Mental Matters: What is the Continuum of Mental Health

“Mental health exists on a continuum.”

These days, more and more Instagram posts are saying something along these lines and I agree wholeheartedly. But it does beg the question: what the hell does that actually mean?

One way to make sense of it — and the framework favoured in Dialectical Behaviour Therapy (DBT) — is to think of the mental health journey as moving from being unable to control your behaviour to healing your deepest wounds, to living joyfully, to transcending your ego.

That’s a mouthful but here’s what it looks like on the ground.


This is a nerdy, clinical way of saying that someone compulsively does destructive things they don’t feel good about. Cutting, substance abuse, staying in bed all day, procrastination, disordered eating, attack or withdrawal in a relationship, overwork, compulsive spending and a whole bunch of other behaviours fall into this category.

It’s important to remember that all such actions are actually solutions to the problem of suffering. People at this point on the continuum of mental health learned early in life that doing one or more of these things temporarily reduces their suffering.

Unfortunately, over the long term, these behaviours actually add to their suffering and lead to a classic vicious cycle.


Once a person learns to manage their suffering in ways that don’t create more suffering — their next task is to bring awareness and presence to what Carl Jung called ‘the shadow’.

At this point on the continuum, a person begins to heal the deep wounds that drove their destructive behaviours in the first place. Therapies like EMDR, Somatic Experiencing and Sensorimotor Psychotherapy were designed to help specifically with this process.

It’s kind of humbling to realize how much shit we haul around without even being aware of it and this point on the continuum of mental health is all about finding and transforming it.


Joy is about how we choose to live our lives if we’re no longer using up all our time and energy running away from our pain. This point on the continuum is characterized by loving relationships, a sense of meaning and purpose and an alignment between our most deeply held values and our actions.

However, it shows up — whether through time in nature, connection with loved ones, caring for our body, investing in our business, honing our craft or any number of other things — joy is about authenticity, calm, connection and integrity. It’s pretty sweet.


This point on the continuum is what the spiritual teachers throughout history are always on about. The main message here is that in this one little moment, everything we could ever want or be, we already have and are.

We catch glimpses of transcendence in the moments where time stops: falling in love, standing on top of a mountain, witnessing the birth of a child or marvelling at the beauty of the sunset. Subject and object, time and space, me and you — all of it just falls away and underneath it is a profound oneness and unspeakable peace and power.

A great therapist can help you figure out where you fall on this continuum, get clarity on what’s keeping you stuck and take concrete steps toward joy or transcendence.

John Roche is a therapist in Kitchener-Waterloo