By Andrew Kemp, Professor of Psychology at Swansea University and Honorary Clinical Researcher at Swansea Bay University Health Board and Zoe Fisher, Consultant Clinical Psychologist at Swansea Bay University Health Board and Associate Professor at Swansea University.
Wellbeing is a complex topic: difficult to define, study and promote. Dictionary definitions refer to the state of being happy, healthy and comfortable. Yet happiness is often fleeting, health is often driven by factors beyond our control, and it is impossible to be comfortable all of the time.
Achieving wellbeing through discomfort and adversity
People engage in activities that, for others, are associated with great discomfort – including long-distance running, open ocean swimming and silent meditation retreats. These approaches to improving wellbeing emphasise the importance of learning to be comfortable with discomfort.
Developing a sense of meaning in life is a core component of wellbeing, and we can rarely achieve this without some discomfort and adversity. Interestingly, it’s been shown that the very pursuit of happiness can ironically lead to less happiness – and even an increase in depression, anxiety and stress.
Post-traumatic growth and wellbeing for those with chronic conditions
Health and happiness often go hand-in-hand, but our research shows that even people with chronic conditions like acquired brain injury can experience post-traumatic growth and wellbeing. Their traditional emotional processing mechanisms may be compromised, yet they can still achieve wellbeing under the right circumstances.
Theories underpinning positive psychology work
So what is wellbeing and how can we define it? It’s a topic of much discussion and debate in scholarly literature, which we have spent a lot of time reading and working through.
There are at least three main theories underpinning much of the work in positive psychology. One is ‘hedonia’, which focuses on strategies to promote positive emotions through, for example, savouring or positively reframing our experiences.
There is also ‘eudaimonia’ – this refers to other psychological constructs, including finding meaning and purpose in life and personal growth.
A third influential theory is the integrative PERMA model, which characterises five components thought to be essential to wellbeing. These include positive emotion, engagement (or flow), social relationships, meaning and achievement.
Different approaches, different considerations
Irrespective of the focus of this work, psychologists tend to focus on the individual, rather than groups or systems in which people are embedded. While clinical psychologists do consider systems, their primary ‘clients’ remain individuals, couples or families.
This is different to public health, which takes a population-based approach. These differences have led to a lack of integration between the two fields, especially when it comes to theories of wellbeing.
For instance, psychology-based wellbeing models neglect the impact of nature or socio-structural elements – areas where public health research typically shines.
From armchair observer to a deep dive into research
So how might psychologists work to promote individual and societal wellbeing? The answer involves thinking outside the traditional silos of our discipline.
I [Andrew] was an armchair observer of positive psychology for many years before actually diving into the deep end and undertaking research on this topic.
I was especially challenged by some of the critiques of the field, including that the dedication to promoting wellbeing is the preoccupation of rich white people. Or that wellbeing had become the victim of modern consumer society and the focus of the wellbeing industry.
That was until I moved to Wales and met my colleague and co-author, Zoe, a consultant clinical psychologist who had been embedding positive psychology into the Community Brain Injury Service at Morriston Hospital.
I [Andrew] was fascinated by the idea that someone who was battling a lifelong chronic condition like a brain injury would be capable of wellbeing, especially when reflecting on traditional definitions of wellbeing.
The field of positive psychology had neglected the application of these ideas to those living with disability, disease or injury. It could be argued that fostering wellbeing in such individuals is of even greater significance.
A new way of looking at wellbeing
We began to rethink what it means to experience wellbeing and developed our own theoretical framework that we’ve described as the GENIAL model (Fisher et al., 2022; Kemp & Fisher, 2022; Mead et al., 2021). It’s word that means ‘friendly’ and ‘cheerful’ in English (and ‘excellent’ in Spanish!).
It is also an acronym that maps out the pathway from Gene-Environmental interactions through to Longevity. Important mediators of this link include the vagal Nerve, which underpins our capacity for social interaction. This helps our body to maintain internal balance (homeostasis) while meeting its needs (allostasis). This process, over time, can influence our Longevity.
The vagus nerve is arguably the most important nerve in the human body and plays a key role in regulating key functions like heart rate, blood pressure, breathing and digestion. In fact, it can be considered a structural link between mental and physical health.
It has been shown to be associated with a host of outcomes, including:
- emotion regulation
- social connection
- nature connection
- premature mortality.
Improving vagal function
If we were to be pushed to define wellbeing in a single word, that word would be ‘connection’, and the vagus nerve has been shown to support capacity to connect to ourselves, others and nature.
Importantly, we can improve vagal function in various ways, including:
- doing physical activity
- health diets
- practising meditation
- being with friends and family
- spending time in nature.
A series of interventions based on the GENIAL framework
Our greater understanding of wellbeing has allowed us to completely transform our approach as clinicians and educators. We’ve now developed a range of interventions to promote wellbeing based on our GENIAL framework.
These include a wellbeing science module for undergraduate students and a positive psychotherapy intervention for people living with acquired brain injury. And we’ve even begun an ecotherapy project for the wider community – embedded in a community-supported agricultural project – on the site of a major teaching hospital here in South Wales.
We’ve published several papers relating to our work across the education and healthcare sectors, reporting that undergraduate student wellbeing improved after completing the wellbeing science module during the pandemic.
Our papers also demonstrated that people living with acquired brain injury have tremendous potential for wellbeing under the right conditions, despite living with considerable suffering and adversity.
Close partnerships with different sectors and community-based organisations
This work is not just isolated pockets of activity within the education and healthcare sectors. It represents a new way of working across different sectors to realise previously unimagined opportunities leveraged through close working partnerships with community-based organisations.
It also represents a new approach to promoting wellbeing focused on individuals, communities and the planet– with close attention paid to the promotion of individual, collective and even planetary wellbeing.
To promote sustained wellbeing and community integration using a ‘systems informed’ approach, we have co-developed a wide range of initiatives. These include nature-based groups, local conservation projects, surf and ski therapy, and sustainable construction.
A catalyst for meaningful, systemic change
These initiatives have all been guided by our theoretical frameworks and co-produced in partnership with community-based organisations. Engaging in community partnerships has created new opportunities to enhance and sustain wellbeing.
It’s also prevented further downstream adverse health consequences for people with chronic conditions following discharge from the health service. Partnering with community providers also contributes to the health and wellbeing of our communities – supporting wellbeing and resilience at a larger scale.
To be clear: our approach is not just a research initiative – it’s a catalyst for meaningful, systemic change. Its influence is affecting lives and systems at local, national and international levels, offering an innovative approach to the complex, interrelated challenges of wellbeing.
You might also like...
How do our bodies respond to stress?
Finding flow to boost your mood and make life meaningful
