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Read Chapter 2 in Health: The Basics - Psychosocial Health: Being Mentally, Emotionally, Socially, and Spiritually Well.

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2
Psychosocial Health
BEING MENTALLY, EMOTIONALLY,
SOCIALLY, AND SPIRITUALLY WELL

Do I have to be religious to be spiritual?
How do others influence my psychosocial health?
Can negative emotions make me sick?
How can I recognize a
panic attack?

How can I choose the right
therapist for me?

OBJECTIVES
■ Define each of the four components of psychosocial health,
and identify the basic traits shared by psychosocially healthy people.
■ Learn how internal and external factors affect your psychosocial
health; discuss the positive steps you can take to enhance your
psychosocial health.
■ Discuss the dimension of spirituality and the role it plays in your
health and wellness.
■ Identify common psychosocial problems, such as anxiety
disorders and depression, and explain their causes and treatments.
■ Explain the methods of different types of health professionals, and
examine how they can play a role in preventing specific types of
psychosocial health problems.
ISBN: 0-558-34154-3
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

Although the vast majority of college
students describe their college years as
among the best of their lives, many find
Emotional health
the pressure of grades, financial concerns,
(Feeling)
relationship problems, and the struggle to
find themselves to be extraordinarily diffi-
PSYCHOSOCIAL HEALTH
cult. Steven Hyman, provost of Harvard
Social
Spiritual health
University and former director of the National Institutes of
health
(Being)
Mental Health sounded this alarm about student mental
(Relating)
Mental
health: “The mental state of many students is so precarious
health
that it is interfering with the core mission of the university.”1
(Thinking)
Psychological distress caused by relationship issues, family
issues, academic competition, and adjusting to life as a
college student is rampant on college campuses today.
Experts believe that the anxiety-prone campus environment
FIGURE 2.1 Psychosocial Health
Psychosocial health is a complex interaction of mental, emotional,
is a major contributor to poor health decisions such as high
social, and spiritual health.
alcohol consumption and, in turn, to health problems that
ultimately affect academic success and success in life.
Fortunately, even though we often face seemingly insur-
They know who they are, have a realistic sense of their
mountable pressures, human beings possess a resiliency that
capabilities, and respect themselves even though they
enables us to cope, adapt, and thrive, regardless of life’s
realize they aren’t perfect.
challenges. How we feel and think about ourselves, those
They feel comfortable with other people. They enjoy satis-
around us, and our environment can tell us a lot about our
fying and lasting personal relationships and do not take
psychosocial health and whether we are healthy emotionally,
advantage of others or allow others to take advantage of
spiritually, and mentally. Increasingly, health professionals
them. They recognize that there are others whose needs are
recognize that having a solid social network, being emotion-
greater than their own. They can give love, consider others’
ally and mentally healthy, and developing spiritual capacity
interests, take time to help others, respect personal differ-
don’t just add years to life—they put life into years.
ences, and feel responsible for their fellow human beings.
They control tension and anxiety. They recognize the
underlying causes and symptoms of stress in their lives
and consciously avoid irrational thoughts, hostility,
Defining Psychosocial
excessive excuse making, and blaming others for their
problems. They use resources and learn skills to control
Health
reactions to stressful situations.
They meet the demands of life. They try to solve problems
What Is Psychosocial Health?
as they arise, accept responsibility, and plan ahead.
They set realistic goals, think for themselves, and make
Psychosocial health encompasses the mental, emotional,
independent decisions. Acknowledging that change is
social, and spiritual dimensions of what it means to be healthy
inevitable, they welcome new experiences.
(Figure 2.1). It is the result of a complex interaction between a
They curb hate and guilt. They acknowledge and combat
person’s history and his or her thoughts about and interpretations
tendencies to respond with anger, thoughtlessness, self-
of the past and what it means to the present. Psychosocially
ishness, vengeful acts, or feelings of inadequacy. They
healthy people are emotionally, mentally, socially, intellectually,
do not try to knock others aside to get ahead but rather
and spiritually resilient. They respond to challenges and frustra-
reach out to help others—even people they don’t particu-
tions in appropriate ways most of the time, despite occasional
larly like.
slips (Figure 2.2). When they do slip, they recognize it and take
They maintain a positive outlook. They approach each day
action to rectify the situation. Once they are informed about the
with a presumption that things will go well. They look to
resources that are available to help them get through tough situa-
the future with enthusiasm rather than dread. Reminders of
tions, they use them. Most authorities identify several basic char-
good experiences brighten their day. Fun and making time
acteristics shared by psychosocially healthy people.2
for themselves are integral parts of their lives.
