What does good mental health look like?

Most of us know what poor mental health is, but what about somebody who is mentally healthy? 

We take that for granted, but Nancy McWilliams doesn’t, here are the ten threads that when woven together give you a tapestry of good mental health:

• Safety and attachment security

We all need somewhere safe to land. A place where another person’s presence brings comfort rather than fear, tension, or unpredictability. Part of therapy is helping people move from insecure patterns of attachment towards something steadier and more secure.

• Self-continuity

Some people feel cut off from themselves across time. They talk about their childhood as though it happened to someone else, or imagine the future as a blank space. Mental health involves a sense of inner continuity – being able to feel like the same person across past, present, and future, and to hold both strengths and flaws in mind without falling into shame or grandiosity.

• Sense of agency

When agency is weak, life feels like something that just happens to you. A healthier mind carries the sense that your choices matter, that you can act, respond, and shape your course even when life is difficult.

• Realistic and reliable self-esteem

Some people live under the tyranny of perfectionism, where anything less than flawless feels like failure. Others protect themselves with inflated self-importance and a constant need for admiration. Healthier self-esteem sits somewhere in the middle: stable enough to survive criticism, honest enough not to depend on fantasy or flattery.

• Resilience and affect regulation

Life brings frustration, grief, disappointment, and stress. Good mental health doesn’t mean never feeling these things. It means being able to bear them without becoming overwhelmed or emotionally shut down. Humour, self-reflection, sublimation, perspective-taking – these are all signs of psychological resilience.

• Reflective function and mentalization

A healthy mind can look at itself. It can ask, “Why did that affect me so strongly?” without spiralling into self-hatred. It can also recognise that other people have minds of their own – their own feelings, motives, fears, and blind spots. This capacity to reflect on both self and other is central to emotional maturity.

• Self-advocacy and community sacrifice 

Modern culture often pushes people toward individualism, while other cultures can lean too heavily on duty and self-sacrifice. Mental health is not about choosing one over the other. It is about being able to do both: to stand up for yourself when needed, and to give something up for others when the situation calls for it.

• Vitality

Some people are not obviously depressed, yet they seem cut off from aliveness. Their energy is flat. Their spark has gone dim. There is little spontaneity, pleasure, or enthusiasm. Therapy often involves helping a person recover that sense of vitality – not just functioning, but feeling genuinely alive.

• Acceptance

Not everything can be changed. Therapy helps patients grieve what was, forgive what couldn’t be, and find gratitude for what is. Acceptance makes life’s fleeting moments precious.

• Love, work, and play

Freud’s old formula still has something to it. A healthy life includes the capacity to love, to work, and to play. Love means genuine care for another person’s wellbeing, not just idealisation or need. Work means meaningful effort, not merely earning money. Play means spontaneity, pleasure, creativity, and the ability to be absorbed in life.

Good therapy seeks psychological change, not just symptom relief. Its about helping somebody build a life that feels more connected and whole.

This is a very brief look at what McWilliams would describe as good mental health as she discusses on YouTube (https://www.youtube.com/watch?v=Tv6yNJcZhl0), I will go into each of these in more detail in future posts.