Who Defines “Health”? When Mainstream Psychology Meets Indigenous Understandings of Holistic Well-Being
Original Chinese title: 誰定義「健康」？當主流心理學遇見原住民族的整體福祉觀
Defining mental health only through reduced symptoms and restored individual functioning can obscure family, community, land, culture, language, and spirituality. International Indigenous health frameworks offer a broader way to understand human well-being.
王莉如
王莉如 is a counseling psychologist and counseling supervisor whose work focuses on lived experience, relationships, trauma recovery, cultural difference, and the helping professions.
Are Fewer Symptoms the Same as Health?
Modern mental-health services need assessments and measures of outcomes. The degree to which anxiety has eased, whether sleep has improved, and whether someone can return to work or school are all important information. But when these indicators become the only standard, recovery can easily be reduced to “functioning again.” A person may arrive at work on time while still feeling that life has no direction. They may complete an emotional-health questionnaire yet not know how to describe the pain of losing connection with family, land, or ancestors.
This is not an argument that symptoms do not matter. It is an acknowledgment that health may be larger than symptoms alone. Many Indigenous health frameworks understand a person within a network of relationships: body, mind, emotions, spirituality, family, community, language, land, and history are interconnected. If distress arises from ruptured relationships, healing cannot consist solely of asking an individual to adjust in isolation.
The Four Walls of a House
Māori scholar Mason Durie’s Te Whare Tapa Whā model uses a meeting house as a metaphor for health. Its four walls represent physical well-being, mental and emotional well-being, family well-being, and spiritual well-being, while the land forms the foundation. New Zealand’s Ministry of Health explains that damage to any one wall can place an individual or a collective out of balance. Unlike approaches that locate mental health solely in the brain or the individual’s inner life, this model treats questions such as “Do I belong?” and “How am I connected with the past and the future?” as part of health itself.
Canada’s First Nations Mental Wellness Continuum Framework likewise places culture at the foundation and identifies four core outcomes: hope, belonging, meaning, and purpose. Psychological well-being is supported not only by professional treatment, but also by language, Elders, family, land, ceremony, and community capacity. These are not decorative additions outside therapy. They may be fundamental to a person’s desire to continue living and to their belief that they have a place in the world.
What Assessment Scales Cannot See
Standardized scales are useful for comparison and tracking, but they are generally developed within particular linguistic and cultural contexts. Some questions assume personal independence, direct expression, and the active pursuit of self-actualization. In a context that values interdependence, responsibility, and collective harmony, the same answer may mean something different. For example, “I often consider my family’s needs first” might be interpreted as a lack of boundaries, or it might reflect a deliberate relational ethic. The task is not to label the choice positive or negative, but to understand whether it is freely made, whether it causes distress, and whether it accords with the person’s values.
An assessment scale should therefore not determine the direction of treatment on its own. Counselors can also ask relational and cultural questions: Who has helped you feel that you belong recently? Has your connection with land, language, or faith changed? What kind of life would count as “getting better”? Questions like these allow the person seeking counseling to help define the goals by which progress will be understood.
A Holistic View Does Not Mean Rejecting Professional Treatment
Discussing culture, land, and spirituality does not mean rejecting psychotherapy, medication, or crisis intervention. Holistic care is about enabling different forms of support to work together, not asking one to replace another. A person may need psychiatric care, trauma therapy, family support, cultural activities, financial assistance, and safe housing at the same time. A professional’s responsibility is to identify risk, provide effective interventions, and respect the healing resources that the person considers important.
Nor should a helping professional independently arrange a ceremony, invite an Elder, or insist that someone “return to culture.” Any use of cultural resources requires the person’s consent and respect for authority and differences within the community. Cultural safety does not mean inserting traditional elements into a treatment plan. It means giving the person substantive power to define health and decide which support networks belong in their care.
From Restoring Function to Restoring a Place in Life
Perhaps the deepest question in counseling is not “How can we return you to normal?” but “What kind of life do you want to return to, and with whom—or with what—do you hope to reconnect?” When health is understood as a house supported by the body, mind, relationships, culture, and land, counseling is not simply a matter of repairing one wall. It is a process of accompanying a person as they find a place in life where they can once again feel grounded.
References
- New Zealand Ministry of Health, Te Whare Tapa Whā model of Māori health
- Health Canada and Assembly of First Nations, First Nations Mental Wellness Continuum Framework
- World Health Organization, World Mental Health Report: Transforming Mental Health for All
Sources retained from the Chinese original
AI use and content-safety disclosure
Yuan Media AI assisted in organizing international public information and counseling-psychology perspectives for the Life Creation Lab column. This article provides general educational information and does not replace individual psychological counseling, psychotherapy, psychiatric care, or crisis intervention.