Five scholars reflect on what this means
in the twenty-first century: A need for trust
Our jittery video call suddenly freezes as Tenzin Namdul greets me from a Tibetan refugee community in southern India. His voice is garbled so he pauses to try a different connection. In a few moments, he’s back online and cheerfully continues his story.
Namdul is a Tibetan physician and post-doctoral scholar in epidemiology and community health at the University of Minnesota. Together with researchers from Washington State University, he is investigating the unusually low prevalence of Alzheimer’s disease in Tibetan monks.
The study was the inspiration of Dedra Buchwald, professor and director of WSU Spokane Health Sciences Institute for Research Education to Advance Community Health (IREACH).
Namdul says more than a million Tibetans have fled to India and other parts of the world since the People’s Republic of China invaded their nation in the 1950s. The refugee village where his team is conducting research is home to one of their large monasteries.
“A 2016 epidemiological study reported a uniquely low prevalence of Alzheimer’s and related dementias among the Tibetan population,” he says. “Numerous studies also show they have very strong cognitive resilience. For example, Tibetans who have been imprisoned and later escape, show very low levels of post-traumatic stress disorder.
“Our team is studying the monks’ daily lifestyle activities, sleep quality and stress, as well as education and meditation practices to see if there is any correlation with brain health or Alzheimer’s disease,” says Namdul. “Research suggests a strong association between meditation practices and the ability of the brain to stay intact and resilient.”
It’s a troubling contrast to the United States where chronic conditions like Alzheimer’s disease continue to rise. Though the underlying causes are complex and varied, Namdul and other scientists believe some of it is related to stress and our general state of mental well-being or, if you will, our happiness.
To be sure, navigating three years of the COVID-19 pandemic along with political and social upheaval, the specters of climate change, war, and other chaos, has challenged the most stalwart American, elevating stress and uncertainty across the board.
Many people, finding their lives upended on multiple levels, have been forced to stop and reevaluate their life expectations, career goals, and relationships.
To ask with soul-searching honesty, what is really necessary? What do I keep and what do I let go? What is it that really makes me happy?
Such was the focus of a recent study reported in the Business Insider, which asked why Nordic countries like Finland, Denmark, and Iceland consistently rank the highest in happiness. The answer, said the authors, is largely due to more equality in health care, education, and public transportation as well as higher levels of basic human trust.
The bottom line, they suggest, is that people are much happier when they’re in an environment where someone’s watching their back.
One might say that happiness was written into America’s DNA with the 1776 signing of the Declaration of Independence, which states, “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness.”
“That concept of happiness comes from Aristotle and later, from the Enlightenment, which our Founding Fathers were a part of and read about,” says Ken Faunce, WSU associate professor of history.
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“The way I find happiness is through family and community. I am happiest when I spend time with my family, and when I’m active and part of the community.” —Ken Faunce
“Specifically, it came from English philosopher John Locke who wrote about life, liberty, and the pursuit of property. In the early US, you had to own property in order to vote. Jefferson liked the idea of owning property, so he combined it to say that by owning property, you are a true US citizen, and you have a voice. This gives you well-being, therefore, happiness. Therefore, it should be pursuit of happiness.
“So, it wasn’t just let’s be happy but because you own property, you have money and political representation, therefore your well-being is good, so you’re happy,” he says. “Though at the time, Jefferson was only referring to wealthy white men.”
Nevertheless, Faunce says the idea of well-being and happiness crept into general American culture from our earliest days, with Europeans noticing that Colonial Americans smiled a lot and seemed to be happier.
“It really took off in the early nineteenth century as the US became more urban and industrial with people working outside the home and for longer hours,” he says. “Then, you begin to see a push for recreation and fun to counterbalance all that hard work. It started with adults but over time transitioned to children. By the early twentieth century, child rearing books stressed that happiness was essential to your child’s well-being.”
The notion ramped up after World War I, as the United States began mass producing goods during the 1920s. For the first time, average citizens could afford to buy formerly out-of-reach luxury items.
During that period, Sigmund Freud’s American nephew, Edward Bernays, capitalized on Freud’s ideas and used them to sell more products, says Faunce. Bernays began by adapting propaganda techniques used in WWI.
In his 1928 book Propaganda, Bernays said that by understanding the group mind, it would be possible to manipulate people’s behavior without their even realizing it. He went on to rebrand the word propaganda as public relations and became known as the father of PR.
“He used these techniques to tap into people’s inner desires and then provide that new car or trendy product for them to buy resulting in happiness,” says Faunce. “It was called ‘The Happiness Machine.’
“In the past, people bought things for how functional and long-lasting they were. Now, it’s about how this product makes you feel. So, that consumerism coming out of the 1920s was all due to Bernays.”
Faunce says there were many related developments occurring around the same time. In the 1930s, for example, the “Happy Birthday” song became popular, and people began wishing each other “Happy Birthday.” It was again tied to consumerism because what makes a birthday happy? Presents, of course.
“You can see it happening in popular culture, like with Disney, which started in the ’30s but became big in the 1950s with television programs and Disneyland,” says Faunce. “Disney was geared to making kids happy, which in turn makes their parents happy. Here’s this enchanted place and movies and cartoons—the Happiest Place on Earth. A big part of what he was doing was selling happiness to families.
“If you think about it,” he adds, “McDonald’s began in the 1950s and eventually came out with Happy Meals. World War II is over, and everyone wants to be happy again—there’s this mix of consumerism and making people content. Then, in the 1960s and ’70s, we got the yellow Smiley Face and ‘Have a Happy Day!’”
WSU associate professor of philosophy Matt Stichter says business and pop culture still promote the idea that making lots of money and spending it on fancy goods is going to make you feel fulfilled. “But is it?” he asks.
“Does it give your life meaning and are you living well? Or does it seem that no matter what you buy, you’re always looking for more?”
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“Aristotle thought morality was about the big picture ideas—like how to judge that you are living well as a human being. How you could have a crummy day but still know that you’re doing well overall in the grand scheme of things. We know we’ll make mistakes going through life but we’re still trying to do the best we can with the choices we make and goals we pursue.” —Matt Stichter
Stichter, who studies virtue ethics and moral psychology, says that over the last fifty years, there has been renewed interest in Aristotle’s philosophy on ideas like happiness and morality.
In contrast to the hedonic approach offered by fellow Greek philosopher Aristippus, who said a good life entailed the pursuit of pleasure and avoidance of pain, Aristotle proposed the eudaimonic theory of well-being or self-actualization.
“While the hedonic aspects of happiness focus on good feelings and pleasure in the moment, eudaimonic happiness means human flourishing or living well,” Stichter says. “It’s a long-term perspective on our lives about the kind of person you want to be and how to cultivate good character in yourself.
“Aristotle thought to live well as a human being had elements common to everyone—meeting biological and psychological needs as well as having initiative, some autonomy, and choice,” he says. “We also need to feel competent that we can excel in various areas of our lives. Our social relations with other people are also a huge part of human nature and impact what living well consists of.”
Stichter is specifically interested in how the pursuit of goals relates to well-being, whether that’s a career or personal projects, and how those goals ally with our deeply held values, and things we find meaningful or give us a sense of purpose.
“When they align, we get a lot of satisfaction out of the goals we’re pursuing,” he says. “But when they’re out of alignment we’ll find ourselves feeling unfulfilled. Many people will struggle with this in their careers. They may be somewhat in alignment, and it gives them some satisfaction but not enough.”
Stichter shares an example from the pandemic concerning the restaurant industry and how difficult it’s been to hire workers back.
“When people lost their jobs in that industry, it was only when they had time away from it that they realized how miserable that environment was making them,” he says. “They wanted another job but not in that industry. With low pay, long hours, bad working conditions, and constantly fighting burnout, many realized that wasn’t the way they wanted to live.
“It’s unfortunate it took a global pandemic and job loss to get people into a state where they could reevaluate their lives,” Stichter says. “People could take a step back from the entrenched routines, habits, and expectations and ask if that was really what they wanted to be doing.”
The point, he says, is that self-knowledge is required in order to set goals in line with your enduring values and interests. It requires insight and critical thinking to know what gives your life meaning and ultimately happiness.
