The Wellness Model of Mental Health in the 21st Century
The disease or medical model has been the approach towards mental health since the dawning of civilization. It is called the pathographic perspective. Pathography is the history of our suffering. The Wellness Model focuses, not on our disease and deficits, but on our character strengths, virtues, and achievements. A disorder, condition, or dysfunction is what used to be called a neurosis. A neurosis is a common part of natural human development. It is, simply, a condition that negatively impacts our emotional wellbeing and quality of life.
The fact that we are not accountable for the childhood/adolescent exploitation that led to our psychophysiological malfunction does not absolve us of the adult responsibility to do something about it.
Many of us avoid learning about the causes and symptoms of our disorder as if ignoring it will make it go away. When we see evidence that the traits and characterizations of the disorder match our own, it somehow makes it more concrete, more real. It makes us accountable. Although all the relevant data is readily available from credible sources, including the National Institute of Mental Health, Johns Hopkins, the Mayo Clinic, remaining uninformed perceptually abrogates responsibility.
When something is broken, it is deconstructed to analyze the problem. We isolate the components and acquaint ourselves with their objectives. Equal effort is required for the brokenness in us. We must study the traits and symptoms of our disorder, and recognize how they affect our thoughts and behaviors. For us to have any chance at recovery, we need to know what we are recovering from. Replacing or repairing defects is fruitless without knowing what those defects are and how they function. Before a football team faces their opponent, they watch hours of film, review stats, and practice. If an actor wishes to give a good performance, it is prudent to learn the character’s lines before getting on stage. Our disorder is our enemy; it is unhealthy, and it hurts us. Our deliberate ignorance is denial, and that is a deal-breaker. Our disorder will continue to impact our emotional wellbeing and quality of life until we recognize, accept, and confront it.
Recovery-remission is a psychological construct. The revelation we are not responsible for the disorder sets the foundation for recovery. Understanding that we alone are the agents of change begins the construct. Counselors and programs provide the blueprint, but we erect the edifice. The disease model tells us what is wrong with us. We do not need to hear that. Our disorder is not something that can be excised like a tumor, so what is the point of telling us what is wrong with us? The wellness model’s focus and by extension, positive psychology and other optimistic approaches, is on our virtues and strengths.
One group of psychologists describes recovery as “people (re-) engaging in their life on the basis of their own goals and strengths, and finding meaning and purpose through constructing and reclaiming a valued identity and valued social roles.” [i] Enduring recovery grounds itself on our knowledge of our disorder and the implementation of our character strengths and virtues to recover from it.
[i] Schrank, B., Brownell, T., Tylee, A., & Slade, M. (2014). Psychology: An Approach to Supporting Recovery in Mental Illness. East Asian Arch Psychiatry, 24, 95-103 (2014).
The cumulative evidence that childhood and adolescent exploitation is a primary causal factor in lifetime emotional instability has been well-established. This is likely the cause of our disorder. Detachment, exploitation, and abandonment in our formative years can manifest in chronic depression, and feelings of helplessness, hopelessness, and unworthiness. We may be prone to repetitive patterns of shallow relationships. We may have difficulty trusting others; we may be afraid of intimacy and commitment. Add to these, debilitating anxiety, codependence, feelings of insecurity, isolation, and the loss of control over life.
In Maslow’s hierarchy theory, the orderly flow of social and emotional development requires satisfying specific fundamental human needs. The adolescent experiencing detachment, exploitation, or neglect, is disenabled from fulfilling his or her physiological and safety needs and the need to belong and experience love.
Child psychologist B.F. Steele maintains “abuse” includes events that interfere with the optimal physical, cognitive, emotional, and social development of the child. The term is subdivided into physical, sexual, and emotional abuse and various forms of neglect, all of which can occur alone or in combination. Maslow’s hierarchy is not a purely linear exercise, and it is not absolute that one level of needs must be satisfied to get to the next level. The list of individuals who have been deprived of fundamental needs yet achieved greatness is long and inspirational. But disruptions in our natural human development makes it more difficult. We did not make it happen; it happened to us as a child/adolescent. It is not our fault, but it is our responsibility to do something about it.