Grit and Flow as Prescriptions for Self-Actualization

Psychology as a discipline has historically focused on psychopathology and associated evidence-based modalities to alleviate symptoms of mental illness and distress. In recent decades, however, there has been a shift towards studying the positive aspects of human experience that make life worth living. This Positive Psychological perspective was utilized by Humanistic Psychologist Abraham Maslow when he created his theory of Self-Actualization, in which he postulated that the highest aim a person can strive towards is to become the absolute best version of themselves, and to maximize their abilities and potential to the highest possible degree. Aside from describing a hierarchy of needs required before Self-Actualization could be realized, Maslow left little recommendation for how the phenomenon could be enacted. This article recommends the combined utilization of the non-cognitive trait of Grit along with the implementation of activities that promote the full-immersion state of Flow as prescriptions for Self-Actualization. Additional emphasis is placed on the importance of healthcare professionals utilizing the concepts Grit and Flow in their clinical practice with patients.


INTRODUCTION
As the process of evolution allows species to grow and adapt to their environments, expectations for what those species are capable of achieving proportionally increase.40,000 years ago, Homo sapiens began experiencing changes in cranial structure and brain development that anthropologists now refer to as "the great leap forward" [1].As our prefrontal cortices began growing larger and increasingly capable of performing greater feats of executive functioning, our ability to anticipate and predict the consequences of our actions started to expand, and our personalities began developing in more nuanced ways [2].Humans now have the uniquely dissonant experience of having exquisitely elevated thought, while still being bound by the same biological realities and compulsions as our fellow earth-dwelling creatures.The Homo sapiens of today perform acts of kindness for others with no expectation of reciprocity to enhance their own lives; a decision that would have been unthinkable in a time when survival was the first and only consideration.We have awareness of our place in the world, our cultural responsibilities, our role in society, our potential to do good or ill (and associated choice), and our own fragile mortality.Our new, highly developed brains have opened many doors of opportunity that our ancestors in past millennia had insufficient cognitive ability to access.But our novel sense of possibilities can also be a burden, leaving us wondering which of the many open doors would be best to walk through.The myriad potential choices for how to live our lives can facilitate existential angst, which comes from the distinctive experience of human freedom and responsibility [3], leading many to wrestle with what their purpose in life "should" be, or how they can best maximize their personal utility given their gifts, interests, and privileges.The psychology and healthcare sectors have offered a diverse array of potential answers to these questions, but perhaps no theory is more famous or well-known than Abraham Maslow's thesis of Self-Actualization.
or enough food to stay alive (Physiological Needs); there are priorities.Looking at this hierarchy of needs, we can see how our ancestors with underdeveloped prefrontal cortices who were lower on the food chain were primarily (if not solely) concerned with meeting their Physiological and Safety needs.However, the contemporary human with enhanced cognitive faculties and modern technology ensuring safety from predators has the luxury of being able to climb farther up the hierarchy towards Self-Actualization; we have the capacity to orient ourselves towards thriving, rather than just surviving.
This growth-oriented outlook was a fundamental component of Maslow's psychological perspective of Humanistic Psychology, which rose to prominence just as he was constructing his theory of Self-Actualization in the mid twentieth century.Humanistic Psychology focuses on healthy motivations and maximizing human potential through a strength-oriented lens, which is in stark contrast to Sigmund Freud's Psychoanalytic Theory (which dominated the early decades of the twentieth century and focused on unhealthy motivations and psychopathology) [7].This distinction is important to consider when discussing Self-Actualization.
While the human brain and conditions of physiological safety were largely the same from the early-to mid-twentieth century, the way of thinking about psychological health had begun metamorphosing.Speaking broadly, Psychoanalysis largely focuses on what is wrong with the individual and how to fix it, and humanistic psychology focuses on personal agency and human potential.Psychoanalysis would never have focused on a construct such as Self-Actualization as a goal to strive towards, as Self-Actualization is growth-motivated rather than deficiency-motivated [5].The focus on human strengths and capabilities in Humanistic Psychology is quite similar to the focus of positive aspects of human experience and flourishing in Positive Psychology [8], which became a formal psychological perspective at the end of the twentieth century.Humanistic Psychology may have indeed passed the strength-oriented-baton off to Positive Psychology, as the first academic mention of Positive Psychology was in Maslow's famous work, Motivation and Personality, in which the last chapter, "Toward a Positive Psychology", called for man's potentials, virtues, strengths, and aspirations to be studied in greater detail [5].
