More than being medicated: The Hierarchy of Need

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By Grant J Everett

Maslow’s Hierarchy of Needs was a tool created by psychologist Abraham Maslow in 1943. His theory was first published as a paper called “A Theory of Human Motivation” in Psychological Review magazine, and the Hierarchy has remained a popular framework in sociology, management training and psychology instruction to this day. It has undergone many versions and revisions over the years.

The Hierarchy is expressed as a pyramid with our most fundamental needs at the bottom and our most advanced needs at the top. The key idea to keep in mind is that it’s difficult to attain a level without being able to “support” it with all the previous levels. The first four layers of the pyramid are, in order: physical needs, safety and security, love and belonging, esteem and self-actualisation. For instance, if you don’t have your physical needs and safety needs met, this will affect your relationships and self-esteem.

You may have heard people use the word “holistic” when they talk about modern definitions of mental health recovery. Holistic basically means addressing ALL the needs of a person, rather than relying on brain pills to fix everything. While we know that medication can be an effective part of a recovery journey, it’s not a magic solution on its own. Instead of attempting to medicate away our symptoms and calling it a day, holistic treatments address all of the things that humans need to be happy and fulfilled: a social life, intimate relationships (sexual or otherwise), living somewhere safe and appropriate, doing fun and worthwhile things, playing a non-tokenistic role in our own recovery, and having a choice when it comes to therapy and medications are all part-and-parcel of holistic recovery.

While we now know that recovery is possible – a concept very few people believed just a handful of decades ago – sadly, the process of professional treatment can deprive us of many essential components of our lives. For example, spending time in a mental health unit will greatly reduce our ability to choose how we structure our day, our freedom to come and go as we want, who we can see and when, and it will often play havoc with our self-esteem. Merely being diagnosed with a mental health issue can change the way we see ourselves, making us feel powerless, broken, negative, and without hope, but there is always hope.

The Australian mental health system is still very much a medical model system. While medical model experts may be open to modern treatments, some old style elements of treatment that come as standard. There are a lot of components to recovery, and believing that you’re nothing more than a diagnosis is unhelpful at best.

LEVEL ONE: PHYSICAL NEEDS are the bedrock of human survival. If these are not met, your body will fail. Things like breath, warmth, sleep, food and fluids are non-negotiable.

LEVEL TWO: SAFETY AND SECURITY are your next concern once your physical needs are satisfied. This goes beyond clothing and shelter to include financial security, health and mental well-being, protection from abuse and harm, and having our rights respected.

LEVEL THREE: LOVE AND BELONGING comes next. Being neglected or ostracised by our peers can adversely affect our ability to form and maintain emotionally significant relationships. This can make us susceptible to loneliness, social anxiety, and clinical depression. The need to belong can be so strong, in fact, that if we are alone it can feel more essential than our physical and security needs (and not in a healthy way). Having people we can talk to, feeling part of the community, feeling loved by others, and physical intimacy can make the difference between misery and contentment.

LEVEL FOUR: ESTEEM includes our status in society, the recognition we get from others, and the respect we have for ourselves. All humans need to feel accepted and valued, and being deprived of these things can be crippling in our careers, relationships and general self-worth. Low self-esteem can fill us with the need to seek respect from others, but it’s healthier to learn how to accept ourselves for who we are, gain an understanding of our strengths and weaknesses, and not put unrealistic expectations on ourselves. Feeling as though you are contributing to society is great for your self-esteem, too.

LEVEL FIVE: SELF-ACTUALISATION is the desire and drive to accomplish everything that you want. Maslow believed that the only way we could reach this level was to not only achieve all the previous needs, but to master them. Self-actualisation means having our own thoughts, opinions, values and beliefs, learning through study or life experience, making our own decisions, feeling fulfilled by our lives, and contributing to the wellbeing of other people.

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