They feel good about themselves. They typically are not
They value diversity. They do not feel threatened by
overwhelmed by fear, love, anger, jealousy, guilt, or worry.
people of a different race, gender, religion, sexual orienta-
tion, ethnicity, or political party. They are nonjudgmental
and do not force their beliefs and values on others.
ISBN: 0-558-34154-3
psychosocial health The mental, emotional, social, and
They appreciate and respect nature. They take the time
spiritual dimensions of health.
to enjoy their surroundings, are conscious of their place
32 PART ONE Finding the Right Balance
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

Psychosocially
healthy person
— Zest for life, spiritually healthy and intellectually thriving
— High energy, resilient, enjoys challenges, focused
— Realistic sense of self and others, sound coping skills, open-minded
— Adapts to change easily, sensitive to others and environment
— Works to improve in all areas, recognizes strengths and weaknesses
— Healthy relationships with family and friends, capable of giving and receiving love and affection,
accepts diversity
— Has strong social support, may need to work on improving social skills/interactions
but usually no major problems
— Has occasional emotional “dips” but overall good mental/emotional adaptors
— Shows poorer coping than most, often overwhelmed by circumstances
— Has regular relationship problems, finds that others often disappoint
— Tends to be cynical/critical of others; has friends, but friends tend to be similarly negative/critical
— Lacks focus much of time, hard to keep intellectual acuity sharp
— Quick to anger, a bit volatile in interactions, sense of humor and fun evident less often
— Overly stressed, anxious and pessimistic attitude
— No zest for life; pessimistic/hopeless/cynical most of time; spiritually down
— Laughs, but usually at others, has little fun, no time for self
— Has serious bouts of depression, “down” and “tired” much of time; has suicidal,
“life not worth living” thoughts
— A “challenge” to be around, socially isolated
— Developing neurosis/psychosis
— Experiences many illnesses, headaches, aches/pains, gets colds/infections easily
Psychosocially unhealthy person
(Illness likely)
FIGURE 2.2 Characteristics of Psychosocially Healthy and Unhealthy People
Where do you fall on this continuum?
in the universe, and act responsibly to preserve their
Mental Health:
environment.
They enrich the lives of others. They “tune in,” and rather
The Thinking You
than being narcissistic and self-serving, they often think of
The term mental health is often used to describe the “thinking”
others’ needs and try to help whenever possible.
or “rational” part of psychosocial health. It is defined as the
Of course, none of us ever achieves perfection in these
successful performance of mental function and results in pro-
areas. Attaining psychosocial health and wellness involves
ductive activities, fulfilling relationships, and the ability to cope
many complex processes. This chapter will help you under-
with life’s challenges. Mental health plays a role in the way we
stand not only what it means to be psychosocially well, but
think, communicate, express emotion, and feel about ourselves.
also why we may run into problems in our psychosocial
A mentally healthy person has the intellectual ability to sort
health. Learning how to assess your own health and taking
through information, messages, and life events, to attach mean-
action to improve your health are important parts of
ing, and to respond appropriately. This is often referred to as
psychosocial health (see the Assess Yourself box).
intellectual health—a subset of mental health.3
?
(Text continues on page 36.)
what do you THINK?
Which psychosocial qualities do you value most in
mental health The thinking part of psychosocial health;
your friends? ■ What area do you think is your
includes your values, attitudes, and beliefs.
greatest psychosocial strength? ■ Your greatest
weakness?
ISBN: 0-558-34154-3
CHAPTER 2
Psychosocial Health
33
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

ASSESS yourself
Fill out this assessment online at
ASSESSING YOUR PSYCHOSOCIAL HEALTH
www.aw-bc.com/MyHealthLab or
www.aw-bc.com/donatelle.
Being psychosocially healthy requires both introspection
very close to you to take the same test, responding with
and the willingness to work on areas that need improve-
their perceptions of you. Carefully assess areas where
ment. Begin by completing the following assessment scale.
your responses differ from those of your friend or family
Use the scale to determine how much each statement
member. Which areas need some work? Which are in
describes you. When you’ve finished, ask someone who is
good shape?
