A short history of how the profession of psychology understands wellbeing

Throughout the brief history of psychology, there have been many schools of thought regarding how thoughts relate to wellbeing.

Below is a very brief summary of the beliefs about thoughts that the various theoretical orientations assume. Every theoretical orientation starts from a complex understanding of human experience and skilled clinicians of every modality effectively use their theory to direct their interventions. I refer here to the clinical distinction of what the major theoretical orientations assume about the nature of thought and how it influences their interventions: 

Psychoanalytic/psychodynamic – Analyze your thoughts, bringing awareness to what they are, what they’re connected to, and why you have them. As you bring insight and awareness to your thoughts, you become more connected to yourself, work through your feelings, and experience greater wellbeing.

Behaviorism – Change your behavior. Regardless of your thoughts, your change in behavior will result in an increase in wellbeing. 

Cognitive behaviorism – Change your thoughts in order to change your behavior. Change in thoughts from this perspective occurs from bringing insight and awareness to your thoughts and then challenging the irrational thoughts that lead to maladaptive behavior. More effective behavioral options occur as an individual challenges their irrational thoughts. They experience greater wellbeing as a result of both fewer irrational thoughts and more effective behavior.

Acceptance-based/Mindfulness-based cognitive behaviorism – Relate effectively to your thoughts in order to increase your options for behavior. Wellbeing comes from the ability to shift thoughts and behavior flexibly based on the present moment experience.

From this perspective…

Analyzing a thought or feeling to try to find its meaning can get the person “stuck in their story.” It decreases their ability to contact the present moment and respond flexibly to the current context of their lives. Behavior change alone is not sufficient for wellbeing, because the way in which the person relates to their circumstances informs their sense of wellbeing. Finally, challenging thoughts often gets people stuck in their thoughts because their minds immediately generate more reasons why the initial irrational thought might be true. This fuels more uncomfortable feelings and doesn’t breed more flexible behavior. 

Acceptance-based cognitive behavioral methods use mindfulness to help people get distance from their thoughts, watching their thoughts as an observer. From the perspective of an observer, it does’t matter whether or not thoughts are rational or irrational, fused with a feeling or not, you can still choose flexibly which thoughts you want to act on. 

More simply, wellbeing occurs when…

1. Analyze thoughts.  (psychodynamic)

1. Change behavior.   (behaviorism)

2. Change thoughts and behavior.    (cognitive behaviorism)

3. Relate effectively to thoughts and change behavior.  (acceptance-based/mindfulness-based cognitive behaviorism)

With this theoretical foundation, let’s discuss what anxiety is and to relate to it effectively.