For Sound Mental Health, Ask Good Questions (Like These)

Our well-being depends in part on which questions we choose to engage.

Posted Aug 27, 2018

Source: Natashilo/Shutterstock

Life often requires us to ask, and answer, tough questions — to make hard choices between two opposing options. Shakespeare’s "to be or not to be" is probably the most famous, and fundamental, example. But once we have chosen to be, the challenge remains of how to be. From a mental health perspective, one’s success in navigating life depends in part on which questions one chooses to engage. Some questions are more important than others. If you’re on the roof of your burning house, the question of what will happen to the flower garden underneath when you land in it is less important than the question of what will happen to you if you don’t jump. Here are a few of the useful, basic questions one might benefit from asking as one tries to figure out this dance of life:

To Act or Not to Act?

An important choice we often face in the mental health space is between action and inaction. We can move or stay still. We can make a call or wait for a call. We can intervene or stand by. We can speak or remain silent. Passivity — per Webster: not acting; receiving impressions from external agents; being the object of acts rather than the subject — often gets a bad rap. We are commonly encouraged, even bullied, to be proactive, to pursue, to strive, to climb up the ladder. Indeed, passivity and silence do carry risks — of missed opportunities, of misunderstandings. At times, it pays to stir things up, to initiate the action, to intervene, and to shape the narrative. Asking a question in class is usually better than wallowing silently in the fog of confusion. Writers who wait for inspiration are less likely to succeed than those who chase it by writing daily. It’s better to pursue the criminal than to wait for them to turn themselves in.

Yet there are potential rewards in passivity, in waiting patiently, in letting be, or in playing dead, for that matter. For example, in therapy, silence can be as productive as monologue, allowing thoughts and emotions to emerge and cohere; when the water is still, you can see through to the depth, goes the old wisdom. The notes you don’t play, said Miles Davis, are more important than the notes you play.

To Approach or to Withdraw?

Dealing with the events and people in our lives often presents a choice between two options: approach, embrace, and explore, or withdraw, leave, escape, and avoid. In fact, approach and withdrawal are foundational aspects of human temperament, wired into our genetic makeup. Individual differences in approach versus withdrawal tendencies are detectable reliably in infants. Some babies are sociable, curious, and active in the pursuit of positive experiences, while others are fearful, reactive, and timid, concerned with avoiding negative experiences. Likewise some adults are suspicious, cautious, and tentative, while others’ default mode is to trust and jump in.

Both tendencies need to be managed if they are to be helpful. Unchecked, an approach tendency can become reckless thrill seeking, while a tendency toward withdrawal may beget isolation and paralysis. It is useful, therefore, to recognize your tendencies in this context and make sure that they work for you, rather than vice versa. Clearly too, different circumstances call for different strategies. In general, withdrawal often serves us well in situations of real danger. It is therefore useful to spend time figuring out whether what you’re avoiding is actually dangerous. Withdrawal is also useful when it is motivated by preference rather than fear. In other words, avoiding things or categories of experience we don’t like is just one way by which we curate for ourselves the life that we want. Absent a true threat or a clear preference, an approach tendency is often best, as it is conducive to learning, and we are a learning animal.

To Accept or to Reject?

A variant of the approach-avoidance question involves the related decision as to whether to say yes or no. Again, here acceptance has come to connote something good, while rejection is a rather noxious word and feeling. And, indeed, acceptance has its place. In dealing with negative emotion, for example, an acceptance of the feeling is usually preferable to actively pushing it away. But sound mental health requires a capacity for both. You are right and healthy to reject a bad deal, a corrupt candidate, or an unwelcome sexual advance. In cognitive therapy, clients learn the value of rejecting distorted, catastrophic thoughts, while accepting low-odds risks. We may accept someone's attempts at persuasion, but reject their attempt at coercion. 

To Seize the Day, or Plan for a Rainy Day?

Live for today. Be here now. All you have is the present. You’ve heard these mantras before. And they make sense. At the same time, you’ve also learned about Aesop’s grasshopper and ant, about saving for a rainy day, about keeping your eyes on the prize, about delaying gratification, about planning for retirement. So what gives? Are we supposed to live in the now or plan for tomorrow?

Well, first it is useful to realize that the playing field is not level with regard to this question. Our brain privileges the short term, the immediate gratification, the get-rich-quick scheme. Therefore, it is usually more difficult for us to delay gratification, save money, plan ahead; imagine the future vividly and connect emotionally to that image. So, our mind is biased toward the short term. Alas, with any luck, life is long term, and achieving long-term goals usually requires short-term sacrifices. Spending now is fun, but a habit of saving is likely to benefit us down the road. At the same time, sacrificing the present entirely for the sake of the future is risky. Life, said John Lennon, is what happens to you while you're busy making other plans. Many habits, acquired quickly, become change-resistant down the road. Those who become accustomed to holding back are unlikely to shift toward abandon late in the game. Poker champions don’t smile much even when they win.

Moreover, while focusing on a future goal can keep us from succumbing to distractions, it may also blind us to newly emerging opportunities and risks. You can’t drive while looking to the horizon.

Here, again, context is key. Certain matters and events call for immediate, spontaneous response or total immersion. Others call for careful planning and delayed gratification. Generally speaking, short-term solutions are useful when used sparingly, in a pinch, and for the short term. Trusting a short-term fix to hold over the long term, or deploying a series of short-term measures in lieu of a long-term strategy will usually fail.

To Take a Risk or to Play It Safe?

