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Working With a Fixed Standard to Improve Client Mental Health

By Frank Hannah, LMHC (Ret.)
Palm Beach Gardens, Fla.

Here’s what bothered me during my years in clinical practice: I was seeing clients with diagnosable “mental and nervous disorders,” but I sensed that those were not the real issues. 

For instance, I spent many clinical hours working with clients on how to deal with anxiety and even more with those experiencing alcohol- and drug-related problems, but even when they reduced their anxiety or learned to stay clean and sober, they were not automatically mentally healthy. It became apparent to me that mental health is far more than simply the absence of a mental illness or disorder.

However, what was not clear was how to define mental health in straightforward and practical terms. It was easy enough to describe some of the qualities and characteristics that a mentally healthy person would exhibit, but that didn’t answer the question as to what mental health actually is, how to achieve it, or what obstacles might impede progress in moving towards optimizing it.

What was required, I reasoned, was a fixed standard by which clients could measure or evaluate their own mental health. After all, we love to measure stuff—from the length of a meter (the distance the vibration of a cesium atom travels in one second) to a golfer’s performance (par for the course). But what could be a fixed standard for mental health? I recalled a passage from a 1962 book called, “An Introduction to Existentialism,” by Robert G. Olson, that I had read in the late ’60s. Olson suggested that, “… freedom of choice, individual dignity, personal love, and creative effort are the existential values …”

Here was the key! How consistent one’s thoughts, feelings, and behaviors are with these qualities could be considered a standard for evaluating mental health. If Olson is correct, then it follows that these qualities are relevant for all humans, they are present from birth, and it is within our nature to move towards them.

Slightly rephrased, human dignity, freedom of choice, sense of accomplishment, and love collectively became four inbornintentions. I coined this term in a pamphlet published in 1980 titled, “The ABCs of Self-Understanding” based on Olson’s existential values. Little did I dream at the time that they could also be used as a standard for evaluating mental health. I see moving towards inbornintentions as mentally healthy, while moving away from them shows compromised mental health … but not mental illness.

Of course, my clients strayed from inbornintentions more often than not. Why, I wondered? This brought into focus the whole question of why they thought, felt, and behaved as they did. It was tempting to answer this by saying that they cognitively chose their course of action, but this only begs the question. Why do clients make choices that are harmful to themselves, their families, society, and the environment when they are clearly contrary to their own nature? 

It must be that their subconscious basic beliefs—concepts learned through their lifetime—determine what they think, feel, and do. Therefore, I concluded that to the extent that one’s basic beliefs are consistent with inbornintentions, mental health is as it should be, but when they conflict, there is room for improvement.

So now I had a working definition of mental health, and, by helping clients change their basic beliefs to be consistent with inbornintentions, a way for them to optimize their mental health. However, all was still not sunshine and dew on the roses. Understanding inbornintentions and changing basic beliefs both require thinking, reason, and logic, abilities easily compromised by anxiety. Consequently, before attempting to assist clients in improving their mental health, I found it necessary to help them learn to reduce unavoidable anxiety in healthy ways. This set the stage for learning to prevent unnecessary anxiety by changing basic beliefs, thereby improving clients’ mental health.

While I am retired from active clinical practice, I wish I had been aware of the interactive role that inbornintentions, basic beliefs, and anxiety play in determining one’s mental health when I first put out my shingle. Those new to the profession, and even those with years of experience, might consider this orientation as they provide services to those who place trust in them.

Frank Hannah, LMHC (Ret.), is a past president of the Florida Mental Health Counselors Association and a former chair of AMHCA’s Public Awareness, Advocacy and Marketing Committee. His website is <>. He lives in Palm Beach Gardens, Florida, with two cats.