`
Fairly
Most of
All of the
Never
Rarely
Frequently
the Time
Time
1. My actions and interactions indicate that I am confident
in my abilities.
1
2
3
4
5
2. I am quick to blame others for things that go wrong in
my life.
1
2
3
4
5
3. I am spontaneous and like to have fun with others.
1
2
3
4
5
4. I am able to give love and affection to others and show my
feelings.
1
2
3
4
5
5. I am able to receive love and signs of affection from others
without feeling uneasy.
1
2
3
4
5
6. I am generally positive and upbeat about things in my life.
1
2
3
4
5
7. I am cynical and tend to be critical of others.
1
2
3
4
5
8. I have a large group of people whom I consider to be
good friends.
1
2
3
4
5
9. I make time for others in my life.
1
2
3
4
5
10. I take time each day for myself for quiet introspection,
having fun, or just doing nothing.
1
2
3
4
5
11. I am compulsive and competitive in my actions.
1
2
3
4
5
12. I handle stress well and am seldom upset or stressed out
by others.
1
2
3
4
5
13. I try to look for the good in everyone and every situation
before finding fault.
1
2
3
4
5
14. I am comfortable meeting new people and interact well
in social settings.
1
2
3
4
5
15. I would rather stay in and watch TV or read than go out with
friends or interact with others.
1
2
3
4
5
16. I am flexible and can adapt to most situations,
even if I don’t like them.
1
2
3
4
5
17. Nature, the environment, and other living things are important
aspects of my life.
1
2
3
4
5
18. I think before responding to my emotions.
1
2
3
4
5
19. I am selfish and tend to think of my own needs before those
of others.
1
2
3
4
5
20. I am consciously trying to be a “better person.”
1
2
3
4
5
21. I like to plan ahead and set realistic goals for myself and others.
1
2
3
4
5
22. I accept others for who they are.
1
2
3
4
5
ISBN: 0-558-34154-3
23. I value diversity and respect others’ rights, regardless of culture,
race, sexual orientation, religion, or other differences.
1
2
3
4
5
34 PART ONE Finding the Right Balance
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

`
Fairly
Most of
All of the
Never Rarely
Frequently
the
Time Time
24. I try to live each day as if it might be my last.
1
2
3
4
5
25. I have a great deal of energy and appreciate the little things in life.
1
2
3
4
5
26. I cope with stress in appropriate ways.
1
2
3
4
5
27. I get enough sleep each day and seldom feel tired.
1
2
3
4
5
28. I have healthy relationships with my family.
1
2
3
4
5
29. I am confident that I can do most things if I put my mind to them.
1
2
3
4
5
30. I respect others’ opinions and believe that others should be free to
express their opinions, even when they differ from my own.
1
2
3
4
5
INTERPRETING YOUR SCORES
these items (scores of 5) from this grouping of 25, and add
Look at items 2, 7, 11, 15, and 19. Add up your score for
up your scores for the remaining items. Then divide your
these five items and divide by 5. Is your average for these
total by the number of items included. Now what is your
items above or below 3? Did you score a 5 on any of these
average?
items? Do you need to work on any of these areas? Now
Do the same for the scores completed by your friend or
look at your scores for the remaining items. (There should
family member. How do your scores compare? Which ones,
be 25 items.) Total these scores and divide by 25. Is your
if any, are different, and how do they differ? Which areas do
average above or below 3? On which items did you score a
you need to work on? What actions can you take now to
5? Obviously you’re doing well in these areas. Now remove
improve your ratings in these areas?
MAKE it happen!
ASSESSMENT: The Assess Yourself activity gave you the
4.
Chart your progress in the journal. At the end of one
chance to look at various aspects of your psychosocial health
week, consider how successful you were in following
and compare your self-assessment with a friend’s percep-
your plan.
tions. Now that you have considered these results, you can
5.
Revise your plan as needed. Are the short-term goals
change certain behaviors that may be detrimental to your
attainable? Are the rewards satisfying?
psychosocial health.
MAKING A CHANGE: To change your behavior, you need to
EXAMPLE: John assessed himself as a positive and
develop a plan. Follow these steps below and complete your
upbeat person, but the assessment his friend gave him
Behavior Change Contract to take action.
rated him as impatient and cynical. John resolved to slow
down and become more appreciative of the good things
1.
