don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

The questions we ask and the way we ask them, the issues we probe and the expectations we create affect the answers we get, the things we discover and the realizations we experience. This is illustrated in an old riddle about traveling to St. Ives. Before trying to solve this riddle, reread the first sentence and thus be forewarned about getting off track.

As I was going to St. Ives I met a man with seven wives Every wife had seven sacks Every sack had seven cats Every cat had seven kits Kits, cats, sacks and wives, How many were going to St. Ives?

Did you quickly see that the best answer is one? You can only know, based upon the information given, that the narrator alone is going to St. Ives. You cannot rationally divine where the rest are going, if indeed they are going anywhere—they could be quite content where they are! Gaps in information often are used to seduce or distract us from some sleigh of hand (often by skilled conjurers or illusionists). On another level, the omission of certain ideas can be crucial in affecting outcomes, as I am about to suggest regarding the mental health profession.

In promoting wellness, most enthusiasts emphasize that it is about health enhancement for its own sake. Wellness neither invites nor requires a doctor’s prescription or involvement; basically, the dimensions and skill areas associated with wellness (self-responsibility, fitness, sound nutrition, humor, play, meaning and purpose, etc.) are primarily non-medical issues.

Most wellness promoters, myself included, welcome and encourage the promotion of lifestyle matters by health care practitioners, but have traditionally focused their own energies on what can be done by individuals for themselves, regardless of medical problems or support of doctors and others in the healing arts. One reason for this orientation has been to distinguish wellness from that which usually receives nearly all the attention and resources of the health care or sickness system, namely, problems, diseases, dysfunctions, crises and other "negative" situations.

Of course, many doctors have long been in the forefront promoting wellness lifestyles. The National Wellness Conference, now in its 26th year attracting nearly 2000 celebrants annually to Stevens Point, WI for a week-long festival of presentations, was started and is still directed by William Hettler, the physician who heads the university’s student health service. Halbert L. Dunn, M.D., is credited with coining the phrase “High level wellness.” Nonetheless, despite the well-documented importance of exercise and most of the other wellness skill areas, most physicians and other medical practitioners have been too busy dealing with illness crises and otherwise preoccupied to integrate wellness into mainstream medical practice.

As I wanted to suggest with the little ditty about St. Ives, mental health professionals, especially those dealing with addictions and other recovery issues, have been similarly noted for their focus on other than wellness matters. This has distracted many clients, in my view, from the gains they might obtain from learning about, considering, adopting and carrying out positive lifestyle initiatives. Well, this is starting to change!

In March, The Institute of Medicine released a report entitled “Crossing the Quality Chasm” that indirectly documented the lag between what is known to be effective and what is actually done. Suggesting it can take 15 to 20 years for doctors and hospitals to incorporate best practices based upon solid evidence for efficacy, the report contained a judgment that between the health care we have and the care we could have lies not just a gap, but a chasm.

While nobody would suggest that wellness skills, principles, concepts and programs are or should be only for the well, the fact is that, with few exceptions, this has been the case since the modern wellness movement got underway starting about 30 years ago. There is evidence that the gap or chasm between what is known and supported about wellness values within significant parts of the health care/sickness system is now being embraced and promoted.

Most notable in this regard are initiatives within the mental health field to connect wellness with the recovery process. The latter is, according to a policy adopted by the California Institute for Mental Health/Wellness Recovery Task Force in April, an approach to wellness that is anchored for many in a range of interpersonal relationships, including peers, as well as families, friends and significant others. Such messages as “it’s up to each individual to take responsibility for his or her own illness” (there is no one else who can do this for us) are considered key facets of recovery. Other wellness elements in this recovery process include attention to self-efficacy in overcoming learned helplessness, exercise, emphasis upon choices to be made and guidelines for recovery-oriented services loaded with the same kind of accountability content found in the non-medical dimensions of wellness promotion.

Some of the leaders in this aspect of the mental health leadership write of the shift from a medical model to psychosocial rehabilitation mode that incorporates the kinds of elements most of us associate with wellness promotion.

Wellness is not only too important to be presented grimly but it is also too valuable to be run by and devoted to the well alone. The efforts by California and other mental health professionals to reclaim wellness promotion roles and what one leader in this movement termed a life beyond the medical and mental health system is very good news that all of us might cheer and support.

On your way to St. Ives or wherever you’re heading, if anywhere save where you are, stay well and look on the bright side of life.

(Note: This essay will be filed in the archives in the MENTAL DOMAIN under the skill area of mental health. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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