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Year : 2013  |  Volume : 11  |  Issue : 1  |  Page : 16-24
What makes people healthy, happy, and fulfilled in the face of current world challenges?

MD, PhD. Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA

Date of Submission29-Nov-2012
Date of Decision09-Dec-2012
Date of Acceptance10-Dec-2012
Date of Web Publication21-Mar-2013

Correspondence Address:
C Robert Cloninger
Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 6311
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1229.109288

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Recent research on the relations of personality to well-being shows that the people who are most healthy, happy and fulfilled are those who are high in all three of the character traits of self-directedness, cooperativeness, and self-transcendence as measured by the Temperament and Character Inventory. In the past, the healthy personality has often been considered to require only high self-directedness and high cooperativeness. However, now the self-centred behaviour of people who are low in self-transcendence is degrading the conditions needed for sustainable life by all human beings. Consequently, human beings need to and can develop their capacity for self-transcendence in order to maintain their individual and collective well-being.

Keywords: Character; Cooperativeness; Ecological shift; Health promotion; Human evolution; Self-directedness; Self-transcendence; Well-being

Peer reviewer for this paper: Anon

   Introduction Top

Research in the science of well-being has recently suggested a need to revise outdated traditional concepts of a healthy personality by recognising the character features that facilitate adaptation to current challenges to the survival of humanity (Cloninger and Zohar, 2011 [7] ; Cloninger and Kedia, 2011 [4] ). As I described in a previous work, Mens Sana Monograph, it is an unfortunate fact that war, greed, and divisive propaganda dominate the world stage at present despite the remarkable human capacities for compassion, generosity, and self-awareness (Cloninger, 2008 [10] ). As long as human beings were able to treat the world as an unlimited resource to be consumed indiscriminately, it was sufficient to regard people who were self-directed and cooperative as healthy even if they were also low in self-transcendence (Cloninger and Kedia, 2011 [4] ). For example, Freud suggested that healthy people were those who were capable of working and loving; he regarded spirituality as immature wishful thinking (Freud, 1927 [14] ). This concept of a well-organised character with low self-transcendence is still the favoured social norm in many Western cultures (Josefsson et al., 2012 [17] ). The organised character has even been proposed as a description of healthy personality in DSM-5 (Cloninger, 2010 [11] ).

However, since 1986 human utilisation of resources has exceeded the capacity of the planet to replenish itself (Wackernagel et al., 2002 [20] ). Consequently, the characteristics of healthy people must be revised to recognise the need for people to live sustainably in appreciation of the needs of humanity as a whole and the capacity of the world environment to support those needs. The changing world conditions reveal the crucial advantages that the creative character structure with high self-transcendence has over the organised character with low self-transcendence.

First, I will review data about the well-being of different character configurations from recent research on the science of well-being based on well-validated procedures for quantifying character profiles with standardised scores using the Temperament and Character Inventory (TCI) (Cloninger, 2010 [11] ; Cloninger et al., 1993 [5] ). This indicates that the organised and creative characters are the healthiest and were probably about equal in fitness as long as the capacity of the planet to replenish itself exceeded human demands on its resources.

Second, I will review data about the current devastation and depletion of the planet Earth under the current leadership of the world by people with organised characters who are generally low in self-transcendence.

Third, I will discuss the flaws in organised and immature characters that lead to denial or fear of recognising the imperative need for changing current ways of life in order to be prepared for adaptation to the uncertain future conditions of life on Earth.

Fourth, I will outline how the self-transcendence of creative characters facilitates flexible and resilient adaptation in harmony with other people and nature. This suggests that spiritual development of greater self-transcendence is the key to the future of human survival as a species, not continued prolific reproduction, wasteful consumption, military power, or technological innovation. The survival of human beings depends on spiritual evolution of greater plasticity, virtue, and far-sighted functioning. The conditions needed for such spiritual evolution and development are described elsewhere using evidence-based methods of health promotion and therapeutics that integrate available ways to facilitate the development of human plasticity, functioning, and virtue (Cloninger, 2006 [12] ; Cloninger et al., 2010 [6] ; Cloninger and Cloninger, 2011 [3] ).

