Well-being is not enhanced by wealth, power, or fame, despite many people acting as if such accomplishments could bring lasting satisfaction. Character development does bring about greater self-awareness and hence greater happiness. Fortunately, recent work on well-being has shown that it is possible to improve character, thereby increasing well-being and reducing disability in the general population, and in most, if not all, mental disorders (4,7,10,14-16). The most effective methods of intervention all focus on the development of positive emotions and the character traits that underlie well-being.
Randomized controlled trials of therapies to enhance well-being in patients with mental disorders show improvements in happiness and character strengths that increase treatment adherence and reduce relapse and recurrence rates when compared to cognitive-behavioral therapy or psychotropic medication alone (10,14,15). Randomized controlled trials showed that interventions to enhance well-being are also effective in samples of students and volunteers from the general population (4,17).
The methods of improving well-being can be understood as working on the development of the three branches of mental self-government that can be measured as character traits using the Temperament and Character Inventory (TCI) (6,18). These three TCI character traits are called self-directedness (i.e., responsible, purposeful, and resourceful), cooperativeness (i.e., tolerant, helpful, compassionate), and self-transcendence (i.e., intuitive, judicious, spiritual). In essence, high scorers in all these character traits have frequent positive emotions (i.e., happy, joyful, satisfied, optimistic) and infrequent negative emotions (i.e., anxious, sad, angry, pessimistic).
Our findings are illustrated in Figure 1. Using the TCI, we distinguished people who were in the top third of selfdirectedness (S), cooperativeness (C), and self-transcendence (T), from those in the lowest third (s, c, t), or in the middle third on each test (-). About a third of people who were low in self-directedness were depressed. The percentage of those low in self-directedness who were happy was 5% if people were also neither cooperative nor transcendent, and increased to 26% if they were both cooperative and transcendent. Furthermore, if self-directedness or cooperativeness was high, but not both, then people did not differ much in mood from those with average character profiles. If both self-directedness and cooperativeness were elevated, then happiness was much more frequent than sadness (19% versus 1%). Finally, people who were elevated on all three aspects of character had the highest percentage of happiness (26%). In other words, the development of well-being (i.e., presence of happiness and absence of sadness) depends on the combination of all three aspects of self-aware consciousness. The lack of development of any one of the three factors leaves a person vulnerable to the emergence of conflicts that can lead to a downward spiral of thought into a state of depression.
These character traits can be exercised and developed by interventions that encourage a sense of hope and mastery for self-directedness, kindness and forgiveness for cooperativeness, and awareness and meaning greater than oneself for self-transcendence.
Low TCI self-directedness is a strong indicator of vulnerability to major depressive disorders (19). TCI selfdirectedness is a predictor of rapid and stable response to both antidepressants (20,21) and cognitive behavioral therapy (CBT) (22). Encouragement of problem solving leads to increases in autonomy and sense of personal mastery, which facilitate greater hope and well-being in ways that are common in effective psychotherapies, including CBT (23-25) or CBT augmented with modules for awareness of positive emotions (10,14,15), mindfulness (26,27), or spiritual meaning (15,16,23). The addition of modules for cultivating positive emotions, mindfulness, and/or spiritual meaning reduces drop-outs, relapse, and recurrence rates substantially. For example, in the treatment of patients with recurrent depression, additional work on positive emotions lowered relapse and recurrence rates from 80% to 25% over 2 years in recurrent depressives (15). Likewise, mindfulness training reduced the relapses from 78% to 36% at 60 weeks in depressives with three or more episodes (26- 28). Finding of spiritual meaning through self-transcendent values also reduced relapse and improved well-being in randomized controlled trials of patients with depression, schizophrenia, and terminal diseases (16).
Improvements in each of these areas is beneficial, but emotional consistency and resilience depends on the balanced development of all three major dimensions of character (6,7,18). Western concepts of mental health usually emphasize self-directedness and cooperativeness, but neglect the crucial role of spiritual awareness and meaning based on self-transcendent values.
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