“You can’t just rely on the ideas that you grew up with or inherited from your family, religion, or culture,” Stichter says. “You can’t just rest assured those ideas are necessarily accurate or the best conception of what it means to live well.”
The field of psychology, too, has recently begun embracing Aristotle’s broader concept of living well.
“Researchers are discovering there are at least two facets to overall well-being,” says Walter Scott, psychology professor and director of the WSU Psychology Clinic.
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“I love my job. I get a lot of eudaimonic well-being and sense of purpose and meaning from my research and doing projects with my graduate students. [Family] relationships are really important to me and give me a sense of connectedness. I like gardening and I play guitar. I feel connected to the folks in my neighborhood and often get together to jam with friends.” —Walter Scott
“While we all need the hedonic part of feeling positive emotions, our well-being also relies on the eudaimonic part of living a life in accordance with one’s virtues, moral standards, and life goals.”
Scott says there are individual genetic differences in people’s ability to experience positive emotions or “joy juice.”
“Joy juice is really a system of dopamine-mediated brain structures that are activated when we anticipate a reward or excitement of something positive,” he says. “Some people possess temperaments where their joy juice is readily activated.
“You can think of it like a psychic gas pedal—if you see something you want or is exciting, some people have very sensitive gas pedals and go, go, go! It’s related to the trait of extraversion and is linked to genes.
“Studies show that other people have very sensitive fear systems,” Scott says. “Like a psychic brake pedal, they have high reactivity to threats or unfamiliarity and are hesitant to approach. Infants have shown this response as early as 14 months of age, and often turned out to be shy and more prone to anxiety and depression in late
adolescence.
“So, there are individual differences in temperament that predispose some of us to be more or less happy. But biology is not baked. There are lots of factors in play especially in regard to an eudaimonic life of meaning and purpose.”
Scott says a large part of eudaimonia is being self-aware; knowing what we like and what makes us feel good. Then, consciously working to schedule those types of activities into our lives.
Since the beginning of the COVID-19 pandemic, Scott and his colleagues have noticed a steady increase in clients who are distressed, anxious, and depressed. He says the isolation and disconnection from other people, on top of disturbing world events, has caused many to lose their sense of control and competence.
“When people come in depressed or anxious, we focus on treating them with evidence-based interventions such as antidepressants or cognitive behavioral therapy (CBT),” he says. “But relapse is a big problem.
“In the first year of both pharmacotherapy and psychotherapy, we had considered it a success if folks no longer met the criteria for depression. But that doesn’t mean they are healthy—many still report not doing real well, they’re feeling irritable and unhappy. Those persistent subclinical symptoms are a big predictor of relapse.”
Psychologists have recently begun exploring auxiliary treatments such as well-being therapy, based on a theory of psychological well-being developed by University of Wisconsin-Madison psychologist Carol Ryff.
The Ryff Scales of Psychological Well-Being evaluate a patient’s level of self-acceptance, establishment of quality ties to others, sense of autonomy in thought and action, ability to manage complex environments to suit personal needs and values, pursuit of meaningful goals and sense of purpose in life, and continued growth and development as a person.
“In well-being therapy, they try to determine which aspects of well-being people are deficient in and then try to systematically cultivate those areas,” says Scott. “After the successful use of CBT or medications, we might have folks monitor moments in life when they’re experiencing relative well-being as well as what interferes with it.
“Initial findings show well-being therapy reduces risk of depression relapse,” he says. “People feel more connected, competent, and more resilient to the slings and arrows of life. They’re in a stronger place.”
When people experience eudaimonia in their lives, they are often described as flourishing. During the pandemic, however, many felt something of the opposite—a lingering state of blahs called languishing.
“Languishing is the neglected middle child of mental health,” wrote psychologist Adam Grant in a 2021 New York Times article. “It’s the void between depression and flourishing—the absence of well-being.
“‘Not depressed’ doesn’t mean you’re not struggling,” he wrote. “‘Not burned out’ doesn’t mean you’re fired up. Languishing dulls your motivation, disrupts your ability to focus, and triples the odds that you’ll cut back on work.”
