Tuesday, 5 June 2012

What is Well-being?

'Well-being' has become such a buzz word in health nowadays, but what does it actually mean

That question stumped the audience and panel at the Tackling Long-Term Conditions conference in London last week (30th May). It is hard to find a single answer for something so personal, but without considering what it means, how can we develop healthcare systems that promote it? 

The concept of well-being came about in the middle of the 20th century when medicine had made significant progress in overcoming disease, and the idea of positive-health developed (Breslow, 1972). In response, the World Health Organisation re-defined health as 'physical, mental and social well-being, not merely the absence of disease or infirmity'. In a medical world set around pathology and science, that was hard to digest. Despite the campaigning of mental health and social care charities, the medical world can still be narrow minded on occasions with their definition of health. For over 40 years, definitions have been studied and analysed (Quality of Life and Well-being: Measuring  the benefits of sports and culture: Literature Review and Thinkpiece)

The haze around the definition of well-being might be responsible for the difficulties in measuring it, and therefore integrating it into modern healthcare practise. 

Cradle to Grave (Pharmacopoeia)
British Museum
For me, well-being incorporates every aspect of my life, health and illness. I think it can be summed up really well with the aid of one of my favourite pieces in The British Museum in London, Cradle to Grave (Pharmacopoeia). As a patient at the nearby National Hospital for Neurology and Neurosurgery (UCLH) round the corner in Queens Square, the British Museum offers a haven to loose myself in on those stressful appointment days - either killing anxious hours beforehand, or dealing with the aftermath of, appointments. Pharmacopoeia is one of my favourite exhibits in there, and I make sure to visit it every time I'm there. The exhibit is a collection of all the pills, injections, prescriptions, implants, scans and inhaled substances that an individual is given as a patient through their life. Interspersed between the medical paraphernalia are photographs giving a glimpse into the life of that patient as a person. Spanning several meters, it is a tribute to the medicalization of modern life. But it has a deeper meaning than that. . .

The images and souvenirs that punctuate the medical sotry tell a story about an individual, with friends, family, hobbies, emotions and history. This illustrates exactly what well-being is for me - the narrative that overlays our medical history.

My own Pharmacopoeia would have a large number of MRI scans, steroids, neural analgesics, nerve conduction test results, physio reports and many more things I have yet to have! But what I need to make sure are also included are an (at least) equal number of great memories, photos of smiles and laughter, souvenirs from days with friends, family parties and scenes of love and warmth. While there were plenty of these to balance the odd paracetamol BC (before conditions), I need to make sure I have enough to punctuate the drug/scan-filled years AD (after diagnosis).... I need to look after my well-being in the midst of psychical illness - a challenge I am going to rise to!


  1. Interesting! I think one way to go would be to use the evidenced definitions from positive psychology research. For example, Seligman's PERMA model of well-being, consisting of positive emotion, engagement, relationships with others, meaning and accomplishment. Well this isn't a definition as such - but the areas that are important for well-being. And I agree - it's about the person, not the illness.

  2. I think the idea of well being having categories is important - like with "integrated-care" at the moment, it is so personal and so can't be defined, but we need to know what areas it includes . . . .
    Thank you for mentioning PERMA - just looked it up and I think it is really good, because it doesn't look directly at health, so allows people with long-term health conditions to strive for positive well-being which is attainable!