title: The dynamic origins of positive health and wellbeing.
abstract: The causes of wellbeing and illbeing interact with feedback dynamics resulting in the same set of traits giving rise to a variety of health outcomes (multi-finality) and different traits giving rise to the same health outcome (equi-finality). As a result, a full understanding of health and its disorders must be in terms of a complex adaptive system of causes, rather than in terms of categorical diagnoses or sets of symptoms. The three domains of person-centered integrative diagnosis (PID) are considered here as interacting components of a complex adaptive system comprised of health status (functioning/wellness versus disability/disorder), experience of health (self-awareness/fulfillment versus misunderstanding/suffering) and contributors to health (protective versus risk factors). The PID domains thereby allow healthcare and health promotion to be understood in terms of measurable components of a complex adaptive system. Three major concepts of health are examined in detail to identify their dynamic origins: Psychological Maturity, Flourishing and Resilience. In humanistic psychology, psychological maturity (i.e. healthy personality, mental wellbeing) involves the development of high self-directedness, high co-operativeness and high self-transcendence, but self-transcendence is nevertheless devalued in individualistic and materialistic cultures except when people must face adversity and ultimate situations like suffering or the threat of death. Psychological Maturity develops through two complementary processes often labeled as Flourishing and Resilience. Flourishing is the development of one's potential to live optimally, especially as the result of favorable circumstances, whereas Resilience is positive adaptation to life despite adverse circumstances. As a result of the complex feedback dynamics between the processes of flourishing and resilience, each person is a unique individual who has a variety of paths for achieving positive health and wellbeing open to him or her. Person-centered health promotion and care can thereby be approached as a creative life project that can be conducted with the assistance of healthcare workers who are both therapeutic allies and well-informed experts.
authors.affiliation: Psychiatry, Genetics and Psychology; Director, Center for Well-being, Washington University School of Medicine, St Louis, MO, USA.
authors.forename: C Robert
authors.initials: CR
authors.lastname: Cloninger
authors.affiliation: Psychiatry, University of Miami Miller School of Medicine, Miami, Florida, USA and Research Director, Section on Classification, Diagnostic Assessment and Nomenclature, World Psychiatric Association.
authors.forename: Ihsan M
authors.initials: IM
authors.lastname: Salloum
authors.affiliation: International Journal of Person Centered Medicine , Professor of Psychiatry, Mount Sinai School of Medicine, New York University, New York, USA and President, International College for Person-centered Medicine.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Mezzich
keywords: Complex adaptive system; co-operativeness; diagnosis; flourishing; happiness; health promotion; human development; maturity; person-centered care; person-centered integrative diagnosis; personality; resilience; self-directedness; self-transcendance; wellbeing