Relations of well-being to character profiles

Physical, mental, and social well-being all depend strongly on profiles of the character traits of self-directedness, cooperativeness (C), and self-transcendence (T) as measured by the Temperament and Character Inventory (Cloninger, 2004 [9] ; Cloninger et al., 2010 [6] ; Cloninger and Zohar, 2011 [7] ; Josefsson et al., 2011 [16] ). The clinical characteristics and dynamics of the course of development of all possible configurations of these personality traits has been described in detail elsewhere (Cloninger, 2004 [9] ; Josefsson et al., 2012 [17] ). Here only the most and least healthy configurations will be considered because of their crucial importance in defining what constitutes a healthy personality under current world conditions. When high and low extremes of these three character traits are considered, the healthiest people are high in both self-directedness and cooperativeness consistently and the least healthy and most immature are those who are low in both these traits (Cloninger et al., 1993 [5] ). Among these relatively healthy people, two profile types can be distinguished:

  • The "organised" characters, that is, those who are high in self-directedness (S), high in cooperativeness (C), and low in self-transcendence (T); and
  • The "creative" characters, that is, those who are high in self-directedness (S), cooperativeness (C), and self-transcendence (T).
The "creative" characters are usually happier than the "organised" characters, but the two types have similar physical and social health in contemporary Western societies (Cloninger and Zohar, 2011 [7] ; Josefsson et al., 2011 [16] ).

The "organised" character structure is typical of leaders and other successful people in Western society. People with organised characters are highly self-confident, resourceful, purposeful, and responsible (i.e., high in self-directedness). In addition, they are highly tolerant, helpful, and forgiving (i.e., high in cooperativeness). Finally, they are low in self-transcendence so they are primarily concerned with their own interests and of those whom they regard as friends or associates with common goals and interests. They are often rather conventional, materialistic, and practical rather than being meditative, intuitive, or spiritual. As a result, the organised character is a strong-willed practical and goal-oriented leader driven by achieving personal goals. Paradoxically, the strong-willed "organisation man" is often a social conformist who manages his or her reputation studiously because underneath the confidence is an outlook of separateness that leaves him or her concerned about noncompliance with local social norms. Consequently, organised characters are resistant to radical change or revolutionary shifts in their outlook on life, preferring to maintain dogmatic beliefs and the status quo rather than to question the validity of assumptions they have relied upon with success in the past, thereby justifying their description as "organised" (Cloninger, 2004 [9] ).

In contrast, "creative" characters are typical of the positive philosophers and leaders of civilisation during times of the Renaissance and the Enlightenment (Cloninger, 2004 [9] ). People with a creative character have the same capacity for resourceful productivity and helpful cooperation as those with organised characters, but are also more intuitive and meditative, and they identify with nature, humanity, and perhaps the divine or the universe as a spiritual whole. The creative character is driven by interest in coherence and is guided by their intuition to express their potential through self-realisation in harmony with others and nature. They are not eccentric for its own sake because they are developing toward harmony and integration. They are more tolerant of ambiguity and uncertainty than organised characters and more receptive to radical change in outlook when there is a realistic and innovative basis for doing so, thereby justifying their description as "creative" (Cloninger, 2004 [9] ).

Self-transcendence is a necessary, but not a sufficient, character trait for well-being. It is noteworthy that people are often unhealthy, unhappy, and unrealistic when they report being high in self-transcendence but are low in self-directedness [Cloninger et al., 2010 [6] ; Cloninger and Zohar, 2011 [7] . Such individuals have schizotypal characteristics with frequent magical thinking rather than the mature spirituality characteristic of creative characters. Hence, it is the combination of strong development of all three character traits that typifies people who are healthy, happy, and fulfilled (Cloninger, 2004 [9] ).

