The health and well-being of a person can be impacted by many things. According to Duke University researcher Bryan Sexton, Ph.D., (www.hsq.dukehealth.org) well-being is the ability to see the good and the bad across situations. One key element of improving well-being is the ability to access positive emotions. The positive emotions that have been identified as distinctive measurable emotions include joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe and love. Experiencing these emotions involves a positive chemical change in the body that helps improve and stabilize the mood. Conversely, burnout is the impaired ability to experience positive emotions.
Much research has been done on how to promote well-being by enhancing these positive emotions through spontaneous or scheduled behaviors. Many behaviors can be deliberately used to promote well-being.
Because modern life is so fast-paced, many people have very little time to commit to well-being, or self-care behaviors. Duke University’s Center for Healthcare Safety and Quality has put together a collection of strategies that are evidence-based and bite-sized to make it easier to incorporate into daily life but have enduring effects to promote well-being. While designed for busy health care workers, these strategies can be used by all busy people to improve their well-being a few minutes at a time.
One of the best researched and more enduring behavior tools a person can use to improve their well-being is to use “3 Good Things.” This is simply using a few moments at the end of the day to review the day and list three good things that happened in the day. The practice helps people focus on what they have, not on what they don’t have. It significantly decreases depression, burnout and problems in work-life-balance, and increases happiness and enhances the ability to see the positive in life. Research suggests that for most people practicing this for 15 days in a row can improve one’s sense of well-being for up to 12 months.
The second bite-sized strategy is “Looking Forward with Hope.” This practice has a person deliberately name something that they are looking forward to each day. Research suggests that most people bounce back from traumas and difficulties and that those who don’t, in large part, have negative or pessimistic beliefs about the future. The practice of looking forward to what is hoped for appears to shift a person’s perspective to be more optimistic. Optimism is associated with less chronic pain, higher immune functioning, lower blood pressure and longevity.
The third strategy is related to the fact that people matter. Societies all around the world whose members live long happy lives have five things in common: they put family first, are socially engaged, don’t smoke, stay physically active and eat a plant-based diet. Having high-quality social connections is associated with positive emotions and well-being, lower rates of anxiety and depression, lower rates of cardiovascular disease and better immune function. Conversely, loneliness is a predictor of higher stress, more negative emotions, fewer positive emotions, poorer sleep and higher levels of stress hormones, according to research presented by Duke University. The bite-sized tool for social connection is to have one good discussion with someone every day. Having one open, positive conversation a day that focuses on a good thing that has happened recently, and includes self-disclosure and vulnerability, will bring meaning and social connection to a person’s life with intention and purpose.
The next strategy is a gratitude letter. While writing a list of blessings is helpful, expressing that gratitude toward others is more productive than just making a list, and is best when it is open, appreciative, curious, kind, real and sincere. Expressing gratitude can reduce emotional exhaustion and increase resilience, and is linked to sleep quality and quantity. To write a gratitude letter, a person thinks of someone who has done something amazing for them; this person can be alive or not. The writer needs to be genuine, kind and appreciative in the note. Sharing the letter with the person, if possible, will boost the positive effects for the writer and the receiver. Benefits are powerful, but only last four to six weeks, so repeated use monthly or bi-monthly is encouraged.
The next tool is the regular use of mindfulness. This may also include the use of relaxation. Mindfulness is attention training and a quality of consciousness. It is training to be more present-moment focused, to notice without judgement, being aware in the present moment, being open to experiences with greater curiosity and acceptance. It is a type of medicine, reducing stress, and improving immune functioning, sleep, anxiety, depression, eating disorders, memory and creativity, relationships and empathy.
A practice of mindfulness can include regular times of meditation or relaxation when a person sits or lays quietly and notices the sensations in their body, the sounds around them or the thoughts floating through the mind. This can be three minutes or 20 minutes every day or two. But mindfulness practice can also be a more informal, paying attention to everyday activities, being immersed in the experience of a task and focused on senses and sensations involved in the task. One way to build mindfulness in an informal way is to choose an everyday trigger to practice mindfulness. The trigger can be anything a person interacts with on a regular basis, like a door handle, a steering wheel or a coffee pot. When encountering the trigger item the person is reminded to pause and breathe, feel their feet on the ground and mentally let go of what has happened or will happen, to just be in the moment.