Evaluate your behavior, and identify patterns and specific
around him. Among his short-term goals: listening to his
things you are doing. What can you change now? What
sister without interrupting her and expressing a sincere
can you change in the near future?
compliment to a family member or friend every other day.
2.
Select one pattern of behavior that you’d like to change.
John found that paying compliments made him stop to
think about the qualities he appreciated in friends and
3.
Fill out the Behavior Change Contract found at the front
family. Although he struggled to listen without interrupting,
of your book. It should include your long-term goals for
John found that he was learning a lot about his sister
change, your short-term goals, the rewards you’ll give
that he had never known before. After several weeks,
yourself for reaching these goals, potential obstacles
John’s friends commented on his calmer and happier
along the way, and strategies for overcoming these
demeanor.
obstacles. For each goal, list the small steps and specific
actions that you will take.
ISBN: 0-558-34154-3
CHAPTER 2
Psychosocial Health
35
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

A mentally healthy person is likely to respond to life’s
the environment that is causing them, and the appropriateness
challenges constructively. For example, suppose you spend
of our actions.
your spring break with friends on the beaches of Mexico,
Emotionally healthy people usually respond appropriately
knowing that you have a major term paper due on the first
to upsetting events. Rather than respond in an extreme fash-
day back from vacation. The night before the paper is due,
ion or behave inconsistently or offensively, they are able to
you quickly throw it together. Rather than falling off the deep
express their feelings, communicate with others, and show
end and blaming the instructor if you get a D on the paper, as
emotions in appropriate ways. How many times have you
a mentally healthy student you would accept responsibility
seen someone react with extreme anger by shouting or punch-
for the choices you made, learn from mistakes, and plan
ing a wall? Ex-lovers who become jealous of new relation-
differently next time.
ships and damage cars or property are classic examples of
When mentally healthy individuals realize that they are
people exhibiting unhealthy and dangerous emotional reac-
getting into trouble with classes, relationships, and life in
tions. Such violent responses and emotional volatility have
general, they know when they are still okay and when they
become a problem of epidemic proportions in the United
are starting to slide. Sadness, unhappiness, fear, and frustra-
States (see Chapter 4).
tion aren’t inherently bad and should be acknowledged and
Emotionally healthy people are usually able to respond in
dealt with. When the emotions begin to overwhelm you,
an appropriate manner to upsetting events. Emotionally
knowing when to seek help, talk to a trusted friend, or take
unhealthy people are much more likely to let their feelings
time out for rest and regrouping are all part of healthy
overpower them. They may be highly volatile and prone to
adapting and coping. Unfortunately, far too many of us get
unpredictable emotional outbursts and inappropriate, some-
caught up in our emotional upheavals and are unable to pull
times frightening, responses. An ex-boyfriend who is so jealous
ourselves out of the deep “funks” we can find ourselves in.
of your new relationship that he hits you or tries to manipulate
you into spending time only with him is showing an extremely
Emotional Health:
unhealthy and dangerous emotional reaction.
Emotional health also affects social health. Someone feeling
The Feeling You
hostile, withdrawn, or moody may become socially isolated.5
Because they are not much fun to be around, their friends may
The term emotional health is often used inter-
avoid them at the very time they are most in need of emotional
changeably with mental health. Although the
support. For students, a more immediate concern is the impact
two are closely intertwined, emotional health
of emotional trauma on academic performance. Have you ever
more accurately refers to the feeling, or subjective, side of
tried to study for an exam after a fight with a close friend or
psychosocial health that includes emotional reactions to life.
family member? Emotional turmoil may seriously affect your
Emotions are intensified feelings or complex patterns of feel-
ability to think, reason, and act rationally. Many otherwise
ings that we experience on a regular basis. Love, hate, frustra-
rational, mentally healthy people do ridiculous things when they
tion, anxiety, and joy are only a few of the many emotions we
are going through a major emotional upset. Mental functioning
feel. Typically, emotions are described as the interplay of four
and emotional responses are intricately connected.
components: physiological arousal, feelings, cognitive
(thought) processes,
and behavioral reactions. Each time you
are put in a stressful situation, you react physiologically as
>try it NOW!
you consciously or unconsciously interpret the situation.
