Criteria to Evaluate Models of Health
(Excerpt from Lifetrack Therapy, by Dr. Yukio Ishizuka published in Psychiatr J. Univ Ottawa, Vol. 13, No. 4, 1988).
“In 1958, M. Jahoda produced a monograph entitled ‘Current Concepts of Positive Mental Health,’ reviewing the then existing literature and research on the subject. This included contributions to the literature looking at the concept of Mental Health, Normality, Happiness and Self-Actualization. Based on her extensive review, she offered six conditions for evaluating the criteria of Positive Mental Health:
- The idea that there can be one single criterion of Positive Mental Health should be abandoned. Good mental health cannot be reduced to one simple concept and a single aspect of behavior is not an adequate indicator.
- As the terms we use to describe mental health have tended to be abstract, we should now strive to more scientifically define our operating procedures and methodologies. There is a need to have scales and measures for each criterion.
- Each of the criteria should be thought of as a continuum since there are unhealthy trends for an otherwise healthy person.
- These criteria should, at any point in the individual’s progress, serve either to define the state of the individual, or to indicate trends towards wellness or disease. Implicit in the criteria is the concept of gradients of mental health.
- The criteria are regarded as relatively enduring attributes of a person—not just functions of isolated situations the individual finds himself in at a given time.
- The criteria are intended as indicators of the optimum of mental health. They are not to be regarded as absolutes—and the minimum standard for any individual to achieve has yet to be determined, and may indeed change with age. Each person has his own limits, and no one reaches the optimum in all criteria. Still, we assume that most people can achieve the optimum.
Positive Mental Health
The following six criteria were offered by Jahoda as empirical indicators, or a sort of recipe, for Positive Mental Health:
1. Positive attitudes toward the self.
2. Growth, development, and self-actualization—including utilization of abilities, future orientation, concern with work, and so on.
3. Integration, as in a balance of psychic forces, the unifying of one’s outlook, and resistance to stress and frustration.
4. Autonomy, as in self-determination, independent behavior, and, when appropriate, non-conformity.
5. A true perception of reality.
6. Environmental mastery, meaning adequacy in love, work and play, adaptation and adjustment, and the capacity to solve problems.
Little Followed Jahoda’s Work
Twenty years later, H.R. Spiro, in 1980, in his review of the evolution of concept of Positive Mental Health, observed that regrettably little investigations followed Jahoda’s work during the ensuing decades, citing only several related contributions:
‘Cambell examined responses to a series of questionnaires intended to evaluate positive affect, life satisfaction and perceived stress. Bradburn, Andrews, Withley, all attempted to develop scales that measure social indicators of psychological well-being.’
‘Cambell’s initial results suggested that factors in a life cycle explain much of the variance in the index of positive affect and life satisfaction scales. Positive affect and life satisfaction scales vary together with the most positive results appearing among married persons with children six years of age and older. Responses are far more negative for divorced and separated persons. Positive affect shows the lowest scores among the widowed, the divorced, the separated, and young people who are not married. The results seem to indicate that family status is the most important single variable in Positive Mental Health. Occupation, education, religion, race and sex contribute very little to the variance.’
Survey of Happiness
In 1980, a survey of a large number of Americans on happiness conducted by Friedman produced similar findings to those of Campbell. Friedman reported that the single most important predictor of happiness was the presence of a loving close relationship with someone, followed by satisfaction at work. Friedman also found that the objective level of success, wealth, independence, and freedom had little predictive value of happiness of the individual, why more subjective elements, such as a sense of confidence in his life values, sense of purposefulness and meaning in his life, and sense of mastery of his fate etc., were more important determinants of one’s happiness.
Lifetrack Model of Positive Mental Health
Building on the above and other concepts of Positive Mental Health, integrating various therapeutic schools of thought, but most importantly learning from the patients in his private practice, Dr. Yukio Ishizuka developed a structured model of Positive Mental Health, that has led to the development of Lifetrack therapy, the role of breakthrough intimacy in changing the structure of personality, a better understanding of happiness (goal happiness ?), and an interesting perspective on the functioning of a healthy and happy mind (life purpose).
Most Stressful Life Events and Insights
In way of developing a working concept of Positive Mental Health, Ishizuka points out it is also helpful to remember the well-known Social Readjustment Scale, developed by Holmes and Ray. Their 43 stressful life events can be categorized into the following three spheres: Intimacy (death of a spouse, divorce, marital separation, death in family, marriage, marital reconciliation, etc., 21 items), Achievement (21 items), and Self (7 items). When the weight given to each event on their 100 point scale, are added, Intimacy sphere receives 50% of the total points, Achievement 40%, and Self 10%.
Spheres of Health: Self (self definition, Intimacy (love definition) and Achievement (work definition)
These three spheres are partly converged on each other and are dynamically interactive with one another. Building on the above, and other concepts of Positive Mental Health, integrating various therapeutic schools of thought but, most importantly, learning from the patients in his private practice, whose clinical condition must be continuously monitored at least daily, Ishizuka has developed a structured model of Positive Mental Health, in which Self, Intimacy, and Achievement spheres are further defined in three dimensions and nine elements each, meeting all six conditions of criteria for Positive Mental Health proposed by Jahoda, in 1958.”
(Excerpt from Lifetrack Therapy, by Dr. Yukio Ishizuka published in Psychiatr J. Univ Ottawa, Vol. 13, No. 4, 1988). To download the full journal article (3MB) press lifetrack therapy).
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Read our section Happiness and Health, Science of Health (life way), Happiness Defined? Quantified? (cycle of life), Happier? (fear of the unknown), Why Positive Mental Health Works (objective subjective), Insights (life purpose), and Applications (international behavior).
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