If you ask any physician to tell you about heart disease, they will be able to give you a detailed exposition, beginning with the idea that the disease is caused by the buildup of plaque along the walls of the blood vessels that feed the heart. This buildup is due to an inflammatory condition in the wall of the blood vessel, called the endothelium. As more and more plaque builds up, the vessel narrows and, as with a clogged drain, blood flow to the heart muscle decreases, ultimately causing a myocardial infarction–what we call a heart attack. Nearly every physician will you tell some variation of this scenario.
Now ask your physician another question: What is wellness?
What is wellness?
You will get a variety of responses. Wellness is at once both broad and personal–an experience, not a measurable quantity.
Wellness has become quite the buzzword. Every hospital now has some type of wellness program (if only in name). But wellness isn’t some new fad; it’s been around at least since the middle of the twentieth century.
“Wellness” was born out of the need to reinvent health. For too long, popular and scientific culture has feasted on a cosmetic understanding of health, a superficial focus, primarily on the physical body. The proof is found on the covers of the magazines crowding grocery store checkouts, and between the covers of biology textbooks. It’s what our children see and our students learn, informing an incomplete view of health and of ourselves.
The result is that a tremendous knowledge vacuum has been created within our culture, which is starving for a practical, actionable understanding of health and the whole human being. Wellness and well-being have been born into this vacuum for the specific purpose of restoring meaning to health.
Wellness went from being just another word to becoming a movement in the 1950s. Dr. Halbert Dunn, chief of the National Office of Vital Statistics, wanted to define health in a new, more comprehensive way. “High-level wellness for the individual,” he wrote, “is defined as an integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable. It requires that the individual maintain a continuum of balance and purposeful direction within the environment where he is functioning.”
According to Dr. Dunn, wellness is not just about feeling good, it’s growing toward your maximum potential. This growth process is described by psychologist Abraham Maslow as “self-actualization.” Maslow wrote that self-actualization is the tendency of the individual “... to become actualized in what he is potentially. This tendency might be phrased as the desire to become more and more what one is, to become everything that one is capable of becoming.”
Depending on what text you reference, wellness can be defined as physical health, physical and mental health, or achievement of your maximum potential. Whereas health has primarily dealt with the optimal functioning of the physical body, wellness includes cultivation of the mind and other areas of life. Well-being, on the other hand, implies something even more comprehensive.
What is health?
In 1948, the World Health Organization put its stamp on the word well-being when it declared that health is “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” This is a powerful definition, but it too is incomplete. Well-being doesn’t just address the physical, mental, and social aspects of the human being.
The heart of well-being is being—a person’s natural state. We are, after all, human beings. Yet, we are often caught up in doing, thinking, and feeling, rarely recognizing that we have a choice to simply be. There’s a constant, often unexamined pressure to jump to the next item on the checklist and keep moving from activity to activity in our daily lives. At home, there’s always the next meal to think about, the next soccer game, the next trip to the grocery store, the next pickup from school, and so on. At work, there’s the next promotion, the next pat on the back, the next meeting. It never ends.
Yet, being is always available, independent of doing, thinking, and feeling. There is no prerequisite for being. It is always with us—not as an abstraction, but as a sense of utter ease and equanimity that is prior to doing, thinking, and feeling. Being can be accessed now, as you read this, no matter who you are and what your background is. It only takes a shift in attention.
Being is not a state of physical or mental health, but something more fundamental, simpler even. The problem is that we have been conditioned to think we have to go somewhere or do something to experience the freedom and joy of being. We’re fed the message that something needs to be improved upon, something needs to be corrected, or something needs to change. (Most advertising depends on this assumption.)
Many of the stages of “acting out” that happen in the course of a human lifetime are rooted in the search for being—the search for something fundamental that appears to be missing from our lives. But it isn’t missing, only forgotten. When the freedom of being is forgotten and our attention is completely diverted into the channels of doing, thinking, and feeling, we experience a subtle sense of loss and uncertainty. And then we go on a search. It may be a formal search or an informal one. We may label it a search or we may be oblivious to the searching. But search we do. We do things to find that fullness. We think and plan about how we may get there. We feel (or actively resist feeling) whatever comes along the way, yearning to ride the waves of the next adventure.