Psychologist Richard Lazarus has indicated that there are
Seek change! Change is an inevitable part of life, but it
four basic types of emotions: emotions resulting from harm,
can also be a challenge to your psychosocial health.
loss, or threats; emotions resulting from benefits; borderline
Develop skills to cope with change by making change a
emotions, such as hope and compassion; and more complex
regular part of your life. View change as an exciting chance
emotions, such as grief, disappointment, bewilderment, and
for growth rather than a negative event. Think of the
curiosity.4 Each of us may experience any of these feelings in
positive things that change will create. Take a different
any combination at any time. As rational beings, we are re-
route to class, study at the coffee shop instead of the
sponsible for evaluating our individual emotional responses,
library, or pick out the people you don’t know in class as
your project partners. Don’t get stuck in a “same old,
same old” approach to life.
emotional health The feeling part of psychosocial health;
includes your emotional reactions to life.
emotions Intensified feelings or complex patterns of feel-
Social Health: Interactions
ings we constantly experience.
with Others
ISBN: 0-558-34154-3
social health Aspect of psychosocial health that includes
Social health, an important part of the broader concept of
interactions with others, ability to use social supports, and
psychosocial health, includes your interactions with others
ability to adapt to various situations.
on an individual and group basis, your ability to use social
36 PART ONE Finding the Right Balance
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

resources and support in times of need, and your ability to
the quality of the social bond, the more likely a person is to
adapt to a variety of social situations. Socially healthy indi-
ask for and receive social support. For example, if your car
viduals have a wide range of interactions with family, friends,
broke down on a dark country road in the middle of a snowy
and acquaintances and are able to have a healthy interaction
night, who could you call for help and know that they would
with an intimate partner. Typically, socially healthy individu-
do everything possible to get there? People who are socially
als are able to listen, express themselves, form healthy attach-
isolated, estranged from their families, and have few social
ments, act in socially acceptable and responsible ways, and
connections will have difficulty thinking of someone to count
find the best fit for themselves in society. Numerous studies
on when they are in trouble. Often mentally ill and homeless
have documented the importance of positive relationships
individuals lack the support networks necessary to help them
with family members, friends, and one’s significant other in
get off the streets and sustain health. Psychosocially healthy
overall well-being and healthy longevity.6
people create and maintain a network of friends and family
As social animals, we grow stronger and learn valuable
with whom they can give and receive support, and they work
lessons in groups, whether the interactions are positive or
hard to maintain those relationships even in difficult times.
fraught with conflict. From the moment we are born, we rely
Social health also reflects the way we react to others. In its
on families for our care and friends for our sense of “fitting
most extreme forms, a lack of social health may be repre-
in.” We depend on others to learn new skills and develop
sented by aggressive acts of prejudice toward other individu-
much of our sense of self-worth as a result of our interactions
als or groups. In its most obvious manifestations, prejudice
with others. Our adult lives are spent working with others,
is reflected in acts of discrimination, hate, and bias, and in
developing relationships with family and friends, and partici-
purposeful intent to harm individuals or groups.
pating in our community. In many ways, our value to society
is measured by the number of connections we have and even
Spiritual Health: An Inner
by how many people attend our funerals. Few would disagree
that social bonds are the very foundation of human life.
Quest for Well-Being
Social bonds reflect the level of closeness and attachment
that we develop with individuals. They provide intimacy,
Although mental and emotional health are key factors in over-
feelings of belonging, opportunities for giving and receiving
all psychosocial functioning, it is possible to be mentally and
nurturance, reassurance of one’s worth, assistance and
emotionally healthy and still not achieve optimal well-being.
guidance, and advice. Social bonds take multiple forms,
What is missing? For many people, the difficult-to-describe
the most common of which are social support and community
element that gives zest to life is the spiritual dimension.
engagements.
Most experts agree that spirituality
Social support consists of networks of people and services
refers to the personal quest for seeking
Do I have
with whom you share ties. These ties can provide tangible
answers to life’s ultimate questions, find-
to be
support, such as babysitting services or money to help pay
religious to
ing meaning in one’s life purpose, and
the bills, or intangible support, such as encouraging you to
be spiritual?
seeking a sense of belonging to some-
share intimate thoughts. Generally, the closer and the higher
thing greater than the purely physical or
personal dimensions of existence.7 For
some, this unifying force is nature; for others, it is a feeling
of connection to other people; for still others, the unifying
force is a god or other spiritual symbol.
