Psychological well‐being is more than the absence of depressive feelings and anxiety – it incorporates feeling good, optimistic, connected with others, and engaged with our lives and living a rich and meaningful life. As busy dental professionals, creating a career that is flourishing and a personal life that nourishes and inspires us, we could benefit enormously from unpacking the science of well‐being. The research from positive psychology, the scientific study of what makes individuals and organisations thrive, has many applications to dental professionals. It incorporates happiness, self‐compassion, emotional intelligence, mindset, motivation, strengths, positive communication, and meaning to resilience and post‐traumatic growth. Since the conception of psychology study, there has been a sharp focus on the negative aspects of life that contribute to psychological health amongst the research rather than positive factors. Positive psychology addresses this imbalance. In this and subsequent chapters, we explore how we can use the research to improve our own well‐being.
The Two Types of Well‐being
Positive psychology draws some of its key principles from philosophy. Two different types of well‐being explored in the literature are known as hedonic well‐being and eudaimonic well‐being. The origins of the two types date back to ancient Greek philosophers around 400 BCE: hedonism by Aristippus and eudaimonia by Aristotle. Hedonic well‐being refers to happiness from feeling pleasure in the moment. The problem with this, however, is that it is fleeting, and we need to constantly top up our levels to maintain its effects. Eudaimonic well‐being taps into happiness we gain from having meaning in our lives and aligning to a purpose that is bigger than ourselves. Although we do need pleasure in our lives, the psychology research suggests that pursuing meaning is strongly related to happiness compared with just pursuing pleasure (Schueller and Seligman 2010).
Another way to think about well‐being is considering how we evaluate our life and the interplay with our positive and negative emotion levels. This is known as subjective well‐being. Subjective‐well‐being has three parts, one evaluative and the other two focused on our mood. In positive psychology, it is expressed as the following handy formula:
This translates as how we think about our life, in terms of our expectations and resemblance to our ‘ideal’ life, plus how positive we feel minus how negative we feel. See the Measure Your Well‐being worksheet to measure your satisfaction with life and positive emotions.
Languishing versus Flourishing
Do you ever feel a bit disengaged? Like you are on a treadmill, just going through the motions but not really feeling engaged with your life? There is actually a term for this very common feeling: languishing. Coined as the neglected middle child of mental health by some, languishing describes the feeling of stagnation, feeling unsettled but not highly anxious and unmotivated. Moods may appear not too high or low. You may not feel happy, but you also do not feel sad. It is the gap between depression and flourishing – the absence of well‐being.
Corey Keyes, a psychologist and socialist, was the first to describe both concepts in relation to mental well‐being. Flourishing, otherwise known as thriving, refers to a state of mental wellness; we feel good, engaged, connected, fulfilled, and positively challenged. In the next section, we explore what the building blocks to thriving look like.
Building Blocks of Thriving
PERMA is a positive psychology model of well‐being that describes five building blocks to flourishing: Positive emotions, Engagement, Relationships, Meaning, and Accomplishment (Seligman 2011). Research has shown significant associations between PERMA pillars and physical health, job satisfaction, life satisfaction, and organisational engagement (Kern Aet al. 2015). Umucu et al. (2020) examined PERMA among a sample of 205 student veterans. The authors reported that the PERMA questionnaire could help researchers and practitioners better gauge well‐being in student veterans. Increasing each ingredient of PERMA can increase our levels of well‐being through working on fostering positive thoughts, feelings, and actions. Before we consider how, let us delve into each pillar.
Positive emotions: Increasing our diet of positive emotions, from optimism, curiosity, awe, and zest to compassion, looks different for every individual. As a community that emphasises productivity, this strand of PERMA is the focus on doing more activities that make you feel good. At work, this could be actively practicing gratitude during a morning team huddle, recalling positive moments with patients, practicing mindfulness for two minutes pre a team meeting or during your work day with your nurse, or journaling about the funny moments during your day.
Engagement: This pillar focuses on activities that help you feel more engaged with your life. There are several routes to increase our levels of engagement, at work, and at home. This can be through activities that help us get into the ‘flow’ state, otherwise known as ‘in the zone’. These are activities in which we get completely absorbed and lose track of time. Another route to engagement is doubling down on our strengths. To learn more about strengths, see Chapter 10.
Relationships: As humans, we are wired to be connected with loved ones. This pillar concentrates on the positive relationships at work and at home that bring us joy and support. This pillar is particularly crucial as dental professionals work in a multidisciplinary setting amongst dental nurses, hygienists, reception staff, specialists, and community services. Positive, caring, and supportive interpersonal connections are essential to our well‐being at any stage of our life (Diener and Seligman 2002).
