions of you based on how you look.      We try to make sense out of what
our eyes show us and tend to categorize people based upon how they look. You
want to be sure you are sending the message you want. Many people in society tend
to dress down, but if you make an effort to improve your appearance it will
transform your state of mind and the way you are perceived. When you see
someone else who has made an effort to enhance their appearance it evokes
appreciation and respect. In the military, sharp dress and appearance help to create
self discipline and attention to detail.   Some garments signify authority in one‘s field
such as the policeman‘s uniform or the doctor‘s white coat. Colors and patterns can
accentuate our natural tones, grab attention and affect emotions. It is important to
recognize which ones work for you and which ones don‘t.        When clothes work well
for someone they add to his or her presence and personality. It pays to understand



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the importance of your clothing and grooming and your overall personal appearance.
(Centeno, 2008)


       For those who achieve the highest degrees of social intelligence, exceptional
social health is related to the capacity to form a colorful personality that has great
appeal to others. Social appeal is the power or ability to attract others, amuse,
stimulate or arouse others interest. It is the art of being ―cool,‖ of creating beauty.
Cool is the beauty of attitude, behavior, comportment, appearance, style and the
taste of a particular culture and time. Sometimes being cool is associated with
composure and poise, a general state of wellbeing, a transcendent, internal peace
and serenity, an absence of conflict, a state of harmony and balance, or being
detached, mentally calm, or laid back.    Cool can mean impressive or intriguing. To
be cool is to be approved of or admired. What is considered cool changes over time
and varies among cultures and generations.


       The interpersonal presence of a person includes his or her bearing, carriage or
air. Presence implies a distinguished bearing or poise, self-assurance and easy
manner. Someone with presence may have a compelling personality and command
respect. Presence comes with effective use of the body, the voice and the spirit.
The union of presence and relaxation bring about a simple, solid air or spirit. In the
heights of confidence a person acts cocksure or may conduct themselves or walk
with a swagger.


       A person‘s personality is composed of traits or distinguishing characteristics
that persist over time. These traits are deeply ingrained patterns of thinking and
behaving. People with colorful personalities possess a rich variety of desirable traits
that lead others to seek them out because of their positive qualities and imitate
them. Colorful traits include being interesting, warm, unusual, funny, playful,
shrewd or wise, lively, gregarious, sexy, charming or charismatic. It is the beauty of
colorful traits that creates their appeal. You can become more interesting to others
by bringing fresh ideas and viewpoints to conversation. Also, talking with interesting
language helps to hold others‘ attention. Having unusual ideas or style will appear
colorful to others. Finding funny ways to amuse others and provoke laughter also
gives personality more color. If you can be full of fun and high spirits and celebrate
life, people will be drawn to your playful character.   A person is considered shrewd




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when he or she possesses a keen awareness, sharp intelligence and practicality. A
lively spirit that is full of life and energy can be infectious. A gregarious personality
tends to seek and enjoy the company of others.


       Sexiness can create strong interest, excitement or appeal. Some people
radiate sexuality and arouse sexual desire or interest. They may appear glamorous
or physically attractive but sex appeal may be strongly influenced by factors like
smell, facial symmetry, vocal pitch, financial stability and kissing prowess. You can
invest in items that make you look and feel sexy, clothes that enhance your best
attributes, wearing an attractive scent. You can give extra attention to your hair,
nails and skin and do whatever makes you feel desirable, or even irresistible, or
whatever lifts you up emotionally.


       To be charming is to delight or please others, to fascinate, to captivate,
entrance, enrapture, or allure others toward oneself. Some people develop personal
polish and smoothness. Charisma is a rare trait that includes extreme charm, strong
personal magnetism or appeal, considerable persuasiveness and exceptional
communication skill. Charismatic people generally project unusual calmness,
confidence, assertiveness, dominance, authenticity, and focus. (Wikipidia.com,
2006) The makeup of our personality is strongly influenced by role models. If you
can find role models with social appeal, presence, and attractive colorful
personalities, you will more likely develop appeal, presence, and a colorful
personality yourself. A person with a colorful personality appears radiant to others
and he or she lives life gloriously. He or she may light up the room. Some people
believe that the supreme all attractive personality is that of God, that He can be
worshipped by everyone. May we share a spark of His attractiveness and social
appeal.


       People with exceptional social intelligence achieve great social appeal,
presence, and colorful personalities. Others may merely enjoy the benefits of
rapport and social ease, form strong intimate bonds, marry and raise a healthy
family. Developing social intelligence is not only personally satisfying but also
appears to promote optimal mental health and functioning.




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Storytelling


       At age 12 or 13, I played summer baseball in my hometown. One day during
batting practice I was out in center field working on my defensive skills. Coach Rigo
was pitching and my teammates took turns at bat, others out in the field. I noticed
a younger kid maybe 10 riding his bicycle along the road that passed the field about
40 or 50 yards from pitcher‘s mound. Then suddenly, a car with some teenagers in
it came rushing down the road honking the horn. The car was headed right for the
kid on his bike. We all watched in disbelief. The kid swerved off the road and the
car screamed past. The kid got his bike back on the road but the car came back at
him from the other direction at a rapid pace. Coach Rigo threw a ball at the
speeding vehicle. Surprisingly the ball didn‘t hit the car, it went through the open
passenger window, past the passenger, and hit the driver in the side of the face. He
swerved off the road, stopped the car and climbed out screaming in pain from his
injury. It was a miraculous pitch, truly an extreme achievement. For me after
witnessing that event anything was possible.


       A story or narrative is a causally linked set of events that is told in
conversation, written word, visual media, dance, music or art. We make sense of
our own past and others behavior with narrative descriptions. We also use stories to
imagine outcomes of situations and inform our decisions. We are impelled to tell
stories as we find meaning in experiences. We tell stories about stressful or
emotional experiences, fact or fiction. Narratives produce insight.     We build
resilience by learning from stories. Recounting stories of stressful events reduces
anxiety, protects immune function, and results in more positive emotions. It may be
possible to recount life‘s stories and create a positive perspective even on largely
negative events.




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Touch




        Touch is not a well studied aspect of social life. Touch is a basic language of
trust and emotional connection. It is the first form of communication between
parent and infant. The experience of touch is rewarding and pleasurable. It builds
trust and reciprocity. It is soothing and signals safety. Non-human primates spend
twenty percent of their time grooming each other. Infants deprived of human touch
fail to thrive; if they aren‘t handled despite adequate nutrition and absence of
disease, they will die.   The benefits of therapeutic massage are well known.
Massage not only relaxes you, it can ease depression and anxiety, increase attention,
enhance performance, decrease levels of stress hormones, decrease pain, enhance
immune function and enhance the growth of premature infants. While more
research is needed, including human touch in one‘s life may help in achieving optimal
mental health.




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The Health Benefits of Sex


        Most people are well informed about the problems, risks and dangers
associated with sex but few people are well informed about the health benefits of
sex. Today we are saturated with negative information about sexuality including
sexually transmitted diseases, dysfunction, addictions, pedophilia, unwanted
pregnancy, abuse, infidelity, and the struggles of sexual minorities for their civil
rights. Yet, research suggests that healthy sex and responsible sex, including
autoeroticism, may benefit physical health, mental health, social life, and spiritual
life.


        The benefits of sex to physical health for both men and women include
increased longevity of life and improved cardiovascular function, fewer colds and flu,
weight control and staying in shape, better pain relief, better sleep and research
shows that regular sex helps maintain a youthful appearance. For women, regular
sex results in more regular menstrual cycles, improved fertility, lighter periods and
better hormone balance. For men, regular sex improves prostate function and
improves hormone balance.


        Benefits to mental health of regular sex include reduced stress, better moods,
higher self esteem, and better quality of life. Sex increases feelings of affection and
intimacy and sexual satisfaction is associated with the stability of relationships.
Passionate sex can be maintained for a lifetime in a flourishing, committed
relationship. Finally, people who associate sexual experiences with spirituality
(soulful sex) have reported better relationships and greater quality of life.


        People are typically well informed about negative factors associated with sex,
but healthy and responsible sex contributes to better physical and mental health. It
is important therefore not to allow the public‘s voice about sex to cast a shadow on
the benefits of a healthy sex life. (Plannedparenthood.org, 2007)




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Providing Effective Parenting




       80% of all Americans become parents according to The Parenting Project.
(www.preparetomorrowsparents.org, 2006) What is learned during the formative
years of childhood and adolescence can have a tremendous impact upon adult health
as well as health during childhood. Parents and other caregivers are responsible for
children‘s safety and emotional wellbeing. Hopefully, parents and other caregivers
have a gleam in their eyes for their children as they love and care for them.
Parenting styles vary and there is no single right way to raise a child; however, skills
at parenting can play an important part in the health of children far into adulthood.
The development of good parenting skills also supports the emotional health of
parents as problems with children can be minimized and family life gains quality.
The following section provides advice for effective parenting including methods of
preventing common problems encountered by youth.


The following tips for parents come from The Substance Abuse and Mental Health
Services Administration (www.mentalhealth.samhsa.gov, 2006):




      Do your best to provide a safe home and community for your child, as well as
       nutritious meals, regular health check-ups, immunizations, and exercise.


      Be aware of stages in child development so you don‘t expect too much or too
       little from your child.


      Encourage your child to express his or her feelings; respect those feelings. Let
       your child know that everyone experiences pain, fear, anger, and anxiety.


      Try to learn the source of these feelings. Help your child express anger
       positively, without resorting to violence.


      Promote mutual respect and trust. Keep your voice level down—even when
       you don‘t agree. Keep communication channels open.


      Listen to your child. Use words and examples your child can understand.
       Encourage questions.



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   Provide comfort and assurance. Be honest. Focus on the positives. Express
    your willingness to talk about any subject.


   Look at your own problem-solving and coping skills. Do you turn to alcohol or
    drugs? Are you setting a good example? Seek help if you are overwhelmed by
    your child‘s feelings or behaviors or if you are unable to control your own
    frustration or anger.


   Encourage your child‘s talents and accept limitations.


   Set goals based on the child‘s abilities and interests—not someone else‘s
    expectations. Celebrate accomplishments. Don‘t compare your child‘s abilities
    to those of other children; appreciate the uniqueness of your child. Spend
    time regularly with your child.


   Foster your child‘s independence and self-worth.


   Help your child deal with life‘s ups and downs. Show confidence in your child‘s
    ability to handle problems and tackle new experiences.


   Discipline constructively, fairly, and consistently. (Discipline is a form of
    teaching, not physical punishment.) All children and families are different;
    learn what is effective for your child. Show approval for positive behaviors.
    Help your child learn from his or her mistakes.


   Love unconditionally. Teach the value of apologies, cooperation, patience,
    forgiveness, and consideration for others. Do not expect to be perfect;
    parenting is a difficult job. Many good books are available in libraries or at
    bookstores on child development, constructive problem-solving, discipline
    styles, and other parenting skills.


    It is important for parents to build their children‘s self-esteem. Parents can
nurture their child‘s self esteem by supporting his or her independence and by
praising accomplishments. Parents help to support their child‘s self-esteem by
consistently offering love, hugs and compliments. Children should learn that
everyone makes mistakes so that they don‘t place unreasonable expectations
upon themselves. It is important to avoid statements, criticisms, or comparisons
with other children that belittle a child and injure self-esteem. Parents can help



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their children with negative peer pressure by building their self-esteem, by
teaching refusal skills, and by advising their kids to avoid other kids who break
the rules.


    When disciplining a child, the goal is to teach the child self-control rather than
acting on impulse. Physical punishment stops misbehavior out of fear; but
children disciplined with physical punishment often do not learn how to rein in the
impulse to misbehave. In fact, sometimes kids who are punished in this way
learn aggressive behavior. The following suggestions for parents may help kids
gain self-control: (www.kidshealth.org, 2006)


   birth to age 2: Infants and toddlers frequently get frustrated because there's
    a large gap between the things they want to do and what they are actually
    able to do. They often respond to those frustrations with temper tantrums.
    You may be able to prevent your child from having an outburst by distracting
    him or her with toys or other activities. By the time your child is 2 years old,
    you may want to use a brief time-out (when your child is taken to a
    designated time-out area - a kitchen chair or bottom stair - for a minute or 2
    to calm down) to show that there are consequences for outbursts. Time-outs
    can also teach your child that it's best to take some time alone in the face of
    frustration, instead of throwing a temper tantrum.


   ages 3 to 5: At this stage, you may want to continue to use time-outs. But
    rather than sticking to a specific time limit, it's a good idea to end time-outs
    as soon as your child has calmed down. This can be an effective way to
    encourage your child to improve his or her sense of self-control. It's also a
    good idea to praise your child for not losing control in situations that are
    frustrating or difficult.


   ages 6 to 9: As your child enters school, he or she will likely be able to
    understand the idea of consequences and that he or she can choose good or
    bad behavior. It may help your child to imagine a stop sign that he or she
    needs to obey and think about a situation before responding. You may want
    to encourage your child to walk away from a frustrating situation for a few
    minutes to cool off instead of having an outburst.




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      ages 10 to 12: Older children are typically able to better understand their
       feelings. Encourage your child to think about the situation that is causing him
       or her to lose control and then analyze it. You may want to explain to your
       child that sometimes the situations that are upsetting at first don't end up
       being as awful as they first seem. You may want to urge your child to take
       some time to think before responding to a situation.


      ages 13 to 17: At this point, your child should be able to control most of his
       or her actions. But you may need to remind your teen to think about long-
       term consequences of his or her actions. Continue to urge your teenage child
       to take time to evaluate upsetting situations before responding to them. Also
       encourage your child to talk through troubling situations rather than losing
       control, slamming doors, or yelling. At this point you may need to discipline
       your child by taking away certain privileges, for example, to reinforce the
       message that self-control is an important skill.


   Effective parenting also includes learning how to prevent common problems
children can face that have a detrimental effect on mental health. Parents can help
to prevent drug and alcohol abuse; childhood obesity; physical, sexual, and
emotional abuse and neglect; violence, bullying and delinquency; and prejudice.




Parenting Tips to Help Prevent Child and Adolescent Drug and Alcohol Abuse




       Drug and alcohol abuse are serious problems that lead to increased risk of
death by suicide, homicide or motor vehicle accident. Children who use drugs,
alcohol and tobacco are more likely to show low self esteem, unintentional injuries,
physical fights and behavior problems, work and school problems including academic
failure, unprotected sex, and illegal behavior. The long-term effects of alcohol abuse
can include liver disease, cancer, cardiovascular disease, and neurological damage,
as well as psychiatric problems such as depression, anxiety, and antisocial
personality disorder. Alcohol use has been a factor in 42% of motor vehicle crashes.
Use of drugs can cause depression, anxiety and psychosis. Drug use has also been
linked directly to the spread of HIV. Youth who misuse alcohol and other drugs may
be establishing a pattern of abuse or addiction of longer duration which results in



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more serious consequences. About 25% of 12-17 year olds and as many as 50% of
18-25 year olds have used drugs. (National Center for Chronic Disease Prevention
and Health Promotion, 2006; Grunbaum et al. 2004; Keepkidshealthy.com, 2006)


       In order to prevent drug and alcohol abuse, parents should attempt to reduce
risk factors for substance use and enhance protective factors. Early interventions
that reduce risk factors at a young age can have the greatest impact by changing a
child‘s life course away from problems. For example, effective parenting that helps a
preschool aged child with aggressive behavior or poor social skills can reverse the
tendency for such children to develop further risks for drug and alcohol abuse. Yet,
any modifications that reduce risk will help prevent drug or alcohol abuse at any age.
Risk factors associated with drug and alcohol use in children and adolescents include
aggressive behavior, academic failure, school dropout, a lack of attachment and
nurturing by parents or caregivers, a lack of parental supervision, use of drugs by
caregivers, association with drug and alcohol-abusing peers and peer pressure, drug
and alcohol availability, and beliefs that drug or alcohol abuse is o.k. The more risks
for substance abuse a child is exposed to the greater the likelihood that they will
abuse drugs or alcohol; but, the majority of children who are exposed to risks do not
end up with drug or alcohol abuse. Some risk factors may have greater impact at a
particular stage of development. For example, association with drug and alcohol
abusing peers is typically the greatest risk for adolescents while risk factors within
the family have a stronger impact on younger children.


       Certain protective factors are associated with reduced incidence of drug or
alcohol abuse. Developing strong parent-child bonds, parental monitoring, and
consistent appropriate discipline and enforcement of family rules including those
forbidding drug and alcohol use are protective. Parental involvement in their
children‘s lives including talking to children about drugs, getting to know their
friends, finding out about the problems they face, and supporting their learning, is
also protective. Children‘s self-control, good social skills, interest and ability in
academics, the arts, sports or community activities, and developing good drug-
refusal skills have also been found to offer protection against drug abuse. Parents or
caregivers can work to support these protective factors for children.
(www.nida.nih.gov, 2006)




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       If you suspect your child of drug or alcohol abuse, you should consult with
your pediatrician. A pediatrician will be able to complete an assessment and get
your child treatment if needed. Adults looking for help with drugs or alcohol can also
get connected to treatment through their doctor or specialist.




Parenting Tips to Help Prevent Childhood Obesity


       Childhood obesity is increasing in the United States. The prevalence rate of
overweight among children aged 6 to 11 more than doubled in the past 20 years,
going from 7% in 1980 to 18.8% in 2004. The prevalence rate among adolescents
aged 12 to 19 more than tripled, increasing from 5% to 17.1%. (Ogden et al. 2006)
Childhood obesity is associated with poor body image, low self-esteem,
stigmatization, poor social skills, poorer school attendance and low achievement.
(www.healthinschools.org, 2006) Establishing a pattern of behavior that leads to
obesity in childhood tends to translate to continued obesity in adulthood and its
associated physical and mental health problems. A number of factors are thought to
have contributed to the increase in childhood obesity including more time spent in
sedentary activities like watching television and playing video games, eating
fattening meals that lack nutrient variety such as fast food and snack foods, and
drinking sweetened, nutrient-poor beverages such as sodas rather than milk.
Parents or caregivers play a crucial role in children‘s health-related behavior
patterns. Parents strongly influence children‘s values and attitudes by rewarding or
reinforcing particular behaviors and by serving as role models for children. Parents
influence children‘s opportunities for recreation and physical activity, and the types
of food available in the home. This section provides tips for parents to help prevent
childhood obesity.


       For infants, research has shown that breast feeding for the first four to six
months of life helps to prevent obesity later in childhood. Early introduction of
sweetened beverages or high-fat sweet foods may predispose infants to childhood
obesity. During the toddler years, persistence in offering a variety of foods, even if
they are initially rejected, will help establish healthier eating patterns.   Parents and
caregivers can help maintain appropriate portion sizes so that young children don‘t
feel pressure to finish their plates even though they feel full. It is also important to
establish a pattern of eating meals together as a family so that children learn to eat


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the variety of foods offered at meals. Meals eaten separately are more likely to
consist largely of favorite foods and a less nutritious and potentially fattening diet.
Also children should be encouraged to avoid high calorie beverages with low nutrient
value. Parents can make healthy foods available in the home, serve fruits and
vegetables with meals, and make high-calorie, high-fat snacks available only
occasionally.


