How to go from Unhealthy to Healthy

In a way, you can’t.

Hey, that was the easiest commentary I’ve ever offered and I’d be lying if I didn’t take pride in my brevity. In all seriousness, I will offer a couple of personal insights that I’ve developed during the course of my work that briefly highlight my perspective. I believe that our preoccupation with health and ‘unhealth’ has neglected the construct of ‘function,’ which ultimately has a greater impact on a life lived in line with values. I will talk about what ‘function’ means in psychotherapy a bit more in a moment, but I want to first clarify why I believe that it is impossible for anyone to progress from (completely) unhealthy to (perfectly) healthy.

Although we view these states as attainable in some absolute form, at their extremes they are illusory constructs (they do not exist). No one is fully healthy or unhealthy. Furthermore, there are almost innumerable domains in which we can measure health or ‘unhealth’ (Cardiovascular, Orthopedic, Pulmonary, Neurological, Intellectual, Spiritual, Moral, etc.). We are all plotted on various positions along almost countless spectra in some wilderness between sickness and health. That’s what I keep in mind before meeting with any of my clients. We are not on different playing fields, playing different games – We’re just two people in the same ball-park, perhaps in different seats.

Enter the concept of function.

Function, as I view it in psychotherapy, refers to the degree to which a person’s thoughts, behaviors, and emotions are working for them in various contexts. More simply, how does the way a person think, behave, and feel influence their ability to live a life in line with their values (family, spirituality, achievement, financial stability, etc.). My perspective is that a primary focus on health often leads to stigma, disillusionment, pressure, unrealistic expectations, and lack of direction. In the medical field the term ‘function’ is often invoked to describe biological performance in a number of domains (heart function, liver function, functional range of motion). This allows for an understanding that there is a “good enough” balance of function that allows someone to be “healthy”. When doctors say “healthy,” they’re often referring to a desirable or acceptable level of functioning, given a patient’s age, family history, and personal goals. This is no different in the psychological realm.

When I work with my clients the approach is simple: 1) Determine Values, 2) Distill values to small, measurable, achievable goals, 3) Evaluate the ways in which their thinking, behavior, and relationship with emotions are impeding progress toward those goals, and 4) Collaborate with them to make sure that we address dysfunctional thinking and behavior so as to increase functioning in valued domains – bringing them closer to the kind of life they want to live. Notice that I chose the word ‘closer,’ as no value is fully met and no potential is fully realized. The good news is that we can persist in moving forward toward our values, improving function, and changing our relationship with the world around us. This is as close to psychologically healthy as any of us can get, but the reward is pretty sweet when we get there.