Earlier in Motivation and Personality, Maslow describes in detail the qualities that he believes are inherent in all people who are striving towards Self-Actualization, who have already satisfied the first four needs on his hierarchy.He states that Self-Actualizing persons have an efficient perception of reality and are comfortable with their relations to it.They live more in the real world of nature than in the man-made mass of concepts, abstractions, expectations, beliefs, and stereotypes that most people confuse with the world.They stay true to themselves and don't strain to please others or conform to social norms; they're less enculturated.They are not neurotic, and rarely experience shame, anxiety, defensiveness, or guilt.There is no sense of "artificial dignity" or narcissism [5].Self-Actualizing people are more aware of their subjective tastes and preferences, and this allows them to be more spontaneous.However, they are not distracted by desires and immediate concerns, and are more focused on the big picture -never getting "so close to the trees that they cannot see the forest" [5].They experience mystic and peak experiences on a regular basis and are dependent on their own growth for satisfaction rather than exterior sources of validation.Yet they focus on problems outside of themselves, and are not ego-centered.Self-Actualized people adhere to the Alderian spirit of Gemeinschaftsgefühl -a feeling of social interest that describes a state of social connectedness and concern with the well-being of others [9].For Self-Actualizing individuals, "duty is pleasure", and "work is play" [5].
When looking for the answers to maximizing our personal potentials in the pursuit of Self-Actualization, we are often instructed to consult the helpers in our society: our Doctors, Social Workers, and Healers.Healthcare professionals are sought after for their expertise by individuals who want to improve their lives.Whether patients are recovering from physiological ailments, suffering from dysregulating psychological disturbances, or feeling stuck for reasons beyond their understanding, there are none among us who don't wish to enhance our wellbeing and climb to the next level of our abilities.While healthcare professionals are aided by modern technology and advanced training in their respective fields to deliver best practices to patients, the pursuit of becoming the best physical, psychological, and spiritual versions of ourselves can be an exasperating expedition to embark on.To be best equipped for this journey, we need to think outside of the box and utilize different methods and practices that may exist beyond the standard recommendations and methodologies that have been historically employed by the healthcare industry.Indeed, the aforementioned depiction of Maslow's conception of Self-Actualizing individuals is undoubtedly a lofty goal for everyone to strive towards.Perhaps it is for this reason that Maslow postulated that Self-Actualization "rarely happens… certainly in less than 1% of the population" [10].While not backed by empirical evidence, such an assertion by an eminently distinguished psychologist like Maslow is alarming.How can the ultimate state of being for mankind -the highest fulfillment of our abilities and potentials in our most developed level of evolution -only be achieved by less than 1% of the population?It is confounding to think that thousands of years of natural selection and adaptation have afforded Homo sapiens the ability to maximize their personal utility and aptitude to unprecedented heights, only to have a scruple actually realize that potential and step through the door of Self-Actualization, so to speak.The present article will examine barriers to Self-Actualization that exist in society today and explore different constructs in the field of Positive Psychology (which were operationalized and defined after Maslow's time) that may be able to offer a clearer path to Self-Actualization in light of identified barriers.

Barriers to Self-Actualization "Compared to what we ought to be, we are only half-awake" -William James
Fortunately, barriers to Physiological and Safety Needs in modern American society have been exhaustively studied and addressed through various social welfare and poverty alleviating programs such as the Supplemental Nutrition Assistance Program (SNAP), earned income tax credit, Social Security, Temporary Assistance for Needy Families (TANF), Section 8, the Emergency Medical Treatment and Labor Act (EMTALA), Medicaid, and others.As a result, the vast majority of Americans have access to the necessary resources for procuring food, water, shelter, and personal security [11,12,13].While this is good news, we are so far only discussing the first leg of our Self-Actualization journey.