       Children‘s physical activity should be encouraged. Parents can support their
children‘s interest in sports and encourage them to play outside. If it is possible,
children can be encouraged to walk or ride their bikes to school, when visiting their
friends or when taking other close trips. Parents can also limit sedentary time
children spend watching television, using the computer, or playing video games. The
Institute of Medicine recommends that recreational screen watching time be limited
to less than two hours per day. Parents can also set a good example for their
children by eating a well rounded diet and healthy portion sizes, getting enough
physical activity or exercise, and by maintaining a healthy body weight. Finally,
parents should keep regularly scheduled well child check-ups with their pediatrician
to help monitor their child‘s progress, get needed immunizations, and keep up to
date about new research findings related to the care of children. Childhood obesity
is caused by insufficient exercise and too much eating. Parents can help to create
both healthy eating habits and regular physical activity for their children. Effective
parenting can play an important part in the prevention of obesity in childhood.
(www.iom.edu, 2005)




Tips for Parents to Prevent Child Abuse and Neglect


       The maltreatment of children results in a host of psychiatric problems for
victims. Sadly, parents are most often the perpetrators of child abuse and neglect.
Characteristics of parents that are risk factors for abuse include: substance use
(alcohol and other drugs), domestic violence, and learned behavior (the cycle of
abuse). It has been found that exposure to domestic violence either as a victim or a
witness is a strong predictor of domestic violence. Similarly, victims of sexual abuse
are more likely to abuse other children. Hopefully, we can break this cycle of abuse
and protect our children. Laws against the abuse of children were adopted relatively




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recently and their impact has been an initial rise followed by a reduction in reported
cases of abuse. Unfortunately, many instances of abuse are not discovered.


       Children are unable to represent themselves in the prevention of abuse. In
most childhood diseases, the parents rise up in arms for their children‘s rights and to
raise money for research and better clinical services. In the case of child abuse and
neglect, the parents of abused children have not taken a proactive role in prevention.
However, as general interest in the abuse and neglect of children increases,
hopefully parents will get more involved in efforts to protect their children. Parents
may be able to help reduce child abuse by educating themselves about the forms of
abuse to be avoided, by getting treatment for drug and alcohol abuse, and by
learning effective parenting skills. Parents may also be able to prevent abuse by
valuing their children, providing economic stability for the family, by discouraging
corporal punishment and other forms of violence, and by preventing the birth of
unwanted children. (Bethea, 1999) Parents who have been victims of abuse as
children can help protect their own children and break the cycle of abuse by getting
treatment through psychotherapy.


       Child abuse takes on several forms including physical abuse, sexual abuse,
emotional abuse, and neglect. Physical abuse is any act that results in non-
accidental trauma or physical injury. Most often physical abuse occurs as a result of
unreasonable and severe corporal punishment or unjustifiable punishment and
happens when a frustrated or angry parent strikes, beats, shakes, throws, kicks,
bites, burns or otherwise harms a child. Sexual abuse is any misuse of a child for
sexual pleasure or gratification. It can interfere with a child‘s healthy development.
Victims of sexual abuse often suffer severe emotional disturbances from feelings of
guilt and shame. Sexual abuse can include sex acts with a child as well as indecent
exposure and exhibitionism, exposing children to pornographic material, deliberately
exposing a child to sex, masturbation in front of a child, fondling, making a child
touch an adult‘s sex organs, any penetration of a child‘s vagina or anus by an object
that doesn‘t have a medical purpose, engaging a child for the purposes of
prostitution, or using a child to film, photograph or model pornography.


       Emotional abuse is the systematic tearing down of another person that
attacks the victim‘s psyche and self concept. Children who are emotionally abused




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can suffer as much, if not more, than those who are abused physically. Emotional
abuse can include rejecting behavior that tells a child that he or she is unwanted
such as telling the child to leave, calling him or her names, telling the child that he
or she is worthless, not holding or talking to the child or blaming the child for family
problems as a scapegoat. Emotional abuse can also include ignoring behavior such
as showing no interest in the child, not expressing affection or even recognizing the
child‘s presence. Terrorizing occurs when parents ridicule a child for displaying
normal emotions, single a child out to criticize or punish, place expectations on a
child far beyond his or her normal abilities, or threaten death, mutilation or
abandonment. Isolating a child from peers, forbidding extracurricular activities, or
requiring a child to stay in his or her room from the time school ends until the next
day are also forms of emotional abuse. Finally, corrupting a child by permitting them
to use drugs or alcohol, to watch cruel behavior toward animals, or to witness or
participate in criminal activities such as stealing, assault, or prostitution are other
forms of emotional abuse.


       Child neglect is a failure to provide needed care. Physical neglect includes
child abandonment, inadequate supervision, rejection of a child leading to expulsion
from the home, and failing to provide for the child‘s safety and physical and
emotional needs. Educational neglect occurs when a child is allowed to chronically
miss school. Emotional neglect occurs when a child is permitted to use drugs or
alcohol or there is a refusal or failure to provide needed psychological care for a
child. Medical neglect is the failure to provide appropriate health care for a child.
(Preventchildabuse.com, 2006)


       Child abuse can be avoided by valuing children, dealing with parents‘ risks for
abuse and by learning to recognize abuse when it is occurring. Since children cannot
advocate for themselves and their safety, it is important for parents to protect their
children from abuse and neglect.




Tips for Parents to Help Prevent Bullying, Youth Violence, and Delinquency


       Bullying of a child occurs when a stronger and perhaps older child exercises
power over their target with hostile or malicious intent. Hostile physical and verbal




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behavior characteristic of bullying include teasing, name-calling, insulting,
threatening, humiliating, general verbal or physical abuse, as well as gossiping,
spreading rumors, excluding and shunning. (Colvin et al., 1998; O‘Connell et al.,
1999) There are a number of negative consequences of bullying. Children bullied in
school have difficulty concentrating on school work and struggle to achieve
academically; they also have higher rates of absenteeism and school dropout.
Children who are targets of bullying suffer with anxiety, depression, insecurity,
loneliness and low self-esteem. Kids who are persistently bullied can become
severely depressed and despondent and even suicidal or homicidal. (Ballard et al.,
1999; Nansel et al., 2001) Bullying is an antecedent to violence in its perpetrators
and can produce bullying or violence by its victims as well. (National Association of
Attorneys General, 2000) The feelings of isolation and loss of self-esteem that occur
in victims of bullying can last well into adulthood. (Clarke and Kiselica, 1997)


       Parents play an important role in the prevention of bullying. Research has
shown that the success of any school bullying prevention program is largely
dependent upon whether the same kinds of approaches are used at home. (Labi,
2001) When a child complains of being bullied, parents should take them seriously
and take the appropriate steps to intervene. The child‘s teacher and principle should
be contacted to report the specific details related to the bullying. Children can
become more resilient to bullying by learning to report instances of bullying to
teachers and other concerned adults, by getting closer to friendly classmates and
other children outside of school, and by gaining skills in athletics, art, music or other
areas that build self-esteem. (www.stopbullyingnow.hrsa.gov, 2006)


       SAMHSA‘S National Mental Health Resource Center has the following
recommendations for parents who suspect that their child is a bully:
(www.mentalhealth.samhsa.gov, 2006)




If You Think Your Child is a Bully


      Be sure that your child knows that bullying is NOT acceptable behavior.
      Tell your child the penalties for bullying and be sure that you enforce them
       fairly and consistently.
      Help your child learn alternative ways to deal with anger and frustration.



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      Teach and reward more appropriate behavior.
      Work out a way for your child to make amends for the bullying.
      Help your child develop an understanding of the impact of their bullying on
       the target.
      Seek help or counseling if the behavior continues.
      If contacted by the school, STAY CALM; TRY NOT TO BECOME ANGRY AND
       DEFENSIVE! Make yourself really listen. Remember this is ultimately about
       the wellbeing of your child!




       Parents also play an important role in the prevention of youth violence. In
1999, youth arrests for all crimes totaled 2.4 million in The United States with
104,000 arrests for violent crimes. (www.surgeongeneral.gov. 2001) The capacity
for empathy formed early in development is believed to play an important role in the
prevention of violence. Parents can teach empathy to youngsters by modeling
empathic behavior. The following tips for parents are suggested by The National
Youth Violence Prevention Resource Center. (www.safeyouth.org, 2006)


       What Parents Can Do to Help Prevent Youth Violence:


      Give your children consistent love and attention. Every child needs a strong,
       loving, relationship with a parent or other adult to feel safe and secure and to
       develop a sense of trust.
      Communicate openly with your children, and encourage them to talk about all
       aspects of their lives: school, social activities, and their interests and
       concerns. Listen respectfully and solicit their opinions. Then, if a problem or
       crisis arises, they will be more likely to come to you.
      Set clear standards for your children's behavior, and be consistent about rules
       and discipline. Involve your children in the setting of rules whenever possible,
       and discuss the reasons for rules with them. Make sure they understand what
       you expect and the consequences for disobedience, and then enforce rules
       consistently.
      Make sure your children are supervised. Insist on knowing where your
       children are at all times and who their friends are. Try to get to know their
       friends' parents and your children's teachers. Encourage your children to




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       participate in supervised after-school activities such as sports teams, tutoring
       programs, or organized recreation.
      Promote peaceful resolutions to conflict by being a good role model. Deal with
       conflict at home calmly, considerately and quickly and manage your anger
       without violence. Talk with your children about handling disagreements, and
       help your children learn how to examine and find non-aggressive solutions to
       problems.
      Talk to your children about the consequences of drug and weapon use, gang
       participation, and violence. If you own firearms, make sure that they are
       unloaded, locked up, and inaccessible to children. Other dangerous weapons
       should also be kept out of the reach of children.
      Try to limit your children's exposure to violence in the media. Monitor the
       programs your children watch, the music they listen to, and the video games
       they play. Take time to watch television programs with your children and
       discuss any violence with them. Is the violence realistic? What would be the
       real-life consequences of such violence?
      Try to limit your children's exposure to violence in the home or community.
       Work toward making your home a safe, nonviolent place, and always
       discourage violent behavior or hostile, aggressive arguments between family
       members. If the people in your home physically or verbally hurt and abuse
       each other, get help from a psychologist or counselor in your community. If
       your children are exposed to violence in the street, at school, or at home,
       they may need help in dealing with these frightening experiences. A
       psychologist, a counselor at school, or a member of the clergy, are among
       those who can help them cope with their feelings.
      Take the initiative to make your school and community safer. Join up with
       other parents, through school and neighborhood associations, religious
       organizations, civic groups, and youth activity groups. Talk together about
       your concerns about youth in the community, including issues related to
       alcohol, drugs, and violence, and share your common parenting concerns.
       Support the development and implementation of school and community plans
       to address the needs of youth.


Parents can also help prevent their children from becoming violent by developing a
strong parent-child bond, by expressing an intolerant attitude toward delinquent
behavior including violence, by maintaining high but realistic expectation of your


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children and by fostering a strong commitment to school and learning. Parents need
to know their children well enough to discern warning signs of unusual behavior
including suspicions of substance use, bullying, delinquent behavior, or the
development of friendships with negative peer influences or affiliation with gangs.


   Juvenile delinquency causes parents tremendous distress and is often the
precursor to children becoming career criminals. Therefore, parents ability to
address behavior early shows promise in the prevention of adult crime. Warning
signs of child behavior problems include disruptive behavior that is more frequent
and more severe than other children of the same age group; and the persistence of
disruptive behavior, tantrums and aggression beyond the ―terrible twos and threes.‖
At a later age, poor academic performance, a weak commitment to school with little
educational expectation and low motivation also correlate with children becoming
juvenile offenders. Having friendships with deviant peers or close relationships with
deviant siblings is also associated with delinquency. Parental risk factors for
delinquency of children include antisocial behavior of parents, parents abusing drugs
or alcohol, the mother suffering from depression, family poverty, having a large
family, marital conflict, erratic or overly harsh discipline, and family violence. Having
been a victim of violence or frequent exposure to violence on television, in movies or
video games are also risks for juvenile delinquency. (University of Pittsburg Office of
Child Development, 2006) Parents can help to prevent juvenile delinquency of their
children by reducing these risk factors and by taking proactive steps to be effective
parents.




Preventing Prejudice




       Parents can also play an important role in the prevention of prejudice in their
children. Parents can mold their children‘s attitudes and behavior and serve as role
models to their kids. If sex discrimination or other forms of prejudice occur at home,
children will pick up these attitudes. Parents can bring diversity into their lives by
developing friendships with people of other races and cultures. Children can be
taught about the beliefs and holidays of other cultures. They should also learn that
the experience of human needs for love, security, achievement and self-respect and
the experience of emotions such as love, happiness, sadness, anger, fear, and pain


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are common to all people. Parents should discuss the issue of prejudice with their
children and clearly establish that diversity should be valued and that discrimination
based upon race, religion, origin, background, financial status, gender, or
appearance is unacceptable. Parents should discuss any reported or witnessed
incidences of discriminatory, racist or sexist behavior with their children so that
logical reasoning can overcome any learned prejudice or stereotypes. Parents can
find experiences for their children that expose them to positive portrayal of people of
other races and ethnic backgrounds in books, movies, travel or any other method.
Parents‘ love and respect of their child can help him or her to value and respect
others.    If your child experiences prejudice or discrimination, encourage the
expression of feelings and acknowledge their validity.    Parents should make a
special effort to support their kids‘ self-esteem when they have been the victim of
prejudice and help them to decide how best to respond.




Finding the best parenting style


          Parenting styles are repeated patterns in the way we raise our children. Our
style of parenting is often based upon the way we were raised but we may choose to
raise our families differently than our parents or grandparents or our friends. Often
parenting approaches change and evolve as the family grows. Yet, the essence of
the job of parenting remains the same: we have the responsibility to ensure that
our children have loving, safe, and secure homes in which to develop into well
balanced, healthy, adjusted, rational and reasonable, social and happy young people
who can contribute much to society.


          Diana Baumrind, an important theorist in parenting styles described four
different styles based upon two aspects of parenting, parental responsiveness and
parental demandingness. Parental responsiveness refers to how much the parent
responds to the child‘s needs. Parental demandingness is the degree to which the
parent expects more mature, sensible and responsible behavior from their child. The
four parenting styles are authoritarian (too hard), permissive (too soft), authoritative
or assertive-democratic (just right), and neglectful (don‘t care).




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       Authoritarian parents are characterized by high demandingness and low
responsiveness. Authoritarian parents exert too much control with rigid, harsh, and
demanding approaches to parenting.      Children are kept firmly in their place, arguing
is unacceptable. Authoritarian parents can be abusive.     The result of authoritarian
parenting is individuals who may be irritable, conflicted, and moody. There may be a
negative impact on social and cognitive skills. They may be discontented, distrustful,
withdrawn, unable to verbalize anger or even self-destructive.


       Permissive parents have low demandingness and high responsiveness.
These parents are overly responsive to children‘s demands and rarely enforce
consistent rules. Such children learn to get away with bad behavior and have
difficulty telling right from wrong. The result of indulgent permissive parenting is
impulsive, aggressive children, spoiled brats who are inconsiderate, selfish, and
impatient. They may exploit relationships, are entitled, and do whatever they want.
They lack self-reliance and self-control. They have less of a tendency to explore, low
cognitive and social competencies and develop relationship problems.


       Authoritative or assertive-democratic parents are characterized by moderate
demandingness and moderate responsiveness. It is balanced parenting. These
parents are firm but not rigid; they are willing to make exceptions when the situation
warrants it. These parents hold high expectations of maturity. They understand
their children‘s feelings and help them learn to regulate them successfully. They
respond to their child‘s needs but are not indulgent. They encourage their children
to be independent and make decisions based upon their own reasoning. They give
them freedom but set limits on behavior and maintain boundaries of what is
appropriate. These parents are warm and nurturing to their children and encourage
a democratic verbal give-and-take. They give their children good guidance. They
trust their children and show them respect. When punishing a child, these parents
explain their thinking and punishments are consistent and fair.    They may often
forgive and teach rather than punish the child when a mistake is made. Children are
encouraged to help around the house by doing chores and they are rewarded for
helping out. Expectations are age-appropriate so that the children can experience
success and competency. These parents expect mature, independent and age-
appropriate behavior from their children.    They are engaged with their children and
really interested in what they are doing with their lives. The results of authoritative
or assertive-democratic parenting include early development, energetic, friendly,



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self-reliant, contented, explorative, independent, competent, well balanced
individuals with self-control, a secure social circle, and high self-esteem.


       Neglectful parents are uninvolved.    This style of parenting is characterized by
low demandingness and low responsiveness. There is little warmth and little control.
Parents give the message, ―I don‘t care about you.‖     There is little concern for the
development of their child. The results of such parenting include alcohol and drug
abuse, being unsuccessful, promiscuity and low self-esteem.


       There are several other parenting styles. Traditional parenting can be based
upon religious faith and the application of scriptural principles on parenting.
Concerted cultivation is the parents‘ attempt to foster the talent of their children
through structured leisure activities. Overparenting occurs when a helicopter parent
hovers over their child and attempts to sweep all obstacles out of the path of their
child‘s day to day experiences and problems. Finally, in slow parenting parents plan
and organize less for their children in order to allow them to enjoy their childhood
and explore the world at their own pace.


       The style of parenting that each of us employs can depend on how we were
reared, what we consider good parenting, our child‘s temperament, the current
environmental situation, and whether we place more importance on our own needs
or an investment in our child‘s future success. In a threatening environment,
parents may be more authoritarian in order to protect their child‘s safety. Parents
who are concerned with their child‘s intellectual development may push their children
into extra-curricular activities such as music, summer school, or foreign language
lessons. (www.parentingstyles.co.uk 2010; Hoffman 2010)




       Providing effective parenting for your children will promote both your
children‘s mental health as well as your own. There are no perfect parents; but, it is
possible for parents to educate themselves, learn from mistakes, and take the time
to be effective parents.




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On Being a Role Model


       The concept of role model was developed by Robert Merton who hypothesized
that individuals compare themselves with people who occupy a desired social role.
In general use the term role model applies to anyone who serves as an example and
whose behavior is copied by others. Some people may consider their role models
individuals they don‘t know such as movie stars, political figures and athletes while
others find role models in people involved in their day to day lives. It has been said
that, ―it takes a village to raise a child.‖


        Certain groups of people in respected roles in society are in a unique position
and expected to model high standards of behavior. For example health care
providers are expected to model healthy behavior, teachers are expected to
demonstrate good conduct to their students and political and religious figures are
expected to represent high morals and exemplary behavior. But anyone, despite
what is expected of them, can be a good example to others.


       Role models can not only demonstrate healthy behavior or strong morals but
can inspire those around them to rise above adversity and live a great life. Inspiring
others occurs not only by what we say but more importantly by the way we live our
lives. A role model might rise above terrific adversity to be an example of success
and a happier and healthier way of life.       A role model may also be an excellent
example of the good that comes from upholding strong values or the many great
things that can be done by a person.       A role model might be a good example of
wisdom and leadership and show that you can become whatever you hope to
become. A good role model might teach important things about life and help others
to thrive.