The importance of all three character traits is further evidenced by the findings of "third-wave psychotherapies" that have sought to address the limitations of earlier "behavioural" and "cognitive-behavioural" approaches (Cloninger, 2004 [9] ; Cloninger, 2006 [12] ; Cloninger et al., 2010 [6] ). Cognitive-behavioural therapies are effective in promoting self-directedness and cooperativeness, but do not address self-transcendence. In contrast, third-wave psychotherapies, such as Mindfulness-Based Cognitive-Behavioural Therapy, Dialectical Behaviour Therapy, and Acceptance and Commitment Therapy, reduce drop-outs and improve physical, mental, and social health outcomes by adding mindfulness and related spiritual practices that also promote self-transcendence (Cloninger, 2004 [9] ; Cloninger, 2006 [12] ; Cloninger et al., 2010 [6] ).

World devastation by unsustainable consumption

Sustainable living requires that people consume no more resources than the Earth can replenish annually. Unfortunately, since about 1986, people have consumed more than the Earth is able to restore, leading to depletion of irreplaceable resources and degradation of local ecosystems around the world (Wackernagel et al., 2002 [20] ). The industrialisation and excessive consumption patterns are leading to many interdependent problems, including global warming, acidification of oceans, widespread food and water shortages, depletion of common elements (zinc, copper, nickel, and phosphorus), and global economic stagnation (Ahmed, 2010 [1] ). Only 10% of the land surface of the Earth is arable and its capacity is being exceeded by population growth from 2.5 billion in 1944 to 7 billion today and by degradation of soil from chemically based monoculture farming by agribusiness that neglects principles of soil biology. The rising atmospheric level of carbon dioxide from industrial activity is an unsustainable threat to all life including our own: We are in the midst of the sixth great mass extinction event on the Earth with one-third of all known species of plants and animals already threatened and half of all species expected to become extinct within one lifetime (Cloninger, 2009 [8] ; Barnosky et al., 2012 [2] ). The degradation of local ecosystems is expected to encompass 50% of the planet by 2025, thereby approaching an irreversible tipping point at which the global ecology of our planet may shift radically to conditions that human beings have never had to adapt to at any time in the past (Barnosky et al., 2012 [2] ).

Not all countries are equally responsible for the unsustainable destruction of the human habitat. If everyone lived like the average resident of the United States of America, we would need more than four planets like Earth to support human demands. We would need more than two planets like Earth to support the consumption of residents in Europe or Russia. In contrast, one planet can currently support the demands of two countries with consumption patterns like that of the average resident of India. Nevertheless, the devastation of the planet by greedy cultures will have catastrophic effects on the whole Earth, creating severe challenges for human survival as the effects of global warming and depletion of soil, water, and minerals activate a vicious cycle of feedback systems (Lynas, 2008 [18 ).

Why are most people in a state of fear or denial?

In the past five great mass extinctions, the dominant animal species became extinct. However, human beings have evolved the capacity for self-awareness, which enables us to have foresight about the long-term consequences of what we are doing (Sussman and Cloninger, 2011 [19] ). In the words of Sir Julian Huxley, human beings are "evolution conscious of itself" (Huxley, 1959 [15] ).

Unfortunately, we are not using our capacity for self-awareness well. Despite frequent past warnings by scientists and an occasional politician like Al Gore, it is commonplace for people to deny the danger of human extinction posed by our excessive consumption or to react with unreasoning fears like survivalists preparing for an imminent doomsday by fortification and saving several months of food and water. Most political leaders pander to people's fears and appeal to their immediate self-interest, rather than acting with responsibility and foresight for the well-being of humanity as a whole. Speculative promises are made that future technological innovations will magically solve all our problems without requiring any serious changes in lifestyle.