Dr. N. Lee Smith, internist and associate professor of
medicine at the University of Utah, defines spiritual health
in the following ways:8
■ The quality of existence in which one is at peace with
oneself and in good standing with the environment
social bonds Degree and nature of interpersonal contacts.
social support Network of people and services with whom
you share ties and get support.
prejudice A negative evaluation of an entire group of
people that is typically based on unfavorable and often wrong
ideas about the group.
spirituality A belief in a unifying force that gives meaning
to life and transcends the purely physical or personal
Support from family and friends is a vital component to your
dimensions of existence.
social health.
ISBN: 0-558-34154-3
CHAPTER 2
Psychosocial Health
37
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

■ A sense of empowerment and personal control that
includes feeling valued and in control of one’s responses
Interconnectedness
(but not necessarily in control of one’s environment)
Connect to self, others,
and larger purpose
■ A sense of connectedness to one’s deepest self, to other
people, and to all that is generally regarded as good
Community
Mindfulness
■ A sense of meaning and purpose, which provides a sense
Live in
SPIRITUALITY
Be fully present
of mission by finding meaning and wisdom in the here
harmony
in the moment
and now
Everyday life
On a day-to-day basis, many of us focus on acquiring
Develop to our
material possessions and satisfying basic needs. But there
fullest potential
comes a point when we discover that material possessions do
not automatically bring happiness or a sense of self-worth.
As we develop into spiritually healthy beings, we recognize
FIGURE 2.3 Four Major Themes of Spirituality
our identity as unique individuals and gain a better apprecia-
tion of our strengths and shortcomings and our place in the
universe.
greater awareness, clarity, and acceptance of present-
In its purest sense, spirituality addresses four main themes:
moment reality or a form of inner flow—a holistic
interconnectedness, the practice of mindfulness, spirituality
sensation you feel when you are totally involved in the
as a part of everyday life, and living in harmony with the
moment rather than focused on some distant future event
community (Figure 2.3).
that may or may not happen.10
Spirituality as a part of daily life. Spirituality is embodied
Interconnectedness. The term interconnectedness
in the ability to discover and articulate our own basic
expresses a sense of harmony with oneself, with others,
purpose in life; to learn how to experience love, joy, peace,
and with a larger meaning or purpose. Connecting with
and fulfillment; and to help ourselves and others achieve
oneself involves exploring feelings, taking time to consider
our full potential.11 This ongoing process of growth fosters
how you feel in a given situation, assessing your reactions
three convictions: faith, hope, and love. Faith is the belief
to people and experiences, and taking mental notes when
that helps us realize our purpose in life; hope is the belief
things or people cause you to lose equilibrium. It also
that allows us to look confidently and courageously to the
involves considering your values and working toward
future; and love involves accepting, affirming, and respect-
achieving your goals without compromising those values.
ing self and others, regardless of who they are.12
Practice of mindfulness. Mindfulness is a form of medita-
Living in harmony with our community. Our values are an
tion that focuses on one’s ability to be fully present in the
extension of our beliefs about the world and our attitude
moment. According to molecular biologist and guru of
toward life. They are formed over time through a series of
mindfulness, Jon Kabat-Zinn, PhD, living mindfully
life experiences, and they are reflected in our hopes,
means “making more of your ordinary moments notable
dreams, desires, goals, and ambitions.13 Though most peo-
and noteworthy by taking note of them. . . . When you pay
ple have some idea of what is important to them, many
attention to boredom, it gets unbelievably interesting.”9
spend life largely unaware of how their values impact
Mindfulness has been described as a way of nurturing
themselves or those around them until a life-altering event
shakes up their perspective on life. Altruism, the act of
giving of oneself out of genuine concern for others, is a
interconnectedness A web of connections, including our
key aspect of a spiritually healthy lifestyle.14 Volunteering
relationship to ourselves, to others, and to a larger meaning
to help others, doing charitable work, donating resources
or purpose in life.
to help people in need and other community service
venues help you give back to the community and to people
mindfulness Awareness and acceptance of the reality
who have supported you.
of the present moment.
faith Belief that helps each person realize a unique
purpose in life.
hope Belief that allows us to look confidently and coura-
geously to the future.
love Acceptance, affirmation, and respect for the self and
?what do youTHINK?