“It’s a generalized feeling of dissatisfaction,” says Anne Mason (’02 BS, ’05 MS Nursing) associate dean of the College of Nursing at WSU Spokane Health Sciences. “We can be unhappy with our job or a relationship, but this is a more generalized feeling that is a perpetual state between work and home. We suddenly don’t feel connected to the things we normally do, or feel emotion around, or there’s a lack of joyfulness.”
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“For me, happiness is feeling energized and looking forward to activities I have coming up for the day, and the ability to plan for the short- or long-term future and really feel invested in the positive outcomes of those plans.” —Anne Mason
Mason says she’s seen some languishing in the children and parents she works with as a parttime psychiatric mental health nurse practitioner at the Emily Program in Spokane for adolescents with eating disorders.
“For adolescents, the lack of connection and easy socialization opportunities during COVID were real losses and it wasn’t replaced by online-based connections,” she says. “We found it quite starkly—these young people, who seem so competent on their phones, were suddenly thrust into a situation where everything they did is through a screen. And they didn’t do well.
“And I think that’s really important to recognize,” Mason says.
“We had adolescents who didn’t want to attend treatment programs through a telehealth option. Kids really wanted to go back for the in-person opportunity.
“In the program, we do things like therapeutic meals and it’s hard to do that on telehealth and feel we’re making a good connection with individuals,” she says. “An in-person environment is much easier, and it feels like you can provide a much different level of support.”
Mason says one of the foundations of nursing care is to evaluate whole-person health—to check in with the patient’s mental, physical, emotional, and spiritual well-being.
“All those areas are equally important,” she says. “We use an element of assessment for all four spheres. We are obviously aware of the physical symptoms, but we also ask about spiritual practices and assess how they are emotionally handling what they’re going through.”
To collect data for his Alzheimer’s disease studies, Namdul has spent years living among the Tibetan refugees, getting to know them personally and documenting their lifestyle and activities—within those four spheres.
“Most of my research informants have become my teachers—many were monks and elderly Tibetans,” he says. “One of the things that is considered so important in their culture is cultivating the happiness that is sustainable and rooted in inner calmness and well-being.”
Namdul says Tibetans believe that if happiness is contingent upon external things, there’s a chance it won’t be sustainable because things change all the time.
“Therefore, the emphasis is very much on internal happiness and well-being which is not only sustainable but also more reliable,” he says. “By internal, they mean their own minds and so their mind is the source of happiness and their whole cultural focus is on how to protect and safeguard their minds.”
The primary way they do that is by looking out for others.
“The trick here, for them in this culture, is that the moment when their focus shifts from oneself to others, the level of one’s own confidence and security increases and the level of one’s propensity to judge others and feel bad about one’s own condition, all of it gets to a more controllable level,” Namdul says.
“It may sound very counterintuitive. I’ve asked my informants, ‘How can you be happy when you look out for the happiness and well-being of others all the time?’
“They say that if you go deeper into things, you realize we are very much dependent upon everyone in our environment. You see the only way to safeguard yourself and your well-being is to take care of others whom you are dependent upon.”
Namdul says this includes family members, friends, colleagues, partners—and also animals, plants, birds, water, and the planet in general.
“Therefore, the more I look out for them, the more I will be in a much better position to put myself in a state of happiness or a deep level of satisfaction,” he says.
It’s a philosophy that aligns well with Mayo Clinic studies showing that people who volunteer their time helping others report higher levels of life satisfaction and happiness. By investing in others’ well-being, volunteers gain a sense of purpose and meaning while also building stronger social bonds.
Aristotle said the greatest virtues are those which are most useful to other persons. In other words, whether we give or receive support, it seems humans are happiest when we’ve got each other’s backs.
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“I gave a talk on stress and had to put a mirror in front of myself to really be honest about how I handle it. I have worked on this for years yet wonder sometimes how we can be unconscious of our own stress level.
“The best way I’ve found to assess my stress levels is by the way I interact with my close circle of friends and family members. I realize that when I’m not so nice to them, the stress is getting to me. I have to really look inward and think about all the things I’ve learned or heard from my teachers and try to incorporate that into my own engagement with stress.” —Tenzin Namdul