The dynamic origins of positive health and wellbeing

Main Article Content

C. Robert Cloninger
Ihsan M. Salloum
Juan E. Mezzich


The causes of well-being and ill-being 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 well-being) 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 well-being 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. 

Article Details

Fourth Geneva Conference on Person-centered Medicine: Person-centered integrative diagnosis (PID)
Author Biography

C. Robert Cloninger, Sansone Family Center for Well-Being at Washington University School of Medicine, St. Louis, MO, USA

Prof Cloninger is Wallace and Lucille Renard Professor of Psychiatry, Professor of Psychology and Genetics, and Director of the Sansone Family Center for Well-Being at Washington University School of Medicine in St. Louis. He is also Scientific Director of the Anthropedia Institute Dr. Cloninger received his B.A. with High Honors and Special Honors in Philosophy, Psychology, and Anthropology from the University of Texas at Austin, 1966.  He received his M.D. from Washington University in 1970 and an Honorary Doctorate from the University of Umea, Sweden in 1983.  He has published 10 books and more than 400 articles in psychiatry, psychology, and genetics.   His recent books include the Origins of Cooperation and Altruism by Springer, Feeling Good: The Science of Well-Being by Oxford University Press, and Personality and Psychopathology by American Psychiatric Press.  Among his many awards, Dr. Cloninger has received the American Psychiatric Association’s Adolf Meyer Award (1993) and Judd Marmor Award (2009), and lifetime achievement awards from the American Society of Addiction Medicine (2000) and the International Society of Psychiatric Genetics (2003).  He is a Distinguished Life Fellow of the APA, a fellow of the American Academy for the Advancement of Science, and a member of the Institute of Medicine of the National Academy of Sciences.  The Institute of Scientific Information ranks him among the most highly cited psychiatrists and psychologists in the world. His personality inventories have been used in more than 4000 peer-reviewed publications.


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