An important question we face often is whether to play to win or to not lose. To play offense — invest our savings in a startup and take a chance on the big payoff — or play defense, keep the money in a safe savings account, protect it, and avoid a devastating loss. Again here, the psychological field of play is not level. Human beings are notoriously loss averse. Changes that make things worse (losses) loom larger than improvements or gains.

We desire not losing more than we desire winning. In part, this is because losses are more painful than wins are pleasurable. Emotionally, our lowest lows are lower than our highest highs are high. Reading appraises of your work, a lone negative criticism is bound to affect you more deeply than ten glowing reviews. The marriage researcher John Gottman famously spoke of the 5-1 ratio, whereby five positive interactions are needed to cancel out the adverse effects of one negative interaction.

So we are by nature cautious about taking big chances with losing what we already have.

At the same time, human beings are also restless, curious, competitive, and overconfident. Those qualities, while begetting risk taking and with it potential loss, are also, at times, adaptive. For example, the maverick dot-com entrepreneurs who appear like congenital risk takers are not actually risk happy. They are just by and large more confident about their odds of success (often because they have already had success or evidence of their potential for it elsewhere)

Moreover, adolescents commonly construct personal fables of uniqueness (I’m special; no one understands me), omnipotence (I’m important; I can do anything), and invulnerability (it won’t happen to me). These fables, while egocentric, inaccurate, and hence risky, nevertheless can function to foster creativity, courage, and independence in young people, to positive ends.

At the end of the day, while playing it safe is generally, well, safer, a tolerance for risk is often required if we are to move in the world — and raise our adolescents — without losing our minds (and our sleep).

To Put Myself or Others First?

In Freud’s original formulation, the ego performs a crucial purpose as the servant of three masters: the id (our raw sexual and aggressive impulses), the super ego (our society's moral dictates), and reality (the state of things in the world as they actually exist). These forces are often at odds with each other. Sound mental health in the Freudian system therefore requires a strong ego. The ego, however, has since acquired quite a bad reputation. Current presidency notwithstanding, egoism is often considered an insult, while its opposite, altruism, is considered a positive value. But life is contextual, which means that everything received its meaning from the context within which it is embedded. Egoism — looking out for number one; thinking and acting in one’s self-interest — is sometimes right and necessary. If you don’t protect and advance your concerns, who will? Likewise altruism can in some cases be misguided. Giving to charity in support of those who’ve fallen through the cracks is problematic if it stymies attempts to fix the cracks.

Moreover, altruism often involves a complex psychological transaction. The giver may come to patronize the receiver. In addition, even people who need charity are often ambivalent about receiving it. This is in part because most of us don’t like to feel weak, and we resent those who cause us to feel this way, in this case, our powerful benefactors. Also, the moral calculus that underlies our altruism is generally lazy. We often respond altruistically when it is easiest, rather than when it's most urgent. We give to those who are nearest to us, or those who present the most compelling narrative, not to those who have the greatest need. Finally, a debate still rages in psychology as to whether true altruism is indeed a thing. This is because a strong argument can be made that your decision to sacrifice for or give to someone else without an expectation of reward is in fact motivated selfishly — your ego enjoys seeing itself (and being seen) as kind.

To Be Flexible or to Be Rigid?

A thread that weaves through all the questions discussed above relates to one crucial meta consideration: the importance of flexibility. While rigidity has its place (bones need not be flexible; some recovering alcoholics do well to rigidly insist on zero alcohol intake; etc.), flexibility is more often than not the better way in the realm of mental health. Psychologists speak frequently of three types of flexibility in the realm of mental health:

Cognitive flexibility refers to the ability to think creatively about the issues we confront, to entertain differing perspectives, to tolerate uncertainty. It is linked to empathy, the ability to see things through someone else’s eyes. It is a feature of "executive function," a collection of cognitive processes essential for higher-order mental operations. 

Emotional flexibility is the capacity to produce context-dependent emotional responses to different life events; to laugh and cry when it is appropriate; to express oneself with fidelity; and to employ the full range of emotional expression. Such flexibility predicts long-term adjustment and improved mental health.

Behavioral flexibility refers to the ability to respond in different ways to different situations and environmental conditions. Behavioral flexibility is the ability to adapt to different social situations, to switch codes — from formal to informal, from professional to intimate — like an expert driver may shift gears, lanes, and directions depending on road and traffic conditions.

In the realm of the body, a measure of flexibility, of "give," is an important indicator of health. Keeping some bodily elasticity is important to our ability to perform physical tasks, avoid injury, keep our balance, and coordinate movement. Likewise in the realm of the mind, flexibility is a mark of health and adaptation.

Flexibility often manifests in the quality of our boundaries. Life, at least in the way our brain perceives it, is comprised of systems: solar, nervous, cellular, social, family, self, etc. The notion of a system implies boundaries, which work to define the parameters and parts of the system. There exists an inherent tension around the boundaries of a system between blocking and allowing entry. By way of timely metaphor, we may think of immigration. Many nations are struggling to find a balance between allowing immigrants in — which is often the humane, morally righteous, and (in the long term) economically beneficial thing to do — and leaving immigrants out for fears of becoming overwhelmed, losing status or an established sense of identity, or descending into chaos.

One example of a highly effective boundary is our skin. It is self-repairing, flexible, and rather hardy over time. It absorbs certain things and repels others. It allows us to receive information from the outside world and react to it. Psychologically and socially, sound mental health requires that we develop and maintain healthy psychological skin — a boundary between our environment and ourselves that allows rich and rewarding contact, while maintaining the identity and the integrity of our system. You can’t walk around skinless. But you also can’t live inside a medieval suite of armor. Can’t dance in those things…