Love and Esteem needs prove to be considerably more difficult to satisfy in the current cultural climate.Our need for Love on Maslow's hierarchy describes our human desire for connection with others and meaningful bonds of intimacy with family members and loved ones.Unfortunately, 22% of adults in the United States today say that they always or often feel lonely, lack companionship, or feel left out or isolated, and 54% say that no one really knows them well [14].Since Maslow's time, the size of the average American household has noticeably reduced, as one-person households are now the 2nd most common household type [14].As household size has decreased, distance away from other family members and friends has increased, and the frequency of our interactions with those that love us most has reduced and shifted from in-person socialization to communicating via social technology and networks, leading to emotional disconnection [15,16].Indeed, increased use of social media and other social platforms has made it more difficult to satisfy our Esteem Needs on Maslow's hierarchy (need for confidence, status, self-esteem, and achievement), as increased use of social media is correlated with low levels of self-esteem [17,18].This correlation is concerning considering the significant increase of social media use in recent years [19], and this may contribute to the fact that most adult Americans have struggled with self-esteem issues at some point in their lives [20].
Here we can see why Love and Esteem are higher up on the hierarchy than Physiological Needs and Safety Needs; feeling loved and accomplished are more elusive conditions to meet than staying dry or being well-nourished.While the realities of modern disconnection and self-esteem lowering platforms are obstacles to contend with, Psychologist Michael Lerner suggests that a primary reason why our lives are not all they can be is because we have come to believe that poor life circumstances cannot be changed [21].While members of society are bound to some level of actual powerlessness given the structure of power in our society, Lerner believes that we add to that level of powerlessness "to the extent that our own emotional, intellectual, and spiritual makeup prevents us from actualizing possibilities that do exist… for us to actualize our Human Essence" [21].He calls this additional self-imposed sense of powerlessness "Surplus Powerlessness", and cites it as a major contributor in our inability to maximize our human potential (or strive for Self-Actualization, as Maslow might say).Lerner believes that there is an epidemic of unhappiness and unfulfillment in society as a result of Surplus Powerlessness, and that members of society go along with lives that are fundamentally unfulfilling because they feel that they have no alternative.This description bears striking resemblance to Martin Seligman's concept of Learned Helplessness, in which individuals experience a profound loss in their sense of self-efficacy after being victims of circumstances beyond their control [22,23].The feelings of Learned Helplessness inherent in Surplus Powerlessness enable us to "become our own jail keepers", and facilitate integration into "a cult of victimhood that sometimes substitutes for careful thinking" [21].
Psychologist Aaron Beck, the father of Cognitive Therapy, might argue that feelings of Surplus Powerlessness contribute to cognitive distortions such as negative filtering, jumping to conclusions, and catastrophizing, all of which can lead to maladaptive coping mechanisms [24,25].Lerner identified several such mechanisms that contribute to our inability to actualize our human potential.He acknowledges classic maladaptive coping strategies such as substance use and sexually acting out, but also asserts that people have a tendency to become preoccupied and overly engrossed in "frenetic activities" such as sports, politics, and religion as ways of coping to their own detriment.This may seem counterintuitive at first, as the physically active and community aspects of sports have been proven to be beneficial for overall health [26], and religion can be an ideal context to foster social bonds and membership in a community [27], both of which would incline one to consider them as boons to the satiation of Love and Esteem Needs on Maslow's hierarchy.However, when sports or religion (or any activity) become a person's entire emotional life, it leaves little room for reflection, self-introspection, or a critical examination of the relationship between one's self and one's problems, and how that relationship is influenced by personal disposition or societal constructs [21].For many, sports are an ideal vehicle for stress reduction, but it can also be used as a way to divert attention from the pains of the world; the pain doesn't go away, it's just redirected or displaced.In religious communities, people may pray for absolution of sins or for a better life instead of recognizing their own role in their problems.Over-engaging in these activities and others can serve to further entrench ourselves in feelings of powerlessness by distracting us from working on ourselves, or from spending our energies in useful ways that would improve society and reduce sources of oppression that limit our ability to thrive and flourish [21].
