Mental Health as Above Normal Functioning: Model A Explained

Most of us think about mental health in terms of what’s missing – anxiety, depression, burnout. We ask, “Am I okay?” rather than, “How well am I actually functioning?” But one influential model in psychology flips this question entirely. Instead of treating the absence of illness as the goal, Model A – Mental Health as Above Normal proposes that true mental health means functioning at a level that is superior to the average. It sets the bar not at “not sick,” but at genuinely thriving. This post unpacks what that means, where the idea came from, and how psychologists have tried – with mixed success – to measure it.

What does “above normal” mean?
Historical context: from psychosomatic absence to positive traits
Marie Jahoda’s criteria for mental health
1. Positive attitudes toward the self
2. Growth, development, and self-actualization
3. Integration
4. Autonomy
5. Accurate perception of reality
6. Environmental mastery
Assessing above-average functioning: the GAF scale example
The need for broad and culturally sensitive definitions

What does “above normal” mean?

The phrase “above normal” might sound like it’s describing high achievers or outliers, but in this psychological model, it refers to a qualitative standard – a profile of characteristics that define what a genuinely healthy mind looks like. Rather than positioning mental health on a neutral baseline, this model treats it as something that must be actively present and demonstrably positive. Simply not having a diagnosable disorder is not enough. A person can be free of clinical symptoms and still lack the qualities – self-awareness, resilience, autonomy, social competence – that this model considers essential to real mental health.

This is a significant shift in perspective. For decades, clinical psychology was overwhelmingly focused on identifying and treating pathology. Mental health was essentially defined by the absence of mental illness. Model A challenges that assumption directly. It asks: if we removed every disorder from the diagnostic manual, what would we actually be left with? What does optimal functioning look like – and can we define it precisely enough to be useful?

Historical context: from psychosomatic absence to positive traits

The push to define mental health in positive terms did not happen overnight. For a long time, especially in the early 20th century, the field of mental health was consumed by the study of disorders, symptoms, and dysfunction. As documented in the American Journal of Psychiatry, it was not until 1941 – when the U.S. draft board needed health professionals to define what constituted mentally fit candidates for military service – that there was even a formal institutional demand for a definition of mental health, as opposed to mental illness.

At that time, the working definition was essentially negative: a person was considered mentally healthy if they showed no significant psychosomatic symptoms – that is, no physical complaints rooted in psychological distress. This was a practical, if limited, standard. It screened people out, but it said almost nothing about what a mentally healthy person actually looked like in positive terms.

After World War II, this began to change. The war had forced mass-scale psychological assessment and raised urgent questions about human resilience, adaptation, and functioning under extreme stress. The postwar period saw a wave of research on normal adaptive behavior, studying non-patient populations rather than hospital cases. Researchers began asking not just “what goes wrong?” but “what does going right look like?” This was the intellectual climate in which Austrian-British psychologist Marie Jahoda produced her landmark work.

Marie Jahoda’s criteria for mental health

Marie Jahoda (1907-2001) argued that the absence of mental illness is not a sufficient indicator of mental health. In her 1958 book Current Concepts of Positive Mental Health, she criticized the field’s near-exclusive focus on disease and proposed a framework for what genuinely healthy psychological functioning involves. She viewed positive mental health as either an enduring personality characteristic or a less permanent function of personality and the social situation.

Based on her review of the existing literature, Jahoda offered six empirical criteria – a kind of framework for positive mental health:

1. Positive attitudes toward the self

This involves having self-confidence, self-reliance, and initiative, alongside a realistic understanding of one’s own strengths and weaknesses. It is not blind self-esteem, but an honest, grounded relationship with oneself – accepting limitations without being defined by them.

2. Growth, development, and self-actualization

According to Jahoda, there must be an ability for people to develop their potential and become fully functioning human beings. This includes future orientation, the capacity to grow, and a meaningful engagement with one’s work and life goals.

3. Integration

This criterion refers to inner coherence – a balance of psychological forces, a unified outlook on life, and crucially, resistance to stress and frustration. A mentally healthy person, by this standard, is able to handle life’s pressures without being destabilized by them. It is about psychological cohesion under pressure, not the elimination of stress altogether.

4. Autonomy

Autonomy means the capacity for self-determination and independent decision-making. It involves self-determination, independent behavior, and, when appropriate, non-conformity. A mentally healthy person acts from an internal framework of values and beliefs – not purely in response to social pressure or external demands.

