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Balancing Me Myself and I plus One

» Mental Health Library » Treatment Approaches » Cognitive-Behavioral Therapy » Featured Article

By Dr. Shannon Barnes

Dr. Shannon Barnes


Research has shown that many factors including biological makeup and life experiences can influence a person’s mental health. Physical fitness, social relationships, family cohesion, cognitions, perceptions and spiritual beliefs have all been determined to be influential factors of the development or lack of development of mental health needs. However, this influence deserves to be explored from a new perspective. This article will provide some current research while exploring how the balance between these factors actually influence mental health symptoms.


Optimal health is believed to be achieved when a complete state of social, mental, and physical well-being is achieved (The World Health Organization, 1948). Spirituality is also believed by many to be an influencing factor of total health. Therefore, a healthy lifestyle should take into consideration a balance between these factors. A healthy life should include the absence of disease and mental health needs. A healthy life should incorporate a balance between physical, psychological, social, and spiritual health. It can be assumed that if a person has a healthy balance of these factors, then mental health issues are less likely to develop. Then it is also logical to assume that a person who does not have a healthy balance of these factors is more likely to develop mental health symptoms. Fortunately, those symptoms can be treated by implementing a treatment approach that brings about balance.

To Elaborate With Current Research

People are biological mammals who have a physical makeup of bones, coronary systems, respiratory systems and so on. People can be born with disease or they can develop disease during their life span. How a person chooses to care for the self can determine a person’s physical well-being. Self-care including consistent exercise and healthy eating habits have been found to be correlated with mental health symptoms. Biddle and Asare, (2011) determined that a sedentary lifestyle has negative effects on mental health where as physical activity can have positive effects on mental health. Dr. Carl C. Pfeiffer (1987) found that including specific vitamins and minerals in a diet are beneficial with treating mental health disorders including depression, anxiety, and others. Knoesen, Mancuso, Thomas Komesaroff, Biomed, Castle, (2012) also found that a strong relationship exists between mental health and perceived physical health. Therefore a balance between the physical wellbeing and psychological wellbeing must exist for health.

The psychological state which is made of a person’s cognitions, perceptions, attitudes, coping skills, and defense mechanisms also influences decisions. These cognitive processes will also affect a person’s mental health well-being. The psychological state will also impact a person’s social wellbeing.

People live in a society where they are always in contact with other people. People have intimate relationships, family relationships, friendships, coworkers, and even interact with strangers on a daily basis. The social makeup of a person is affected by various factors. Lee and Turney,(2012) found that when people perceive themselves to be discriminated against the people are more likely to have increased mental health needs making social status related to mental health needs. Positive social relationships in the workplace has also been demonstrated to have a positive influence on mental health and self-reported physical health (Rydstedt, Head, Stansfeld, Woodley-Jones, 2012), and people who are in positive romantic relationships were found to report higher levels of life satisfaction than those who are not married or maintaining a romantic relationship (Uecker, 2012). Social relationships evolve in many manners but typically people who share the same spiritual beliefs maintain the same social circles.

Every person has developed a belief system regarding spiritual issues. There are many religions which dictate a person’s spiritual belief system. For those who do not associate themselves with a specific religious or spiritual group, such as Atheists, the lack of religious association is still a belief system. A belief system will guide a person’s life decisions and bring about a person’s sense of purpose. The belief system produces the spiritual wellbeing of a person, which may greatly influence social and physical decisions which will in turn affect their total wellbeing. Faith based organizations have been found to be highly beneficial with treating public health (Schumann, Stroppa, Moreira-Almeida, 2011). Cook, Powell, and Eagger (2010) discuss the relationship between spiritualism and well-being as well as pointing out that psychiatrists should have a full understanding of what religious beliefs patients are practicing as part of their treatment.