       Some role models through their success help establish a higher ground or
plateau of what can be achieved. Some role models help to overcome prejudice.
Role models affect others in a way that makes them want to grow, progress, and
become better people. Some people look to role models who come from the same
place as they and show what can be done with one‘s life. A role model might go
through similar struggles or challenges. A role model might help others to not set
limits on what can be done and help them see the possibilities within themselves.



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Role models might encourage others to be different, to go beyond the usual; they
may also encourage others to believe that they can get where he or she is. A role
model might show what courage really is or any other strength or virtue. A good
role model helps others make the right choices in life.


       If you are out in the community, your community, you are being looked at
and all of the good things you do reflect yourself, your family and those with whom
you associate. Being a role model means representing your family, your work, your
school, your place of worship, your friends, your community, or your team. Those
who achieve exceptional mental health and interact with others truly serve as role
models. We are always looking for better role models, mentors and heroic figures.




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The Healing Relationship



        In The Heart and Soul of Change, published by the American Psychological
Association, it points out that as it became established that a large number of
different talk therapies were beneficial it was also found difficult to find any obvious
differences in outcome. This led to the conclusion that all helpful therapies shared
common elements that contribute to the majority of change: clients as self- healers,
the therapeutic relationship, hope and expectancy, and specific techniques. It was
clear that corrective experiences occur in therapy and the therapeutic relationship
was an important causal factor. It seems that the healing relationship activates the
innate healing and growth potential native to every person.


        Some of the attributes of the healing relationship include: unconditional
positive regard, collaboration with the other person involved and a shared
responsibility against a common foe, respect, and a security enhancing, caring
presence. The healing atmosphere can come from a place of stillness, optimism and
instilling hope, nonpossessive warmth, friendliness, caring and emotional
involvement. You can share ego and spirit and empower others. Genuineness and
trustworthiness create a climate of confidence. It can help to express empathy and
contain others negative emotions with your own capacity for strength. With accurate
empathy one recognizes the other person‘s innermost experience, state or
motivation so that they feel understood. It helps to promote the other person‘s
friendliness and positive linking to oneself the benevolent and kind people from the
past.


        A healing relationship should include attentive listening and being
nonjudgmental. It means giving the message that I hear you, I see you, and what
you say matters to me. Attractiveness and flexibility contribute to the goodness of
fit in a healing relationship. Having a flexible repertoire of relationship stances that
suit different people‘s needs and expectations including such things as degree of
formality, self-disclosure, supportiveness, warmth and empathy, and pace of
interchange will allow for better complementarity. Some of the healing techniques
can include teaching self- care, interpretation that helps others gain insight and learn
to mentalize better, support and encouragement for the unmotivated or those
lacking trust, agreement on the goals, and most importantly evidence-based



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medicine. Evidence-based medicine is the use of therapeutic interventions that are
established by rigorous research. In the best of care, healing relationships include
expertness. (Bachelor and Horvath 1999) The capacity to form healing relationships
with others in need helps create healthier individuals and healthier communities.


       In the best of circumstances we create corrective emotional experiences that
repair the traumatic influences of past experiences and take someone from a state of
imbalance to balance, disharmony to harmony, weakness to strength, imperfection
to successful adaptation, illness to health, feeling overwhelmed to peace despite
tension and turmoil, failure to thrive to the point where nothing is lacking, flourishing
as though a god. We see these experiences in the work with professional athletes as
weaknesses are strengthened to excel at winning. It happens when a mentor guides
a student or a therapist works with a client or patient. It might be argued that
corrective emotional experiences occur only by a healing relationship; but
experiences in nature like climbing up a mountain or reveling at the beauty of a
sunset can also have therapeutic benefit. We experience corrective literature and
film, music and dance, any form of art that moves our spirit, allows us to interact
with others more deeply and honestly, and lifts our burdens. We must experience
something strongly and make sense of things for a corrective effect.




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Part Six: Spiritual Approaches to Optimal Mental Health

          Belief in a spiritual cause of mental illness dates back to before biblical times.
The early writings of the Chinese, Egyptians, Hebrews, and Greeks show that these
groups attributed mental illnesses to demons that had taken possession of the
affected individual. In the New Testament of the Bible, many of the healings
attributed to Jesus involved casting out ―unclean spirits.‖ In the Middle Ages, 500
A.D. to 1500 A.D., treatment of mental illness was left primarily to the clergy
because of the general belief at that time that it was caused by evil spirits.
(Baldwin, 2005) Some people have believed that mental illness and its associated
suffering is punishment for karmic debts in a person‘s present life, past life, or the
debts of one‘s parents or grandparents. Some people believe that life is a spiritual
―test‖ and that mental illness and its associated suffering is part of life‘s test of
character. Others have believed that mental illness is caused by interference from
the spirits of deceased people or even aliens. A spiritual cause of mental illness
cannot be proven and the majority of mental health care specialists today reject
spiritual explanations of illness. However, the scientific community has been more
accepting of the evidence for certain spiritual factors‘ positive effects on mental
health.


          Religiosity has been consistently correlated with wellbeing. According to
Udermann, ―Strong scientific evidence suggests that individuals who regularly
participate in spiritual worship services or related activities and who feel strongly
that spirituality or the presence of a higher being or power are sources of strength
and comfort to them are healthier and possess greater healing capabilities.
Numerous research investigations have reported positive correlations between
spirituality and decreased rates of stroke, cancer, cardiovascular disease,
hypertension, drug abuse, suicide, and general mortality.‖ (Udermann, 2000) Some
would argue however, that it is difficult though to disentangle the values of spiritual
faith and church goers fellowship or community support and compassionate
relationships. (Steffen 2005) Nevertheless, heightened spirituality with a sense of
gratitude, hope, grace, faith, forgiveness, and awe, helps people to endure bad times
and experience ordinary events with a sense of wonder and joy. Research suggests
that certain positive styles of religious coping support good health while negative
styles of religious coping contribute to ill health, both physically and mentally. For


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some people, spiritual growth means learning to be centered, developing inner
strength and finding inner peace. For some it means coming into the right
relationship with oneself and with God. It may be to say that ―it is well with my
soul.‖ Eastern approaches to medicine base their practice upon theories of energy
balance that cannot be measured scientifically; yet, perhaps an ongoing energy
balance can help lead to optimal health. Spiritual health may arrive by lifting the veil
of ignorance and illusion to see clearly and be liberated. Some believe that the
noblest work is to cultivate the soul. Ultimately, it may be that the spirit of the life
force inspires in us the will to live and the will to thrive while true health can be
found in spiritual wholeness. According to the Canadian Institute for Health
Information, ―Spiritual well-being can involve religious practices as well as the
broader values and principles that give meaning to life.‖ A variety of spiritual
approaches may help to bring about optimal mental health.




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Religious Coping


       Religious coping refers to particular patterns of response to stress that include
spiritual practices, beliefs and attitudes. Some religious coping styles can contribute
to good mental health while others may increase psychological distress. In a study
investigating responses to stress following cardiac surgery, positive forms of religious
coping including religious forgiveness, seeking spiritual support, collaborative
religious coping (fellowship with others who share the same beliefs), spiritual
connection, religious purification and thoughts of religious benevolence were
associated with better health outcomes; while negative coping patterns including
spiritual discontent, thoughts of punishing God, insecurity, demonic thoughts,
interpersonal religious discontent, religious doubt, and discontented spiritual
relations were associated with poorer outcomes. (Ai, 2006) While some people
respond to negative events with initial reactions characterized by religious struggle
or spiritual discontent, they may transition to positive forms of religious coping.
Other people can get stuck in negative patterns of religious coping. One study found
that religious struggle of medically ill elderly patients predicted poorer physical
recovery and a higher rate of death. (Pargament et al. 2001) In another study,
religious struggle was found to correlate with higher levels of emotional distress and
depressive symptoms. (Fitchett et al. 2004)


       Negative religious coping patterns can include: anger at God, questioning
God‘s love, feeling abandoned by God, beliefs that one is being punished by God,
religious doubt, demonic thoughts, or beliefs that the devil has caused one‘s ill
health. Such forms of religious discontent appear to contribute to an increase in
psychological distress. Positive forms of religious coping on the other hand, such as
gratitude, faith, prayer, reading scriptures, attending religious services, getting
involved in church, temple or mosque activities, obtaining spiritual support from or
fellowship with others who share the same beliefs, and acts of religious purification
appear to support good mental health.




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Gratitude


       A sense of gratitude is to feel appreciative and thankful for the good things in
life. Gratitude occurs in the context of a relationship, a relationship with another
person or a relationship with God. Along with one‘s sense of gratitude comes a
sense of belonging. When a gift is given, the appropriate response is gratitude.
Gratitude results in reciprocal kindness as one grateful act tends to precipitate a
grateful response. Even negative situations can offer opportunities for which to be
grateful. The world's major religions, including Christianity, Judaism, Islam and
Hinduism, encourage gratitude.


       People who describe themselves as feeling grateful to others, to God, or to
creation in general appear to have more vitality and optimism, experience less
stress, and are more resilient to depression than the general population. Grateful
people tend to be more content, less materialistic and suffer less anxiety about
accumulating possessions or social status. A psychologist, Robert Emmons, found
that exercises in which people kept a journal of things for which they felt grateful
improved physical health, raised energy levels and could even relieve pain for some
people. Those who benefit most have a wider assortment of things they are thankful
for. (Wallis 2005) Emmons‘ research indicated that daily gratitude exercises
resulted in higher reported levels of alertness, enthusiasm, energy, determination,
and optimism. Additionally, those who completed gratitude exercises experienced
less depression and stress, were more likely to help others, exercised more regularly
and made more progress toward personal goals. It was also found that people who
feel grateful are also more likely to feel loved.   It has also been found that grateful
people report higher levels of positive emotions, life satisfaction, and vitality.
(McCullough, et al. 2002)


       People of modest financial means or those who have suffered personal
tragedies may report feeling grateful, while those who are well off and attractive in
appearance may show little gratitude. The current cultural emphasis on self-reliance
and independence may explain why some people fail to think about indebtedness to
others. Many people never consider those people who came before them and made
much of the joys of life possible. Also, atheists or those who have lost respect for
faith may reject ideas of gratitude toward God; while those of faith appear to believe




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that God wanted them to exist, that life is precious, and that they are fortunate to
experience life. According to Emmons, "To say we feel grateful is not to say that
everything in our lives is necessarily great. It just means we are aware of our
blessings. If you only think about your disappointments and unsatisfied wants, you
may be prone to unhappiness. If you're fully aware of your disappointments but at
the same time thankful for the good that has happened and for your chance to live,
you may show higher indices of well-being." (Easterbrook, 2006) It has been found
that for people who are grateful in general, life events have little influence on
experienced feelings of gratitude. (McCullough, et al. 2004) A sense of gratitude
appears to help promote good mental health. It may be important for people to
count their blessings and feel thankful for all that is good in their lives.




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Hope


       Hope involves the capacity to look forward to the future with the expectation
of better things.   According to Erik Erikson hope is ―the enduring belief in the
attainability of fervent wishes.‖ Hope grows with the ability to see potential
pathways toward desired goals and increases further with movement in the direction
of accomplishing these aims. According to the general literature on hope, individuals
who are hopeful live more positive lives than those who experience hopelessness.
Hope is associated with health and well-being. (Lohne 2004) Hope is optimistic with
a sense of trust in another person, a group or community of people or something
greater than oneself that will see oneself through hard times. One person can instill
hope in another. If you can offer someone guidance or assistance he or she might
develop a sense of hope that your help will serve his or her needs. Your help might
provide a pathway toward desired goals.


       Hope appears to bring about change by belief or self-fulfilling prophesies. It
is believed that hope or expectancy may be responsible for extraordinary reversals of
disease and disability or miracle cures. The degree of improvement in
psychotherapy correlates positively and significantly with expectancies.    In research
models the placebo effect, where an inactive sugar pill results in successful
treatment of illness, teaches about self-healing, it works.   With hope and
expectancy, placebos result in a cure by nothing but oneself.     Faith in doctors, faith
in medical treatments, faith in divinity and a positive attitude all seem to have
healing power. Any and all roads should be explored to find those that are most
suited to help one achieve his or her goals.


       In a spiritual sense, people may place trust in God which allows them to hope
for goodness and mercy and better things to come. Some may believe that God
acting in the hearts of people gives us hope. To have hope does not imply that one
expects a miracle without any effort; but rather it is a spiritual sense that a better
life is possible and that one can contribute to its realization. With maturity, people
grow out of childlike beliefs that great things will come without effort; yet, hope
allows people to look forward to the future and work toward better things.       While
individuals gain hope for the future, a group of people can have collective hope.




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Faith


        Faith comes in several forms. One can have faith in oneself, faith in others,
faith in the universe (that is essentially just and good), and a trust in God or
something higher than oneself. Many well known authors have written eloquently
about faith. Alfred Adler once said that, ―man knows much more than he
understands.‖ It is such knowing without understanding that creates faith. Elbert
Hubbard said, ―The supernatural is the natural not yet understood.‖ The
development of faith involves a trust in things that cannot necessarily be understood
with logic. According to Elton Trueblood, ―faith is not belief without proof, but trust
without reservations.‖


        Faith is a spiritual feeling and knowledge. Albert Einstein has said that, ―to
know what is impenetrable to us really exists, manifesting itself as the highest
wisdom and the most radiant beauty… this knowledge, this feeling, is at the center of
true religiousness.‖ In Ralph Waldo Emerson‘s words, ―all that I have seen teaches
me to trust the Creator for all I have not seen.‖ To have faith is to rely on
something unknowable. It first includes a belief in yourself, but also in something or
someone greater than yourself in whom you can place your assurance and trust.
Faith is supported by one‘s experience of life. According to Mohandas Gandhi, ―faith
must be enforced by reason; when faith becomes blind it dies.‖


          In the Christian tradition according to Martin Luther, ―faith is a living, bold
trust in God's grace, so certain of God's favor that it would risk death a thousand
times trusting in it. Such confidence and knowledge of God's grace makes you
happy, joyful and bold in your relationship to God and all creatures. The Holy Spirit
makes this happen through faith.‖ (Luther, 1522) With faith, a person can surrender
personal will to Divine will. By acknowledging Divine will, you do not give up
passively to God in resignation, but rather, align yourself through intuition with a
greater will. In The Bible Jesus says, ―Do not let your hearts be troubled. Trust in
God, trust also in me.‖ (John 14:1)


        When you reflect upon the amazing vastness and beauty of the world, it is
difficult not to surrender yourself to something or someone greater. It is awesome
to think that we people are here on earth at all. Thomas Edison has said, ―I know


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this world is ruled by infinite intelligence…Everything that surrounds us, everything
that exists, proves that there are infinite laws behind it. There can be no denying
this fact. It is mathematical in its precision.‖ The astonishment of it all evokes a
sense of respect, admiration and awe.


       Faith is comforting in the face of adversity. Having an unshakeable faith in
oneself, in one‘s resources and one‘s abilities, while also having strong faith in other
people and in God helps us overcome life‘s obstacles. Loss of faith in oneself is
associated with self-doubt and anxiety; yet, greater faith can be found in oneself by
surrendering personal will to Divine will and by doing your part. One can trust in
God with faith; yet, not expect God to do all of the work. Manoj Khatri says, ―If you
trust God there is no reason to get bogged down.‖ According to Dada JP Vaswani,
―There are supernatural forces to help you if you‘re on the right path. Have faith in
those forces.‖ ―Where there is faith there is no fear. Out of faith grows the spirit of
courage. Cultivate faith.‖ Faith helps people get through tough times and find joy in
life. Faith in oneself, faith in others, and faith in God appears to promote better
mental health.




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Guidance


       People often attribute the experience of spiritual guidance to higher mental
health. Such guidance grows out of a person‘s development of a relationship with
the Divine as he or she perceives it. For some, spiritual guidance comes with
reflection on the presence and action of God in one‘s life. Guidance can pertain to a
specific issue or may simply involve becoming more attuned to God‘s presence in all
of life. People look for guidance about what is right in different situations, how to
bring about what one hopes for and to ultimately know one‘s highest good. Some
have suggested that we are more likely to experience a sense of guidance when our
hearts are open with warmth, love and light. We may gain a greater sense of
guidance with prayer, reading scriptures, meditation, spiritual music, or for some
spending time in nature, lighting candles or burning incense. In the Christian
tradition, guidance comes by trusting in the Lord and seeking His will in all that you
do.


       According to Oprah Winfrey, ―Nothing but the hand of God has made this
possible for me. ... I know I've never been alone, and you haven't either. And I know
that that presence, that flow—some people call it grace—is working in my life at
every single turn, and yours too, if you let it in. It's closer than your breath, and it is
yours for the asking… I have felt the presence of God my whole life. Even when I
didn't have a name for it, I could feel the voice bigger than myself speaking to me,
and all of us have that same voice. Be still and know it. You can acknowledge it or
not. You can worship it or not. You can praise it, you can ignore it or you can know
it. Know it. It's always there speaking to you and waiting for you to hear it in every
move, in every decision. I wait and I listen. I'm still—I wait and listen for the
guidance that's greater than my meager mind… The only time I've ever made
mistakes is when I didn't listen. So what I know is, God is love and God is life, and
your life is always speaking to you. First in whispers. ... It's subtle, those whispers.
And if you don't pay attention to the whispers, it gets louder and louder. It's like
getting thumped upside the head, like my grandmother used to do. ... You don't pay
attention to that, it's like getting a brick upside your head. You don't pay attention to
that, the whole brick wall falls down. That's the pattern I've seen in my life…
Whispers are always messages, and if you don't hear the message, the message
turns into a problem. And if you don't handle the problem, the problem turns into a



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crisis, and if you don't handle the crisis, disaster. Your life is speaking to you. What
is it saying?"




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Forgiveness


       Forgiveness is a process in which someone makes a purposeful change of
heart toward another who has hurt them. Research suggests that forgiveness
reduces the stress associated with bitterness, anger, hatred, resentment, and fear of
being hurt or humiliated again. Forgiveness lightens one‘s emotional load. Everett
Worthington separated two forms of forgiveness. Decisional forgiveness involves a
commitment to reconcile with the perpetrator; whereas, emotional forgiveness is
described as an internal state of acceptance. According to Edward Hallowell,
forgiveness goes against the natural tendency to seek revenge and the redress of
injustice. (Lewis 2004)


       Robert Enright has developed a step by step forgiveness process. According
to Enright, the first step is to uncover your anger. This phase includes asking
yourself to face your anger, recognize fears associated with exposing guilt or shame,
recognizing if your anger has affected your health, recognizing obsessions with your
injury or the offender and recognizing if your injury changed your life or your world
view. The second step is to decide to forgive. This phase includes deciding that your
current efforts are not working, developing a willingness to begin the forgiveness
process, and deciding to forgive. The third step is working on forgiveness. This
phase includes working toward understanding, working toward compassion,
acknowledging your pain and letting it be, and doing an act of kindness toward the
offender to demonstrate your change of heart or to honor your decision to forgive.
(You might use prayer and ask God to bless those who have harmed you knowingly
or unknowingly). The last step is discovering the release from emotional pain. This
phase includes discovering the meaning of suffering, discovering your need for
forgiveness, discovering that you are not alone, discovering the purpose of your life,
and discovering the freedom of forgiveness. Enright‘s method is described in his
book entitled ―Forgiveness is a Choice: a Step by Step Process for Resolving Anger
and Restoring Hope,‖ published by The American Psychological Association.


       People also seek forgiveness for their personal wrongdoing and how they
have foolishly hurt others. According to the Christian tradition fear comes from a
guilty conscience, but Christ‘s perfect love replaces fear. To experience this love is
to feel the forgiveness of sins; to be cleansed, to trust in God‘s grace through faith.


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(Warren, 2008) According to Paul in the Bible, God‘s love surpasses knowledge. The
breadth and depth of God‘s love reaches all men, women and children, all people of
the world. According to the Bible, God is holy, righteous and pure. The forgiveness
and mercy of God is beyond our comprehension.


       You can also simply forgive yourself, you can be free. You might say, ―I‘ve
done something wrong, sorry. I‘ll try to do better next time.― You don‘t have to
punish yourself, victimize yourself. You judge yourself, you‘re completely free. You
can let it go. What is wrong with forgiving ourselves? You can keep the door of your
heart open to you no matter what you‘ve done.


       According to Ronald Pies, in the Judaic tradition we are prohibited from
forgiving on someone else‘s behalf.   According to Stein and Kaminer, ―at times
forgiveness may not always be appropriate.‖ Pies argues that ―there are some
crimes so heinous, they may simply be beyond the human capacity to forgive (such
as genocide, murder, and rape).‖ According to Rabbi Abraham Joshua Heschel, ―no
one can forgive crimes committed against someone else… even God Himself can only
forgive sins committed against Himself, not against man.‖ Pies points to the
difference between the limits of forgiveness and the capacity to let go of hatred.
―Relinquishing hatred does not mean excusing someone‘s actions or to even cease
hating the cruelty of a person‘s actions… Acts are not persons, and there is no
ethical prohibition in any major faith against hating evil deeds... We may hope that
we can transform our revulsion and rage into something higher and nobler;‖ perhaps
as Barack Obama has suggested, ―to expand our moral imaginations, to listen to
each other more carefully, to sharpen our instincts for empathy, and remind
ourselves of all the ways our hopes and dreams are bound together.‖ (Pies 2011)




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Detachment


       According to the law of karma, we are destined to face negative situations in
our lives because of our own past mistakes or bad judgment. Those people who
accept the law of karma believe that each soul accrues good and bad karma over the
course of one‘s present lifetime as well as prior lifetimes or incarnations of the soul.
According to this law, by experiencing necessary negative events we help our souls
come into balance. We can avoid creating new negative karma by behaving
responsibly in our lives; yet, we must accept the unfolding of past bad karma. We
can nurture our good intentions in order to gain positive karma and challenge
ourselves to rethink any bad intentions. In this way we treat ourselves and those we
encounter in life with great respect. It has been argued that with good karma, by
serving and helping others, we develop soul power.


       Detachment is often associated with disconnecting emotionally or developing
an attitude of indifference. Yet, detachment in the spiritual sense involves an
acceptance of the unfolding of karma. By accepting this process, we can detach a
little bit emotionally from negative experiences and accept that we must suffer
because of bad karma and that we can exercise our soul power with good karma.
We must suffer in order to enable our souls to obtain balance. According to Dada JP
Vaswani, ―Everything that happens happens for our good… suffering purifies us.‖
By accepting this law and the process by which our souls come into balance, we need
not jump to judgment or anger or other negative emotional states. Instead we can
detach emotionally a bit and allow the process to unfold without a strong attachment
to the outcome of situations. We can remind ourselves in many negative situations
that ―this too shall pass.‖ With detachment there is a great reduction of pain in
negative experiences and an acceptance of the natural processes of life. Through
detachment it is thought that we may grow wise. The capacity for detachment
during negative events may also help to promote optimal mental health.




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Prayer


         Prayer is considered the most popular form of complementary or alternative
approaches to medicine. Recent research aimed at investigating the possible
benefits of prayer during times of illness has found benefits of prayer; although,
which illnesses respond to prayer or what forms of prayer are best has yet to be
discovered. As spiritual practices have been shown to improve a variety of health
outcomes, some researchers have hypothesized that the benefit of prayer lies in its
tendency to reduce stress but the mechanism by which prayer is helpful remains
unknown. While people often respond to ill health or stressful events with prayer,
people also offer praise or gratitude or share their experiences in prayer. Prayer can
include either spontaneous or prepared words. The health benefits of prayer may be
greatest when a person takes a collaborative stance in that he or she will do what he
or she can to improve his or her situation, help someone else, or promote his or her
health while also leaving the outcome up to God. It may help to approach prayer
with an attitude of reverence and expectancy.




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Grace


        Through spiritual development, some people learn to become elegant spirits.
Those who demonstrate grace in their lives offer kindness to others. They are
benevolent souls who act decently in a caring manner to others in need. ―Those who
embody graceful living seem to draw from a wellspring of deep and abiding love.‖
(Schubert, 2003) According to Hubert Pryor, ―Living gracefully means to rise above
earthly matters. In a spiritual sense, living gracefully depicts a Godly quality or
generosity of spirit. It‘s all a matter of attitude. You believe, you just know, that
there‘s a force for good at work, yours and everyone else‘s. And you know how to
go with that flow, trimming your sails and steering as events demand. Your
destination remains constant.‖ (Pryor, 2003)


        In Christianity, grace refers to unearned favors or mercy received from God.
We are blessed by the grace of God that brings pleasure, contentment or good
fortune, that we may enjoy the bliss of heaven. In Chronicles in the Old Testament
of The Bible a man named Jabez calls upon God, ―Oh, that you would bless me and
enlarge my territory! Let your hand be with me, and keep me from harm so that I
will be free from pain!‖ And according to the next verse, ―And God granted his
request.‖ (1 Chronicles 4:9-10) In the words of Keith Urban:


But for the grace of God go I
I must've been born a lucky guy
Heaven only knows how I've been blessed
With the gift of YOUR love
And I look around and all I see
Is your happiness embracing me
Oh Lord I'd be lost
But for the grace of God


I look around and all I see
Is your happiness embracing me
Oh Lord I'd be lost
But for the grace of God




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Oh Lord I'd be lost
But for the grace of God


          In the words of Martina McBride: ―I thank God for all I‘ve been given.‖ God‘s
grace is an example to follow. The meaning of grace has extended to the charm,
poise and beautiful character of a refined person. Those with grace give up
resentments toward others. They show compassion and understanding for the
wrong doing of others. Having grace may help to promote exceptional mental
health.




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The All-Sufficient Spiritual Sacrifice




        The practice of sacrifice is seen in archeological remains of animal and human
corpses with sacrificial marks dated long before the oldest written records. In many
religious traditions spiritual sacrifices have been made to please, for worship, for
forgiveness of sins or in order to gain blessings. In the Jewish tradition the blood
sacrifice of an unblemished animal and bloodless sacrifices of grain or wine were
made for guilt or peace offerings. It has been proposed that God allowed sacrifices
as a concession to human psychological limitations but prayer and meditation are
superior to sacrifices. In Islam animals are sacrificed to help the poor. In Hinduism,
butter, grains, spices and wood are offered in a fire to represent devotion, aspiration
and seeds of past karma. In other religions virgins were sacrificed in order to gain
favor from the gods. It is asked in the Bible, ―Shall I give my firstborn for my sin,
the fruit of my body for the sin of my soul?‖ In response it is said that the Lord
requires ―only to do justly, and to love mercy, and to walk humbly with thy God.‖
(Micah 6:7-8) Any religious practice of human sacrifice is considered murder
throughout the world. Some may believe that they need to make a deal with the
devil and sacrifice their soul in order to obtain some cherished reward. According to
the Christian tradition however, Jesus died on the cross as a perfect holy sacrifice.
His death was the reconciliation of God and humanity, replacing all insufficient
sacrifices, and no other spiritual sacrifice will ever be needed again. Christ on the
cross, his body and blood, transcends time and space and applies to the redemption
of believers, their intentions and prayers. The rest of human suffering adds to
Christ‘s all- sufficient sacrifice. (Wikipedia 2010)




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Being Centered


       Some people may experience being centered as a part of their spiritual
growth. Although being centered is a spiritual state it is also experienced as a mind-
body state. According to Eastern traditions, a person‘s physical center is just below
the naval. Being centered physically is being in a state of balance and stability;
while also feeling energized. The body is relaxed. This physical experience of being
centered can be tied to breathing deeply from the belly. The mental aspects of being
centered include feeling calm and focused, aware of oneself and the surroundings,
feeling loving, compassionate and connected to other people, feeling connected to
one‘s environment, having confidence, a sense that one is larger than one‘s
challenges and energized by purpose, yet, feeling unattached to the outcome of a
situation. The mind is clear and peaceful. Being centered is feeling a sense of
harmony with everything that was, that is at present and that will be. One is free of
conflict; anger and frustration are absent. Being centered is having fun and laughing
often. For some people, learning to be centered comes from meditation where the
individual physically and mentally relaxes into his or her center. The capacity to be
centered is also associated with optimal mental health.




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Inner Strength


       Many people would agree that it is inner strength that enables people to not
 only survive but to thrive. In general, people do not hope for an easy life, they
 hope to be strong and prevail. Inner strength is both the ability to bear and the
 ability to do. It is one‘s internal sense of power. It is the strength to struggle
 courageously and overcome obstacles. It is the will to stand up against evil and
 pain. Inner strength is firmness and determination. Emotional maturity is inner
 strength; it is the strength to bring about change, take charge of your life and not
 postpone action. It is emotional resolve and sureness of purpose, knowing the
 result you want to produce and understanding why the result matters. It is
 daring to do what is right and facing unpleasant consequences. It is exercising
 calm and assertive authority based upon what is right. Inner strength brings
 about tenacity. The strength of a person‘s determined spirit supported by an
 unshakable faith in his or her mission helps to get the most challenging things
 accomplished. Courage is not a matter of muscle but rather strength of the heart.
 Inner strength supplies the courage to struggle through hard times. It has been
 suggested that inner strength comes from a synergy of physical strength, mental
 strength, strength of the heart and strength of the spirit. Power can be effectively
 exercised with the body and the spirit.

       Human strength is often associated with physical ability. Being physically
strong means being capable of producing great physical force and also being capable
of withstanding great physical force. While physical force is transitory, the power of
the spirit is believed to be everlasting. The spirit can be strengthened by nurturing
your ability to sense God‘s presence through intuition and other people‘s help and by
gaining a sense of strength, power, hope, peace, and comfort. Knowing that God
cares for everyone helps build your strength of spirit. God can seem close during
hard times. You can use what inspires you to feel connected to God such as prayer,
religious services, rituals, books, music, nature, children, pets, or projects.
Relationships with others can strengthen the spirit. Support from family, friends,
counselors, people from places of worship, or others in the community, helps one
develop greater strength. Caring for yourself as well as helping others also helps
strengthen your spirit.   Trust your instincts to sense what your spirit needs and
strive to meet those needs. Take time to reflect on your life and what you have



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done and think about what you would like to do. You can integrate the elements of
your past into your current plans.



       Inner strength is the ability to overcome resistance. It means overcoming
negative thoughts and feelings. It involves being determined and unyielding in the
pursuit of goals. It includes a steadfast maturity in handling responsibilities and
dealing with others. Certain aspects of strength may come from sexual energy.
Being strong means approaching life aggressively, going after what you want like a
warrior who will not accept defeat. Inner strength brings about the fighting spirit in
the face of trouble. The fighting spirit is the will to plow through with dogged
determination. It is a hunger. It is the spirit of a man or woman on a mission, the
spirit that brings about a championship season in sports. People with a fighting spirit
in difficult times show much less depression, anxiety or other mental health
problems. When it comes to terminal illnesses the fighting spirit may or may not
prolong life but it vastly improves quality of life.   It appears on the other hand that
helplessness and hopelessness can shorten life expectancy. The fighting spirit is a
shining and irrepressible spirit in the face of trouble.


       Standing on the defensive indicates less strength, while attacking problems
indicates an abundance of strength. One can impose his or her will on that which
stands in the way. Inner strength means making success and positive things
happen. According to Sun Tzu, in military combat, ―the whole army of opposition
can be robbed of its spirit‖ and ―if you find yourself in difficult circumstances, by
always looking for advantages you can turn misfortune into gain.‖ Finally, if you
cultivate a bold sense of adventure, you will meet challenges with greater inner
strength. Those with truly great strength are gentle with restraint and courtesy.
Those with great inner strength project a powerfully strong energy and bring about
an atmosphere of simple solid spirit. With inner strength comes peace.




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Inner Peace


       For some people, spiritual growth means finding inner peace. Mahatma
Gandhi has said that ―each one has to find his peace from within. And peace to be
real must be unaffected by outside circumstances.‖ According to Ralph Waldo
Emerson, ―to be one with God is to be at peace…peace is to be found only within,
and unless one finds it there he will never find it at all. Peace lies not in the external
world. It lies within one‘s own soul.‖ Many spiritual practices consider inner peace
an experience of knowing oneself. Many believe that inner peace is only possible
with divine intervention of some form or another. (Wikipedia.com, 2006)


       Characteristics associated with inner peace include quiet calm and a personal
balance of physical needs, emotional needs and spiritual needs. Neglecting any of
these needs appears to upset one‘s sense of peace. You can instinctively sense your
own particular needs and get those needs met. Inner peace is an integration of
body, mind, heart and spirit. It also appears to require a balance in the intimate
relationship between oneself and the environment. It has been described that with
inner peace there is an absence of discord or struggle between one‘s head and heart
and no discord or division in spirit. Discord and pain has been faced with
compassion and healed. Those with inner peace are thought to face life just as it is.
Inner peace is not an absence of the tensions and turmoil of life, but rather peace in
the midst of tension and turmoil. Inner peace has been associated with a stillness
and presence within oneself. Some consider the experience of inner peace as feeling
at home with oneself or of learning to live in such a way that there are no enemies to
struggle with and no battles to win. Life‘s adversity can be welcomed as a blessing
and opportunity for growth rather than a threat to peace. For those who experience
inner peace even during times of great turmoil, the peace of God passes all
understanding.


       In the Buddhist tradition, inner peace comes when you stop holding on so
tightly to beliefs, ideas, objects or beings. According to Ajahn Chah, ―If you let go a
little, your will have a little peace. If you let go a lot, you will have a lot of peace. If
you let go completely, you will have complete peace and freedom. Your struggles
with the world will have come to an end.‖




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       It is possible to develop a way of relating to the world so that the spiritual
person is said to be in the world but not of it. Those who experience inner peace find
a spiritual place deep within themselves where they are poised and composed where
there is peace and stillness. It may be the realization of one‘s unity with life, light,
and the abundant goodness of God within themselves. Those who find inner peace
discover that it is not a destination to be reached but rather a way of living and
being. A sense of inner peace would seem consistent with optimal mental health. In
the words of Robert Lowry:


No storm can shake my inmost calm
while to that Rock I‘m clinging.
Since love is Lord of heaven and earth,
how can I keep from singing?




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Inner Joy




       Inner joy or inner joyfulness is an energy or spirit of a person. Someone
whose energy is truly joyful is content, calm, cheerful, glad, peaceful, playful and
happy. Some believe that joy comes when you heart is open and also with self-love.
Some feel that clearing your past reveals inner joy, moving from the wounded self to
presence. This can occur by releasing your pain with the healing power of
forgiveness which allows for an inner life of joy. Others believe that knowing where
your strengths and talents lie and your willingness to use them increases your inner
joyfulness. Still others believe that inner joy grows by being able to trust, take risks
and yet feel that the inner child is safe.   In the Christian tradition, inner joyfulness is
present in the believers heart all of the time. As Jesus advises in the New Testament
of the Bible, ―Be of good cheer,‖ ―let not your heart be troubled,‖ ―be not anxious,‖
―be not afraid,‖ ―rejoice, and again I say, rejoice.‖ Also in the New Testament Peter
states that, ―in believing in him you are filled with an inexpressible and glorious joy.‖
(1 Peter 1:8) And also, ―I will joy in the God of my salvation.‖ (Habakkuk 3:18) In
meditation, inner joy can be an expansion, a broadening of receptivity. According to
Sri Chinmoy, ―real joy comes from the feeling that we are constantly in the Lap of
the Supreme… If we can feel this, then we will see infinite joy in us and around us.‖
(Chinmoy 1974) Inner joyfulness, the joy of the spirit should be ours all the time.
Follow your heart and the path that brings you joy.




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Inner Beauty




       Usually, people think of beauty from the exterior of a person; but, there is
beauty that emanates from a person‘s core. You may see it in someone‘s radiant
glow, the gleam in his or her eyes or the warmth of his or her smile. Some have
suggested that inner beauty comes from who you are and how you live. Others have
professed that a person‘s beauty is the total impact of his or her physical, mental,
emotional, and spiritual makeup. Inner beauty has been tied to the heart,
compassion, and tenderness. Inner beauty may stem from genuine love of others as
well as oneself. From a spiritual perspective, inner beauty is the beauty of spirit, the
soul, the spark that emanates from within. One aspect of spiritual life is to
appreciate beauty, the beauty in every person, within yourself and the beauty all
around you. It is spirit that is beautiful. Wherever a person perceives beauty, spirit
is present. If someone is beautiful, it is because of the spirit within them. You can
promote your inner beauty by taking care of your spirit. You can learn to trust your
instincts, meet the needs of your spirit that you sense intuitively, and maintain in
this way healthy and beautiful spirit. The beauty of a healthy spirit is easily
recognized by others. There is a sparkle in the eyes. The eyes are clear and bright.
You are radiant and lovely. Having a personal sense of one‘s own inner beauty will
foster a general sense of wellbeing.




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The Fruit of the Spirit


        According to the Christian tradition, when a person accepts Jesus Christ as
their Lord and repents of their sins they are born again in a spiritual rebirth. As a
part of this rebirth, sin is thrust out of the new Christian, he or she is filled with God
the Holy Spirit and then the process of becoming more and more Christ-like and
spiritually mature begins. As a part of this process of becoming spiritually mature
under the influence of the Holy Spirit is the fruit of the Spirit. The growth of this fruit
depends upon one‘s study of the Word of God in the Bible as the Holy Spirit inspired
the Bible; it also depends upon prayer and fellowship with other believers. Also, the
fruit of the Spirit is not displayed when a Christian disrupts his or her fellowship with
Christ with sin. It is by maintaining a close and obedient relationship with Christ that
a Christian becomes more spiritually mature and Christ-like. This fruit of the Spirit
according to Galatians in the New Testament is love, joy, peace, patience, kindness,
goodness, faithfulness, gentleness and self-control.