Lerner refers to these distractions from dealing with internal difficulties as "narcotizing" coping strategies, which prevent us from realizing our full potentials.The ubiquitous availability of such attentional distractions in modern life, combined with the difficulty of introspection and stigma of self-improving practices such as psychotherapy, all contribute to a trend of complacency -ingrained to the point that not actively striving to become the best versions of ourselves has become normalized, despite our heightened, evolved capacities.Our lack of genuine social connectivity, over-utilization of shallow social media platforms, and self-imposed Surplus Powerlessness have enabled average performance to be an acceptable ceiling for our standards.Maslow certainly understood this to be true, and proclaimed that "what we call normal in psychology is really a psychopathology of the average; so undramatic and so widely spread that we don't even notice it" [28].Maslow believed that healthy human behavior should trend toward Self-Actualization.Therefore, he regarded behavior that was unconcerned with Self-Actualization (especially when the necessary conditions for it were in place) to be unhealthy, or pathological.Our pathological complacency is likely what led him to deduce that less than 1% of people become Self-Actualized.However, there are constructs in Positive Psychology today that we can use to shape our behaviors and priorities in ways that can bolster our self-efficacy, sharpen our skills, and increase our sense of fulfillment and purpose.Since Maslow's death, extensive research has been conducted on the non-cognitive trait of Grit, and the full immersion state of Flow.Were he alive today, Maslow would have assuredly endorsed these concepts as necessary components for the journey of Self-Actualization.

Grit "He who has a 'why' to live for can bear almost any 'how'" -Friedrich Nietzsche
One factor that may contribute to Surplus Powerlessness are judgmental lamentations of our own shortcomings, with thoughts such as "if only I was smarter, I would be more successful", or "I'm just not naturally gifted enough to achieve more".Research from the University of Pennsylvania dispels the legitimacy of such disempowering notions, however, with exciting exploration into the trait of Grit.Angela Duckworth is the world's foremost authority on Grit, and she defines the trait as "perseverance and passion for long term goals" [29].Grit has been shown to be a better indicator of success than intelligence and IQ, health, good looks, and talent [29].When we look at the most prominent leaders in every field, the most consistent trait they share is Grit [30].
Scores on Duckworth's Grit Scale (used to measure the trait) can predict which cadets at the United States Army's West Point Academy are most likely to graduate from "Beast Barracks", the initial 6-week training at the institution during which many new students drop out [29].West Point is one of the most difficult academic institutions to gain acceptance to in the United States (10% acceptance rate), and every accepted student has stellar SAT scores, an elite GPA, and impressively well-rounded credentials.In a sample of eminently qualified and talented applicants, Grit Scores are used to accurately highlight who among them are the most passionate and driven, and those are the cadets that are ultimately most successful.Duckworth states that Grit is about having an "ultimate concern"; a goal that you are so passionate about that it gives meaning and organization to everything that you do [29].Failures on the road to achieving this goal are not a deterrent towards its striving, but are regarded as necessary parts of the process.As Duckworth states, "The gritty individual approaches achievement as a marathon; his or her advantage is stamina.Whereas disappointment or boredom signals to others that it is time to change trajectory and cut losses, the gritty individual stays the course" [30].We can apply the imagery of the gritty individual's achievement marathon to Maslow's belief that the multifaceted journey of life should be spent in the constant pursuit of becoming our best.