Another well-being tool is self-compassion, that is, acknowledging one’s own suffering, and treating it with compassion; caring for oneself as one would care for someone they truly love. According to research reported by Duke University, increasing self-compassion improves depression, stress, anxiety, self-criticism, rumination, eating behavior, and mindfulness, life satisfaction, happiness, self-confidence, optimism, curiosity, creativity and gratitude. It includes three components, self-kindness (understanding, not punishing), sense of common humanity/connectedness (everybody goes through this), and mindfulness (noticing with neither ignoring nor exaggerating feelings of failure).
Self-compassionate happens in the self-talk a person uses. Statements can say things like, “I’m doing the best I can right now,” “Others have gone through this, I will too,” “I will honor my physical and emotional needs,” “I can do this,” “I’m allowed to feel this way and will learn from this experience,” “I deserve to surround myself with supportive people,” “I am worth of love and respect,” “It’s okay to relax,” and “I can let go of anger and fear and let in love and joy.”
Self–compassion helps provide the safety people need to turn toward and accept painful emotions so they can heal. The practice includes noticing critical thoughts, then gently shifting them using the self-talk phrases. It also involves noticing the emotions, being with it and expressing it, breathing and grounding oneself and taking a break if needed. Then, later on, when emotions have calmed down, learning from the experience, by asking things like “What did I do well?” “What did I learn?” and “What do I want to do differently next time?” It also means recognizing and giving oneself permission to use resources, whether that is friends, family, or professionals, or organizations and systems. It can be good to do a daily check in on one’s self-compassion by journaling.
Lastly, another well-being tool is the practice of cultivating the attitude of awe. The attitude of awe is the practice of approaching life with a perspective of wonder. Experiencing awe has many benefits, like reducing inflammatory markers, expanding people's perception of time by bringing people to the present moment, making them less impatient. It also increases the desire to help others, and reduces materialism, leading to improved satisfaction with life. Duke’s findings are consistent with those reported by Annette McGivney (Backpacker, 3/2018) on various studies that show not only does exposure to wilderness decrease PTSD symptoms, but also that the degree of change was directly correlated with the magnitude of the awe; the greater the awe, the greater the benefit.
A simple strategy that is suggested by Dr. Sexton is an Awe Walk. This is taking a walk while watching afresh at things around. It is choosing to look at things differently, looking for interest, beauty and wonderful details, seeing vastness and connection, the grand and the small. A person can also look for experiences that are outside their norm, and can plan exposure to new and different things, through experiences like travel, new events or visiting a new part of town. But even the simple act of taking five to seven minutes to reflect on an awe-inspiring experience is enough to improve a person’s emotional recovery, ability to bounce back, adapt and regain a positive outlook.
There are many things people can do to promote well-being. For further study here are some books and websites that may be helpful: Learned Optimism by Martin Seligman, Together by Vivek H. Murthy, Love 2.0 by Barbara Fredrickson, Daring Greatly by Brene Brown, Flourish by Martin Seligman, 10% Happier by Dan Harris; Mindfulness of Beginners by Kabat-Zinn; Wherever you go there you are by Kabat-Zinn; The Miracle of Mindfulness by Thich Nhat Hanh; The Mindful Path to Self-Compassion by Christopher Germer, The Mindful Self-Compassion Workbook by Kristin Neff, The Gifts of Imperfection by Brene Brown, Rising Strong by Brene Brown, Radical Compassion by Tara Brach, self-compassion.org, positivepsychology.com and centerformsc.org. Duke University’s online tools can be accessed at hsq.dukehealth.org.
For those who need more intense professional help MyMichigan Health provides a Psychiatric Partial Hospitalization Program at MyMichigan Medical Center Alma, a day program for those struggling with mental health issues and need more than an outpatient visit. Those interested in more information about the PHP program may call (989) 466-3253. Those interested in more information on MyMichigan’s comprehensive behavioral health programs may visit www.mymichigan.org/mentalhealth.