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Feeling Good
This page intentionally left blank
Feeling Good
The Science of Well-Being

C. ROBERT CLONINGER

OXFORD
UNIVERSITY PRESS

2004
OX-FORD
Oxford New York
Auckland Bangkok Buenos Aires Cape Town Chennai
Dar es Salaam Delhi Hong Kong Istanbul Karachi Kolkata
Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi
Sao Paulo Shanghai Taipei Tokyo Toronto

Copyright © 2004 by Oxford University Press, Inc.

Published by Oxford University Press, Inc.

198 Madison Avenue, New York, New York, 10016
http://www.oup.com
Oxford is a registered trademark of Oxford University Press
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.
Library of Congress Cataloging-in-Publication Data
Cloninger, C. Robert.
Feeling good: the science of well-being / C. Robert Cloninger.
p. cm. Includes bibliographical references and index.
ISBN 0-19-505137-8
1. Health. 2. Psychiatry. 3. Psychophysiology. 4. Mind and body.
5. Consciousness. 6. Personality. 7. Philosophy of mind.
8. Happiness. 9. Love.
I. Title.
RA776.C625 2004 613—dc22 2003190053

9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
PREFACE

To be truly happy people must learn to live in radically new ways. Well-being
only arises when a person learns how to let go of struggles, to work in the service
of others, and to grow in awareness. Prior approaches to feeling good have small
or brief benefits because they separate the biological, psychological, social, and
spiritual processes of living that must be in harmony for a happy life. The intro-
duction of modern drugs and psychotherapy techniques has not resulted in more
people who are very happy with their lives than in the past. Psychologists know
much about the psychosocial skills of people who are happy but know little about
their biology or spirituality. Psychiatrists know much about the biomedical char-
acteristics of people who are unhappy, but not those who are happy. No one has
integrated the psychosocial and biomedical knowledge that is available about well-
being in a coherent developmental perspective.
Fortunately, psychosocial and biomedical approaches to well-being can be fully
integrated, as is done in this book for the first time. The path to well-being de-
scribed here provides the foundation needed to transform human personality and
cure mental disorders. This ambitious book is a holistic account of the principles
and mechanisms underlying the path to the good life—that is, a life that is happy,
harmonious, virtuous, and wise. "Feeling good" cannot be authentic or stable
without "being good" because happiness is the effortless expression of coherent
intuitions of the world. Authentic happiness requires a coherent way of living,
v
vi Preface

including the human processes that regulate the sexual, material, emotional, in-
tellectual, and spiritual aspects of experience. Sex, possessions, power, and friend-
ships can be self-defeating or adaptive, depending on how aware people are of
their goals and values. The degree of coherence of human thoughts and social
relationships can be measured in terms of how well our thoughts and relation-
ships lead to the harmony and happiness of the good life. This holistic approach
quantifies the development of human self-awareness as a sequence of quantum-
like steps, which has many implications for everyday life, neuroscience research,
and the practice of mental health. Likewise, my own understanding of personal-
ity had to be expanded step by step in order to account for observed phenomena,
such as self-awareness, free will, creativity, and quantum-like gifts of the mind
and spirit that could not be explained otherwise. What eventually emerged is an
integrated science of well-being that unifies all the traditional divisions of psy-
chology, psychiatry, and neuroscience.
This book will interest a broad range of readers because of its wide scope. It is
intended for all open-minded people who are interested in understanding as much
as they can about basic human needs, consciousness, creativity, and well-being.
It is written for the general reader as well as for students and practitioners in the
fields of mental health.
The broad range of subject matter in the book required the writing to be acces-
sible to any intelligent person because few people have expertise in all the fields
into which it delves. Even experts in one field or another will find much that is
new and provocative throughout the book. Each chapter contains all essential
introductory material, as well as extensive references for further reading.
In addition to its broad scope, the book focuses in depth on the most funda-
mental questions about human life. What is good? Who am I really? How can I be
happy and creative? These are questions for which there are no complete or simple
answers. Those who think they already know the true answers will not want to
read this book unless they are prepared to challenge their minds and reevaluate
some cherished assumptions. On the other hand, those who recognize the inex-
haustible nature of the mysteries embedded in these questions will enjoy the book.
Useful general principles of living are described along with practical exercises
for the mind to help in exploring the steps of the path to greater wisdom and well-
being. Such exercises are essential to experience different levels of conscious-
ness directly, rather than viewing them as abstract concepts. This book will also
be of interest to theologians, philosophers, and social scientists because it pro-
vides contemporary scientific concepts and language for addressing the peren-
nial human questions about being, knowledge, and conduct at the crux of civilized
thought. It is designed to help each of us to reflect and ponder the basic questions
that everyone has about healthy living. This book stimulates the reader to develop
his or her own self-awareness without reliance on any external authority, includ-
ing myself.
 Preface vii

This is the first of several books I intend to write on the science of well-being.
It is limited primarily to describing the foundations of normal development, es-
pecially the development of self-awareness. The assessment and treatment of
mental disorders will be considered in more depth in a second book because the
principles of well-being must be recognized before psychopathology can be ef-
fectively understood.
The path of development of self-aware consciousness is described here from
several interdependent perspectives, including physics, genetics, physiology, psy-
chology, sociology, and philosophy. However, my focus is on human psychobi-
ology because no one can provide an adequate theory of everything. A broad range
of biomedical and psychosocial sciences is synthesized here to provide a solid
foundation from which to understand both normal and abnormal development.
The principles derived from this foundation provide the clues that have long been
needed for mental health to advance from a predominantly descriptive and em-
pirical science to one that is founded solidly on a self-organizing theoretical un-
derstanding of the basic mechanisms of life.
Tentative intuitions about the mysteries of life are described and tested in rig-
orous scientific terms. Sometimes the metaphorical descriptions of transcenden-
tal writers provided inspiration when their terms could be translated into a scientific
form that was measured, tested, and refined in a stepwise manner. It is wonderful
to be living at a time when creative advances in science and culture allow a deep
and inspiring understanding of what it means to be human. We now have the
opportunity to examine old, universal, human questions within a current, quanti-
tative, scientific framework.

St. Louis, Missouri C.R.C.

This page intentionally left blank
ACKNOWLEDGMENTS

This book could not have been completed without the help of many others. Fiona
Stevens and Jeff House at Oxford University Press provided lucid editorial advice
and steadfast encouragement over many years. The Wallace Renard Professorship,
the Sansone Family Center for Well-Being, and the U.S. National Institutes of Health
gave stable support that allowed me to work in creative freedom. The collegial at-
mosphere characteristic of Washington University in St. Louis, particularly in the
Departments of Psychiatry and Psychology, has been conducive to the integration
of psychosocial and biomedical approaches. I have learned much from many col-
leagues all over the world, but especially the founding members of our local center,
psychiatrist Dragan Svrakic, psychologist Richard Wetzel, anthropologist Tom
Przybeck, physicist Nenad Svrakic, and administrator Gerri Wynne. Our commit-
ment to open-minded inquiry into fundamental human issues in the Center for Well-
Being continues the spirit I first experienced in Plan II at the University of Texas in
Austin under the leadership of philosopher John Silber. Fortunately, the late psy-
chiatrists Eli Robins and Samuel Guze wisely nurtured the same deep philosophical
spirit in psychiatry at Washington University.
Writing this book has been a wonderful adventure shared with my family and
friends. My parents Morris and Concetta taught me much about the principles of
coherent living by the example of their own fully engaged lives. My wife, Sherry,
and sons, Bryan and Kevin, are continual sources of inspiration and love as we all
learn to follow the path of well-being together.

ix
This page intentionally left blank
CONTENTS

Introduction, xv

1. A Brief Philosophy of Weil-Being, 1

The Basic Triad of Human Needs, 1
How Can We Be Happy? 4
Aristotle's Errors, 6
The Way of Positive Philosophers, 9
The Way of Negative Philosophers, 13
The Way of Humanists, 19
What Makes Life Stressful? 26

2. The Search for an Adequate Psychology, 35

The Essential Questions of Psychology, 35
Human Personality as Temperament, 39
Human Personality as Self, 44
Human Personality as Coherence of Being, 50
The Transcendental Phenomena of Development, 60

3. The Measurement and Movement of Human Thought, 79

The Path of the Psyche, 79
Experiencing the Stages of Self-Aware Consciousness, 84

XI
xii Contents

Description and Measurement of Thought, 95

Movement of Thought in Time, 114
Brain Regulation of Attention and Affect, 119
The Spiral Path of Consciousness, 122

4. The Social Psychology of Transcendentalism, 137

The Cultural Atmosphere of Early America, 137
Emerson and the American Transcendentalist Movement, 143
Measuring Emerson's Thoughts, 151
Reliability and Validity of Measuring Thought, 154
Measuring Emerson's Social Relations, 157
The Development of Thoreau, 175
The Significance of the Transcendentalists, 184
Conclusions about Thought and Social Relations, 186

5. Psychophysical Theories of Contemplation, 189

The Prevalence of Contemplative Thought, 189
The Stages of Understanding Causality and Consciousness, 191
Explanatory Level of Causal Theories, 198
Facilitating Contemplative Experience, 200
Description of Contemplative Thought, 202
Quantum-like Nature of Insight and Giftedness, 208

6. Psychophysiology of Awareness, 231

The Biopsychosocial Approach, 231
Testing the Stepwise Nature of Development, 234
The Psychophysiology of the Steps in Thought, 239
The Global Brain Energy State, 247
Psychophysiology of the Stages of Consciousness, 249
Psychosomatic Effects of Meditation, 254
Degeneracy of Reductive Paradigms, 260

7. The Epigenetic Revolution, 269

The Significance for Psychobiology, 269
Early Theories of Development and Evolution, 272
Epigenetic Mechanisms of Molecular Memory, 278
The Inheritance of Epigenetic Effects, 283
Comparative Genomics and Evolution, 286
The Epigenetics of Personality, 290
Evolution of Creativity in Modern Human Beings, 303
 Contents xiii

8. The Irreducible Triad of Well-Being, 313

The Hierarchy of Life Systems, 313
The Dynamics of Biopsychosocial Systems, 319
The Topology and Functions of the Human Psyche, 321
The Noncausal Nature of Human Creativity, 329
Implications for the Future, 343

Appendix: The Quantitative Measurement of Thought, 353

Index, 359
This page intentionally left blank
INTRODUCTION

Within every person is a spontaneous need for happiness, understanding, and love,
yet neither psychiatry nor psychology has been effective in understanding the steps
that lead to such a happy life. In fact, these disciplines have almost exclusively
studied the unhappy. Available treatments of mental problems are usually based
on empirical discoveries that ignore the importance of growth in self-awareness
for the development of well-being. Consequently, available treatments are pallia-
tive and incomplete, not curative. Most patients with common mental disorders
remain ill with varying degrees of recurrent or chronic disability throughout their
life despite conventional biomedical and psychosocial treatments. Available psycho-
tropic drugs and psychosocial interventions are often effective for acute relief of
some symptoms of mental disorder. Despite the use of modern therapies, how
ever, there has been no overall increase in the proportion of people in the com-
munity who are happy and satisfied with their life.
The meager progress by psychiatry and psychology in understanding the science
of well-being is in part related to a failure to integrate major advances in other
fields of science. Some phenomena of human consciousness, such as creative gifts
and free will, may be explainable only in terms of quantum physics. Neverthe-
less, most psychologists and psychiatrists assume people are essentially machines,
like computers. The deterministic algorithms of computers cannot explain human
creativity or freedom of will, which at least seem to be important to the happiness
xv
xvi Introduction

of self-aware individuals. The mental health field needs a general approach to

describe and understand human consciousness that is compatible with the funda-
mental principles of quantum theory.
The mental health field also needs a way to describe and understand the regu-
lation of human self-aware consciousness that is compatible with recent advances
in psychobiology and neuroscience. Self-aware consciousness is the unique
human ability to remember and reexperience the past in the immediacy of our
own intuition. It is the basis for the awareness of one's self, the sense of subjec-
tive time, and recollection of personal events in the context of a particular place
and time. Self-aware consciousness depends on the mature development of spe-
cific brain regions, such as the prefrontal cortex, that are well developed only
in human beings. Quantitative methods of brain imaging have shown that the
movement of thought in self-aware consciousness is synchronous with sudden
transitions between discrete brain states. The transitions between discrete func-
tional states of the brain depend on changing connections between distributed
neural networks that span the whole brain. A human being is actually an inte-
grated hierarchy of biological, psychological, and social systems that adapt to
changes in context. The degree of adaptability of a person depends on his level
of awareness of the context in which he lives. Awareness of context varies greatly
between individual persons and within the same person at different times, fre-
quently changing from moment to moment. Even at the level of individual cells
in the brain, biologists have recently found that the regulation of gene expres-
sion is controlled by complex adaptive systems of learning and memory. The
regulation of gene expression is described as "epigenetic" because it depends
on information that is not translated into the proteins that make up the structure
of the body and may be acquired through experience. In other words, the inher-
itance of acquired characteristics is essential to the adaptive development of cells
in every organ system, especially the human brain. In contrast to the dynamic
nature of human awareness and brain states, however, most psychologists and
psychiatrists make the highly doubtful assumption that people can be diagnosed
and treated as if they had fixed traits of psychological health or illness, such as
a discrete diagnosis like major depressive disorder. The field of mental health
is in great need of a fundamentally new system of assessment and classification
that is dynamic and compatible with the fundamental findings of modern biology,
genetics, and neuroscience. We need a new method for assessing self-aware
consciousness that can explain personal growth and well-being as well as men-
tal disorders.
Furthermore, the science of mental health must recognize that individuals
operate within the context of the goals and values of society. In turn, self-aware
human beings evaluate society within a spiritual context that is ultimately non-
dualistic. As people develop in maturity, they grow in the radius of their aware-
ness of the many biological, psychological, and social influences on themselves
 Introduction xvii

and their relationships with others. The self-aware consciousness of a person

progresses through a hierarchy of stages that leads to increasing levels of wisdom
and well-being, as has been documented clearly in longitudinal psychosocial re-
search. Consequently, the mental health field needs a method for describing self-
awareness that recognizes its stage-like development.
In effect, the science of mental health has been stagnated by its division into
two parts. The biomedical part studies the brain, whereas the psychosocial part
studies the mind. Essentially these two approaches define two separate paradigms
for understanding mental health and disease. The psychosocial approach is con-
cerned with the paradigm of the person whose thoughts, feelings, and behaviors
are understood mentally in terms of adaptive responses motivated by external and
internal events. In contrast, the biomedical approach is concerned with the para-
digm of disease categories, which are discrete entities described in terms of a set
of causes, specific criteria for diagnosis, and predictable course of development.
For example, in the first part of the twentieth century, psychoanalysis dominated
the field of psychiatry based on its paradigm of the person. Later, the biomedical
approach and categorical diagnosis began to dominate the field of psychiatry along
with advances in basic neuroscience and psychopharmacology.
Unfortunately, each part of the science of mental health—that is, the paradigm
of the person and the paradigm of disease categories—is an inadequate basis to
understand the relations of the body and the mind. The psychosocial paradigm of
the person has lacked a coherent model of the biomedical basis of mental pro-
cesses. Likewise, the biomedical paradigm of discrete disease categories has been
unable to identify any specific laboratory tests for any mental disorder or to de-
velop any treatments that enhance self-awareness and well-being. Many psycho-
active drugs are moderately effective for treating acute symptoms, and some reduce
the risk of relapse as long as they are maintained on a long-term basis. However,
no biomedical treatment cures a person of their vulnerability to future mental ill-
ness. Likewise, no biomedical treatments produce progressive improvement in
character and satisfaction with the meaning of one's life.
Self-critical leaders of each approach have usually sought to integrate these two
parts. For example, Emil Kraepelin studied with the experimental psychologist
Wilhelm Wundt and wanted to integrate the understanding of emotional and in-
tellectual processes using psychological, genetic, pharmacological, and anatomi-
cal techniques that were innovative for the time. Kraepelin originally thought that
mental disorders could be explained as specific diseases that involved defects in
specific brain regions, but toward the end of his career, he concluded that this was
unlikely to be true. Likewise, Sigmund Freud originally wanted to establish the
neurobiological basis for a scientific psychology but quickly recognized that the
tools to do this were not available during his lifetime. Unfortunately, later fol-
lowers of the disease category and personality paradigms have assumed that their
approach provided an adequate explanation of the whole field.
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