DC Psychiatrist Dr. David J. Fischer's Logo for Columbia Center for Psychiatry
Dr. David J. Fischer's Logo for Columbia Center for Psychiatry
COLUMBIA CENTER FOR PSYCHIATRY

DAVID J. FISCHER, M.D.
MEDICAL DIRECTOR

PHONE: 202-363-4333
PHONE: 202-686-0114
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THE HEALTHY INDIVIDUAL

(return to philosophy of psychotherapy page)

The healthy individual has a strong sense of self, the capacity for successful interpersonal functioning and the ability to function well occupationally. Such an individual possesses an awareness of having a unique identity, grounded in personal history, with well-delineated interpersonal boundaries leading to a firm sense of self. The ability to experience, think about, and make sense of internal sensory, affective, and cognitive experience is present.  The individual’s identity remains intact, interactive and spontaneous in the context of relationships. This identity, however, is not static but open to growth and change. The self-concept is associated with a relatively consistent and self-regulated level of positive self-esteem and self-respect. One’s self-appraisal is accurate and based in reality, neither grandiose nor deprecating. The person has the ability to identify, set and attain satisfying and rewarding personal goals. The healthy individual can analyze what a situation requires, selects an appropriate goal, decides how best to implement that goal and proceeds to carry out the plan and achieve the goal.  The person has a sense of direction, meaning, and purpose resulting in a sense of fulfillment in life.

Psychiatric mental health

Essential to being a healthy individual is the capacity for effective interpersonal functioning. The healthy individual possesses the essential social skills to recognize, interpret, and respond constructively to emotions in oneself and others. This is reflected in the ability to understand and appreciate the mental state of others and to comprehend and appreciate the effect of one’s personal actions on others. The individual responds in an open and flexible manner to a range of other peoples’ ideas, emotions and behaviors. The individual has a desire for and engages in multiple affiliative and reciprocal relationships. The ability to establish and maintain closeness, intimacy and friendships is enhanced due to increased confidence and a lack of defensiveness. In effective social functioning an individual derives a positive sense of well being, belonging, meaning, and purpose from being part of and contributing back to something larger and more permanent than themselves (e.g. nature, social groups, organizations, movements, traditions, belief systems).

COMPETENCY AND MASTERY

Occupational functioning is an individual’s capacity to perform goal-directed activities, initiate and organize behavior and flexibly apply knowledge to a variety of tasks.

AUTHENTICITY MEANS BEING OPEN AND NOT BEING DEFENSIVE

Authenticity means being able to respond in a greater variety of ways to information from one’s self, other people, and the world. The authentic individual has moved away from self-concealment and away from needing to meet the expectation of others and moves towards being himself.

DECISIVENESS

Life presents all individuals with a series of decisions. The choice the person makes either propels them into a risky unknown future or leads them back to the status quo, a safe routine, and a predictable past. Healthy individuals are aware that choosing the unknown future leads to “ontological anxiety” (the fear of the unknown, unstructured future), whereas, choosing the safe status quo leads to “ontological guilt”, (a sense of missed opportunity but safety). All individuals are burdened with the painful state of this ambivalence. Authenticity involves being decisive and accepting this painful state of affairs and yet finding the courage and hardiness to persist in the face of ontological anxiety and choose the future, to develop and grow as a person. Action in the face of awareness and uncertainty means action, which incorporates anxiety. This is what leads to growth. Action without anxiety and awareness is impulsivity, which is behavior without adequate forethought as to the consequences of one’s actions.

BEING FULLY PRESENT

An authentic individual can be in the “here and now”. The most important moment in life is the here and now. The here and now is the locus of change, it is the time frame in which change takes place. The individual is actively and consciously dealing with the time frame of the present in an attempt to create something new and better in the future. This is accomplished by continually being self aware of one’s feelings, thinking and behavior and of the external events to which they are responding.

PROACTIVE VS. REACTIVE

The healthy individual chooses and selects the ways they will respond to situations, rather than being reactive and passively responding to the pressure of events. The proactive person demonstrates a general transcendence of the environment rather than a simple "coping" with it

AWARE AND CAPABLE

The individual is able to analyze what a situation requires, select an appropriate goal, decide how best to implement that goal and proceed to act and effectively execute the plan of action that was chosen.

OPEN, RECEPTIVE, AND RESPONSIVE

The healthy individual is capable of identifying, understanding, interpreting, and responding constructively to emotions within the self and others. They enjoy interacting with and being fully responsive to others, as opposed to being closed, shut down, reacting in a stereotypical manner and being oblivious to others. There is a desire and ability to engage, establish and maintain multiple affiliative and reciprocal relationships. This person is capable of entering and forming intimate relationships with others, which are spontaneous, mutually satisfying, and characterized by positive feelings and behavior. Both parties develop and grow in a relationship that is satisfying to both.

OPEN, RECEPTIVE, AND RESPONSIVE TO SELF

The healthy individual is open to what is occurring internally within oneself (feelings, thoughts, perceptions and fantasies), learns to listen sensitively to self and is able to accept a full range of feelings, thoughts and fantasies without the presence of paralyzing anxiety, guilt, and fear. The person accepts what is so, good and bad, about them.

MEANING

The healthy individual has found meaning, direction and purpose in their life. A critical component of mental health includes beliefs that give one the feeling that there is purpose in and meaning to life. An individual’s physical and psychological health is profoundly affected by the degree to which they have found meaning, direction and purpose in their existence.

ENGAGEMENT

Being engaged in life provides a person with meaning. It is the individual’s responsibility to discovery what to be engaged in.



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