Shepherdess: High-level Wellness

What does it mean to be really well? If you ever feel that you could use a bit more energy to face your daily tasks, perhaps what you need is high-level wellness.

Patricia S. Jones, R.N., Ph.D., is associate dean and director of the graduate program at the School of Nursing, Philippine Union College, Manila.

God intends for each of His children to experience a high level of wellness. Most of you are well, some more so than others. Some of you may have a chronic problem that keeps you from feeling on top. Or you may have noticed a lack of energy recently and find you just can't do as much as you used to. You wake up in the morning feeling tired, and by the end of the day you're exhausted. Compared with the individual in an impoverished area, you are healthy, but you know that being really healthy feels better than this.

Improving life quality

Our ever-increasing life span has led to a new emphasis on improving the quality of life. We are coming to view health as more than physical well-being. We are also beginning to recognize the influence of mental and emotional health on physical well-being. But mysteries still remain. In fact, the power of our complex minds and emotions over our bodies scares us. And when depression sets in, how powerless we feel to resist it!

We strive to maintain a positive attitude, to trust God more, and to accept ourselves more fully. But often, in spite of our best intentions, we fail in our expectations and later wonder why. Sometimes, in desperation, we look around and say to ourselves, "Other people seem so energetic and happy, smiling and singing all the time. What's wrong with me? Why am I not a more energetic and joyous person?" So we ask ourselves, "What is health? And what does it mean to be healthy in the fullest sense of the word?"

Seventh-day Adventists have long understood health to mean "wholeness"--the integration of body, mind, and spirit. In fact, "making man whole" is the aim of both our health and educational programs.

One of my personal and professional objectives is to understand more fully how that wholeness can be promoted, and how the health potential of individuals can be maximized. In my search I have found definitions of health that agree with our Adventist view and that help in formulating, promoting, or facilitating wholeness in myself and others.

One such definition is that of Halburt Dunn, a physician, who speaks of health as "high-level wellness." "High-level wellness," he says, "is defined as an integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable."1 Other terms used by authors to describe an individual in such a healthy state are "fully functioning" and "fully alive." This kind of wellness, or wholeness, is dynamic; it is ever-changing. And it calls for energy.

Let's think for a few minutes about Dunn's definition and the words he used. First of all, there's the word maximizing, which implies a dynamic process of becoming. Potential stands for what one is capable of doing. So, maximizing one's potential is a process of moving toward an even higher level of functioning within the limitations of one's physical and mental abilities.

Carl Rogers used the term "fully functioning" to describe a person who is psychologically free to experience all of his feelings, to trust himself, to be creative, and to live more completely each moment. 2

Abraham Maslow examined the prevalence of these qualities in individuals and estimated that only one person in a hundred could be described as "fully functioning." 3 He further estimated that most people realize about 10 percent of their life potential, see 10 percent of the world's beauty, and are alive to only 10 percent of the deep and rich feelings possible to human beings. In the words of John Powell, "the greater part of their energies is siphoned off by fears, angers, guilt feelings, hatreds, loneliness, and frustration." 4

John Powell's description of a "fully alive" Christian also speaks of what God designed as part of health and wholeness for His people. Powell says that "fully alive people"

1. "are using all of their human faculties, powers, and talents."

2. "are alive in their external and internal senses. They see a beautiful world. They hear its music and poetry. They smell the fragrance of each new day and taste the deliciousness of every moment. Their senses are also insulted by ugliness and offended by odors. To be fully alive means to be open to the whole human experience.... They... are able to experience . . . wonder, awe, tenderness, compassion, both agony and ecstasy."

3. "are . . , alive in their minds." They are always "thoughtful and reflective. " They are "glad to be alive and to be who they are." They "truly love and sincerely respect themselves." "Their general disposition towards all is one of concern and love."

4. "experience failure as well as success. They are open to both pain and pleasure. . . . They cry and they laugh."5

The fully functioning, fully alive Christian woman, then, is one who understands her emotions and deep feelings and is not afraid to face them. She knows her fears, frustrations, and insecurities as well as her strengths. Through the grace of God she is able to accept and love herself in spite of her inadequacies. Through self-acceptance she grows past insecurities to become more fully functioning, mobilizing energy for the development of God-given potential.

If what Rogers, Dunn, Powell, and Mrs. White say about health is true, the question that confronts us all is How can I become like that? How can I become healthier, more fully functioning and alive, and above all, whole?

A helpful starting point is Maslow's description of the spectrum of needs common to all human beings. He refers to the framework simply as basic needs. 6 You may already be familiar with his work, but I'll review it briefly as we attempt to answer the questions I have posed.

First of all are the physical needs. This group is considered the most basic or most essential because it refers to such needs as air, water, food, rest, and exercise. Here I will mention just a few things particularly common to women.

