MHM Magazine

Issue 1 | 2023 | MENTAL HEALTH MATTERS | 25 MHM for engaging in preventative healthcare services, and engage with better health behaviours, such as diet and exercise. Indicators of poor health and disease have conversely been found to be associated with poor eudaimonic well-being. From a biological perspective, eudaimonic well-being has been linked with: • better regulation of the endocrine system; • lower prevalence of cardiovascular risk factors; • lower allostatic load; • better sleep and; • better inflammatory profiles. Neurologically, eudaimonic well-being is linked to: • lower amygdalic response to negative stimuli; • greater activation of the ventral anterior cingulate cortex; • lower cortisol output and; • greater insular cortex volume. The potential valence of eudaimonic life purpose for patient health and health promoting behaviours is further noted against recent empirical findings from Oxford University which demonstrate that much of the guidance offered by physicians to obese patients does not result in effective behaviour change and consequent weight-loss. The study promotes that physicians speak opportunistically with patients living with obesity, and where such discussion should support patients in making beneficial, meaningful lifestyle changes by way of evidence-based practice, tailored to the individual patient. The study further finds that a structured, deliberate approach to such dialogue is critical. Consequentially, by employing Socratic patient dialogue with key application of Ryff’s six key aspects of eudaimonic well-being, healthcare practitioners have the opportunity to meaningfully probe into both the ‘why’ and the ‘how’ of patient health and in so doing create the foundations of sustainable behaviour change. It’s noteworthy that the affective neuroscience perspective (ANP) considers flourishing an outcome of various interrelated motivations, interpretations and behaviours in the brain, and where probing into both the why and how of the various flourishing aspects holds promise in satisfying the multiple-cause nature of flourishing. Specifically, such Socratic dialogue would perhaps provide an intervention platform from which patient positive evaluations of flourishing domains through ventromedial prefrontal cortex activity is promoted. From a practical perspective, application of Socratic dialogue to Ryff’s key aspects of eudaimonic wellbeing holds promise toward the creation of a deliberate, structured approach in promoting patient health through eudaimonic well-being. For instance, discussion with a patient regarding the need for behavioural change for health reasons could be extrapolated as follows: • Autonomy: To what degree is the patient able to take ownership of the behavioural change, and to what degree are they in fact aware of their agency in this regard. • Environmental Mastery: To what degree is the patient cognisant of supportive resources in their environment, to what degree are such resources in fact capable of enabling required health behaviours? • Personal Growth: What is the patient’s perception of themselves in this process, do they view the process as one of growth, or one of punishment. If punishment, why, and how can the process be better incorporated into a perspective of growth. • Positive Relations with Others: To what degree does the patient present with relationships in their lives that will enable and support their proposed change in behaviours, to what degree do these relationships enable negative, or positive behaviours. • Purpose in Life: What objective, purpose or rationale exists for the behavioural change in the patient’s life? Does this in fact relate to a deeper reason (family, achieving a personal goal as examples) or is the behavioural change construed as one that must be done (extrinsically motivated)? • Self-Acceptance: To what degree does the patient present with acceptance of the self, the reality of behaviour change, and to what degree will the behavioural change satisfy a process of greater self- acceptance and growth. The notion of eudaimonic well-being and applying Socratic dialogue to Ryff’s key aspects of eudaimonic well- being provides a means of creating both depth and individualisation of key health related conversations with patients, and where the small investment in consultation time herein holds further promise for meaningful and sustained health related behaviour change in patients. References available on request.