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Mental Health

Maintaining good mental health is as important to good quality of life as maintaining good physical health is. We gauge mental health by assessing several factors, including how fulfilling people's relationships are, how well they adapt or cope with adversity, the level of their communication skills, their resilience, and their self-esteem.


The interdependence of the physical, mental, social, and spiritual dimensions of health are emphasized throughout the Concise Guide. This notion remains true in regard to mental health. The word psychosomatic refers to the mind's influence on the body. In Chapter 6 the body's physical reaction to stress was discussed. Biology and emotions also influence each other, as shown in Figure 7.1.

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When we are angry, our body responds by secreting certain types of chemical messengers called hormones which, in turn, influence neuro-transmitters in the brain that relate to mood. When our body produces too little of certain neurotransmitters, depression can result. Just as the body has a fight-or-flight response to danger or stress (see Chapter 6), it also may respond to thoughts and feelings with back or chest pain, changes in appetite, constipation, high blood pressure, insomnia, upset stomach, weight loss, or weight gain.

Culture can also influence our mental health. When society emphasizes the importance of something an individual member of that culture can't attain, it causes conflict and potentially negative mind/body outcomes. Conversely, some institutions and organizations (such as religion or support groups) can greatly improve mental health and one's sense of well-being. This influence of culture is hard to measure but is nonetheless an important factor that individuals must include in making decisions regarding mental health.


When discussing mental health, there are a few basic terms you should know. Behavior is how someone acts. Motivation is something that causes a behavior. Self-concept is a set of core beliefs and values that you feel describes yourself. Self-esteem is how you feel—either positively or negatively—about your core qualities and attributes. And finally, assertiveness is being very open and honest about declaring your rights, whereas aggressiveness is forceful behavior with the intent to dominate.

Are You on the Correct Path to a Healthy Self Esteem?
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Maslow's Hierarchy of Needs

Abraham Maslow's (1970) hierarchy of needs is a model that describes the motivation for behavior. As shown in Figure 7.2, Maslow's contention is that people display behaviors in order to meet needs. Further, he describes five levels of needs. The first level is physiological needs—for food, water, and shelter.

Source: Maslow A. Motivation and Personality (2nd ed.). New York: Harper and Row, 1970.
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Once our physiological needs are satisfied, the most basic psychological need is to feel safe and secure. If these two basic levels of needs are met, then people tend to be motivated by needs higher in Maslow's hierarchy, such as the desire for love and belonging or for self-esteem. Successful people who seem to be living life to its fullest might be seen as reaching the level of self-actualization, though some say this level is questionable, since we can never really know what our full potential is.

Simple Behavior Paradigm

Using Maslow's hierarchy of needs as a reference point, we can conclude that our behavior is either need-directed or goal-oriented. A simple paradigm to describe behavior is presented in Figure 7.3. The needs referred to in this figure can be the needs identified by Maslow (physiological needs, safety and security). Once the need is identified, people display an instrumental behavior to meet the need. If the behavior leads to achieving the goal, we get relief.


We discover early in life that the real world is rarely as simple as what Figure 7.3 describes. That is, our behaviors don't always result in a need being met. Often we display a behavior and the need is not met; the goal is not reached. The result of a need not being met is displayed in Figure 7.4. Basically, we experience tension, frustration, and conflict, and then we respond. For example, we often interpret family expectations and personal expectations for success as needs or goals. When the expectations are not met or the goal is not reached, how we respond can result in relief or in no relief, in which case the tension, frustration, and conflict can either increase or lessen.

Responding to Unmet Needs and Defense Mechanisms

When a need is not being met, the most simple response is anger. Another way to respond is to be assertive and challenge something (or someone) to try to get the need met. If anger and assertiveness do not work, then people often become aggressive, which involves either verbal or physical domination. It is not a good approach for resolving conflict and often is counterproductive, especially if the aggressiveness is extreme or violent.

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Another common way we respond to unmet needs is to protect or defend our ego, our conscious state of how we perceive ourself; hence, these responses are called defense mechanisms. One such mechanism is rationalization, or making excuses for our need not being met. Another defense mechanism is denial, or simply not acknowledging that there is any frustration or conflict. Displacement is expressing our frustration by attacking another target—for example, a person may have a bad experience with a coworker but takes out her frustration on her spouse. Repression, or selective forgetting, is another defense mechanism—we refuse to think about the event that led to the frustration. Reaction formation is displaying behaviors that are the opposite of the ones that we are actually feeling. Finally, projection formation is accusing another person of the same unacceptable behaviors that we have displayed.

Use of defense mechanisms is normal. However, they can be harmful if they are overused to the point where the individual never deals directly with the problem.

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The National Mental Health Association has identified ten characteristics of people who are mentally healthy:

  1. They feel good about themselves.

  2. They do not become overwhelmed by emotions such as fear, anger, love, jealousy, guilt, or anxiety.

  3. They have lasting and satisfying personal relationships.

  4. They feel comfortable with other people.

  5. They can laugh at themselves with others.

  6. They have respect for themselves and for others even if there are differences.

  7. They are able to accept life's disappointments.

  8. They can meet life's demands and handle problems when they arise.

  9. They make their own decisions.

  10. They shape their environment whenever possible and adjust to it when necessary.

These characteristics have some common themes that are related to Maslow's hierarchy of needs, the behavior paradigm, and the use of defense mechanisms. These themes include a positive self-image, good communication skills, a sense of humor, responding in a healthy way to unmet needs, and good problem-solving skills. It makes sense that people who display the characteristics of good mental health are well-balanced, good problem-solvers and accept personal responsibility for their behavior.


Good mental health allows people to cope with the stresses and challenges of life. People's behaviors are motivated by their physical and emotional needs. According to Maslow's hierarchy, the most basic needs are the body's needs for food and shelter. Once those needs are met, people attempt to fill the most basic emotional needs, including a need for feeling safe and secure. When a need remains unmet, frustration results. Often people cope with unmet needs by using defense mechanisms such as denial, displacement, repression, reaction formation, and projection formation.