It has always been understood that our physical, spiritual, and psychological social wellbeing will influence each other; however, this theory should be expanded to consider that these four domains actually depend on each other for the whole function of living. Daily evolution of these four factors based on life experiences will determine if balance is actually maintained. Once a physical experience occurs, the other four domains are altered as well. Once a psychological experience occurs, the other four domains are altered as well. For example, if a person has a near death automobile accident, a person experiences physical changes in heart rate, blood pressure, cortisol, dopamine, adrenaline, and other brain chemicals. The cognitions, perceptions, and attitude (psychological) will be altered as a result and cause that person to make decisions regarding future rides in a vehicle, the person will have cognitions and perceptions about the person’s relationships (social), and the person most likely will consider the person’s belief system as well (spiritual). The social domain will be affected and altered based on the person’s interactions and change in behaviors or decisions made. The spiritual domain may be affected based on the person’s belief system, and the physical domain may then be affected by a change in sleep patterns, eating habits, lack of or increased self-care. This is when trauma symptoms or anxiety may develop. As each domain is altered a new balance is created. If one domain does not establish balance again, then the other domains will compensate causing a lack of balance in the other domains. Over time, each domain compensates to account for the lack of balance in the other domains. This lack of balance will decrease life satisfaction and increase the chances of developing mental health symptoms until balance is regained.

Various treatment approaches can be utilized in order to treat the lack of balance in each domain. As each domain regains balance, the other domains will also be altered to regain balance. The person in the near death automobile accident may be treated with trauma therapy along with education regarding sleep, exercise, and healthy eating habits which will decrease anxiety. The person’s social connections may offer support and positive reinforcement for the decrease in anxiety and understanding a spiritual connection within the belief system the person has chosen will most likely also decrease anxiety. Therefore, as treatment progresses all four domains are treated and balance is regained. Once balance is regained the mental health symptoms are decreased or extinguished.


Professionals in the mental health field continue to seek information regarding factors that may influence the development of mental health illness. A new approach to deny the nature versus nurture model and embrace the nature with nurture model by understanding how the four primary domains discussed here add to this growing body of knowledge regarding the development of mental health needs in the general population... The physical domain, the social domain, the spiritual domain, and the psychological domain must maintain a strong balance between each domain in order to maintain a total healthy well-being that will result with life satisfaction. However, if balance is disrupted or is not reached, life satisfaction is not obtained and mental health issues may surface. Further research is needed in order to explore how these domains depend on each other versus just influencing each other.


Biddle, S.J.H., & Asare, M. (2011). Physical activity and mental health in children and adolescents: A review of reviews. The British Journal of Sports Medicine. doi:10.1136/bjsports-2011-090185.

Knoesen, N.P., Mancuso, S.G., Thomas, S., Komesaroff, P., Biomed, S.L., Castle, D.J. (2012). Relationship between severity of obesity and mental health: An Austrailian community survey. Asia-Pacific Psychiatry, 4 (1), 67-75. doi: 10.1111/j.1758-5872.2011.00164.x.

 Lee, H. & Turney, K. (2012). Investigating the relationship between perceived discrimination, social status, and mental health. Society and mental Health, 2 (1), 1-20. doi:10.1177/2156869311433067.

 Rydstedt,L.W., Head, J., Stansfeld, S.A., and Woodley-Jones, D. (2012). Quality of workplace social relationships and perceived health. Psychological Reports, 110 (3), 781-790. doi: 10.2466/01.13.21.PR0.110.3.781-790

 Schumann, C., Stroppa, A., & Moreira-Almeida, A. (2011). The contribution of faith based health organizations to public health. International Psychiatry, 8 (3) 62-64.

 Uecker, J.E. (2012). Marriage and Mental Health among Young Adults. Journal of Health and Social Behavior 53 (1),67-83.

 World Health Organization. (1948). Health as adopted by the International Health Conference. Official Records of the World Health Organization, 2, 100. Retrieved from

About the Author...

Dr. Shannon Barnes earned a Master of Science degree in Clinical Counseling from Brenau University. She continued on to Capella University where she earned a Doctorate Degree in Philosophy Counseling Studies. The doctorate degree provided an opportunity to expand her research skills. Dr. Barnes maintains private practice in two office locations. Dr. Barnes' primary focus is adjustment disorders, marriage counseling, and individualized trauma treatment for those who have suffered from various negative life events. Dr. Barnes also works with children and adolescents who exhibit oppositional definant behaviors. When Dr. Barnes is not seeing clients, she conducts research studies evolving from her various research interests.

Last Update: 3/19/2015

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