but you might have thought about your spirituality or you as a spiritual person. Spirituality is a broad term with room for many perspectives. Fundamentally, though, spirituality focuses on the deeper aspects of ourselves as persons (our personhood!) and what it means to be alive, happy and connected with the world.
Human flourishing as happiness
The term ‘human flourishing’ has existed for thousands of years. Originally coined as eudaimonia (meaning human flourishing or happiness) by the philosopher Aristotle, the term has existed as a way of expressing all that we know to be human and to live out our personhood. Eudaimonia is an active term meaning we as human beings actively work in pursuit of happiness. Such happiness includes our subjective experiences in pursuit of ends (outcomes or achievements) that are worthy of choosing for human beings.
Eudaimonia is a unifying principle, suggesting that to be happy we have to actively pay attention to such virtues as belonging, harmony, social justice, fairness and equality. Being happy in the world (or to flourish) is not about the pursuit of pleasure, hedonia (think about hedonism!), but is the pursuit of a state of well‐being by ‘concurrently doing what I want to do while at the same time doing what I ought to do’. What Aristotle suggests here is a moral perspective on our being as agents in the world and which should resonate with us as healthcare workers – we are effective as a person when the actions we actually take are the same as those we ought to be taking as a moral agent. To do this requires an understanding of what is required of us as persons (the evidence that informs our practice) whilst at the same time being in a position to want to do the right thing, to enjoy doing it and sometimes to be uplifted by doing it.
So, to flourish means living out the virtues. Virtues are a subset of our character as persons. They are not innate qualities, like eyesight or hearing, but instead are characteristics we acquire and develop through our upbringing, experiences, education, etc. We build them over time and the more we actively work on them, the more attuned we become to how they work for us. The contrary also applies, of course, in that if we don't use them, we lose them and can slide into immoral attitudes and behaviours. If we consider some of the characteristics of persons discussed in Chapter 1, then the possession of virtues could also be seen as a defining characteristic of persons and one that distinguishes us from non‐persons. This is because behaving through the lens of the virtues requires us to have ‘reason’. That is, we have to reflect on our moral actions and make decisions about our behaviours, practices and actions and if they are morally virtuous or not. Such reflection guides our decisions and ultimately our life as moral agents, i.e. our flourishing. Aristotle identified four primary moral virtues – prudence, justice, temperance and fortitude – but over many years of critique and ongoing development of virtues as a framework for moral action (see for example MacIntyre 1992), the range of possible virtues to include in a virtues‐based moral framework has become much more diverse and inclusive.
Human flourishing as psychological wellness
Since the work of Aristotle, human flourishing has grown and developed as a way of capturing our humanness and indeed is the foundation of a branch of psychology called ‘positive psychology’. Positive psychologists argue that human flourishing in this context moves beyond the confines of ‘happiness’ (although this argument is flawed if we view happiness as eudaimonia!) and embraces a wide range of psychological constructs that offer insights into what it means to be happy and to feel well. The origins of such thinking arise from the work of Martin Seligman (2011) who postulated that flourishing arises when we pay attention to and deliberately set out to build and maintain the five components of the PERMA model, designed by him. The five components of the model are:
Positive emotions
Engagement
Relationships
Meaning
Accomplishments.
If we use the PERMA model as a framework for thinking about and reflecting on human flourishing and what that means for us, then we need to consider the following questions.
1 Overall, are our emotions more positive than negative?
2 How engaged are we with the parts of our life that are important to us, such as work or hobbies?
3 Do we have sufficient deep and meaningful relationships to sustain us in our lives?
4 Have we got a sense of purpose in our life, through which we create meaning?
5 Do we apply our talents, gifts and qualities as persons to achieving our goals and then celebrating these achievements (no matter how small)?
PERMA is a useful model for understanding human flourishing and for reflecting on ‘where we are at’ as spiritual beings. However, living a positive life (just the same as being person‐centred as we argued in Chapter 2) is not completely dependent on our own ways of being, actions, relationships and behaviours. The context in which we live our life also plays a key role. So, the success of flourishing is context dependent.
In their paper on engagement in the context of person‐centred practice, Dewing and McCormack (2015) argued that for staff to be fully engaged (or to flourish), the conditions necessary for engagement to happen need to be in place. Conditions such as a culture that nurtures positive relationships, consistency between individual goals, desire for achievement and organisational goals, management and leadership styles that invest in people as persons and strategies for learning and development that nurture individual vitality and energy are essential. So, no matter how actively driven we might be towards our own flourishing, it is clear that the cultures in which we work and live have a significant impact on our ability to do so. It is also important not to lose sight of the PERMA attributes plus the essentials of Optimism, Physical Activity, Nutrition, and Sleep. This is now referred to as PERMA+. You might like to see this well‐being resource for more details on how PERMA + has been used to shape public health policy for well‐being (www.wellbeingandresilience.com/sites/swrc5/media/pdf/permaandcentreoverview.pdf).
Conditions for human flourishing
In recognition that human flourishing is something experienced by persons in context, McCormack and Titchen (2014) developed a set of suggested conditions for human flourishing. These conditions are based on an evolving understanding of human flourishing over 10 years of transformational critical and creative development, research and inquiry. McCormack and Titchen set out this process of evolution of their understanding of human flourishing as something that is intrinsic to persons but is also facilitated through meaningful creative connections with others.
Human flourishing is experienced when people achieve beneficial, positive growth that pushes their boundaries in a range of directions, for example, emotional, social, artistic, metaphysical. And it could be experienced in diverse ways, such as deep fulfilment, radiance, being our real selves and through deep connection with nature, beauty and people. McCormack and Titchen suggest that human flourishing occurs when we move with flow from a point of inner knowing to taking right action effortlessly (Titchen and McCormack 2010). People are helped to flourish (i.e. grow, develop, thrive) during experiences of growth and development that have a focus on well‐being for all. Flourishing is supported through contemporary strategies for learning and development, connecting with beauty and nature and blending with ancient, indigenous and spiritual traditions (Titchen et al. 2011, p. 2). As a result of this evolved creative understanding of human flourishing, McCormack and Titchen (Titchen et al. 2011, p. 19) define human flourishing as:
Human flourishing occurs when we bound and frame naturally co‐existing energies, when we embrace the known and yet to be known, when we embody contrasts and when we achieve stillness and harmony. When we flourish we give and receive loving kindness.