        Love, the first aspect of the fruit, is the most characteristic quality of the
Christian. In the Bible Jesus is quoted:‖By this all men will know that you are my
disciples, if you have love for one another.‖ (John 13:35) ―Love your neighbor as
yourself.‖ ―Love God with all of your heart, soul, mind, and strength.‖ The love
referred to here is the highest form of love where the person filled with the Holy
Spirit sees something infinitely wonderful in the object of his or her love.     It is agape
love or divine love. "Love is patient, love is kind. It does not envy, it does not boast,
it is not proud. It is not rude, it is not self-seeking, it is not easily angered, it keeps
no record of wrongs. Love does not delight in evil but rejoices with the truth. It
always protects, always trusts, always hopes, it always perseveres. Love never fails."
(1 Corinthians 13:4-8). This love is demonstrated by the loving actions of the
person experiencing it. A person who loves in this way always seeks the best for
others despite what they have done. Christian love is extended even to those who
have caused harm or pain, even one‘s enemies. According to the Christian tradition,
this love grows supernaturally as the Christian surrenders himself or herself to the
will of God and is filled with the Holy Spirit.


        Joy is the second aspect of the fruit of the Spirit. According to the Christian
tradition, the joy of the Lord fills the believer‘s heart. The word for joy used in the



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New Testament of the Bible refers to joy from a spiritual source: the joy of God the
Holy Spirit. According to the Bible, the joy of the Holy Spirit does not depend upon
circumstances. While pleasures are temporary in life, the joy of the Holy Spirit is
deep and enduring even in the worst events of life. Usually we think of joy occurring
as a result of getting what we desire. Spiritual joy, the joy of God, holiness and
heaven may be the composed, serene, calm and unruffled feeling of light, harmony
and peace, of faith, hope and love. It may be complete self-command, the divine
completion of the Father who becomes more and more complete. As it says in the
Bible, ―Be still and know that I am God‖ (Psalm 46:10) As St. Thomas Aquinas has
said, ―love produces ecstasy.‖ Spiritual joy is the love of God.


       The peace experienced by Christians filled with the Holy Spirit is described as
the peace of God which passes all understanding. It is the tranquility of the soul, an
untroubled heart, that is unaffected by circumstances. With such peace, the
Christian maintains calm inner stability. In order to experience this peace the
believer begins with peace with God. According to the New Testament peace came
between sinful man and God by Christ‘s perfect sacrifice. As the Christian is filled
with the Holy Spirit he or she comes to experience the true peace of God and with
this peace he or she becomes a peacemaker, winning over others to friendliness and
bringing them into agreement and harmony.


       The word patience in the New Testament refers to a Christian‘s ability to
endure harm without anger or thought of retaliation. It refers to a joyful, hopeful,
loving heart that looks upon others with compassion and it refers to perseverance in
challenging circumstances. When difficult situations or trials test one‘s faith, the
Christian believer is strengthened by the Holy Spirit. Despite this ability to wait upon
the Lord, the patience of the Holy Spirit is not an excuse for procrastination.


       As a Christian becomes more Christ-like he or she displays kindness with
everyone. This loving kindness includes compassion and gentleness in relation to
others. It is a willingness to help others in need with a generosity of spirit. It is
goodness of heart and includes kind words and kind actions. This kindness involves
acting for the good of other people no matter what they do.




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       The Christian filled with the Holy Spirit aims for the highest moral and ethical
standards, righteousness and honesty.      The Bible asks that a Christian behave in
such a manner that God may consider them worthy of their calling and that they
may glorify Christ by their goodness. The goodness produced by the Holy Spirit is
the goodness that results from deep love, the actions of a good heart. The believer‘s
goodness serves to please God.


       Faithfulness in the fruit of the Spirit‘s sense refers to fidelity. It is accepting
the responsibilities of a Christian life. It is being true to one‘s promise, dedicated,
dependable and worthy of trust. Being short of faithfulness is an indication of
spiritual immaturity. According to the Christian tradition, all Christians will stand
before Jesus Christ to explain their works done since conversion to Christianity and
to be judged on the basis of how faithful they have been. This faithfulness includes
living according to the principles of righteousness as described in the Bible, reading
scripture and prayer. Faithfulness as an aspect of the fruit of the Spirit is
faithfulness to one‘s calling and responsibilities.


       Gentleness as an aspect of the fruit of the Spirit means more than sensitivity
to others, it means being even-tempered or brought under control.         With gentleness
there is a quiet strength.   Power is controlled like a skilled rider on horseback. It is
being reasonable, considerate and fair. Gentleness is thinking of oneself with
modesty, resisting urges to become defensive when feelings are hurt, and it is
maintaining poise. Those who are gentle are balanced in spirit. They rule their spirit
well. When Jesus is quoted as saying that the meek will inherit the earth, he was
referring not to weakness but to the gentle in spirit.


       Self-control is mastery over one‘s thoughts and actions. It is control over
one‘s use of food, alcohol, sexual behavior, anger and any other passion that may
lead one to overstep one‘s responsibilities. Self-control is personal restraint and
mastery over one‘s natural impulses. It is the ability to remain sober and calm.


       As the Christian yields his or her will to the will of God, the Holy Spirit lives
within and brings about the growth of the fruit of the Spirit: love, joy, peace,
patience, kindness, goodness, faithfulness, gentleness and self-control. The fruit of




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the Spirit in the Christian tradition appears to be consistent with optimal mental
health. (Graham, 1978)




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Spiritual Energy and the Life Force


       Everything that is alive seems to pulsate with energy. Every event in life is
an expression of energy from the level of a single living cell to the complex behaviors
associated with interpersonal relationships. A person‘s energy has physical, mental,
emotional and social components; yet, the energy of a person comes across as his or
her spirit. You get a sense of someone‘s energy during interpersonal interaction. In
the presence of another person‘s healthy energy, we tend to feel healthier ourselves.
On the other hand, some people‘s unhealthy energy can drain us emotionally if we
do not take breaks to recharge ourselves, refresh our spirit, cleanse ourselves and
get back into balance. We project on the outside what we feel on the inside.


       The physical contributions to a person‘s energy or spirit are important to the
overall spirit of a person. A person who exercises or is involved in significant
physical activity emits a different energy than a sedentary person. A person who
eats a healthy diet will feel different in spirit to us from someone whose diet is poor.
People who are physically ill feel different in spirit than those who are well.


       The mental and emotional contributions to a person‘s spirit or energy come
from thoughts. We often don‘t exactly know why particular thoughts enter our
minds; yet, we can influence our thoughts. Our emotional energy wells up from our
past and present relationships, powerful or traumatic experiences, our storehouse of
memories, and our beliefs and attitudes. Positive experiences bring about vitality
while negative experiences can sap our energy unless we come to terms with such
unpleasant events, refresh and recharge ourselves. An optimistic person emits a
different energy than someone with a negative attitude. The formation of attitude is
complex involving beliefs, values, and feelings. Attitudes are relatively stable and
enduring. They predispose us to behave or react in particular ways. According to
Victor Frankl who endured imprisonment in Nazi concentration camps, ―everything
can be taken from a man but… the last of human freedoms- to choose one‘s attitude
in any given set of circumstances, to choose one‘s own way.‖


       Charles Swindell has said, ―The longer I live, the more I realize the impact of
attitude on life. Attitude, to me, is more important than facts.    It is more important
than the past, than education, than money, than circumstances, than failures, than


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successes, than what other people think or say or do. It is more important than
appearance, giftedness, or skill. It will make or break a company, a church, a home.
The remarkable thing is we have a choice every day regarding the attitude we will
embrace for that day. We cannot change our past… we cannot change the fact that
people will act in a certain way. We cannot change the inevitable. The only thing we
can do is play on the one string we have, and that is our attitude. I am convinced
that life is 10 percent what happens to me and 90 percent how I react to it and so it
is with you.‖ Your attitude is under your control and a healthy attitude brings about
better quality of life, positive energy and a healthy spirit. Every day, we experience
the energy of our own attitude and the attitudes of those people around us.


       We most easily recognize others‘ energy or spirit in a social context. The
quality of our own social energy influences other people‘s reactions to us while
others‘ social energy brings about a gut level reaction in ourselves. Another person‘s
bold disposition, passion and enthusiasm, calm assertiveness or kind firmness feels
very different from someone else‘s chaotic drama, suspiciousness, indecision,
apathy, inflexibility, negativism, or fear. There is an emotional contagion to social
energy. Calm social ease produces calm social ease in others while an awkward
disjointed energy makes others uncomfortable as well. Social ease and positive
social energy appear to support our health while negative social energy leads to
distress and even illness. We need to choose our social environments wisely so that
our health is not negatively influenced by others. When negative influences are
unavoidable we need to take time to get back in balance, cleanse, recharge and
refresh ourselves, and revitalize our spirit. According to Oprah Winfrey, ―All life is
energy and we are transmitting it at every moment. We are all little beaming little
signals like radio frequencies, and the world is responding in kind.‖ Jill Bolte Taylor
advises us to ―Please take responsibility for the energy you bring into this space.‖


       In the Eastern medical tradition, one‘s energy state is thought to account for
illness or good health. Healing interventions at the energy level have been
performed with healing touch, massage, acupuncture, herbal medicines and other
methods. Practitioners of these alternative methods of healing are acutely sensitive
to the energy of another person. Some believe that energy is inborn and also
influenced by diet and activity. Another theory poses that energy is developed in
seven chakras or energy centers along the spine and this energy runs through the




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body. According to this theory, the power of the first chakra comes from a general
sense of belonging and tribal culture. The power of the second chakra comes from
relationships. The power of the third chakra comes from one‘s self- esteem and
intuition. The power of the fourth chakra comes from emotions: love, compassion,
forgiveness and an empowered heart. The power of the fifth chakra comes from will,
self-expression, and the triumph of faith over fear. The power of the sixth chakra
comes from mind, the ability to detach, become consciously aware, and develop
insight and wisdom. The power of the seventh chakra comes from spirituality and
spiritual awakening.


          According to Eastern medical practitioners, a person‘s energy needs to be in
harmony in order to feel well. There needs to be a balance between Yin and Yang,
between different organs of the body and between the body and the environment.
(In Western culture, Yin and Yang are often inaccurately portrayed as corresponding
to ―evil‖ and ―good‖ respectively; rather, Yin and Yang are complementary and
opposing forces which are present in everything: passive-active, darker-brighter,
cold-hot). According to these practitioners, the balance of energy is constantly
getting imbalanced, but a healthy body quickly restores the dynamic equilibrium.
When our systems are functioning naturally we are considered to have harmonious
energy flow. The body (and mind) provides the right defense or immunity when
needed, the wear and tear of the body (and mind) is repaired, waste and negative
emotions are eliminated, and countless other processes occur to keep the whole
being healthy. When this energy remains unbalanced, then illness and pain are
experienced. According to this model, disease and dysfunction can be eliminated by
readjusting the energy balance in order to create greater harmony. Traditional
Chinese medicine corrects the imbalance through the use of acupuncture, herbal
remedies, exercise, diet and lifestyle. As balance is restored in the body, so is
health.


          Many cultures through history have proposed that an animating force lies
within living beings. Only in death is this vital force thought to leave us. This vital
spirit, life force, or energy helps to inspire in us the will to live and to thrive. People
can often detect a strong presence or diminished presence of the life force in others.
You can sense it in a person‘s air or spirit. This force can inspire in us a sense of
personal power and inner strength. It seems that we can get in touch with and rely




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on the influence of our life force to help us promote both exceptional physical and
mental health. By learning to recognize the life force energy within we may come to
live with greater health, vitality and quality of life.


       There is energy in the spirit of a person. It has been suggested that getting
that energy into greater balance and harmony brings with it greater health. Optimal
mental health may depend upon an ongoing adjustment and regulation of energy in
order to bring about its balanced and harmonious flow through the body, mind, heart
and spirit. In line with this theory, if the energy of our system is properly cultivated
and kept active, if the energy of the body is in proper balance and full flow, there is
perfect physical and mental health.




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Radiating Your Spiritual Light


       Life can be darkened by negative events, confusion, frustration and the
negativity of other people, but light radiates in opposition to the darkness of life.
Spiritual light is good in all respects. It has been said that a person‘s light comes
from the eternal presence of God. It is the divine energy that radiates in a person‘s
spirit. According to the Bible, by the grace of God, a person‘s light will shine.
According to some believers a person can become a light that radiates the presence
of God through their soul and personality. The light of God is ignited in a person in
the way that one candle lights another; nothing is depleted by sharing the light. It
has been said that as a people we are united by one light, God‘s light, our spark
within. To be illuminated is to be bathed in spiritual light.   Do you have God‘s light
shining within you?


       Some people believe that we increase our spiritual light by exposing ourselves
to other people (and their works) who have reached higher spirituality than
ourselves. It has been said that a person‘s spiritual consciousness or light is his or
her basic reality. It is by our good works that other people know our light shines. It
has been said that the more light a person has within his or her soul, the more
gratitude he or she has to God. According to the New Testament of the Bible, ―For
the fruit of the light consists in all goodness and righteousness and truth.‖
(Ephesians 5:9) In the Old Testament it says, ―Arise, shine, for your light has
come…‖ (Isaiah 60:1) It appears that radiating one‘s spiritual light is consistent with
optimal mental health.




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Getting Grounded


       Another aspect of spiritual life and religious practice that has been associated
with exceptional mental health is the experience of being grounded. To be grounded
is to have a strong foundation upon which mental and emotional stability is built.
Many feel that by learning about and practicing a faith, a solid context is created
through which new experiences are understood and a solid base or anchor is
established so that a person can venture out into the world with confidence. For
example, the religious traditions may bring balance and stability.


       When people are ungrounded, they may lack goals or direction. They may be
easily upset, unsettled or emotional. They may seem spacey and out of touch with
the here and now. Some have proposed that being ungrounded means that one‘s
soul is off somewhere else. In this view, the soul can be pulled back into the body
by anchoring oneself to the ground. For example, a person might imagine just
briefly a powerfully strong cord of energy from the center of his or her body
anchored to the center of the earth.


       Others feel that being ungrounded is due to the tendency of people to live in
their heads rather than inhabiting their bodies. Life may seem to exist only from the
neck up. It is not unusual to stop appreciating the sensations of the body. In this
model of getting grounded, by developing a body felt sense we become more whole
and stable.


       While viewpoints differ about exactly what constitutes getting grounded,
many people have considered getting rooted, anchored or grounded an important
benefit of spiritual work. Clearly, the experience of feeling grounded can be
associated with exceptional mental health. A strong foundation helps to create
exceptional mental and emotional stability.




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Keeping Your Heart Open


        According to the mystic poet Rumi, ―the only lasting beauty is the beauty of
the heart.‖   In addition to a physically beating heart we have a feeling heart, a
spiritual heart. We feel with the heart. The open heart is receptive to others. When
we open our hearts we let go of negative emotions, we are calmer, warmer, more
peaceful and happy. Being aware of love opens the heart.       The heart that loves
stays young. The heart can become emotionally closed from pain, suffering, loss and
guilt. Whenever you react to situations in a negative way it closes your heart.
Letting go of emotional baggage makes your heart feel lighter so you can heal and
empower yourself. According to James Baraz in his book Awakening Joy, ―The
willingness to be with any situation, no matter how challenging, trains the heart to
stay open -- an essential ingredient for a joyful life.‖ He also says that ―fearlessly
being with your sorrows keeps your heart open to all of life.‖ (Baraz and Alexander,
2010)


        Some people are hesitant to open their hearts because of fears that they will
be vulnerable or hurt again. You have to let your guard down and be willing and
open. If you can find a safe, trusting, loving environment you can let the walls
down. You cannot let your guard down safely with someone else who is not willing
to also let theirs down. As the walls come down, your capacity to love reciprocally
increases.    Smiling opens the heart with happy feelings, love, joy, peace, gratitude,
and comfort. Compassion, acceptance and forgiveness also open the heart.         It has
been said that there is a light that shines in the heart as you love yourself and open
your heart to divine love. It has also been said that love and laughter soften the
heart to the beauty of life and God. Some have used meditation to open their
hearts. Breathing deeply opens the heart while shallow breaths seem to close the
heart. A loving kindness meditation where one expands their feelings of compassion
from those who are close, to oneself, to one‘s community, and then to the world
community also helps to open the heart.


        Some people say that your heart becomes stronger as it opens and more
resistant to negative emotion. It has been said that there is no greater misfortune
than having an enemy and in times of conflict you may need to protect your heart.
But the heart breaks free with victory. Your heart rests with peace. Your heart opens
when you trust. Some believe that your heart heals by opening so that you can


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become more whole and complete, satisfied and fulfilled.   When your heart grows
wide open it can become as open as the sky. You can receive the world and what
comes with open arms.   An open heart lifts the spirit and makes optimal health and
functioning possible.




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Wonder and Awe




         Wonder and awe may be the foundation of spirituality. It is the experience of
tremendous reverence and admiration when contemplating that which exists, what is
known and what remains unknown.        Wonder and awe is a spiritual feeling, possibly
being moved to tears or to exaltation. We may experience wonder and awe listening
to great music, taking in the beauty of nature or art or digging into the magnificent
and incredible complexity of life on planet earth. Some have tremendous reverence
for the dead, for God, or for the miracle of the origin of life. There is so much
compelling about all that is known, not to mention what is not known. Awe is
inspired with the awareness of how small one is in relation to the universe, so vastly
huge, beautiful, and mysterious. Albert Einstein described a cosmic religious feeling
when one contemplates ―the nobility and marvelous order which are revealed in
nature and in the world of thought.‖ For many of us there is a magnificent beauty
and extraordinary elegance in the laws of nature and the cosmos.


         Asking profound questions inspires wonder and awe: What happens when we
die? What is the purpose of what we are doing here? What is our place in the
world?    Who is God?   Wonder opens us to an unseen world beyond scientific
explanation, entertaining the possibility that there is something more than physical
reality. As Jesus claims, ―the kingdom of God is within you.‖ (Luke 17:21) According
to the mystic poet Rumi, ―when you look for God, God is in the looking.‖ When one
experiences the fabric of wonder and awe one finds themselves at the doorsteps of
spirituality. This feeling may be a basic ingredient of spiritual health and a
component of optimal mental health.




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Honoring the Sacredness of Life



       When a person looks at the world and all of life as God‘s creation, he or she
can become deeply respectful of the sacredness of it all. According to Gary Zukov,
―The decision to become a reverent (or deeply respectful) person is essentially the
decision to become a spiritual person.‖ To see the world and all of life as sacred
makes a person act with maturity. Nothing and no one is treated with disregard for
its, his or her intrinsic value and holiness. It is by honoring the sacredness of life
that we appreciate all of what life offers us and give our best as a token of our
appreciation. In relationship it has been said that ―the divine in me honors the
divine in you.‖   According to Jean Houston, ―We can live on earth in ways that honor
each other, that honor the web of life, of culture, for both today and future
generations.‖ (Houston 2009) Honoring the sacredness of life may help to promote
optimal mental health.




