Estimated read time: 11.5 mins
Happiness has been described as “the experience of joy,
contentment, or positive wellbeing, combined with a sense that one’s life is
good, meaningful, and worthwhile”. It is a complex, abstract social construct
and because it is subjective in nature, it is difficult to measure and desirable
but often elusive. There is supporting evidence for the primacy of happiness and
other goals are valued because it is believed that they add to human happiness.
References to the pursuit of happiness can be traced back
nearly 2,500 years ago. Confucius, Buddha, Socrates and Aristotle have all
tackled some aspect of happiness and have many things in common. The Greek word
that usually gets translated as ‘happiness’ is eudaimonia. It was Aristotle’s
view that ‘happiness’ was the ultimate purpose of human existence, and to lead
a virtuous life and do what is worth doing. This is the exercise of virtue.
It is also important to distinguish between pleasure and
happiness. Pleasure relies on external stimuli, which is why it is transitory –
whereas happiness comes from within.
Our surveys suggest that our profession is not happy. Professional
morale – how people are feeling as a collective whole – is low, work-related
stress levels are high and burnout is a growing concern.
The British Dental Association (BDA) reports that almost
half of dentists surveyed experience burnout, and more than one in three
reported symptoms of depression. The most stressful aspects are shown in Figure
In contrast, people who report higher levels of happiness find
their work satisfying, less stressful and enjoyable. They are less likely to
make mistakes, are characterised by a growth mindset and are also likely to be
more successful. The quest for happiness should therefore remain a high
The science of happiness is the study of the factors that
contribute to wellbeing. It is a relatively new field of research that focuses
on the biological/chemical processes that contribute to feelings of wellbeing
The psychological, social and biological factors that
contribute to wellbeing include positive emotions and experiences, a sense of
purpose and meaning in life, a sense of self-worth and autonomy and control of
The chemicals and neurotransmitters that affect mood and
Physical and environmental factors such as sunlight,
exercise and diet also affect neurotransmitter levels, which determine our mood
and happiness. Additionally, researchers have identified some personality
traits that are associated with greater happiness such as extroversion,
conscientiousness and emotional stability. It is a complex area of research,
details of which are beyond the scope of this article.
The Subjective Happiness Scale (SHS) was one of the first developed
by Lyubomirsky and Lepper (1999) to measure subjective happiness. It is short
and reliable and consists of four items indicating the degree of happiness scored
on a 7-point Likert scale.
The SHS is a 4-item measure (Table 1) that asks respondents
first to rate on 7-point Likert-type scales how generally happy they are (1 =
not a very happy person, 7 = a very happy person) and how happy they are
relative to their peers (1 = less happy, 7 = happier). The remaining two
questions require participants to indicate the extent to which a description of
a “very happy” and a “very unhappy” person, respectively, characterises them (1
= not at all, 7 = a great deal).
To score the SHS, the values from the first three items are
scored between 1-7 whilst the fourth item is reverse scored (ie, 7 is turned
into 1, 6 into 2, 5 into 3, 3 into 5, 2 into 6 and 1 into 7). Then the scores
for all four items are added together and then averaged, to give the final
Most people score between 4.5 and 5.5.
In their model of happiness, Lyubomirsky, Sheldon and Schkade (2005) propose a framework in which three factors
contribute to people’s sense of wellbeing and happiness. They suggest that
genetics account for approximately 50% of the happiness equation, circumstances
for approximately 10% and intentional or volitional activity for the remaining
40% (see Figure 2). The strong association between happiness and personality
may limit volitional activity because personality traits are fixed and unlikely
Happiness is the sum of three factors. The formula that is
often quoted is H = S + C + V where:
The key message in this model is
that by focusing on the voluntary 40% a person can significantly improve their
happiness. It is not that simple because the three factors are not independent
and exert an influence on another.
The temptation is to accept this
as a mathematical certainty when it is not.
In our member surveys, the 10%
attributed to ‘circumstances and conditions’ seems a very low percentage. Our analysis
of the responses to some questions would suggest that the true figure could be
double or more that in the base formula. Sonia Lyubomirsky herself refers to
the numbers as ‘averages and approximations’ in one of her presentations. In
2019, she reflected on her and her colleagues’ earlier research and acknowledges
that “the pie chart diagram appears to have outlived its usefulness”. She
suggests that volitional activities may influence happiness less than they
thought - perhaps as low as 15% - and that “happiness can be successfully
pursued, but it is not ‘easy’”.
Policy makers have an important
role to play when it comes to promoting happiness, particularly when it comes
to the ‘circumstances’ element of the happiness formula. Much of the angst and
stress reported by our members can be attributed to work conditions, targets
and clinical pressures – all of which are creations of policy makers or
unintended consequences of failing systems. If we want to improve the
professional mood and enjoy the benefits (for patients and practitioners
alike), we must lessen the impact of the stressors.
In the first chapter of the 2023
world happiness report, it states: “Once happiness is accepted as the goal of
government, this has other profound effects on institutional practices. Health,
especially mental health, assumes even more priority, as does the quality of
work, family life and community.”
Happiness, wellbeing and the quality of professional life
are closely related concepts. There is a positive relationship between
happiness and altruistic behaviours where the wellbeing of the helper and the
helped is improved. It has been shown that those who receive altruistic help
are themselves more likely to help others. We need to be clear that feeling
happy and being happy are not the same thing – there is a difference between
momentary level of happiness and the enduring level of happiness. In the words
of Professor Lord Richard Layard: “By providing evidence of what’s going to make
a difference to people’s happiness, then the policymakers can’t make good
policy.” There is now ample evidence of what will make a difference to people’s
lives and so the profession can be forgiven for saying “over to you” without it
sounding like a dereliction of responsibility.