What do social, mental, emotional, and spiritual
health mean to you? ■ What are your strengths
and weaknesses in each area of psychosocial
others.
health? ■ What can you do to enhance your
strengths? How can you improve areas that are not
altruism The act of giving of oneself out of genuine
ISBN: 0-558-34154-3
concern for others.
strong? ■ Are there community service activities
that you could engage in right now to help others?
38 PART ONE Finding the Right Balance
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

Spirituality: A Key to Better Health Although
the specific impact of spirituality on health remains elusive,
TABLE 2.1
Characteristics Distinguishing
many experts affirm the importance of this dimension in
Religion and Spirituality
achieving health and wellness. Results from studies of spiri-
tuality among college students indicate that spirituality may
Religion
Spirituality
play a role in students’health, their grades, their involvement
Community focused
Individualistic
in student activities, and other aspects of student life.15 These
Observable, measurable
Less visible and measurable,
studies also found a correlation between spirituality and
objective
more subjective
health achievement, with more spiritually oriented students
Formal, orthodox, organized
Less formal, less orthodox,
having better health, better grades, more involvement in char-
less systematic
itable organizations or volunteerism, and more interest in
Behavior oriented, outward
Emotionally oriented, inward
helping others. Students from different racial and ethnic
practices
directed
groups varied in spirituality levels, with African Americans
Authoritarian in terms of
Not authoritarian, little
demonstrating more spirituality and being more engaged and
behaviors
accountability
benefiting more from spirituality-related behaviors. Other
Doctrine separating good
Unifying, not doctrine
recent studies also indicate a correlation between certain
from evil
oriented
elements of spirituality and positive health outcomes. For
Source:
example, mindfulness therapies have been used effectively to
National Institutes of Health, “Prayer and Spirituality in
Health: Ancient Practices, Modern Science,” CAM at the NIH 12,
treat depression, to reduce stress in outpatient therapy and in
no. 1 (2005): 1–4.
the nursing profession, to treat anxiety and heart disease, and
to address other problems.16
discuss the role of spirituality in treating illness and chronic
A Spiritual Resurgence Over recent decades, stud-
pain. Self-help workshops focusing on spiritual elements of
ies have shown that most adult Americans, like their student
health are popular throughout the world.
counterparts, believe in God and consider spirituality to be
important in their lives, although not necessarily in the
Putting Spirituality into Practice How can
form of religion. Many find spiritual fulfillment in music,
you enhance your spiritual dimension of psychosocial
poetry, literature, art, nature, and intimate relationships.17
health? Some people seek solace in religion and equate
Table 2.1 details some characteristics that distinguish reli-
spirituality with religiosity. Although religion and spiritual-
gion from spirituality. Many religious groups have spawned
ity have some common elements, it is important to note
new philosophies that are more inclusive and often influ-
that spirituality and religion are not the same thing.
enced by “New Age” ideas, such as using positive thought to
Enhancing your spiritual side takes just as much work as
achieve your goals and striving to find your rightful place in
becoming physically fit, improving your diet, or working on
the world. A growing body of research focuses on the bene-
your mental health. The Skills for Behavior Change box
fits in quality and quantity of life that optimists—people who
features some strategies you can implement to develop your
maintain a positive and sunny view of the world, even in the
spiritual side.
face of adversity—experience.18 Optimists see the good in
situations and expect things to go the way they expect them
to in life. They always believe the “glass is half full” and
Factors Influencing
focus their energy on the possibilities of life, rather than
on their fears.
Psychosocial Health
For some, spirituality means a “quest for self and
selflessness”—a form of therapy and respite from a some-
Most of our mental, emotional, and social reactions to life are
times challenging personal environment. This quest has
a direct outcome of our experiences and social and cultural
received much scholarly and popular attention. Self-help
expectations. Our psychosocial health is based, in part, on
books that focus on spirituality consistently top the bestseller
how we perceive life experiences.
lists. Television programs promote the virtues of a spiritual or
natural existence. Writers and psychologists such as William
External Factors
James, Carl Jung, Gordon Allport, Erich Fromm, Viktor
Frankl, Abraham Maslow, Rollo May, and Jon Kabat-Zinn
Although some life experiences are under our control, others
have made spirituality a major focus of their work.