The outward search for that sense of ease and completion is bound to end in failure because it was never lost to begin with, only forgotten. In those moments when we experience the failure of the search, we experience catharsis. It may be the cathartic tantrums of the toddler, the cathartic rebellion of a teenager, or the cathartic spree of a midlife crisis. After each period of catharsis, the personality settles down into another mode of searching. The toddler learns to go to school and look up to those in higher grades. The teenager eventually gets a job and starts pursuing dreams of career-building. The middle-aged person sets new career or retirement goals.
All of these behaviors can reinforce the assumption that we are missing something fundamental. Accepting this assumption creates a never-ending checklist of “critical” tasks to do. After all, we could always do better, look better, and feel better, right? How much is good enough? Certainly, actions do need to be taken in life, but they need not distract us from what has never been lost, from what is central, complete, and always available to us as human beings—being itself, the core of the masterpiece.
It is being that makes well-being unique and separates it from health and wellness. Health and wellness address doing, feeling, and thinking, while well-being also goes straight to your core, being.
In the ED, patients are often sidetracked from being by the catalog of diseases and medications assigned to them by the medical treatment system. On every shift I work, I see many patients who are taking more than ten medications, sometimes up to twenty or more. Many times, a prescription is for a single symptom, such as constipation, tingling in the feet, or back pain. Sometimes the medication works, but often the symptoms experienced by a patient on ten medications are the cumulative side effects of the medications themselves.
I’ve seen that the constant barrage of symptoms―and the worry and anxiety they cause―often are a barrier to recognizing being. These manifestations block out what could otherwise be the beginning of a more complete solution—one that that could begin with the patient gaining insight into why his or her symptoms may be occurring to begin with. So much attention gets focused on symptoms, medicines, and side effects that the person inside the patient, the real human being who needs attention, gets lost along the way.
The good news is that even in the face of such powerful distractions, being is ever-present: it is a part of us, after all. We don’t have to pay extra or add it on as an option. But when it is not recognized, well-being can seem so far away, even nonexistent. This is what happens in the medical treatment system—being goes unrecognized, so there is no path to well-being, only disease mitigation. With nothing more substantial than disease to build on, medical science blindly grabs ahold of physical symptoms, unable to see the rest of the human being.
To bring the medical treatment system in line with the experience of well-being, each of us— including those involved in any capacity with the medical treatment system—must first learn to recognize being.
Here are two reflective questions that can point toward being.
If I closed my eyes and suspended all my beliefs and thoughts for a few moments, what would remain?
What is the backdrop against which I recognize my thoughts and feelings?
It is important to recognize that being is not the same as excitement or riding a high. Those are mental experiences that are superimposed on the state of being. Being itself is the background. It’s the stage on which experiences play out. Having recognized being, we can cultivate the behaviors that foster well-being in all areas of life.
It can be very helpful to dedicate time to simply be. It can help us recognize what well-being in all areas of our life truly means—balancing all aspects of ourselves. Without that context, anything that feels good in the moment, including addictive behaviors, can be misinterpreted as well-being.
I remember a time in medical school when I was feeling pleased that I could come up with the right answers to questions from my supervising physicians. Initially, I was delighted, but when I checked in with my own sense of being, I recognized that I was actually feeding an addiction—one that was supported and even encouraged. While it was important to know the right answers and increase my medical knowledge, I also recognized another part of me that wanted validation from the supervising physicians.
I didn’t enjoy discovering that I sometimes compromised what I thought was the right thing to do just to satisfy a need for approval. What initially felt like delight was actually rather dull and unremarkable when I checked in with being. I wondered then how something as subtle and important as being should fit into our understanding of the human being. How did it influence the physical body? Where did it belong in the scheme of medical training? How could it be pointed to and recognized?
I again saw that making room for being meant broadening or reframing my old definitions of the human being. I resolved to learn answers for the purpose of discovering, for my patients and myself, what well-being and healing truly are, regardless of where that took me. Surprisingly, it took me to the Emergency Department.
Adapted from Michelangelo's Medicine
Key Points
Wellness and well-being are responses to an incomplete understanding of health.
The heart of well-being is being. Being is accessible in this very moment by anyone, regardless of external circumstances.
We must prioritize and explore well-being to harness the full potential of the digital revolution.
Frequently Asked Questions
Q: Don’t I have to eat right and do all the other things that people always talk about to be well?
A: Well-being is a combination of well and being. The well part of the word requires activating the Four Engines of Numocore: Nutrition, Movement, Connection, Rest. Accessing being doesn’t require any external action, only turning our attention inward and recognizing what has always been, yet has been forgotten.
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