Why do intelligent people revert to a state of fear or denial? I suggest that the main reason can be found in the weakness of individuals with organised character profiles, which is the socially favoured profile in secular Western cultures (Josefsson et al., 2012 [17] ). People are born with a natural need for virtues like fairness and equality that is expressed as self-aware consciousness develops (Fehr et al., 2008 [13] ). However, in Western cultures social norm-favouring leads to increases in self-directedness and cooperativeness along with decreases in self-transcendence between the ages of 20 and 45 years; self-transcendence only rises again later as people face ultimate situations like their own mortality (Josefsson et al., 2012 [17] ). Unfortunately, organised characters are not self-transcendent: They are largely motivated by their self-interests and the interests they share with those close to them. As a result, they strive to maintain their own power and wealth regardless of the consequences for others who are remote. They want to believe that their efforts can allow them to maintain the conditions that have brought them success, so they are also easily manipulated by disinformation from others in positions of power and influence.

As a result, we elect leaders with organised characters who frequently serve the special interests of the wealthy and powerful rather than attending to the well-being of the electing general population or the world as a whole. The wealthy and powerful want to maintain their wealth and power, so we continue to rush toward extinction in a state of denial, relying on disinformation that is designed to manipulate and/or appease our fears. The lack of leadership by people with creative characters is putting the whole human species at risk to satisfy the blind greed of a small minority.

The need for self-transcendent living

Fortunately, it is not necessary for people to live in either fear or denial. Human beings are the most adaptable species on the Earth and we have a strong drive for well-being (Cloninger, 2009 [8] ; Cloninger and Kedia, 2011 [4] ). Well-being depends on functioning with foresight, plasticity, and virtue (Cloninger and Cloninger, 2011 [3] ). In other words, human well-being requires that we be self-transcendent in our values as well as self-directed and cooperative. People with creative characters function as conscious beings in harmony with nature and other people, not as a separate force that tries to control nature, and people, for self-interest.

The development of self-transcendence has a radical transformative impact on self-directedness and cooperativeness (Cloninger, 2004 [9] ). The purposeful striving of self-directedness is transformed into hope and letting go of fighting and worry. The tolerant empathy of cooperativeness is transformed into love and working in the service of others. Essentially, an outlook of unity (i.e., awareness that one is an inseparable component of a universal unity of being) allows a person to function realistically with plasticity and virtue, thereby living in sustainable harmony with nature and other people. Perhaps this is the reason that leadership during periods of the Renaissance and the Enlightenment have been characterised by the creative character rather than the organised characters that have led us into the current crises of civilisation. Human life is not really sustainable without self-transcendent virtues that have regrettably been relativised and/or neglected in postmodern times.

   Conclusions Top
[See also [Figure 1]: Flowchart of Paper]
Figure 1: Flowchart of paper

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At the present point of human evolution, a healthy person needs to be self-transcendent as well as self-directed and cooperative. The human species is now being endangered by the self-centred behaviour of people who are low in self-transcendence. This suggests that the future well-being of humanity depends on a spiritual evolution that will further develop the extent to which we are self-aware of our participation in a universal unity of being. Syntactic language, art, science, and spirituality are all expressions of our capacity for self-aware consciousness. However, our self-awareness must now be expanded and deepened for us to face the challenges of our current world situation with foresight, plasticity, and virtue.

Take home message

For our well-being and that of humanity as a whole, we need to and can cultivate our capacity for self-transcendence by a variety of methods for promoting well-being (Cloninger, 2006 [12] ). These include mindfulness and contemplative exercises that broaden our perspective to an outlook of unity (Cloninger et al., 2010 [6] ; Cloninger and Cloninger, 2011 [3] ). Instead of the usual outlook of separateness that leads to fear, excessive desire, and false pride, we can approach life with a self-transcendent outlook of unity that leads to love, hope, and humility functioning to serve others, not only ourselves. In this way, we can become both self-sufficient producers and moderate consumers. In other words, we can live sustainably with respect for our necessary harmony with nature and with the generosity needed to help others in a mutually beneficial way. Individual well-being is always a transient illusion when it is not coupled with collective well-being.

Conflict of interests

Dr. Cloninger is Director of the Anthropedia Institute, the research component of a nonprofit foundation dedicated to the promotion of well-being. He is not paid for this service.


This article is an original unpublished work and has not been submitted for publication elsewhere.