Indeed, the gritty individual and the Self-Actualized individual share many commonalities.Recall that Maslow's Self-Actualized individual is focused on the big picture, less distracted by immediate concerns.Focusing on longterm goals is a fundamental aspect of what defines gritty individuals, and their ability to be undistracted by shortterm satisfaction can be explained by Grit's correlation with Self-Control and Conscientiousness [31].For someone with Grit, "meaning seems more robustly related than pleasure to the subjective sense that one is fulfilling one's potential in life" [32].Fulfilling one's potential is what Self-Actualization is all about, and Maslow's Self-Actualized individual prefers a meaning-filled path over a pleasure-filled one.After all, for the Self-Actualized individual, "duty is pleasure", and "work is play", as previously stated [5].Gritty individuals are those that pursue highly engaging and personally meaningful goals over a long period, and what makes this perseverance possible is an identified passion.Identifying such a passion or "ultimate concern" requires a great deal of self-awareness and connection with one's values [31], and the same type of awareness of subjective tastes and preferences is inherent in Maslow's Self-Actualized individual [5].People who have Grit don't depend on positive feedback from others to sustain the pursuit of their goals; their passion is what drives them.Self-Actualized individuals are similarly unconcerned with exterior sources of validation.Here, we can see that the gritty and Self-Actualized serve as their own compass for direction in life.They are not swayed by what others think and do not submit to social conventions or societal pressures.The gritty, Self-Actualizing person stays true to themselves and their values and is continually connected to and inspired by them, acting in accordance with their passions and subjective principles.In this way, they embody the Aristotelian notion of Eudaemonia, in which virtue is cultivated by living in harmony with one's good (eu) inner spirit (daemon) [32].While Duckworth's gritty individual has much in common with Maslow's Self-Actualized individual, the quality of Grit is also efficacious in meeting our Esteem Needs in Maslow's hierarchy.Grit is positively related to high levels of life-satisfaction and self-esteem [33], and this may be because unwavering perseverance towards goals allows us to successfully accomplish them, and thus experience a sense of personal agency, happiness, and achievement [29].Grit and self-esteem may actually have a symbiotic relationship.While Grit allows us to experience accomplishment after successful strivings, which promotes self-esteem, high self-esteem in turn allows us to more robustly persevere through the failure inherent in all long-term efforts [33], and such perseverance is a definitional component of Grit [29].In addition, increased self-esteem that results from accomplishments achieved through Grit can stimulate the realization of our highest potentials [33], or Self-Actualization.This is why Esteem Needs are directly before Self-Actualization on the hierarchy of needs [4].
Previously described barriers to Self-Actualization are a poor match for the gritty individual.While we may be greater distances away from loved ones than in generations past, the gritty family member and friend who values familial and platonic bonds will make associated socialization a priority, and thus will be undeterred by geographic inconveniences.Gritty individuals will not succumb to the impulsive and momentary self-esteem reducing distractions abundantly available in modern society, such as social media, as their passion and drive for personal meaning is their top consideration.In the marathon of Grit-fueled achievement, obstacles such as feelings of Surplus Powerlessness will still be encountered, but can be overcome with strides of effort, passion, and dedicated adherence to maintaining action in accordance with one's values.If we stick with our passions and are undeterred by the external realities of societal constraints and internal realities of self-doubt and cognitive distortions, we can employ Grit as a means to unlock our highest potentials.
For individuals who feel that they lack the necessary qualities for success, healthcare professionals have a duty to extol the virtues of Duckworth's research on Grit.Reminding clients of their passion or "ultimate concern", or helping them to identify such a passion can aid clients in their striving towards achieving their goals and becoming Self-Actualized.For the patient in physical rehabilitation who is disheartened by a lack of improvement and mobility, or the cancer patient who is frustrated by a lack of apparent progress in chemotherapy, healthcare workers can remind them of their long-term objectives and inspire future-oriented motivation.For the client who feels insecure about their intelligence or natural ability, education on Grit can be bestowed, -specifically the reality that effort and sustained passion are more predictive of successful outcomes than other classically revered traits.

Flow "The self expands through acts of self-forgetfulness" -Mihaly Csíkszentmihályi
In the previous exploration of gritty individuals, we saw that being passionate about achieving a long-term goal can result in Grit-fueled perseverance and striving towards that goal, with the ability to withstand tribulations and diversions during that striving.One state of being that can significantly aid such striving is the full-immersion state of "Flow"; a state of such complete absorption that those experiencing it disregard hunger, fatigue, and discomfort [34].Experiencing Flow is often conceptualized as being "in the Zone", as being in a Flow state allows us to operate at our full capacity for however long the state lasts [35].In this way, those in Flow can be thought of as having micro-experiences of Self-Actualization; performing at their maximum potential for moments at a time.To be in Flow, the level of difficulty of the task at hand has to perfectly match one's skill level at that task.If the task is too difficult, we can become anxious, stressed, and neurotic; too easy, and we become relaxed and bored [35].Under this condition of engaging in "just manageable" challenges, experience seamlessly unfolds from moment to moment, and one enters a subjective state of intense focus where action and awareness are merged and temporal consciousness is distorted, as time seems to pass faster than it actually is [35].