There is, of course, that ever-present weight problem. Most of us would feel better physically and have more energy if we weighed less. We would also look a whole lot better and feel better about ourselves. Even our personalities would change with a new body image.

Exercise is also important, for improving heart and lung function and increasing the oxygenation of all organs. Walking is one of the best exercises. It not only will improve body functioning but will also help you lose weight right where women most easily accumulate it.

Walk your way into a feeling of well' being, and even your relationship with God will benefit as you develop a new acceptance and liking for yourself. As your self-image and self-confidence increase, you can even have a more rewarding personal ministry with others.

The second need identified by Maslow is for safety and security. Ministers' and administrators' wives may especially feel this need. Frequent moves, the loneliness of having your husband away on trips, and perhaps his "type A" behavior when he's home can leave you feeling insecure.

Threats to our security, whether they be mental or physical, cause us to become anxious and defensive. Anxiety interferes with our ability to focus, to be creative or even productive. While anxiety speeds up the body's defenses for attack, it also tenses muscles and freezes the mind. We become nervous and almost immobilized, as if our energy were held hostage. In such a state, even socializing with our friends and neighbors becomes a problem. Since it is difficult to relate to others, we tend to keep to ourselves.

The third need identified by Maslow is for love and belonging. We all need to love and be loved, to be appreciated for what we are, and to belong. Erich Fromm says that the deepest need of man is to overcome his aloneness. 7 He describes love as an active power, not a passive effect. It is primarily giving, not receiving. The most important sphere of giving, he says, is not in the world of material things, but in the human realm. 8

Love is not primarily a relationship to a specific person; it is an attitude, an orientation that determines the relationship of a person to the world as a whole. The Bible speaks of the kind of love that underlies all others when it says, "Love thy neighbour as thyself." That is brotherly love.

Motherly love comes very close to a woman's heart. In his book The Art of Loving, Fromm says motherly love does more than make the child feel it is good to have been born. "It instills in the child the love for life, and not only the wish to remain alive." 9 A Bible symbol Fromm uses for motherly love is that of the Promised Land, flowing with milk and honey. He says that "honey symbolizes the sweetness of life, the love for it, and the happiness in being alive." He observes that mothers provide the milk, all right, but the honey is often lacking.'" In order to provide honey, the mother must be genuinely happy, fully functioning, and fully alive.

The next need addressed by Maslow is self-esteem. "Satisfaction of the self-esteem need leads to feelings of self-confidence, worth, strength, capability, and adequacy, of being useful and necessary in the world." 11 On the other hand, "thwarting of these needs produces feelings of inferiority, of weakness, and of helplessness." 12 Satisfaction of this need, then, leads to a healthy, productive life, whereas frustration of this need leads to anxiety, blocking of energies, and even neurosis.

What is commonly referred to as the highest level of need, identified by Maslow, is the one he calls self-actualization. This term refers to man's desire for fulfillment, the desire to become everything that he is capable of being. When a person lives up to his potential, his achievements and the use of his life bring satisfaction. Maslow indicates that to reach self-actualization, one must have a purpose for which to live. And he says that self-actualized people are, without exception, involved in a cause outside of themselves. They feel called to do something, which they love and work hard at.

Self-actualizing people are in good psychological health. Their other basic needs are met. In other words, what motivates them to work hard and to achieve is not a need for recognition or appreciation or any other unmet need. Rather, it is their commitment to a mission in life. 13

Dunn agrees with Maslow on this point. He says, "Unless there is a reason for living, unless there is purpose in our life, we cannot possibly achieve high-level wellness." 14 The greatest expression of this is found in the Christian life where one is not to live for herself, but to share the good news of the kingdom of God. A person's ultimate need can be met only by a trusting relationship with God.

Two other needs listed by Maslow but not often discussed are the need to know and understand and the need for aesthetics.

As human beings with minds capable of storing vast knowledge and solving complex problems, we have a deep need to grow continually in understanding the world around us. The need for beauty and creativity is also built-in and God-given. Taking time to experience beauty in nature or art softens our spirit, deepens our feelings, and leads us to the Creator.

In his original outline of basic needs, Maslow didn't list separately the spiritual need of man, but he didn't deny it either. In fact, he describes psychological health as "movement toward spiritual peace." 15 From a Christian perspective we recognize that no one can be truly well without having the highest level of need met through a personal relationship with the Saviour. As Paul Tournier says, "The spirit is what gives meaning to the body, the psyche, and the mind and at the same time assures their harmony, their articulation, their unity." 16

It may seem that we've wandered from our discussion of health. However, Dunn acknowledges that the basic needs of man are the very ingredients of high-level wellness for the individual," and Maslow says that deprivation of any of the basic needs produces disease. 18 Having attempted to define what constitutes high-level wellness, we've arrived now at the question of how to achieve it, to become more fully functioning and more alive.

