The target article seeks to reorient psychiatric research from a focus on dysfunctions and illnesses to a focus on mental health, by proposing a view according to which the active process of resilience to variable and diverse stressors is what counts for mental health. It further suggests that a single unifying mechanism protects against stress and mediates resilience, namely, the style in which someone evaluates and reacts to a challenge. This is called the positive appraisal style theory of resilience (PASTOR). Although much depends on what constitutes an “appraisal,” Kalisch and colleges say unfortunately little about it. On their picture, appraisal is a context-dependent process of evaluation that determines one's aversive or appetitive motivation toward a stimulus. As shown in their Figure 3, this involves an individual first representing and reflecting on a given situation, and then making judgments about, for example, its novelty, pleasantness, or compatibility with her goals. The individual's emotional response then follows directly from this appraisal.
Intuitively, this kind of judgment may include the kind of explicit, conscious reflection and deliberation familiar to philosophers in action theory. The portrayal of global resilience mechanisms as operating entirely via conscious reflection and evaluation is inconsistent, however, with a commonly endorsed picture of the mind that understands much of our cognition to be implicit and outside of conscious awareness. In many circumstances, we just do not know how stressed we are.
Using indirect methods, current research in social psychology has begun to reveal many interesting failures of self-knowledge. Wilson (Reference Wilson2002), Gilbert (Reference Gilbert2009), and others have shown that this lack of awareness extends to the affective character of our own experiences. In his work on happiness Haybron (Reference Haybron2008) calls this problem affective ignorance, stressing that, not only do we sometimes misjudge or mistake our feelings, but that we can be “essentially blind to hedonically important aspects of our experience” (p. 61). Whereas sudden, sharp changes in our affective state have a way of calling attention to themselves (e.g., accidentally hitting one's funny bone), persistent affects and moods are often diffuse and elusive. We even adapt to some pains and annoyances, failing to notice them at all (e.g., suddenly realizing how irritating the refrigerator sounds only when it turns off). In a recent study, Evans and Johnson (Reference Evans and Johnson2000) demonstrate that low-intensity noise in an office space raised physiological and behavioral measures of stress, but did not affect workers' reports of perceived stress compared with a quiet office. This shows how affective and psychophysiological stress responses often come apart from self-report. An individual can be feeling anxious or depressed, while sincerely claiming, and believing themselves, to be happy.
In other words, affective response to the environment may have little to do with explicit, reflective evaluation of the environment. When it comes to stress and affect, we are not often able to recognize or articulate exactly which stimuli demand a response in the first place. Indeed, on this reading of appraisal, positive appraisal style does not seem to protect against stress at all. Because of this, our resilience mechanisms cannot plausibly depend solely on conscious reflection about our circumstances. Stress depends on more than just explicit judgment on whether conditions are favorable.
The PASTOR approach could be improved by expanding its notion of appraisal to include unconscious evaluative processes. The Evans and Johnson study is especially revealing in this vein, as it demonstrates how stressors often affect us without reflective awareness. Resilience research should be interested in discovering, for example, what differentiates those with a more resilient or positive stress response in a noisy office, regardless of how they reflectively feel about their work environment. This suggests that when it comes to resilience mechanisms, positive appraisal is simply positive affective or psychophysiological response relative to stressor load. To make a positive evaluation, on this picture, is just for an organism to make the best of its circumstances, whether challenging or routine. Resilience is normalized to individuals' actual performance in the face of various stimuli.
I would like to sound a note of caution here. Care should be taken in examining the philosophical implications of this kind of normalization for our understanding of mental health and well-being, especially if a normalized understanding of positive appraisal style is adopted into the very methodology of resilience research, as Kalisch et al. suggest when they propose that “it might be necessary…to choose study cohorts that are confronted with single classes of stressors” (sect. 4.2.8, para. 4). Contrary to what Kalisch et al. claim, socioenvironmental factors are not distant influences on mental health. In particular, in marginalized populations for whom mental health is a crucial concern, systemic inequality raises the magnitude of everyday environmental stressors, and limits many social support–based stress-aversion strategies (Satcher Reference Satcher2001). Therefore, regardless of how resilient an individual might be, it is possible that resilience mechanisms inevitably will collapse in certain environments. A population of individuals all suffering equally is not, colloquially speaking, doing fine. It simply cannot be the case, from an ethical perspective, that what is statistically normal in this case determines what counts as mentally healthy.