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Enlightenment



       Enlightenment is usually associated with the awakening experience achieved
by Gautama Buddha and his disciples. It is sometimes described as perfect sanity or
awareness of the true nature of the universe. It is the end of suffering. The process
of enlightenment involves becoming aware of reality as though awakening from a
dream. It is not something that happens once and is then finished; it is growing all
the time. As a part of this belief system, we already are what we want to become.
We just need to return ourselves to our true nature. According to Buddha, ―whoever
practices the Four Immeasurable Minds together with the Seven Factors of
Awakening, the Four Noble Truths and the Noble Eight Fold Path will arrive deeply at
enlightenment.‖


       The Four Immeasurable Minds are love, compassion, joy and equanimity
(composure). The Seven Factors of Awakening are 1. mindfulness; 2. investigation
of phenomena; 3. energy, effort, diligence, or perseverance; 4. ease, taking it easy;
5. joy; 6. concentration; and 7. equanimity. The Four Noble Truths are 1. suffering,
2. the origin of suffering, 3. the cessation of suffering by refraining from doing the
things that make us suffer, and 4. the path that leads to refraining from doing the
things that cause us to suffer (The Noble Eight Fold Path). The Noble Eight Fold Path
is 1. right view, 2. right thinking, 3. right speech, 4. right action, 5. right
livelihood,6. right diligence,7. right mindfulness and 8. right concentration.


       Immediately before his enlightenment the Buddha was contemplating the
chain of conditions that results in suffering. It is by seeing the dependent arising of
suffering that a person may be liberated. Whatever arises, whatever comes into
being, depends upon conditions. Phenomena arise from the combination of many
conditions or causal factors, while cause and effect can imply that a single cause
results in a particular outcome.    The liberation from suffering occurs by bringing an
end to the chain of conditions that bring suffering about. Removing the fundamental
links that lead to suffering will result in liberation.


       Our lives are a stream of experience and according to Buddhist tradition
consciousness continues throughout our existence. According to Buddha our minds
have been obscured by ignorance, not seeing, not fathoming, the four noble truths.



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Our actions come about based upon the condition of this ignorance. We create our
karma by thoughts (mental acts) and behaviors based upon our ignorance.
According to Buddhism, what arises in consciousness is dependent upon karma, all of
past experience, including past lives. Our consciousness is the condition upon which
our psychophysical being comes about and from this condition our senses arise.
From the input of our senses our consciousness makes sense of the surrounding
world. Feeling arises dependent upon this consciousness of the world including both
the surrounding world and our own inner world.         Dependent upon feeling, craving
arises. We become attached to pleasurable experiences and we desire future
pleasures.


        According to Buddhist tradition, in the space between feeling and craving the
battle is fought to liberate oneself from suffering.    We can cling to sense pleasures,
to opinions, beliefs and theories, to rules or rituals, and to our notions of the mind
and body being a self.    We accumulate our karma based upon this clinging and
craving. Our future life depends upon this karma derived from craving and clinging
and ultimately brings about aging and death. This network of conditions brings
about our present and future life.


       Ignorance can be overcome; developing an understanding of the four noble
truths is possible.   According to Buddhism by overcoming ignorance, all suffering
comes to an end.      Craving is the origin of suffering. Mindfulness helps to prevent
feeling from resulting in craving. Meditation is the core of Buddhist practice to reach
enlightenment. Meditation brings concentration, serenity, and insight. Wisdom is
dependent upon concentration. The wisdom that leads to enlightenment cuts off the
defilements (greed, hatred and delusion). By suppressing the defilements, we
mindfully still the activity of the unwholesome states. Insight meditation is directed
at ignorance.


       It is believed that after achieving enlightenment a person is freed from the
cycle of birth, suffering, death and rebirth.     The roots of all greed, aversion,
delusion, ignorance, craving and ego-centered consciousness are uprooted. With
enlightenment comes transcendent peace. (Wikipedia.com, 2008)


According to Kornfield the following Buddhist principles help to promote wellbeing:




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1. See the inner nobility and beauty of all human beings.
2. Compassion is our deepest nature. It arises from our interconnection with all
   things.
3. When we shift attention from experience to the spacious consciousness that
   knows, wisdom arises.
4. Recognize the mental states that fill consciousness. Shift from unhealthy
   states to healthy ones.
5. Our ideas of self are created by identification. The less we cling to ideas of
   self, the freer and happier we will be.
6. Our life has universal and personal nature. Both dimensions must be
   respected if we are to be happy and free.
7. Mindful attention to any experience is liberating. Mindfulness brings
   perspective, balance, and freedom.
8. Mindfulness of the body allows us to live fully. It brings healing, wisdom, and
   freedom.
9. Wisdom knows what feelings are present without being lost in them.
10. Thoughts are often one-sided and untrue. Learn to be mindful of thought
   instead of being lost in it.
11. There is a personal and universal unconscious. Turning awareness to the
   unconscious brings understanding and freedom.
12. The unhealthy patterns of our personality can be recognized and transformed
   into a healthy expression of our natural temperament.
13. There are both healthy desires and unhealthy desires. Know the difference.
   Then find freedom in their midst.
14. If we cling to anger or hatred, we will suffer. It is possible to respond
   strongly, wisely, and compassionately, without hatred.
15. Delusion misunderstands the world and forgets who we are. Delusion gives
   rise to all unhealthy states. Free yourself from delusion and see with wisdom.
16. Pain is inevitable. Suffering is not. Suffering arises from grasping. Release
   grasping and be free of suffering.
17. Be mindful of intention. Intention is the seed that creates our future.
18. What we repeatedly visualize changes our body and consciousness. Visualize
   freedom and compassion.
19. What we repeatedly think shapes our world. Out of compassion, substitute
   healthy thoughts for unhealthy ones.




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   20. The power of concentration can be developed through inner training.
       Concentration opens consciousness to profound dimensions of healing and
       understanding.
   21. Virtue and integrity are necessary for genuine happiness. Guard your
       integrity with care.
   22. Forgiveness is both necessary and possible. It is never too late to find
       forgiveness and start again.
   23. There is no separation between inner and outer self and other. Tending
       ourselves, we tend the world. Tending the world, we tend ourselves.
   24. The middle way is found between opposites. Rest in the middle and find well-
       being wherever you are.
   25. Release opinions, free yourself from views. Be open to mystery.
   26. A peaceful heart gives birth to love. When love meets suffering, it turns to
       compassion. When love meets happiness, it turns to joy.

(Kornfield, 2008)


       According to Eckhart Tolle, enlightenment is your natural state of felt oneness
with the eternal, ever-present one life beyond the many forms of life that are subject
to birth and death. It is deep within as the innermost invisible and indestructible
essence. Tolle teaches that this eternal Being can be felt when you are present,
when your attention is fully in the here and now. He also teaches that the eternal
Being can never be understood mentally; but, to regain awareness of Being and to
endure in the state of ―feeling realization‖ is enlightenment. It is a connection with
something that is essentially you and yet something much greater than yourself.
According to Tolle, the most important step toward enlightenment is to disidentify
from your mind; you are not your thoughts. The light of your consciousness grows
stronger when you create gaps in the stream of thought. Tolle suggests that one
day you may find yourself smiling at the voice in your head, as you would smile at
the antics of a child; you no longer take the content of your stream of thoughts that
seriously as you no longer depend upon your mind as your sense of self. Rather to
know yourself as the Being underneath thinking, the stillness underneath the noise
of mental activity, and the love and joy underneath the pain, is freedom and
enlightenment. Furthermore, Tolle teaches that one must surrender in order to gain
spiritual power. Through surrender, you may find that situations change without any
effort on your part. (Tolle, 1999)



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Spiritual Liberation


       Spiritual liberation means to be set free as from bondage, oppression, foreign
control, confinement or imprisonment.       Liberation means overcoming obstacles, it is
to be released from the hold of evil and suffering. Those who suffer today may be
free tomorrow. Being liberated means being free of the hatred, envy or jealousy of
others. As Albert Einstein once said,      ―Arrows of hate have been shot at me, too;
but they never hit me; because somehow they belong to another world, with which I
have no connection whatsoever.‖        Those who are liberated can celebrate life as
opposed to being limited to solving the problems of life. Liberation means becoming
a free spirit. According to John P. Milton, liberation is found in relaxation and
presence. The union of relaxation and presence leads to the liberation and natural
cultivation of your life force.   Liberation includes freedom from the need to belong to
the herd, freedom from trends. In the Christian tradition, spiritual liberation is a gift
of grace from God. As a version of Amazing Grace says, ―My chains are gone. I've
been set free. My God, my Savior has ransomed me.‖ In the Buddhist tradition,
liberation means freedom from unhealthy desires, grasping to attachments, and
mistaken thinking or delusion.      Liberation means lifting the veil of ignorance or
illusion to reveal what is true and beautiful, to see clearly and become free at last.
With spiritual liberation the individual is free to realize his or her potential and be
free of suffering.




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Spiritual Power


       When a person thinks of power they typically think of the ability to wrestle
with an opponent and come out of it unscathed and victorious. Power is also
considered the ability to do what one wants, regardless of the will of others. Physical
power means being able to do things physically while mental power is sound thinking
and clear intuition. It has been argued that knowledge is power. Social power is
authority and influence, and the capacity to lead. It has been said that if you lust for
power without love in your heart, your search will be empty and attainments hollow.
According to John F. Kennedy, ―those people who foolishly sought power riding the
tiger wound up inside.‖


       It is possible to access social power with body language and verbal
communication, physical power with exercise, mental power with education and
experience and spiritual power with faith, belief, good karma, or the shared energy
of another person. Some feel that spiritual power must be awakened by an
enlightened master. You may feel very calm when you sit with a spiritual master
while those who are evil minded or very fierce create feelings of restlessness or fear
with their spiritual energy.   Spiritual power can mean the power of faith, to feel
assured that nothing will be impossible for you; there are no limits to what you can
accomplish. It can manifest as the simple divine healing power within you. Many
have said that fasting brings spiritual power as you sharpen your spiritual senses so
that God can get through to you. In the Christian tradition, the Holy Spirit is the
source of spiritual power available to all believers. With good karma created by
serving and helping others it has been said that we develop soul power. It may be
that our power grows through its prudent use. To whom much is given, much is
required.




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Authority and Mastery Over the Unseen Forces of Darkness




       George Leonard in the book Mastery: the Keys to Success and Long-term
Fulfillment, advises that we should honor the darkness, our shadow, but not indulge
in it. Jay Phillips, a psychoanalyst, says that we should consider the devil a worthy
adversary. According to the Bible, the life of Jesus is a perfect example of how to
conduct spiritual warfare and master evil forces. There are many instances
throughout the gospels in The New Testament where Jesus exercised his authority
against spiritual foes in the unseen world. According to Michael Harper, ―God is
equipping his people to respond fully to the attacks of satanic power‖ with
supernatural weapons.     ―God who enlists us in his army also trains us,‖ and ―evil
triumphs when the good do nothing.‖ In Timothy we are advised to ―fight the good
fight of the faith.‖ (1 Tim. 1:6-12) Also, ―submit yourselves therefore to God. Resist
the devil and he will flee from you.‖ (James 4:7) ―Resist him firm in your faith.‖ (1
Peter 5:8) Harper advises, ―When Satan has actually gained access to our lives we
must serve him immediately with an eviction order, but the measure of success we
have may well depend to a greater or lesser extent on the people we are, the use of
the weapons God has placed in our hands, and the procedure we follow. Detection is
half the battle, but expulsion must follow, and we must be prepared to persevere
until the enemy leaves for good.‖ In Jesus words, ―I have given you authority to
tread upon serpents and scorpions and over all the power of the enemy; and nothing
shall hurt you.‖


       According to the New Testament, authority over the unseen forces of
darkness is a ministry which is potentially available to every Christian; it is viewed by
some as a charismatic gift to turn others from the power of Satan to God. Jesus
asserts in Mark 16:17 that the casting out of evil spirits is one of the signs which will
follow ―them that believe.‖ According to Harper, the kind of people that we are and
the kind of life we live may play an important part in our capacity to exercise
authority against demonic powers. He also states that our success depends upon
God but we exercise the authority. It may help to have purity (you can cleanse
yourself by repenting of sins) and a passion for righteousness, to have the power of
the Holy Spirit, to wield authority with faith and to have knowledge of scripture.     In
dealing with these forces it helps to be able to discern spirit, have a good conscience
and make use of scripture with reverence for its authors and God. As Jesus has said,


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―If you ask anything in my name, I will do it.‖ (John 14:13-14) According to the
Bible we are protected by the armor of God. Harper explains that the belt of truth
protects against lies and errors, the breast-plate of righteousness, God‘s
righteousness, protects against evil and sinful desires, the sandals of the gospel of
peace protect against an easy and lazy life, the shield of faith protects against
calamity and accident and we are also protected by the sword of the spirit (both
offense and defense) which is the Word of God. We are protected by the name of
the Lord which is ―a strong tower, the righteous man runs into it and is safe.‖
(Proverbs 18:10) We may also be protected by the angelic hosts.


       You may become aware of evil forces when there is temptation, when it is
difficult to function properly or there is loss of control. It is helpful to have an
attitude of genuine love for the affected individual, including oneself, and to have a
gentle spirit in helping while getting angry and rough with the forces of darkness and
exercising authority spoken in faith. According to Harper, ―it is not the words
themselves that are important, so much as the faith and authority with which we say
them.‖ After people are delivered from the attack of evil spirits, encouragement,
prayer, fellowship and advice will help them heal. The void left behind can be filled
with the Holy Spirit. As it says in the Bible, ―whatever you ask in prayer, believe
that you receive it, and you will. (Matt. 11:24) (Harper, 1970)




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Self-Realization


        Self-realization is the actualization of human potentialities in order to live a
life of excellence. It includes healing childhood trauma and developing a healthy ego
but self realization includes the blossoming of human potential beyond the norm of
the well- functioning ego. As the army says, ―Be all that you can be.‖ The question
for every person is ―which capacities should be developed?‖      Some have advised
that people should strive to become well- rounded at the risk of becoming ―a jack of
all trades and a master of none.‖ Focusing on too many things may deprive one‘s
interests of the needed attention to achieve excellence. Other people advise that
people should concentrate their efforts on one major interest and build other
interests around it. One should find where their talent lies, what they do best, and
do that. But often there are many things a person can do well and they must trust
their gut about what interests them most. It means responding to one‘s deepest
callings and discovering one‘s direction in life. When you realize your purpose you
build character. When it comes to work one must keep economic factors in mind;
your area of interest may not earn you a living if you don‘t choose wisely. In order
to be of value, an area of interest must enhance others or harmonize with them.
The greatest hope for self-realization of humanity is the development of an optimally
coherent system of mutually harmonious fulfillment for us all. One‘s fulfillment fits
well with society, activities are congruent with who you are and cause no personal
harm.


        In the spiritual sense, according to the Hindu tradition, self-realization refers
to the realization that the individual soul is one with the divine ground of all being or
the source of all existence, a loving eternal union with God. This is the realization of
one‘s fundamental nature. According to the Indian Guru Meher Baba, self-realization
is God-realization.   One achieves consciousness of his or her true original identity as
God. According to Meher Baba, God-realization is not truly experienced by reading
or contemplation but rather with the guidance of a master.       ―The happiness of God-
realization is self-sustained, eternally fresh and unfailing, boundless and
indescribable…‖ (Wikepidia.com, 2009) With God-realization comes God-
consciousness, perhaps what every soul craves. Becoming aware of God-
consciousness, our thoughts flow with Godspeed, we understand deeply, everything
makes sense; we do what is correct and avoid doing what is wrong. We can take
steps to strengthen this consciousness and avoid actions that degenerate it.


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Chutzpah


       Chutzpah is a Yiddish term for extreme self-confidence. It includes know how
and ability but also brazen nerve, spunk and gutsy audacity. In United States slang,
cojones is a related term for courage, brazeness, nerve, guts and a brave attitude.
Some consider chutzpah stepping over the accepted boundaries of behavior without
shame.     Others describe chutzpah as blind assertion to avoid trouble, defeating
enemies, or winning streaks. Sisu, a Finnish term also related to chutzpah, is the
strength of will, determination, and perseverance in the face of adversity, to sustain
action against the odds. It may be considered a combination of bravado and bravery,
in the most difficult battles to keep fighting after most would have quit and to fight
with the will to win. It may mean even having a dogged determination capable of
facing down death itself, having staying power, a stoic toughness. It depends upon
good judgment that guides you to not act in foolish ways that belie common sense.
Such self-confidence is an inner quality, a spiritual quality. It is as though God
allows you to have higher thoughts and therefore extreme self-confidence.
(Wikipedia 2011)




                                          293
Contentment and Bliss


       According to Karl Menninger, ―mental health is the ability to adjust to the
external world with contentment and master the task of acculturation.‖ Contentment
is being at ease with one‘s situation, satisfied and happy. It has been said that those
who are happy with their portion or lot in life are rich in spirit.   According to Ben
Franklin, ―contentment makes poor men rich, discontentment makes rich men poor.‖
According to Buddha, ―health is the greatest gift, contentment the greatest wealth,
and faithfulness the best relationship.‖ Bern Williams has said that ―we may pass
violets looking for roses.‖ When one can live with desires and expectations in
harmony with the experiences of life contentment becomes an inward disposition.
According to Lin Yu-t‘ang, ―the secret of contentment is knowing how to enjoy what
you have, and to be able to lose all desire for things beyond your reach.‖ Being
content means remaining free of envy, avarice and anxiety. While some may believe
that the drive of ambition is opposed to contentment, Mohammed has said that
―patience is the key to contentment.‖ According to Gilbert Chesterton, ―true
contentment is a thing as active as agriculture. It is the power of getting out of any
situation all that there is in it. It is arduous and it is rare.‖


       According to Johann Wolfgang von Goethe contented living requires ―health
enough to make work a pleasure, wealth enough to support your needs, strength to
battle with difficulties and overcome them, grace enough to confess your sins and
forsake them, patience enough to toil until some good is accomplished, charity
enough to see some good in your neighbor, love enough to move you to be useful
and helpful to others, faith enough to make real the things of God and hope enough
to remove all anxious fears concerning the future.‖ According to the Dalai Lama true
happiness, contentment and peace comes through ―the cultivation of altruism, of
love and compassion, and elimination of ignorance, selfishness and greed.‖
Contentment is an attitude of the heart rather than something one struggles to
reach. In the Christian tradition, when all has been transferred to God, the believer
learns to be content in whatever state he or she is.


       Bliss is a state of utter joy or contentment, profound spiritual satisfaction and
happiness. Often bliss is associated with religious ideas of the afterlife, heaven,
paradise, and eternal bliss contrasted with eternal torment or dissatisfactions.
Others have pointed out that bliss comes in life from the inner fire, the fire in the


                                             294
belly. Some find bliss with the practice of meditation. Bliss may come from love or
an open heart. Bliss may arrive when one begins to forget oneself or becomes
engrossed in a challenging activity with flow. Bliss may come with the joy of
passionate, soulful sex and intimacy. The ecstasy and spiritual joy of bliss is the
highest form of contentment.