Meaning: This pillar concentrates on ways we feel fulfilled by leaning into causes or a purpose bigger than ourselves. This can be by thinking of big or small ways we can serve the community, creating a charity fundraiser, or even sending a motivational text to a friend who is struggling. To learn more about meaning, see Chapter 4.
Accomplishment: The last pillar focuses on ways we can feel more accomplished. This could be through setting weekly, monthly, or yearly goals that align with our values and what matters the most. To learn more about goals, see Chapter 12.
Additional Theories of Well‐being
There are a number of important theories of well‐being that are useful when we are thinking about practical ways we can an boost our levels of well‐being. Many of the psychological interventions in the research are based on the theories below.
Broaden and Build (Fredrickson 1998): This theory describes the mechanism in which positive emotions broaden our thinking and help us build personal resources, such as resilience. Resilient people have been found to use positive emotions as ways of coping during adversity, such as humour (Werner and Smith 1992; Wolin and Wolin 1993; Masten 1994), creative exploration (Cohler 1987), relaxation, and optimistic thinking (Murphy and Moriarty 1976; Anthony 1987).
Mindfulness to Meaning Theory (Garland et al. 2015): Mindfulness allows individuals to decentre from stress into a state of awareness, which encourages broadening attention to reappraise life circumstances. This reappraisal is then further enhanced when individuals savour positive features of their environment, motivating behaviour driven by values and meaning in life. To learn more about mindfulness, see Chapter 6.
Attention Restoration Theory (Kaplan and Kaplan 1989): This theory describes the mechanism in which spending time in nature restores our concentration, through practice of effortless attention, and being in an unthreatening natural environment reduces stress and improves physiological functions, for example, heartrate and blood pressure.
Flow Theory (Csikszentmihalyi 1990): Flow, otherwise known as ‘getting in the zone’, is the feeling of being completely immersed in an activity. We lose track of time. We get inherent meaning and pleasure from this activity. Research shows flow has many routes to enhancing our well‐being, our engagement at work and performance.
Self‐Determination Theory (Ryan and Deci 2000): The three psychological needs identified in Self‐Determination Theory (connection, choice, and competence) have been shown in the literature to be cross‐culturally valued (Sheldon and Houser‐Marko 2001) and related to well‐being (Reis et al. 2000; Sheldon et al. 1996). Furthermore, there is tremendous support for this theory in relation to a whole range of diverse topics from healthcare, medical education, mindfulness, exercise, and development to digital health and coaching.
Strengths Theory: This describes how the use of our character strengths, that is, the positive parts of our personality that impact how we think, act, and feel (e.g. creativity, social intelligence, and leadership), can improve well‐being and resilience and help us thrive at work. To learn more about character strengths, read Chapter 10.
Barriers to Well‐being
Did you know that there are a number of psychological obstacles that prevent us from building greater well‐being? In this section we explore 3 key challenges.
The negativity bias: You may have noticed that we remember the negative things more than the positive. The analogy of negative news being like Velcro and positive as Teflon is often used to describe this natural negativity bias. The bias is due to how our brains have evolved to be highly attuned for threats and danger. Our amygdala kept us safe from predators, such as sabre tooth tigers, so prioritises the dangers. However, in today’s age, the threats are not external and more about our self‐concept, for example, as a result of social compassion.
We can counteract our natural negativity bias through several evidence‐backed ways. Practicing gratitude, that is, counting our blessings and how they make us feel, is one powerful strategy. Another method is the process of looking for silver linings, known as benefit finding, to highlight potential upsides to even difficult or challenging times.
Social comparison: This refers to the comparison we make with our peers to determine how well be are doing in life. Social media has certainly influenced our perception of how our peers are living and our ideas around success. With filters on top of beautifully curated feeds highlighting the best bits, social comparison presents many challenges. Social comparison in the research has been shown to influence our well‐being; even if our standard of living is relatively good, if it is lower than our peer group, our well‐being levels decrease (Solnick and Hemenway 1998).
Hedonic treadmill: The concept of the hedonic treadmill explains the mechanism in which pleasurable activities, such as buying a new phone, lose their shiny new appeal very quickly. This is why despite having a salary raise, getting married, or succeeding at something, and an initial raise in our happiness levels, we return to our happiness set points. The potential upside, however, to this adaptation is that when we receive bad news, we will feel worse in the short or medium term but then will eventually return to our original happiness levels.
There is a lot of attention paid to negative emotions, and it often seems there are relatively few positive emotions. Traditionally the medical model of care is to fix problems reactively rather than amplifying the positive aspects of life proactively. This is where positive psychology shines.
In the following sections, we explore practical ways you can apply the science of well‐being to your life and counteract some of the obstacles we discussed above. All the exercises are designed to elevate our positive emotions. Through intentional well‐being exercises, like the ones below, our brain responds by releasing important feel‐good hormones: