The 'I' and 'we' of illness and wellness | Behavioral Healthcare Executive Skip to content Skip to navigation

The 'I' and 'we' of illness and wellness

February 17, 2016
by Ron Manderscheid, PhD, Exec Dir, NACBHDD
| Reprints

Illness isolates intensely.

It is no coincidence that one key difference between illness and wellness involves “I” and “we”. Illness of any kind—physical, mental, intellectual, social—generally isolates one from the “we”—from family, friends, and community. Illness also can reduce the “I”—one’s capacity to participate in the everyday living necessary to sustain and enhance these interpersonal relationships.

Stated differently, illness can diminish one’s personal voice, which is necessary to engage with others. And it can rob one of the social and emotional supports provided by others necessary to sustain personal self-esteem and sense of efficacy.

Our common everyday language supports these observations. One might say, “I am out of sorts today,” or “I just am not good company today,” or “I just don’t seem to be part of our group now.” In each instance, this means that the person has lost the “I”—his or her voice—the capacity and the energy to engage others fully.

Importantly, however, illness is not just a cause of social isolation, but illness also can be its effect. If family, friends, and community members lack understanding and withdraw, this can lead to trauma and social isolation, and can result in very serious behavioral health conditions. Thus, despite the particular sequence of events, the person who is ill is very likely to be socially isolated. And social isolation can be progressive, thus further exacerbating illness.

Wellness, by contrast, implies the reverse: one can participate fully in everyday living and engage actively with others, and one can depend on receiving strong emotional support from others. One’s wellness can be sustained and enhanced by one’s own voice and actions—a strong “I,” and by effective social support from family, friends, and community—a strong “we.”

We need to develop good evidence to support the assertion that wellness can dramatically mitigate or even prevent illness. Our practice-based evidence already suggests that overcoming mental illness involves “regaining one’s voice” with others; overcoming addiction frequently involves strong social support from family and friends; ability to live a good life in the community with intellectual or developmental disabilities depends heavily upon support from one’s family and friends, as well as the community at large. In each instance, the effects of illness will be mitigated when one’s social connections are strong.

Our colleagues from the health field have a parallel concept—well-being. It almost always includes consideration of both the “I” and the “we,” our physical, mental, and social well-being, and frequently our spirit as well. A person with strong wellness has strong well-being. We need to explore the notion that the process of wellness leads to a state of well-being.

What are some of the implications of these reflections?




As always, your commentaries provide much needed perspective.
Also important for shaping the context for service delivery- it is useful to keep re-framing approaches in this wellness paradigm from different angles.
Kathy D


Ron Manderscheid

Exec. Dir., NACBHDD and NARMH

Ron Manderscheid


Ron Manderscheid, Ph.D., serves as the Executive Director of the National Association of County...

The opinions expressed by Behavioral Healthcare Executive bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.