                                          295
Soulfulness


       Soulfulness is a spiritual quality with depth of feeling and emotion.   It is the
capacity to touch another person, to move them to open up their heart. It means
resonating deeply with one‘s thoughts or experiences. It is the heart felt expression
of gesture, words or music that a person is trying to get across to someone else.
Someone can sing or play music soulfully, share a message soulfully or have soulful
eyes or a soulful smile. A person may give a soulful hug or walk soulfully.
Soulfulness comes with the depth of love a person feels, soulful people love, perhaps
in a divine way. With a person‘s soulful expression it is as though something is
speaking through them, an instrument for a divine message.      A person‘s soulfulness
may move you or touch you, or uplift you spiritually. When someone talks soulfully
there is a music to it, a deeply emotional music that enables others to connect, that
moves the spirit.




                                          296
Spiritual Growth and the Heights of Spiritual Achievement


       Spiritual growth means developing in response to experience and stressors
while achievement rises to the greatest possible heights of accomplishment. While
growth can produce peace in the midst of turmoil or faith in difficult circumstances,
achievement can mean becoming a model of holiness, heroic virtue, gifts of the spirit
or perhaps even performing miracles. According to the Canadian Institute for Health
Information, spiritual growth can mean ―searching for and finding truth, meaning
and purpose in life and developing feelings of connectedness to oneself, others and a
higher power or something larger than oneself.‖ Spiritual growth can mean learning
that all things are possible if you believe while spiritual achievement can mean that
God authenticates his presence within you with signs, wonders and miracles.
Spiritual growth can mean restoring the balance of forces affecting one‘s life, getting
closer to one‘s deepest calling, health, harmony and prosperity, being liberated from
suffering, and extinguishing all doubt; while, spiritual achievement can mean casting
out demons, healing the sick, or other gifts of spirit. Spiritual growth and
achievement can mean becoming an exemplary model or an extraordinary teacher.
It may mean having great wisdom and followers, being a guru, and sharing the
company of God with others.     It may mean becoming an enlightened master, as
some might say like Buddha, Krishna or Jesus. It can mean becoming a source of
benevolent power. The greatest heights of spiritual achievement may mean climbing
the highest mountain on earth where God gives you a voice that might reach the
very ends of the earth. It may mean saving one person or saving the world. A
person who has been elevated by popular opinion as a great, pious and holy person,
someone who encourages others during their spiritual journey, possessing a sure
and holy intelligence, someone whose good works are an example, a model to be
imitated has achieved the heights of spiritual achievement.




                                          297
Spiritual Issues in Success



       Some may argue that we succeed because of our winning track record
whether we play fair or dirty.    Some may feel guilty for success, but success may be
our good karma unfolding, exercising soul power… exercising soul power from this
lifetime and/or previous incarnations of the soul in order to achieve great things. In
line with this teaching, you do not suffer because of your success but rather to
balance your negative karma and your soul. In Judaism, one is rewarded for his or
her good works and obedience to God‘s laws. In Islam, we succeed by cultivating
our souls: cleaning and changing the environment (removing weeds, garbage,
harmful things), breaking up the soil (identifying any behaviors that block success,
breaking bad habits), sowing/planting seeds (we reap what we sow whether positive
or negative) and nurturing (feeding your spirit with good things). In Christianity, the
believer is forgiven for his or her wrongs with Christ‘s perfect holy sacrifice and
atonement and is also instructed to tithe 10 percent of income to charity and share
the wealth with others in need.    According to this tradition, we succeed because of
God‘s magnificent grace. Some believe that there are spiritual tests on the road to
success, but we can reach our goals without losing our soul.      Success comes by
understanding where you are called. If you follow your bliss doors will open for you.
Just because we encounter snags and obstacles along the way doesn‘t mean we are
not on the right path. When we are on the right path, it is as though supernatural
forces make our success possible. No one knows his or her potential; some believe
that we are pure potentiality, the full field of all possibilities. According to Joanna
Dove, ―It is generally accepted these days that you do not have to give up an
abundant material life to be a true spiritual seeker.‖ To be truly blessed, our work
should not only prosper ourselves but also ripple out to others around us.


       In describing spiritual success, Dr. Bernie Siegel spoke of a young man who
came to his office, ―He came to understand that being a success does not make you
happy and he needed to learn that being happy makes you a success…. The entire
reason for life is so that we can experience love. That is my opinion. And when you
experience love you are a spiritual success.‖




                                           298
Made Complete


       The experience of being spiritually made complete has no literature base I
can find. It occurs in the way that ego is shared between people, one of great
strength sharing ego with another of lesser strength, spirit is passed from one to
another, given and received in a relationship. The greatness of one is passed on to
the other in spirit; the passing of spirit through charisma. One person can transmit
spirit to another through language, body language or verbal communication. Some
believe that spirit can be transmitted remotely from great distances, time and space.
Spirit can also be found. Have you found your highest self? Have you been given
the great gift of empowerment? Perhaps being spiritually made complete is possible
only by divine grace.


       When a person is spiritually made complete by another of great strength, the
shared spirit can bring about the highest levels of functioning, positive emotions,
clarity of understanding, power, strength, comfort, wellbeing and confidence. If the
person falters, the completed spirit is not lost but it may be forgotten. The
completed spirit can be remembered and regained and new spirit can be found or
received through another charismatic gift. The received spirit is embraced to
become one‘s highest self.


       Some who are made complete develop magnificent authority and
administrative power. Such power involves taking responsibility, making decisions for
others and leading them to success and happiness, through hardship or fair weather.
A strong administrative spirit or authority can evoke strength and excellence, power,
charisma, wellbeing and assuredness in others. The people under one‘s authority or
administrative power are acquired either by fortune or by ability. For example,
royalty is established by blood or inheritance; but, new royalty comes about as well.
The new are either entirely new or they are established by adoption into a royal
family. Authority and the administrative spirit are shared among people in business,
government, the military, in schools, on teams, in clubs or religious institutions.


       Some people get a gut level feeling that a romantic partner completes them.
In the film Jerry Maguire, Tom Cruise tells Renee Zellweger, ―You complete me.‖ A
poem by Tiffany Little reads:




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You complete me
Beauty of the highest kind
Found in every corner of your face
The center of your being
The very meaning of grace
You are the beginning
The middle
The end
You are me
My best friend
I belong to you
With my very core…
You complete me
You make me whole
You are my mind
My body
My soul




       When we feel like a complete human being in our body, mind and spirit, we
have a sense of optimal health. To be made complete is to become like a god. May
you be blessed and made complete, more and more complete.




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Optimal Mental Health and Wholeness


       From a spiritual standpoint, health means wholeness. A person‘s wholeness
involves being as whole as one can be given the wounds from assaults to one‘s
person produced by illness or injury. In health and wholeness we rise up from the
traumas we have faced to become as complete and high functioning as possible, to
restore integrity, harmony, and balance. According to Rachel Naomi Remen,
―wholeness is never lost, it is only forgotten.‖ As complete human beings, we are an
inseparable unity of physical, mental, social and spiritual dimensions. Integrating
these aspects of oneself contributes to wholeness. A sense of wholeness in any
single part of oneself can lend itself to movement toward greater wholeness of one‘s
entire being: body, mind, heart and spirit. Together these facets of self can be
coordinated harmoniously into a unified, highly functioning whole. It has been
argued that wholeness also involves the integration of masculine and feminine
aspects of oneself.


       Wholeness may also include fullness and completeness in addition to the
synergy between facets of self. Fullness means that one‘s deepest depths of self are
full to overflowing and that one is able to live fully without reservation. We are filled
by our love, kindness, and compassion for ourselves and other people, by our
creativity and spontaneity, and by developing a genuine love of life. In the Christian
tradition, one‘s fullness with the Holy Spirit comes with faith. Completeness means
in part that we are guided by purpose and assured that life is meaningful.     With a
sense of completeness, all existential doubt is extinguished. In wholeness, the
synergy of physical, mental, social and spiritual dimensions is greater than the sum
of their parts. We find wholeness in the synthesis of these parts; when the
necessary elements of wellbeing combine in harmony. One might say that in
wholeness we find true health.




       According to Kathleen Dowling Singh, ―It is not too late to take stock of our
lives, even in the last weeks and days of terminal illness. And for those of us in the
midst of life, in the apparent safety and security of our health, it is not too early. No
matter how much time we have left to live, the answers to the following questions,




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voiced in the quiet honesty of our own hearts, provide direction to the rest of our
living.


Who have I been all this time?


How have I used my gift of a human life?


What do I need to ―clear up‖ or ―let go of‖ in order to be more peaceful?


What gives my life meaning?


For what am I grateful?


What have I learned of truth and how truthfully have I learned to live?


What have I learned of love and how well have I learned to love?


What have I learned about tenderness, vulnerability, intimacy, and communion?


What have I learned about courage, strength, power, and faith?


What have I learned of the human condition and how great is my compassion?


How am I handling my suffering?


How can I best share what I‘ve learned?


What helps me open my heart and empty my mind and experience the presence of
Spirit?


What will give me strength as I die? What is my relationship with that which will
give me strength as I die?


If I remembered that my breaths were numbered, what would be my relationship to
this breath right now?




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Who am I?


These are questions that pierce through the frivolousness at the surface of life and
confront us with the value and significance this precious gift of a human life offers.‖
While these questions have been applied to those with terminal illnesses in a hospice
setting, asking and answering such questions at any time helps us get in touch with
our spiritual selves. (Singh 2000)




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Part Seven: Environmental Approaches to Optimal
Mental Health

       The prevalence of mental illness is not evenly distributed across the world,
and some regions carry a disproportionately heavy burden for certain illnesses. In a
World Health Organization study of community surveys in 28 different countries,
prevalence estimates of serious mental illness are 4-6.8% in half the countries, 2.3-
3.6% in one-fourth, and 0.8-1.9% in one-fourth. On the other hand, survey
measures of life satisfaction in various countries conducted by Gallop show that
Northern European countries have the highest happiness scores with Denmark
scoring the highest. It is difficult to estimate the environmental burden on mental
illness and it is difficult to sift out the relevant environmental factors in Denmark that
bring about life satisfaction. What are supportive environments like?


       In Denmark, taxes are the highest in the world but unemployment is only
2%. There is greater social cohesion, access to good education and stronger
national identity.   The happiest Danes are thought to be more likely to live around
people they could trust, they feel that their opinions are heard, they value
responsibility, they believe people have equal status and prefer modesty, they feel
secure and tend to be married or in a committed relationship. They tend to
participate in physical activity. Rather than pursue the accumulation of lots of
money, they view the rich as one who has a lot to be grateful for, the more things
for which one develops a fondness, the life richly lived. They pursue jobs they love
and create cozy environments at home with candles, the warmth of a fire place and
friends for the long cold dark nights in that region. They tend to belong to clubs and
volunteer to help avoid isolation.


       The environment includes the surroundings, conditions or influences that
affect a person, all that which is external to the person. Identifying environmental
problems facing members of a community and modifying environmental risk factors
for illness could significantly reduce the disease burden of a community. Also,
creating a healthy environment can improve the prosperity and wellbeing of affected
people. It may often be necessary to learn how to stay healthy in a risky
environment.




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       Healthy homes and neighborhoods are welcoming and supportive places to
live. They cultivate health, positive relationships, a positive atmosphere for learning
and high work performance; they offer opportunities for prosperity and overall
wellbeing. Beautiful living spaces make good use of light, color, temperature, sound,
air quality, plants, design elements and symbols and environmental messages to
create an optimal living environment. You may get the sense of health of an
environment by the way it feels. According to Carol Venolia, ―When you are in a
healthy environment you know it, no analysis is required. You somehow feel
welcome, balanced and at one with yourself and the world. You are both relaxed and
stimulated, reassured and invited to expand. You feel at home.‖ Some
environments feel alive, other places need healing. Venolia also suggests that you
are neither victim nor master of your environment but rather a partner. You
influence your environment and the environment influences you.


       As a child I learned about the importance of environment with a tropical fish
hobby. A healthy community fish tank environment includes clean filtered water,
aeration of water, appropriate temperature, adequate nutrition for the fish, and
adequate light and darkness. You can‘t mix aggressive fish with docile fish, there
needs to be places to shelter and hide, and you must avoid overpopulation.
Contagious infectious diseases are often a problem and require transferring the
affected fish to a hospital tank or treating the whole community. A tank of happy
healthy fish is a joy to behold.


       As environments deteriorate, so does the physical and mental health of the
people who live in them.    Creating an optimal environment for health requires
evaluating environment factors. The goal is to have an optimally healthy
environment in your community for people at all stages of life. We must build
healthy public policy, strengthen community action and create supportive
environments. Interventions in environmental health can make a valuable
contribution towards reducing disease burden and improving the wellbeing of people
throughout the world.




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Part Eight: Thriving


       To thrive is to grow vigorously and flourish. It means gaining wealth or
possessions, to prosper. Yet, it also means prosperity in ways that may not be
related to wealth such as health and happiness. It means steady progress and
fulfillment, to succeed, as a result of circumstances or despite circumstances.      It
means feeling competent at what you do. It means making a difference. It means
having good relationships with other people. It means developing in positive ways.
It means meeting or exceeding the social, cultural, educational, and occupational
expectations of society. Thriving means good fortune, achieving high quality of life
as well as longevity. Life is to be enjoyed, discovering what you can do, what you
can experience. Mark Sisson has argued: ―What‘s the point of living to a ripe old
age if you never taste the fruit?‖ Some people may think that someone reaching old
age did so because they never really lived at all; but, you don‘t have to choose
between longevity and living. (Sisson 2010)


       If you thrive in life you experience feelings of wellbeing, both the absence of
symptoms and positive mental and emotional states. You accept and approve of
yourself. You experience happiness, health, contentment, meaning and purpose, and
fulfillment. You realize the fulfillment of your hopes and dreams. You function at a
high level.   You may thrive in your environment even if it is not nurturing or despite
the fact that it is oppressive. Martin Seligman in his book Flourish says that his
criteria for flourishing are being in the upper range of positive emotion, engagement
in activity, positive relationships, meaning in life, and positive accomplishment.
(Seligman 2011)


       We thrive by building skills for life, by developing strengths and virtues. We
thrive by learning. According to Tony Robbins you must stand guard at the door of
your mind, challenge, resist and refute any harmful ideas and feed your mind with
helpful, healthy ideas. James Allen in his book As a Man Thinketh says, ―A man‘s
mind may be likened to a garden, which may be intelligently cultivated or allowed to
run wild… If no useful seeds are put in it, then an abundance of useless weed-seeds
will fall therein, and will continue to produce their kind. Just as a gardener cultivates
his plot, keeping it free from weeds, and growing the flowers and fruits which he



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requires so may a man tend the garden of his mind, weeding out all the wrong,
useless and impure thoughts, and cultivating toward perfection the flowers and fruits
of right, useful and pure thoughts. By pursuing this process, a man sooner or later
discovers that he is the master-gardener of his soul, the director of his life.‖ Allen
also says that ―the vision that you glorify in your mind, the ideal that you enthrone in
your heart- this you will build your life by, this you will become.‖ (Allen 1903)


       According to Robbins, great ideas have to be pursued; it is unlikely that they
will find you without your effort to seek them.     You can encounter something that
opens up something inside of you; a fire gets lit. It helps to find role models that
show the way. You can read biographies or get to know people who have achieved
what you hope for. It will help to see a pathway to get where you want to go. Then
you must take action, make progress. If something doesn‘t work try a new
approach. In order to thrive, you must follow through, persist with your goals. You
need a vision that is compelling and you need strong reasons why you want to
achieve your goals. The reasons will push you through hard times, help you
overcome resistance. The space between faith and achievement is hard work, and
that comes with a dedication to your goal. It is expectation that brings about
success; you must raise your standards. We follow through in action based upon
who we believe we are, our identity. If we raise our standards of what we expect of
ourselves we take action; we follow through.       You can keep looking for ways how to
be a better person. Your mind is like the muscles of your body. If you use the
muscles of your body they get bigger and stronger; the more you use the mind and
its strengths and virtues, the stronger it gets.


       From an evolutionary perspective we survive to procreate, care for our young,
and continue the human species.     But, it is possible to not only survive. We can
thrive and live optimally. As Karl Menninger suggests, ―we can adjust to the external
world with contentment and master the task of acculturation.‖ We can ―live long and
prosper.‖ This book has described many approaches to achieve optimal mental
health and functioning. As the field of mental health promotion becomes more
evidence based with strong support from research in large samples, it will become
possible to integrate reliable methods of health promotion in order to truly flourish
and live fully. We can thrive as individuals, as families, as communities, as the
world. The future looks good.




                                           307
Part Nine: Complete Wellbeing


       According to the World Health Organization, 1948, ―health is a state of
complete physical, mental and social wellbeing, and not merely the absence of
disease or infirmity.‖ With this view, just because you‘re not sick doesn‘t mean
you‘re healthy.   James H. West says that, ―Health is a large word. It embraces not
the body only, but the mind and spirit as well;... and not today's pain or pleasure
alone, but the whole being and outlook of a man.‖       According to the Complete
Wellbeing magazine, complete wellbeing means ―enjoying a fit body and living a life
filled with joy and fulfillment... It is more than just absence of illness or disease it is
about satisfaction at work, leisure activities, loving relationships, social interests,
spirituality and a purpose in life.‖ (completewellbeing.com 2011) According to
Daniel Kahneman, wellbeing includes experienced happiness and reported life
satisfaction. It means a life rich with pleasure, engagement and meaning. Positive
emotions signal the presence of wellbeing, they may also predict future wellbeing.
(Positive emotions can be enhanced in many ways such as by making an effort to
think about the many things you are grateful for and by imagining oneself in the
future assuming that everything has gone as well as it possibly could.) Complete
wellbeing means recovery from illness and healing, it means conditioning your body,
mind, heart and spirit, and it means being strong and fit. Some might argue that
complete wellbeing is an ideal fiction or that the struggle to achieve it is like pushing
a rock up a hill. Yet, you may be surprised to find the climb invigorating and joyous,
trusting your instincts in a natural unfolding of conscious and unconscious processes.


       In order to achieve complete wellbeing and stay well you will need to take
reasonably good care of yourself.     According to Carrie Latet, ―If you don't take care
of yourself, the undertaker will overtake that responsibility for you.‖ On the other
hand, Sydney J. Harris suggests that ―those obsessed with health are not healthy;
the first requisite of good health is a certain calculated carelessness about oneself.‖
If the soil is prepared, the seed planted, and nourishment provided, wellbeing grows,
like an acorn to an oak tree. We become a friend to our health. If we prudently care
for our health, get help when we need it, and train and condition ourselves like an
athlete, body, mind, heart, and spirit, we can flourish and achieve complete
wellbeing, living from strength to strength.



