16 Characteristics of Mental Health
What is mental health?
It can be hard to keep your focus on a goal that you can’t clearly define. If you’re investing time and money into improving your mental health through therapy, for example, how do you know where you want to arrive at, or that you’re making progress? What should you be measuring? And what am I measuring, as your therapist?
Some people seem to think that mental health means being happy all the time, never feeling sad, always getting what you want, etc. Mental health is not the erasure of all things unpleasant. We need the unpleasant, the painful, the unexpectedly tragic events of life to help us truly appreciate the full spectrum of our life experiences.
So then what is mental health, if it doesn’t mean we have a permanent smile on our faces?
Nancy McWilliams PhD, a clinical psychologist, professor of psychology, and well-known author in the field of psychoanalysis, has created a comprehensive list of 16 characteristics of mental health which I find very helpful in answering this question. Below I will give a brief description of each characteristic on her list. I hope this gives you a sense of what therapy is supposed to help with, and also inspires some reflection on where you fall on the spectrum of mental health according to these criteria. Which of these qualities are strengths for you? Which are areas that still need attention?
The capacity to love
The capacity to love includes the ability to have an authentic intimate relationship with a partner, friends, or family. Intimate relationships are authentic when they are emotionally honest. The capacity to love thus entails a willingness to be real and genuine with others even when it hurts, as this is what creates true intimacy. People who feel the need to compulsively please others at their own expense are not fully capable of loving.
The capacity to work
The capacity to work refers to the ability to feel generative and purposeful in one’s work; to feel that it has real meaning in the world, giving us a sense of fulfillment and satisfaction with our contributions to society. When we work 9-5 jobs that we hate just to pay the bills, we are not fully engaging our capacity to work.
The capacity to play
The capacity to play is built into our neurological circuitry as mammals. This is easiest to see in children, but the capacity to play remains a vital resource in adulthood. We need to be able to relax and have fun. When we lack the capacity to play, life feels dull and colorless. Adult play assumes many forms: dance, singing, sports and other competitive games, sex, the exchange of jokes and laughter, etc.
Secure attachment
Secure attachment refers to the sustained feeling of being safe in the world and trusting that one’s needs will be adequately met. A securely attached person has received consistent nurture, affection, love and connection from a reliable caregiver and has internalized these qualities to such a degree that they remain available in the absence of the original caregiver. This allows the person to successfully regulate their own emotions and to confidently explore the world and take healthy risks.
Agency
Agency refers to a sense of self-efficacy: you can go after what you want. You have some say over how your life unfolds, giving you a sense of autonomy and control. We human beings have a deep need to feel in control of ourselves. When we lack agency, we feel powerless in the face of our challenges. We may find other, less healthy ways of gaining that sense of control over our lives.
Self and Object Constancy
Also referred to as identity integration, this is the sense of stability in who I am and who I perceive others to be. This is the confidence that those who care about me don’t stop caring when they aren’t physically present. I can hold their image in my mind and heart and know that they care about me, and that soothes and nourishes me. I can be myself and I will not be abandoned or rejected.
Self and object constancy also allows me to feel that I am still the same person when I am angry and rageful as when I am feeling happy and playful, and that others too are the same people no matter what they’re feeling or expressing. I can tolerate ambivalence, and having conflicting feelings for someone. I can be angry at them and still love them, and they can be that way with me. Someone who is afraid of expressing anger because they don’t want to become similar to a hostile parent is struggling with self and object constancy. The belief that one will become a different person when they express a certain emotion — a person they don’t want to be — is a self constancy problem.
When we have good self and object constancy, we can allow ourselves to feel and express a full range of emotions, and we can welcome this expression in others without losing touch with ourselves and with them. This allows us to be fully authentic with others without it threatening the relationship. People with borderline personality disorder have particularly strong issues with self and object constancy.
Affect Tolerance and Regulation
A person with good affect tolerance can embrace a whole range of thoughts and feelings without needing to resist or suppress them. When we feel uncomfortable with certain thoughts and feelings because they are disturbing to us and we can’t tolerate that disturbance, we will invest a lot of mental energy in suppressing those thoughts and feelings, and we may also avoid situations that trigger them. This leaves us feeling more guarded and anxious. When we can allow ourselves to experience whatever thoughts and feelings arise, we feel more whole, resilient, and open.
Affect tolerance and regulation is also about the ability to allow different emotions to come and go without getting stuck in any of them. Some people grow up with parents who don’t allow them to express anger. As adults, these people may find themselves getting stuck in feelings of sadness or guilt when they actually need permission to be angry. This experience of getting stuck in feelings that block other feelings is an example of poor affect tolerance and regulation ability.
Ego Strength
Ego strength is about resilience and the ability to handle extreme stress or even traumatic experiences without falling apart, regressing or acting out in ways that are sabotaging. Someone with good ego strength can handle the ups and downs of life without getting overwhelmed. Even when things happen that are extremely stressful, the person stays grounded and keeps their composure. Someone with poor ego strength, on the other hand, may respond to extreme stress by becoming severely anxious or depressed, lashing out at others, or withdrawing from life and self-soothing through addictive behavior.
