Mental Hygiene and Mental Health

In this country “mental health” typically refers only to the negative end of the spectrum, in other words, neutral mental health to mental illness—we too often think of “mental health” in terms of either having mental illness or not. We tend to ignore the role of mental health in terms of strength or resilience—the positive end of the spectrum. Psychologists are thought of in terms of fixing things that have gotten broken, but not thought of in terms of preventing things from getting broken in the first place. We do preventative maintenance our cars, but do not often (enough) think about preventative maintenance on our psyches.


The opposite of negative is not zero, but rather positive. Yet the role we have relegated psychologists to is to deal with the negative to zero range. We have come to equate “happiness” with the absence of being unhappy, and they really are not equivalent. Happiness is a positive, while the absence of unhappiness is actually zero. The greater happiness (in terms of contentment, rather than momentary joy) we have in our lives, the less susceptible to mental illness we are. As long as we ignore half of the spectrum, we will find ourselves more and more in the side of the spectrum to which we do attend.

We fail to recognize that many of the skills and techniques that psychologists have developed for mental remediation and repair can also be used for mental enhancement and strengthening (e.g., communication and social skills, openness to experience, stress management). Pre-marital counseling used to be valued, but now we only go to a counselor after the relationship has become problematic (and even then usually not until the resentment has gotten out of control).

When I was deciding on a graduate program I choose a Counseling Psychology program (rather than the more popular and better known Clinical Psychology) because as a sub-field it was known to emphasize mental wellness, instead of mental illness. Counseling Psychology was (and is) known for the emphasis on optimal function, not simply adequate functioning. Counseling Psychology tends to be more focused on hope, optimism, self-efficacy, emotional intelligence, wisdom, courage, and personal strengths. We are less excited about helping a client get better than we are about helping the client become a better version of himself or herself—even if that is from a position of mental illness.

I think of Counseling Psychology as aspirational, let’s not just make you better, let’s make you the best. When Counseling Psychology was first forming as a discipline within psychology, it focused on what was called “mental hygiene.” It was focused on keeping people’s minds functioning well, not on returning people’s minds to a functional state. There is a wealth of research on the benefits of psychological enrichment, above and beyond psychological remediation. However, we continue to value psychological remediation over psychological enrichment.

I have a friend who is a psychologist who claims that the reparative work he does with clients is more valuable or meaningful than the work that I strive to do with (typically higher functioning) clients to bring them to optimal functioning. In our culture we focus on deficiency rather than enhancement; we focus on what is missing in our lives rather than how to better develop and utilize what we already have. But the research shows that nation-wide, the impact of improving the lives of people who are already functional can have more of a positive impact than bringing (the minority of) people back to base functioning. People’s productivity and pro-social helping behaviors are more affected by life improvement than remediation of a disorder. Improve the lives of many slightly and there is more of a positive impact on society than remediating the problems of the few. However, even in the presence of many studies that have shown that happier people who better manage their stress—including the cost savings of mental preventative maintenance, mental hygiene is dismissed as unimportant.

I often run into people socially who tell me about how their lives are unsatisfying, even though they are adequately functional. They will even tell me they are not unhappy, but also unfulfilled (not happy). Most of these people would never consider going to a counselor, psychotherapist, or psychologist to help them improve their lives because they do not see their lives as “broken.” Instead they spend their time acquiring objects or sex to feel more fulfilled, which will never be as effective as counseling, and more expensive in the long run.