                                            308
Conclusions:

       The evidence suggests that there is a broad spectrum of approaches available
to help promote successful mental functioning and optimal mental health. These
approaches can be divided into biological, psychological, social, spiritual and
environmental areas. An approach in one area may have a small impact or
considerably large impact on health outcome; yet, our current state of knowledge
about these approaches is limited by a paucity of research. The field of mental
health promotion is young and although quite a few factors have become associated
with good health, it may be early to consider particular interventions prescriptive for
optimal mental health.   This situation contrasts with the field of physical health
promotion which has developed specific recommendations to prevent illness and
promote fitness. Following the model of physical health promotion and prevention of
illness, efforts to promote optimal mental health need a foundation of evidence-
based interventions which have been established by research in large samples.
There must be clear outcome measures with indicators that can be measured so that
more funding for research becomes available and widely effective interventions
developed. The goal of research in the mental health promotion field is to learn what
works, establish how these methods work, and find effective methods of health
promotion that are repeatable across different populations of people and different
cultures. Following the model of research used with illnesses and their treatment,
placebo-controlled trials should be used to compare proposed health promoting
interventions with sham interventions without anticipated benefit. In the spirit of
Melvin Sabshin‘s goal for psychiatry, we must move from unsubstantiated
formulations to reliable evidence so that the field of mental health promotion can
emphasize an empirically based, carefully described, biopsychosocial spiritual and
environmental model.


       As Surgeon General David Satcher argues, we must focus more effort on the
positive aspects of mental health out of a basic concern for the welfare of our fellow
human beings. In general, approaches designed to promote optimal mental health
should include specific methods of preventing mental illness, methods of helping
people realize higher levels of mental fitness and wellbeing, and lastly specific
methods of assisting the mentally ill in their treatment and rehabilitation.
Approaches that promote optimal mental health focus on individuals‘ potential for


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functioning and quality of life and not merely the relief of suffering or the elimination
of symptoms.


       If you are suffering from emotional problems or symptoms, it is a good idea
to seek professional help if the problems are severe of if symptoms persist. Often
getting help early can mean better health outcomes. There is tremendous benefit in
getting help during times of need. A mental health professional will help you get an
evaluation and treatment if needed. Depending upon symptoms, treatment will
typically include talk therapy, medication, or a combination of both. Sometimes
psychiatric symptoms are caused by physical problems. Blood testing can rule out
most of the common medical causes of psychiatric symptoms. Less commonly brain
imaging (CT or MRI) or electroencephalographic (EEG) studies are needed to rule out
certain brain diseases. Treatment of mental health problems is informed by a wealth
of research compiled over decades. As research continues, new treatments become
available with better effectiveness and fewer side effects. As part of the recovery
process, the individual with mental health problems can strive to not only eliminate
symptoms but also reach greater physical and mental fitness, strength, and feelings
of comfort and wellbeing. While recovering from illness means solving problems, the
growth that allows for optimal health and functioning requires learning and practice,
translating information into the transformation of self and society.


       The benefits of health promotion information can be found when education
translates into sustained behavior change. Health promotion research has shown
that educational approaches to health promotion require repeated booster sessions
in order to reestablish health-related goals and maintain benefit. Therefore effective
approaches to promote optimal mental health should be reviewed several times in
order to bring them into practice. With ongoing study and contemplation we can
help bring about positive action and exceptional health.


       In order to increase quality and years of healthy life, both individuals and the
communities in which they live must do their part. Individual and community health
are often inseparable. Mental health can flourish more easily in environments that
are safe, just and equitable, and foster good relationships. The exceptional mental
health of individuals translates into exceptionally healthy communities. A healthy
community enables people to maintain high quality of life and productivity and




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develop to their full potential. It nurtures its members. There is access to health
care services that focus on treatment, health promotion, and prevention. People
gain the knowledge, motivation and opportunities they need to make informed
decisions about their health. The community provides a safe environment, the
presence of roads, schools, and playgrounds, a strong economy in which individuals
can maintain gainful employment and wealth, and clean water and air. Families are
well housed and secure from crime. Individuals are able to be physically active and
socially engaged and remain all their lives in a community that accommodates to
changing lifestyles and changing physical capabilities. The community offers
affordable housing for people of all income levels. Community centers exist where
people can gather and mingle as part of their daily activities. People feel connected
and are quick to volunteer and help each other out. The community offers inviting
and affordable public parks and playgrounds, trails and sidewalks, swimming pools,
arenas, and libraries and low-cost healthy food is readily available.


       In an active, healthy community, citizens are involved. They feel that they
belong, which means that they want to make their communities and neighborhoods
great places to live. When people feel strongly connected with each other, they are
more likely to act in the interests of the entire community. People in healthy
communities take pride in working together to create places where life is fulfilling
and fun. Healthy communities embrace diversity and create effective leaders who
facilitate discussion, encourage collaboration, inspire effort and build strong
coalitions and relationships. Healthy communities have a vision for their community
to become a better place to live, work, worship, learn, raise a family and enjoy life.
In healthy communities there is a spirit of service and a desire to contribute, of
optimism and high morale, a spirit of sacrifice, of responsibility, where each member,
according to Barack Obama, ―resolves to pitch in, work harder, and look after not
only one self, but also one another.‖ Furthermore, as communities and cultures
interact, individuals and their communities in which they live must master the task of
acculturation so that differing communities can live in harmony and peace and
flourish together as one greater whole. We are all in this together. We are all
becoming.   With our combined effort society evolves positively and the world
becomes a better place for everyone.




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       Working toward optimal states of health can help you create better quality of
life, live a long and meaningful life, and contribute to your family and your
community. In the best states of mental health, people live fully and glow radiantly.
As we learn more about how to promote optimal mental health, the coming
generations of people will be able to live longer with better quality of life. Optimal
mental health is not a goal in itself but rather the means to a productive and fruitful
life, the means to realize one‘s dreams, live a long and glorious life, and find greater
satisfaction and happiness in life. It means being well so that you can be as Lisa Oz
advises, ―a greater service to others, so that you can love more completely, and so
that you may thrive and fulfill that destiny which is uniquely yours.‖


       So how is it that we come to thrive, as individuals, as a community and as a
world? Some people may believe that the trick is to get our conscious minds out of
the way and let our unconscious integrate all we know in order to fulfill our potential.
Others might say that we need a good plan, a course of action. Still others might
say that we just need a clear view of the future and a strong argument to carry us
through the resistance. Our lives are our own, we have free will; yet, we follow the
course of life created by the divine wind in our sails. As we mature at our own pace
and learn to rule our spirit well, we can fulfill our hopes and dreams and the
promises of health.


       According to the philosophical principle of meliorism, the world tends to
become better. It also suggests that human effort which may interfere with natural
processes (such as disease or aging) can produce an outcome that is progressively
better than the status quo. Anything is possible. It is such a tendency that allows
human effort to promote the mental health and functioning of individuals and the
communities in which they live to progressively higher levels of fitness and health.
With the strength of their ancestors with them, people who love themselves and the
world in which they live can devote themselves to the most important challenges
they face today and bring about change. It‘s about taking what you have in your
hands, your possessions, your skills, your influence, and making the world a better
place. Together we can climb the tall mountain before us and enjoy the adventure of
it all. And we can savor it. Let us claim it and step into it fully. We can truly thrive.
We can discover how to become better people and enjoy life fully. I wish you well




                                           312
and the best of luck in your personal pursuit of optimal mental health and
functioning.


       Some might believe that the book is the hero that fixes the life situation at
hand, that saves you, that completes you with techniques and procedures. But
rather it is you, the reader, self-healer, self-actualizer, who is simply mobilized to
take action and find your own unique and/or established way to the peaks of a
flourishing life and the dreams of your heart.   Nothing but the hand of God makes
such a beautiful life possible, to God be the glory. One candle lights another, and
our candles light some others.




Ending Trance


       The book ends with a naturalistic trance induction. It is naturalistic in the
sense that simply reading the induction can help you get into a relaxed and focused
state, an effectiveness state, in which you can more easily integrate the valuable
lessons of the proceeding chapters of the book. Usually trance induction is
accomplished with talk out loud but just reading a trance induction can help you
develop a light trance state that is productive and fruitful.


       A trance may be defined as being absorbed in experience. People go into
trance purposefully to solve problems, make discoveries and improve with creative
integrations. New combinations of associations and mental skills may be evolved for
creative problem solving, to be well and stay well, and optimization of fitness. At
other times people go into trance simply because the environment suits it. The mind
is an incredibly vast reservoir whose potentials are still unrealized by most people.
Trance is a free period for the inner discovery, exploration, and realization of these
potentials. At this time you will develop a pleasant state of relaxation and comfort;
and it will be enjoyable to experience serenity and make use of what you know.


       You can sit or lie down in any trance position and this will enable you to enter
the trance state any time you may benefit from it and you are safe and comfortable.
You may wonder what your abilities are in trance. They are so much more than you




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dreamed of: to access memories, to learn easily, to imagine, to solve problems, to
create, to improve, to have as much impact on the conscious mind as the
unconscious mind desires.


       Now, you can use your conscious mind to relax your face: easing the tension
of the jaw musculature and the eye musculature and the muscles of the mouth. This
pleasant posture of facial musculature may be familiar to those familiar with trance
and for those who are new to the experience, the enjoyable comfort that develops
may come with surprise. This tranquil feeling is an ideal state to proceed and
investigate your potential. No one knows his or her potential.


       Now, you can become entirely absorbed in the experience without any need
to attend to external things because they just make you more relaxed and
comfortable, in trance any needs for balance and safety are met. Any discomfort can
be relieved and physical, mental, emotional and spiritual needs can be satisfied.
Taking your time… and after making certain minor adjustments… complete relief
develops and needs are satisfied. Just about any form of unfinished business can be
resolved.   The pleasure of trance is found in fulfillment of the mind and the body
and the heart and the spirit. In the trance state one may know the unattained
wishes of the mind and see them fully satisfied… truly happy, healthy and whole.
And one can see the steps that make that happen.


       Now, when you blink in a second, you will notice perhaps an expansiveness
behind the eyes… If not blink again… And you may want to fill a bit of this
expansiveness. You can move through it easily, north, south, east and west, up and
down; you explore the area… taking your time… until you discover a beautiful
treasure. You open it, lifting the lid, and discover a very strong feeling, and here
and there it can be more complete than you may even imagine, the feeling, the
experience of optimal mental health and complete wellbeing… living more rationally,
healthily, happily, and comfortably with behavior aimed toward good will and
kindliness toward others. And it develops further at its own pace, even more and
more complete; completeness always growing more complete… including all the
requisite parts, so good that no one of the kind could be better, having attained
one‘s whole purpose... living in harmony with nature, with each other, and with
God. As Matthew enjoins, ―Be ye therefore perfect, even as your Father which is in




                                          314
heaven is perfect.‖ (Matthew 5:48) ―Thou shalt be perfect with the Lord thy God.‖
(Deuteronomy 18:13) ―On earth as it is in heaven.‖ (Matthew 6:10) And it may
come to pass by creating harmony with nature‘s law, by waiting or by striving and
perhaps only by special divine grace. You are turned by the Spirit of God toward
perfection.


       Now, this capacity exists as both the conscious mind and the unconscious
have magnificent capacities to learn. ―One can learn by reading, by seeing, by
feeling, by being told, by experiencing and the best way of learning, to use folk
language, is by getting the feel of it. You get the feeling of a poem, the feeling of a
picture, the feeling of a statue. Feeling is a very meaningful word. We do not just
feel with the fingers, but with the heart, the mind. You feel with the learnings of the
past. You feel with the hopes for the future. You feel the present.‖ If you want to
learn to swim, you must get into the water, get a feeling for the water, moving in the
water; you cannot learn to swim only by reading or by seeing or by being told.
(Erickson 1976)


       The first changes you may notice are the development of changes in your
breathing rhythm or pleasant feelings around your eyes. And when you look in the
mirror you will begin to appreciate a different view of that image in the mirror, that
image that looks back at you with an integrated body, mind, heart, and spirit.      In
the mirror, in photos of yourself, in video, you see the sparkle of health and
wellbeing, sound body, sound mind and a shining irrepressible spirit.


       In a moment I will count from one to ten and as I count you can transport
yourself to a room of your own, a place just for you to feel and experience. You can
sit yourself down in an easy chair and feel at home and comfortable. You can count
along with me. Beginning the count now…


One, slowly and easily
Two, easily and progressively, feeling yourself
Three, free
Four, more alive
Five, the capacity of your inner mind
Six, helping you with




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Seven, your capacity to become
Eight, more yourself
Nine, absorbed in the experience
Ten, seizing the opportunity to live fully… beautiful, exceptional, happy, healthy, and
strong… thriving, completely well, celebrating life…


        You realize that over a relatively short period something special can happen…
we are all becoming, becoming the image in the mirror that stands so straight and
tall, becoming the image that represents the best you inside, imposing your will.
Make it so. Bloom fully. Let your best self shine through… truly happy and excited
about life. Make it happen. May you believe in yourself, be happy, strong, and
healthy and live a rich, long, satisfying, meaningful, exciting, and fulfilling life that is
true to who you are on the inside. May you impose your will on the opposition, excel
at winning with ease, however you define victory, and rise up this tall mountain to
become more and more complete. People want more than an end to their suffering,
they hope to thrive and live the best things in life. May you be humble and blessed
with the magnificent grace of God. Be well and stay well. Come on, rise up. Come
on, rise up. Rise up.    And you can awaken from this trance state with everything
you have gained, everything acceptable to the self, becoming more alert, refreshed,
and awake… Enjoy the feeling, the experience, fully refreshed and awake. (Zeig,
1991)




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Positive Health Outcome Assessment

       This questionnaire measures your level of positive health. It is recommended
that you complete this questionnaire before reading the book for a baseline assessment
and then return later at the conclusion of the book and see how far you have
progressed.

   -     Please mark your responses to the following questions about positive health. Scores
        range from 0-114.

   1.    Quality of life:
        -   physical health:
                 o 3. very satisfied
                 o 2. fairly satisfied
                 o 1. not very satisfied
                 o 0. not at all satisfied
        - mental health:
                 o 3. very satisfied
                 o 2. fairly satisfied
                 o 1. not very satisfied
                 o 0. not at all satisfied
        - recreation/leisure:
                 o 3. very satisfied
                 o 2. fairly satisfied
                 o 1. not very satisfied
                 o 0. not at all satisfied
        - family/social life:
                 o 3. very satisfied
                 o 2. fairly satisfied
                 o 1. not very satisfied
                 o 0. not at all satisfied
        - housing/transportation:
                 o 3. very satisfied
                 o 2. fairly satisfied
                 o 1. not very satisfied
                 o 0. not at all satisfied
        - education/work/financial :
                 o 3. very satisfied
                 o 2. fairly satisfied
                 o 1. not very satisfied
                 o 0. not at all satisfied




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-   legal issues:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   Personal appearance:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   spiritual life:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   Climate where you live:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   Geography where you live (features of the earth’s surface):
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   degree of safety:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   political and personal freedom:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied
-   Crime level in your community:
         o 3. very satisfied
         o 2. fairly satisfied
         o 1. not very satisfied
         o 0. not at all satisfied




                                      318
     -   traffic congestion:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
     -   quality of entertainment:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied
     -   degree of gender and racial equality:
              o 3. very satisfied
              o 2. fairly satisfied
              o 1. not very satisfied
              o 0. not at all satisfied

2. Subjective sense of wellbeing:
   - How happy am I in general?
           o 3. very happy
           o 2. fairly happy
           o 1. unhappy
           o 0. very unhappy
   - I feel mentally fit and healthy
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree
   - I feel physically fit and healthy
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree

3.   Resilience
             o    3.    I never feel ill
             o    2.   I rarely feel ill
             o    1.   I often feel ill
             o    0.   I always feel ill




                                           319
4. Accomplishment
         o 3. I have achieved much more than I hoped to accomplish
         o 2. I have achieved everything I hoped to accomplish
         o 1. I have achieved some of what I hoped to accomplish
         o 0. I haven’t achieved anything I hoped to accomplish
   - I hope to accomplish more
         o 3. Strongly agree
         o 2. Somewhat agree
         o 1. Disagree
         o 0. Strongly disagree

5.   Strength of character and beauty
            o 3. I have many positive qualities
            o 2. I have some positive qualities
            o 1. I have few positive qualities
            o 0. I have no positive qualities

6.    Social intelligence
     -    I am sought out by others because of my many positive qualities, warmth and
         integrity
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree
     - I have rich and satisfying relationships
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree
     - I work well with others
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree
     - I feel compassion for others, particularly when they suffer
              o 3. Strongly agree
              o 2. Somewhat agree
              o 1. Disagree
              o 0. Strongly disagree




                                          320
7. Emotional intelligence
   - I often enjoy positive emotions
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree
   - I am able to keep a lid on my anger
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree
   - I understand my emotions
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree
   - I understand the emotions of other people
          o 3. Strongly agree
          o 2. Somewhat agree
          o 1. Disagree
          o 0. Strongly disagree

8. Purpose and meaning
   -   I have enjoyed many valued experiences: love in a relationship, raising a child,
      experiencing beautiful art or music or others
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree
   - I have enjoyed creative deeds: creative art, music, dance, inventing, writing or
      others
           o 3. Strongly agree
           o 2. Somewhat agree
           o 1. Disagree
           o 0. Strongly disagree
   - I have developed valued attitudes: bravery, forgiveness, responsibility or others
           o 3. Strongly agree
           o 2. Somewhat disagree
           o 1. Disagree
           o 0. Strongly disagree




                                         321
        -   I have contributed to my community
                o 3. Strongly agree
                o 2. Somewhat agree
                o 1. Disagree
                o 0. Strongly disagree

   9.    Maturity
        -   I am mature for my age
                o 3. Strongly agree
                o 2. Somewhat agree
                o 1. Disagree
                o 0. Strongly disagree

   10. Satisfaction, contentment and bliss
       -   All things considered, how satisfied are you with the life you lead these
            days?
               o    3.   very satisfied
               o    2.   fairly satisfied
               o    1.   not very satisfied
               o    0.   not at all satisfied




Total score:
               __________

   11. Longevity
       -   Age: years
              o _______
       - Quality of life adjusted age: how old do you feel? (Years)
              o _______

   12. Gender
       -   Male
       -   Female




                                                322
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About the Author




       Dr. Jeremy Herschler is a psychiatrist and addiction specialist who lives in
western Maryland with his wife Alison and son Noah. His interest in mental health
promotion grew out of frustrations early in his career with a mental health system
that focused primarily on symptoms of illness and their removal as opposed to the
development of positive healthy attributes. Successful treatment he feels should
include more than an end of symptoms. He has also been struck by the extremely
high prevalence rates of mental illness throughout the world and particularly in The
United States. He hopes that more will be done to help prevent mental illness and
protect people from the immense suffering associated with these conditions. He also
hopes that many more people of our future generations will come to thrive, including
ways not imagined today. His diverse research interests have included an
investigation of mental health clinicians‘ viewpoints of wellness and techniques of
motivation enhancement which are relevant to this book on mental health
promotion. He is a student of his work, not a finished product.




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