Two Views of Well Being

At this point, I should clarify what I mean by emotional well-being. Ryan and Deci7 noted that the study of well-being in psychology emerged from two relatively distinct, though overlapping, philosophical perspectives: (a) the hedonicposition, which views well-being in terms of the experience of personal happiness or the balance between positive and negative affect; and (b) the eudaimonic position, which holds that well-being involves the quest to achieve growth, purpose, and meaning in one's life. These two broad perspectives have given rise to two relatively distinct lines of inquiry. Specifically, the hedonic view has nurtured development of the literature on emotional or subjective well-being (SWB8), while the eudaimonic view has fostered the study of psychological well-being (PWB9).

There has been an evolving consensus that SWB consists of three components: life satisfaction (the tendency to evaluate one's life as generally happy or satisfying), the presence of positive affect (e.g., enthusiasm, interest), and the absence of negative affect (e.g., nervousness).8 Findings indicate that these are interrelated, though relatively distinct, constructs (e.g., Lucas et al.10) that may function together as part of a complex well-being process. By contrast, PWB research focuses on person qualities that are assumed, on theoretical grounds, to reflect healthy functioning (e.g., sense of life purpose, positive relations with others, self-acceptance).9

Consistent with their differing theoretical and philosophical roots, factor analyses of SWB and PWB measures suggest that they reflect somewhat distinct underlying dimensions of well-being (i.e., happiness/SWB vs. growth/meaning11,12). At the same time, several aspects of PWB have been found to correlate highly with life satisfaction/SWB.13 Ryan and Deci7(p148) concluded that "well-being is probably best conceived as a multidimensional phenomenon" that includes aspects of both SWB and PWB.

While Ryan and Deci's conclusion is well-reasoned, it seems essential to take the next step—that is, to ask the question, how do SWB and PWB interrelate (i.e., what is the role of the one vis-a-vis the other)? To address this question, it may be helpful to consider a theoretical framework that encompasses both sets of factors and that offers testable hypotheses about how they fit together. In my theoretical view, SWB—and more specifically, satisfaction with one's life overall and with the central domains/roles of one's life—is the aspect of emotional well-being that deserves particular focus in mental health interventions. PWB is not treated as an alternative or co-criterion of well-being; rather it is seen as offering a central route to SWB. In particular, the resources (e.g., social relations) and methods (e.g., pursuing valued goals) that people use to bring meaning, purpose, and structure to their lives (PWB) also help to promote their emotional well-being, or happiness (SWB). (In the remainder of this chapter, I will use the terms emotional well-being as synonymous with SWB, happiness, and life satisfaction.)

2.2. SWB and Quality of Life

Before elaborating my theoretical position, I will pause to distinguish SWB from a related concept, quality of life (QOL). Although the terms SWB and QOL are sometimes used interchangeably, they do not necessarily reflect the same thing. Indeed, QOL is often used as a conceptual umbrella for a wide array of constructs and measures that reflect some aspect of physical, social, or emotional functioning.14 From this perspective, SWB is one of several indicators of life quality; other examples include social support and adjustment, physical health status, and economic standard of living. This eclectic mix of QOL indicators may reflect the multidisciplinary roots of the QOL literature in sociology, medicine, and psychology.

Although the QOL construct is useful in its focus on numerous aspects of positive adjustment, it may come with excess conceptual baggage. In particular, its multiple meanings may sacrifice precision for breadth and confound emotional adjustment with other aspects of functioning and with socioeconomic status. These are considerable limitations. Purchasing power, for instance, should not be equated with mental or physical health; and physical disease does not necessarily imply emotional ill-health. It is useful to view the person (and his or her environment) along multiple dimensions, yet there is conceptual danger in blurring the distinctions among them or in reducing them all to a single aggregate index of functioning. In the remainder of this chapter, I focus on emotional well-being, or SWB, while also acknowledging the value of assessing other aspects of adaptation (e.g., psychological symptom status, adequacy of role functioning) as part of a more comprehensive picture of psychosocial adjustment during the course of cancer survival.

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