5. Accurate perception of reality

Jahoda argued that mentally healthy reality perception means the individual sees the world as it actually is – free from distortion driven by personal need or wishful thinking. This dimension also includes empathy: the ability to perceive others accurately, to put oneself in another person’s position, and to anticipate their behavior and feelings in social situations.

6. Environmental mastery

Environmental mastery refers to adequacy in love, work, and play – the ability to adapt, adjust, and solve problems effectively. It includes the capacity for positive interpersonal relationships and competence across key social roles. Importantly, this does not require perfection in every domain, but an overall effectiveness in navigating one’s world.

Together, these six criteria represent a portrait of mental health as something actively cultivated – not a default state, but a set of capacities that can be developed and measured. Jahoda’s model was groundbreaking in that it provided a framework whereby mental health – rather than illness – could be measured, offering clear goals for therapeutic work rather than simply a checklist of what to avoid.

Assessing above-average functioning: the GAF scale example

Defining positive mental health is one thing. Measuring it is another. One of the most prominent clinical tools designed to quantify psychological functioning was the Global Assessment of Functioning (GAF) scale, introduced in the DSM system and most fully developed in the DSM-IV.

The GAF is a numeric scale used by mental health clinicians and physicians to rate the social, occupational, and psychological functioning of an individual – in other words, how well a person is managing the various challenges of daily life. It measures how much a person’s mental state affects their day-to-day life on a scale of 0 to 100.

What makes the GAF directly relevant to Model A is what happens at the top of that scale. A score of 91-100 describes superior functioning across a wide range of activities, with no symptoms and an ability to handle life’s problems effectively – a person others seek out for their many positive qualities. This is a clinical attempt to operationalize precisely what Jahoda described: functioning that is not just adequate, but genuinely excellent.

The GAF was constructed as a global measure covering the full range from positive mental health to severe psychopathology. It was used widely in clinical and research settings and shaped how disability ratings, treatment planning, and outcomes were assessed across multiple institutions.

However, the GAF also illustrated the difficulties of measuring “above normal” functioning. Critics raised concerns about its subjectivity – the same patient might receive significantly different scores from different clinicians. The GAF was eventually dropped from DSM-5 and replaced by the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), a more structured and detailed instrument. The shift reflected a broader recognition that a single global score – however intuitive – struggles to capture the complexity of human functioning.

The need for broad and culturally sensitive definitions

One of the most persistent challenges facing Model A is the question of norms. Above normal compared to what – and according to whose standards? Jahoda’s criteria, while thoughtful and comprehensive, were developed within a particular Western, largely individualistic cultural context. Jahoda’s model is unlikely to be culturally relevant for all people, as it assumes an individualistic approach – for instance, autonomy and self-actualization as defined in her framework may not align with collectivist cultural values where interdependence and communal obligation are central to identity and wellbeing.

The criteria for ideal mental health, especially self-actualization, raise significant implications across different societal and historical contexts. For the majority of people navigating economic constraints, caregiving responsibilities, or structural inequality, achieving all six of Jahoda’s criteria simultaneously may be practically impossible – not because of psychological failure, but because of external circumstances. A framework that labels this as a deviation from mental health risks pathologizing normal human experience.

This is not a fatal flaw of Model A, but it does point to an important limitation: any definition of “above normal” must be contextualized. What counts as environmental mastery, realistic self-perception, or even growth looks different depending on culture, life stage, socioeconomic position, and individual circumstance. A strength of this model is its focus on what is helpful and desirable for the individual, and its potential for setting clear, positive therapeutic goals – but those goals must be applied with sensitivity to who the person actually is and where they live.

The most constructive use of Model A, then, is not as a rigid checklist but as a directional framework – a map of what flourishing can look like, adapted thoughtfully to diverse human realities. It reminds clinicians, researchers, and individuals alike that mental health is not a neutral absence, but an active, achievable state worth defining and working toward.

What do you think? Is it realistic to hold mental health to a standard of “above average” functioning, or does this risk setting an unattainable ideal that most people can never reach? And how should models like Jahoda’s be adapted to remain relevant across different cultural and socioeconomic contexts?

References

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Table of Contents

What does “above normal” mean? 🔗

Historical context: from psychosomatic absence to positive traits 🔗

Marie Jahoda’s criteria for mental health 🔗

1. Positive attitudes toward the self 🔗

2. Growth, development, and self-actualization 🔗

3. Integration 🔗

4. Autonomy 🔗

5. Accurate perception of reality 🔗

6. Environmental mastery 🔗

Assessing above-average functioning: the GAF scale example 🔗

The need for broad and culturally sensitive definitions 🔗