Satisfaction of our common, basic needs is determined in part by our own actions and in part by other factors in the world around us. Some of these factors are within our realm of control, and some are not. Once we are aware of our needs, however, the issue of control and change arises.

Two important factors within our control influence our psychological state and thus our wellness. One is our adaptability, and the other is our response when the world around us threatens our satisfaction of basic needs.

We can overcome the tendency to wallow in depression and self-pity by redirecting energy toward appropriate assertiveness and self-improvement. Even slight progress toward greater need satisfaction can make dramatic changes in self-esteem, perspective on life, and energy available for working toward satisfaction of other needs.

A wellness model

As a means of understanding wellness I have developed a model that portrays the interaction of basic needs and adaptability in relation to wellness.

The model is an equilateral triangle, the sides of which are continua. The two sides representing unmet basic needs and adaptability impact on the base, which is the wellness continuum. Lines drawn from any point of the two upper sides to the opposing acute angle intersect at various points within the triangle. A broken line projected downward from the point of intersection, perpendicular to the base, is an indicator of the level of wellness one is experiencing.

For example, a person who is average in adaptability and in need satisfaction would also be average in level of wellness (see Figure 1). Similarly, a person who is above average in adaptability and below average in unmet needs would be above average in wellness (Figure 2). By the same token, a person whose unmet needs are average but who is low in adaptability will be below average in level of wellness.

Improvement in either one of the two upper continua results in an improved level of wellness. And improvement in both continua results in even greater growth toward high-level wellness. Thus, if one's basic needs are high (that is, many unmet) and fixed, as in the case of a quadraplegic like Joni Eareckson, an increase in adaptability can improve the level of wellness possible for that individual (see Figure 3). Likewise, if adaptability is difficult to change, as in the case of an elderly person, greater satisfaction of basic needs can still lead to an improved level of wellness for the individual.

To fulfill their roles as wives, mothers, neighbors, friends, and even as professionals, women need the ability to help others grow toward wholeness and wellness. But before any woman can help others effectively, her own growth toward high-level wellness must be set in motion. She needs to be maturing into a fully alive, fully functioning Christian, developing her own God-given potential.

I have given you a framework for activating high-level wellness. It calls for

1. a broad understanding of the minds and bodies we have been given.

2. an increased awareness of our own feelings and needs, as well as those of people around us.

3. a willingness to enter into sharing, caring relationships with others that will lead to the satisfaction of unmet needs.

God created us in His likeness. We don't know exactly what that means, but we do know that we experience only a fraction of the joys He intended for us. We lack the integration and the whole ness that would bring greater harmony and joy into our lives. I believe that through increased understanding of the complexities of our minds and bodies, we can achieve greater wholeness and become more fully functioning Christians.

Ellen White comments: "The love which Christ diffuses through the whole being is a vitalizing power. Every vital part--the brain, the heart, the nerves--it touches with healing. By it the highest energies of the being are roused to activity. It frees the soul from the guilt and sorrow, the anxiety and care, that crush the life forces. With it come serenity and composure. It implants in the soul, joy that nothing earthly can destroy--joy in the Holy Spirit--health-giving, life-giving joy." 19

Understanding our own health needs and allowing the Holy Spirit to bless us individually is the first step toward facilitating wholeness in our families and the ever-widening circle of people we influence.

1 Halbert Dunn, High-level Wellness (Arlington,
Va.: R. W. Beatty, 1972), p. 4.

2 Carl R. Rogers, On Becoming a Person
(Boston: Houghton Mifflin Co., 1961), pp. 191,
192.

3 John Powell, Fully Human, Fully Alive (Niles,
111.: Argus Communications, 1976), p. 30.

4 Ibid., p. 31.

5 Ibid., pp. 19-22.

6 Abraham Maslow, Motivation and Personality
(New York: Harper & Row, Publishers, 1970), p.
35.

7 Erich Fromm, The Art of Loving (New York:
Harper & Row, Publishers, 1956), p. 13.

8 Ibid., pp. 24-27.

9 Ibid.,p. 49".

10 Ibid.

11 Maslow, op. dr., p. 45.

12 Ibid.

13 Maslow, The Farther Reaches of Human Nature
(New York: The Viking Press, 1971), p. 192.

14 Dunn, op. cit., p. 11.

15 Maslow, The Farther Reaches of Human
Nature, p. 195.

16 Paul Toumier, The Whole Person in a Broken
World (New York: Harper & Row, Publishers,
1964), p. 54.

17 Dunn, op. cit., p. 165.

18 Maslow, The Farther Reaches of Human
Nature, pp. 22, 23.

19 E. G. White, The Ministry of Healing (Mountain
View, Calif.: Pacific Press Pub. Assn., 1942),
p. 115.

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Patricia S. Jones, R.N., Ph.D., is associate dean and director of the graduate program at the School of Nursing, Philippine Union College, Manila.

September 1985

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