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The target article seeks to reorient psychiatric research from a focus on dysfunctions and illnesses to a focus on mental health, by proposing a view according to which the active process of resilience to variable and diverse stressors is what counts for mental health. It further suggests that a single unifying mechanism protects against stress and mediates resilience, namely, the style in which someone evaluates and reacts to a challenge. This is called the positive appraisal style theory of resilience (PASTOR). Although much depends on what constitutes an “appraisal,” Kalisch and colleges say unfortunately little about it. On their picture, appraisal is a context-dependent process of evaluation that determines one's aversive or appetitive motivation toward a stimulus. As shown in their Figure 3, this involves an individual first representing and reflecting on a given situation, and then making judgments about, for example, its novelty, pleasantness, or compatibility with her goals. The individual's emotional response then follows directly from this appraisal.
Intuitively, this kind of judgment may include the kind of explicit, conscious reflection and deliberation familiar to philosophers in action theory. The portrayal of global resilience mechanisms as operating entirely via conscious reflection and evaluation is inconsistent, however, with a commonly endorsed picture of the mind that understands much of our cognition to be implicit and outside of conscious awareness. In many circumstances, we just do not know how stressed we are.
Using indirect methods, current research in social psychology has begun to reveal many interesting failures of self-knowledge. Wilson (Reference Wilson2002), Gilbert (Reference Gilbert2009), and others have shown that this lack of awareness extends to the affective character of our own experiences. In his work on happiness Haybron (Reference Haybron2008) calls this problem affective ignorance, stressing that, not only do we sometimes misjudge or mistake our feelings, but that we can be “essentially blind to hedonically important aspects of our experience” (p. 61). Whereas sudden, sharp changes in our affective state have a way of calling attention to themselves (e.g., accidentally hitting one's funny bone), persistent affects and moods are often diffuse and elusive. We even adapt to some pains and annoyances, failing to notice them at all (e.g., suddenly realizing how irritating the refrigerator sounds only when it turns off). In a recent study, Evans and Johnson (Reference Evans and Johnson2000) demonstrate that low-intensity noise in an office space raised physiological and behavioral measures of stress, but did not affect workers' reports of perceived stress compared with a quiet office. This shows how affective and psychophysiological stress responses often come apart from self-report. An individual can be feeling anxious or depressed, while sincerely claiming, and believing themselves, to be happy.
In other words, affective response to the environment may have little to do with explicit, reflective evaluation of the environment. When it comes to stress and affect, we are not often able to recognize or articulate exactly which stimuli demand a response in the first place. Indeed, on this reading of appraisal, positive appraisal style does not seem to protect against stress at all. Because of this, our resilience mechanisms cannot plausibly depend solely on conscious reflection about our circumstances. Stress depends on more than just explicit judgment on whether conditions are favorable.
The PASTOR approach could be improved by expanding its notion of appraisal to include unconscious evaluative processes. The Evans and Johnson study is especially revealing in this vein, as it demonstrates how stressors often affect us without reflective awareness. Resilience research should be interested in discovering, for example, what differentiates those with a more resilient or positive stress response in a noisy office, regardless of how they reflectively feel about their work environment. This suggests that when it comes to resilience mechanisms, positive appraisal is simply positive affective or psychophysiological response relative to stressor load. To make a positive evaluation, on this picture, is just for an organism to make the best of its circumstances, whether challenging or routine. Resilience is normalized to individuals' actual performance in the face of various stimuli.
I would like to sound a note of caution here. Care should be taken in examining the philosophical implications of this kind of normalization for our understanding of mental health and well-being, especially if a normalized understanding of positive appraisal style is adopted into the very methodology of resilience research, as Kalisch et al. suggest when they propose that “it might be necessary…to choose study cohorts that are confronted with single classes of stressors” (sect. 4.2.8, para. 4). Contrary to what Kalisch et al. claim, socioenvironmental factors are not distant influences on mental health. In particular, in marginalized populations for whom mental health is a crucial concern, systemic inequality raises the magnitude of everyday environmental stressors, and limits many social support–based stress-aversion strategies (Satcher Reference Satcher2001). Therefore, regardless of how resilient an individual might be, it is possible that resilience mechanisms inevitably will collapse in certain environments. A population of individuals all suffering equally is not, colloquially speaking, doing fine. It simply cannot be the case, from an ethical perspective, that what is statistically normal in this case determines what counts as mentally healthy.