MADISON, Wis. - A growing mental health crisis is the "second wave" of health issues that experts anticipate due to the prolonged stress of the COVID-19 pandemic. In a recent Kaiser Family Foundation Tracking poll from July, 53 percent of U.S. adults reported that their mental health had been negatively affected by worry and stress over the pandemic - up from 32 percent reported in March.
Organizations and communities are looking for practical tools to support mental health amidst this growing crisis, which is taking place alongside ongoing social and racial unrest. In a recently published paper in the Proceedings of the National Academy of Sciences, researchers at the University of Wisconsin-Madison introduce a new framework for emotional well-being that focuses on specific skills that can be learned.
The framework is based on scientific evidence that suggests well-being can be cultivated through practice in daily life.
"It's really the 'how' of well-being," says Christy Wilson-Mendenhall, a scientist at the Center for Healthy Minds at UW-Madison and co-author on the paper. "Traditionally, the focus in psychology research has been on treatment of mental illness. We're hoping to broaden the conversation to advocate cultivating well-being at any stage, even when you're relatively healthy. These skills help make us more resilient in moments like we're experiencing now."
The framework focuses on four pillars that have been studied in the lab and have been shown to improve with training: awareness, or attentiveness to one's environment and internal cues such as bodily sensations, thoughts and feelings; connection, or appreciation, kindness and compassion; insight, which refers to fostering curiosity and self-knowledge; and purpose, understanding your values and motivations.
For instance, awareness -- and in particular meta-awareness (being aware that you're aware) -- appears to decrease stress, increase positive emotions, and can be strengthened through mental training practices like meditation. Awareness helps curb some of the harmful effects of distraction, which is shown to impair cognitive function and increase stress-related responses in the body related to inflammation and aging.
Another example is a trait like purpose in life, which is a personally meaningful aim that people can apply to daily life. Purpose is associated with positive biological and physical health outcomes.
"There are qualities of a healthy mind that many people don't know are even trainable," says Cortland Dahl, a research scientist at the center, who is lead author on the paper. "We don't think of them as skills. Many of us have thought we are hardwired to be like this or that, but the reality is these qualities are much more trainable and malleable than we think. It's a very empowering view of the human mind -- we can learn to be in the driver's seat of our own mind."
The new framework provides evidence that people can weather life's ups and downs with resilience, and that the brain and body can change and adapt. Rather than replacing other views of well-being, researchers say the framework complements other models by focusing specifically on scientific evidence for dimensions of well-being that are trainable and can be learned so that people flourish.
The team hopes to make the science as accessible as possible, and they encourage researchers to incorporate this knowledge into therapy, meditation programs, and other mental health treatments.
"This work is parallel with what we're learning about human biology. We're just at the beginning of understanding that our biology is also malleable," says Dahl, who is also the chief contemplative officer of Healthy Minds Innovations, the external nonprofit affiliated with the Center for Healthy Minds, which translates science into tools to cultivate and measure well-being. "We are not born a certain fixed way. Our brains and nervous systems and biology can be shaped. That's such a hopeful view to have -- there are many ways we can influence our minds, brains and bodies for the better."
Wilson-Mendenhall and Dahl note that there's significant work to be done to understand how the framework might be applied across cultures and studied in diverse groups of people. Given that the ideas in the framework have a deep history in contemplative contexts that predate Western science's ability to study them, it's fair to assume their importance, but how they are packaged and presented in mental health interventions moving forward may vary across cultures and contexts and requires additional focus.
References to meditation and other well-being interventions is "akin to the word sports," says study co-author and Center for Healthy Minds director Richard Davidson, the William James and Vilas Professor of Psychology and Psychiatry: "One size does not fit all."
"It describes a huge range of pursuits," he says. "Different types of meditation do different things for your brain, just as different sports trigger different changes in your body. You can train your mind in different pillars that go beyond mindfulness or even gratitude practices."
For instance, the insight pillar, Davidson explains, is "just about getting curious about your own preconceived thoughts and opinions. Your brain is not set. You can question your own assumptions and biases, and this has tremendous potential to heal the division and 'othering' that we see in today's society."
Future research will explore how the framework can help people build resilience, and how it might be used to treat mental health disorders like depression. Other research projects at the Center for Healthy Minds and UW-Madison are now using the framework, implemented through a mobile app, with promise so far.
This work was supported by the National Center for Complementary and Integrative Health (grant P01AT004952) in the U.S. National Institutes of Health.