Self Esteem
Self esteem should be both realistic and reliable. Realistic self esteem gives us the confidence to express ourselves and get our needs met without believing ourselves to be superior to others. Reliable self esteem means that we are able to hold onto that healthy sense of confidence in most situations.
Unrealistic self esteem is the kind that makes us feel we deserve things that others don’t. Unreliable self esteem is the kind that we can’t count on. Sometimes it’s there but often times it isn’t.
Children who grow up in families where the parents are consistently critical tend to become adults with low self esteem. Another scenario that damages self esteem in the opposite way is when parents praise their child universally, giving that child a sense that he can never do wrong. This leads to the unrealistic kind of self esteem that is characteristic of narcissism and does not bode well for relationships.
Values
Values is about ethics, morals and integrity. Someone with strong values is able to be autonomous and stand up for what they believe in even when it’s not popular. People who have a deep sense of personal integrity and morals tend to be trustworthy people. We know what matters to them and we know we can count on them to advocate for themselves and others.
Someone with poor values, on the other hand, may feel untrustworthy to most people. If a person doesn’t have a clear moral code, it’s harder to get to know them. People without a strong sense of personal integrity and morals may also struggle to motivate themselves in life.
Insight
Insight is about understanding ourselves and being understood by others. Understanding feels good. It often feels reassuring to learn why we are the way we are, especially when we’ve lived most of our lives without that understanding. It’s like finding the missing puzzle piece. To make those discoveries in the presence of a caring, supportive person can be very satisfying and calming to our nervous systems.
When we have a high degree of insight about ourselves, we are more confident in our interactions with others and we have a better ability to communicate what we’re experiencing, which invites intimacy. The more insight we have, the more aware we are of what we need. By contrast, when we do not have much insight into ourselves, we will be less capable of getting our needs met and will have more miscommunication and disharmony in our relationships.
Mentalization
Mentalization refers to the recognition that we have a mind that operates separately from those around us — and that they have their own minds, with their own agendas, that have nothing to do with us. This might seem like an obvious fact of life, but it’s actually an important developmental achievement to be able to look at our own minds objectively and recognize the boundaries between minds. It allows us not to take responsibility for the experiences of others and to not take things personally.
Early childhood trauma can disrupt the development of mentalization. In adulthood, those with poor mentalization have a hard time not taking things personally. There may be an exaggerated competitiveness or a hypersensitivity to other people’s reactions to us. Boundaries become blurred and we tend to assume that we are more at the center of other people’s attention than we really are.
If we can recognize that not everything is about us, we can relax a bit and not take our interactions with others so personally. This is an important ingredient of mental health.
Flexible defenses
Having flexible defenses means that when you experience stress, you have a range of possibilities for how to manage that stress. You know how to self-soothe in multiple different ways, so if one method doesn’t work in a given situation, you can use another. People with inflexible defenses tend to have rigid reactions to stressful situations which makes it harder to adapt to the unpredictability of life. Like using a hammer in all situations when sometimes a screwdriver or wrench would be more appropriate, we end up sabotaging ourselves when we take a “one size fits all” approach to managing stress and overwhelming feelings. We need to be flexible in order to develop true resilience.
Balance
There is one particular area of mental health where balance is especially important, and that is in our relatedness to other people. Finding a balance between separateness and relatedness is healthy. We may sometimes need to spend time alone to connect with ourselves, and other times we may need to seek out connection with others. Can we balance social connection with solitude? Too much of either one can be limiting.
Another key area where balance is important is in our relationship to behaviors or activities that are highly stimulating. This might include the use of substances, food, sex, exercise, shopping, video games, or even for some people, watching the news. Whatever it is that you could easily do in excess. Most of us have at least one behavior or activity that could take over too much of our time and energy on a daily basis if we don’t strive for balance.
Vitality
Vitality refers to your life force and the energy that you use to express yourself and to engage with life. Vitality is at the core of creativity, drive, passion, and general enthusiasm and zest for life. If someone has a lot of vitality, they will generally be attractive and interesting to others. Someone with a lot of vitality is often magnetic and possesses a high capacity for connection with others. Life has a quality of adventure and excitement to it.
Low vitality is characteristic of depression and disengagement from life. If I don’t feel very alive, life loses its color. I will be prone to chronic boredom, apathy, and general feelings of dullness and unimportance. I will also struggle to connect with myself and with others, and will probably not have much motivation to do anything about it.
Acceptance
You’re probably familiar with the serenity prayer:
“God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”
A core part of mental health is accepting what cannot be changed about ourselves and about life. Essential to this capacity for acceptance is our willingness to surrender and grieve the losses that are out of our control. Many of us have at least a few things in our lives that we wish could be different but that we cannot change. If we fail to accept these realities, we end up feeling at war with ourselves and with life in general, and this can be a painful and isolating way to live. If we can accept our limitations, on the other hand, we can then truly love ourselves unconditionally and embrace life for the unpredictability that it brings.
Fighting against unchangeable aspects of reality is draining and can lead to resentment and discouragement with life. Embracing those aspects of reality brings us emotional freedom and resilience.
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These 16 qualities of mental health give you a map for understanding where your potential growth areas are. These are all areas to potentially focus on in therapy.