are not. External factors in life are those that we do not con-
Spiritual health courses have emerged in public health and
trol, such as who raised us and where we live.
medical school training. For example, the Harvard Medical
School of Continuing Education offers a course called
The Family Families have a significant influence on
“Spirituality and Healing in Medicine,” which brings together
psychosocial development. Children raised in healthy, nurtur-
scholars and medical professionals from around the world to
ing, happy families are more likely to become well-adjusted,
ISBN: 0-558-34154-3
CHAPTER 2
Psychosocial Health
39
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

SKILLS FOR behavior change
STRATEGIES TO FIND YOUR SPIRITUAL SIDE
Spirituality involves connected- beach or highway cleanup is all a part of
ness to others and to the
being responsible and finding a place to
broader community, so it is
help in the greater scheme of things.
important that we take time
Volunteering can be a huge boost for you
for meaningful interactions with our
when you are feeling down or wondering
friends, family, and people within the
how you fit in.
community with whom we may not
TAKE TIME TO REFLECT
interact regularly. What types of actions
foster connectedness?
Connecting with your self is another
method of finding your spiritual side. Make
VOLUNTEER
a ritual out of taking a few moments each
The ability to notice when others are in
day to think about who you are, what you
trouble and reaching out to help them
value, why you feel good, or what things
through volunteering is an excellent way to
are troubling you. Setting aside this special
feel connected with others and enhance
time to reflect will become a sacred time
your own health. In the aftermath of
meant just for you and can help you relieve
Hurricane Katrina, thousands of people
tension, seek out answers to problems you
volunteered their time, money, and effort
are experiencing, or simply empty your
to help an entire population that was suf-
mind and enjoy this time to yourself.
fering. Recognizing that we are all part of
Community agencies and programs benefit
GET INVOLVED IN
the greater system of humanity and that
from an enthusiastic hardworking group of
SERVICE LEARNING
we have roles and responsibilities to help
students. Students will learn to look at the
others in times of need is a key part of
Service learning involves making meaningful
greater community and world around them,
spirituality. Volunteering by helping your
and productive relationships with the
rather than remaining absorbed in college
older neighbors clean their home, working
greater community. Students have an
life and thoughts of papers due, the party
at the humane society, or participating in a
opportunity to learn new skills and grow.
on Friday night, and basketball practice.
productive adults. Children raised in
stressors, uncertainties, and threats can cause significant
How do
dysfunctional families, in which there is
problems. Drugs, neighborhood crime and threats to safety,
others
violence, negative behavior, distrust,
injury, school failure, unemployment, financial problems,
influence my
anger, dietary deprivation, drug abuse,
natural disasters and a host of other bad things can happen to
psychosocial
parental discord, or sexual, physical, or
good people. But it is believed that certain protective factors,
health?
emotional abuse, may have a harder time
such as having a positive role model in the midst of chaos, or
adapting to life and run an increased risk
certain positive personality traits can help children from even
of psychosocial problems. In dysfunctional families, love,
the worst environments remain healthy and well adjusted
security, and unconditional trust are so lacking that children
(see the next section, Internal Factors). They are often more
often become confused and psychologically bruised. Yet, not
resilient in the face of adversity and are more likely to have
all people raised in dysfunctional families become psycho-
the resources to cope more effectively.
socially unhealthy, and not all children from healthy environ-
Another important influence is access to health services
ments become well adjusted. Obviously, more factors are
and programs designed to enhance psychosocial health.
involved in our “process of becoming” than just our family.
Going to a support group or seeing a trained therapist is often
a crucial first step in prevention and intervention efforts.
The Macro Environment Although isolated negative
Individuals from poor socioeconomic environments who
events may do little damage to psychosocial health, persistent
cannot afford such services often find it difficult to secure
help in improving their psychosocial health.
ISBN: 0-558-34154-3
dysfunctional families Families in which there is violence;
physical, emotional, or sexual abuse; parental discord; or
other negative family interactions.
?what do youTHINK?
Over which external factors does an individual
have the most control? ■ Which factors had the
40
greatest impact on making you who you are today?
PART ONE
Finding the Right Balance
Health: The Basics, Eighth Edition, by Rebecca J. Donatelle. Published by Benjamin Cummings. Copyright © 2009 by Pearson Education, Inc.

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