   References Top

1.Ahmed NM. A user's guide to the crisis of civilization and how to save it. New York: Pluto Press; 2010.  Back to cited text no. 1
2.Barnosky AD, Matzke N, Tomiya S, Wogan GO, Swartz B, Quental TB, et al. Has the earth's sixth mass extinction already arrived? Nature 2012;471:51-7.  Back to cited text no. 2
3.Cloninger CR, Cloninger KM. Person-centered therapeutics. Int J Pers Cent Med 2011;1:43-52.  Back to cited text no. 3
4.Cloninger CR, Kedia S. The phylogenesis of human personality: Identifying the precursors of cooperation, altruism, and well-being. In: The origins of cooperation and altruism Sussman RW, Cloninger CR, editors. New York: Springer; 2011. p. 63-110.  Back to cited text no. 4
5.Cloninger CR, Svrakic DM, Przybeck TR. A psychobiological model of temperament and character. Arch Gen Psychiatry 1993;50:975-90.  Back to cited text no. 5
6.Cloninger CR, Zohar AH, Cloninger KM. Promotion of well-being in person-centered mental health care. Focus 2010;8:165-79.  Back to cited text no. 6
7.Cloninger CR, Zohar AH. Personality and the perception of health and happiness. J Affect Disord 2011;128:24-32.  Back to cited text no. 7
8.Cloninger CR. Evolution of human brain functions: The functional structure of human consciousness. Aust N Z J Psychiatry 2009;43:994-1006.  Back to cited text no. 8
9.Cloninger CR. Feeling good: The science of well-being. New York: Oxford University Press; 2004.  Back to cited text no. 9
10.Cloninger CR. On well-being: Current research trends and future directions. Mens Sana Monogr 2008;6:3-9.  Back to cited text no. 10
[PUBMED]  Medknow Journal  
11.Cloninger CR. Personality and temperament: New and alternative perspectives. Focus 2010;8:161-3.  Back to cited text no. 11
12.Cloninger CR. The science of well-being: An integrated approach to mental health and its disorders. World Psychiatry 2006;5:71-6.  Back to cited text no. 12
13.Fehr E, Bernhard H, Rockenbach B. Egalitarianism in young children. Nature 2008;454:1079-83.  Back to cited text no. 13
14.Freud S. The future of an illusion. In: The standard edition of the complete psychological works of Sigmund Freud, Strachey J, editors. London: Hogarth Press; 1927. p. 1-56.  Back to cited text no. 14
15.Huxley J. Foreword. In: The phenomenon of man Chardin ptd. New York: Harper and Row; 1959. p. 11-28.  Back to cited text no. 15
16.Josefsson K, Cloninger CR, Hintsanen M, Jokela M, Pulkki-Raback L, Keltikangas-Jarvinen L. Associations of personality profiles with various aspects of well-being: A population-based study. J Affect Disord 2011;133:265-73.  Back to cited text no. 16
17.Josefsson K, Jokela M, Cloninger CR, Hintsanen M, Salo J, Hintsa T, et al. Maturity and change in personality: Developmental trends of temperament and character in adulthood. Dev Psychopathol 2012. In press.  Back to cited text no. 17
18.Lynas M. Six degrees: Our future on a hotter planet. Washington, DC: National Geographic; 2008.  Back to cited text no. 18
19.Sussman RW, Cloninger CR, editors. Origins of cooperation and altruism, 1st ed. New York: Springer; 2011.  Back to cited text no. 19
20.Wackernagel M, Schulz NB, Deumling D, Linares AC, Jenkins M, Kapos V. Tracking the ecological overshoot of the human economy. Proc Natl Acad Sci USA 2002;99:9266-71.  Back to cited text no. 20

   Authors Top

C. Robert Cloninger is Wallace Renard Professor of Psychiatry, Professor of Genetics and Psychology, and Director of the Sansone Family Center for Well-being at Washington University in St. Louis. He is a world leader in studies of the relationship of genes and environment to mental health and illness. He has developed a popular theory of the psychobiology and evolution of human brain functions, personality, and well-being. He is on the Honorary International Editorial Board of MSM.


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