Mental Health Needs and Psychopathology

The need, or more generally the feeling of need, is a fundamental motivational concept. It underlies the research and theories of a range of disciplines, including philosophy, biology, psychology, sociology, economics, business and politics. It is also the basis for many practical applications, such as healthcare and the design of products and services.

The word need is used both as a noun (something that is essential, for example, air, water and food) and as a verb (to want). Needs are contrasted with wants in the sense that a deficiency of a need results in clear adverse outcomes, whereas a lack of a want produces ambiguous feelings of dissatisfaction.

For a desire to be considered a need, it must satisfy a number of objective criteria, most importantly that it be necessary for people’s well-being in any given context or situation. In addition, it should be felt to be a motivating force for individuals and therefore not dependent on other motives such as reward, fear, or a desire for status. It must be felt as a driving force rather than as an urge to avoid unpleasant experiences, and it must engender positive emotions such as pleasure and pride. It should be felt by a wide range of individuals regardless of demographic characteristics, personal traits or personality types.

A further requirement is that a need be innate and invariant, so that it operates across different contexts and situations. Finally, a need must have the potential to be satisfied through a variety of ways, not just through conscious choice but also via automatic mechanisms such as the brain’s physiological responses to a given environment or stimuli.

In line with this approach, BPNT focuses on the core three psychological needs of autonomy, competence and relatedness. Moreover, it emphasizes that these needs are not mutually exclusive and that they must be met in an integrated way for flourishing. It is also argued that both the satisfaction and frustration of these needs are important for well-being.

The current understanding of the role of these needs in mental health and psychopathology has evolved significantly over the past decade. For instance, a more holistic perspective has emerged that distinguishes between a need-relevant dynamic of adaptation and growth versus a need-relevant dynamic of vulnerability to psychopathology (Ryan and Deci 2017). Furthermore, recent work in clinical samples using longitudinal designs has demonstrated that need frustration predicts a broad range of ill-being outcomes such as stress, negative affect, and depressive symptoms, with fluctuations in a person’s state of being closely linked to fluctuations in need frustration (Vandenkerckhove et al. 2019b).

In light of this emerging literature, it is clear that more work needs to be done to establish the validity of the BPNT framework. Specifically, it is important to test whether the proposed needs have measurable behavioural and physiological effects and to determine if these effects are durable over time. Furthermore, it is crucial to examine the extent to which a new need’s satiation and frustration have both benefits and costs for wellness.