In addition to these criteria, tasks are able to induce Flow insofar as they are intrinsically motivating to the actor performing them.For this reason, those with "autotelic" personalities (from the Greek autotelēs: "auto" meaning "self ", and "telēs" meaning "goal") are thought to be more likely to experience Flow in their day-to-day lives [35].Those who are autotelic are curious, persistent, have well-defined future goals, and generally do things for their own sake, motivated by intrinsic rewards [36].One best experiences a Flow state when not paying attention to their own experiences or desires, but rather have every faculty of attention focused on the presently engaged activity.Any spare attention not fixated on the task at hand could be focused on the self, and this is why there is a lack of reflective self-consciousness in Flow.By losing awareness of oneself as a social actor, one can experience self-transcendence and an elevated sense of perceiving the world [36].This component of Flow is remarkably similar to a state of being Maslow described as regularly occurring in Self-Actualized individuals, who often undergo "acute mystic or peak experiences" where there is a "tremendous ©JWellness 2020 Vol 2, (2) intensification" of concentration, and "a loss of self or transcendence from it" [5].Maslow is indeed describing a Flow state, long before the concept was ever operationalized or studied.It is intuitive, therefore, to extrapolate that a Self-Actualizing individual will experience states of Flow on a regular basis, based on Maslow's description.
Seeking Flow reflects a motivation to pursue one's highest potentials [32]; a motivation that aligns perfectly with the values of the Self-Actualized.There are behavioral changes that we can implement in our striving towards Self-Actualization that can promote the frequency with which we experience Flow, which will in turn assist our climb to the top of Maslow's hierarchy.The simplest behavioral recommendation would be to increase the amount of time we spend on subjective passions that we find intrinsically rewarding and decrease the amount of time we spend engaging in momentarily pleasurable but ultimately unfulfilling leisure activities.This may prove to be a considerably difficult change to make, given the prodigious amount of media options available to us.With the flick of a finger, we have access to every TV show ever created (Netflix, Hulu, Amazon Prime Video), the answer to any question we can think of (Google, Yahoo!), and ability to view the activities and whereabouts of our friends at any given time (Facebook, Instagram, Snapchat).Never before have so many distractions been so readily available, and the intense, fully engrossed attention required for Flow may be less attainable given the reality that nearly any passing curiosity or whim can be instantly satisfied with modern technology (though no research to date has been conducted to back this hypothesis).Our goals and "ultimate concerns" must be pursued with increased vigor and impassioned Grit, so that we can maintain our Flow-requisite attentional acuity on what matters most to us, and tune out the hum of 21st century diversions.In this way, Grit and Flow are complementary constructs.The passion and perseverance towards long-term goals inherent in Grit is aided by the timeless, intense engagement in the intrinsically rewarding state of Flow.The partnership of these two concepts is a marriage built for the challenging journey of Self-Actualization.

Growing with Grit & Flow "Those that are consumed with the most relentlessness, and burn with the brightest flame, seem to serve the purposes of nature best" -Ernest Becker
Flow is experienced when the amount of difficulty in a presently engaged activity requires the exact level of skill one has in that activity.However, the more one engages in that activity through deliberate practice, the more skilled one becomes.As one becomes more skilled, the level of task difficulty required to experience Flow increases proportionally.Grit allows us to continually increase our skill level and ability by overcoming challenges through diligent, passionate perseverance, and Flow can be considered the reward for increasing one's skill to that next level.Psychologists at the International Laboratory of Positive Psychology in Moscow echo this assertion, stating in a recent publication that "experiencing Flow encourages a person to persist at and return to an activity because of the experiential rewards it promises, and thereby fosters the growth of skills over time" [36].Flow can facilitate sustained effort in our passions over time (Grit) not only because Flow states are intrinsically rewarding, but also because the intense engagement and experience of Flow helps us lose track of time [35].This enables us to sustain effort for a longer duration without our conscious awareness, making the once effortful now seem effortless.As Grit and Flow work together to increase our abilities in our chosen passions, they facilitate our upward trajectory on the final leg of our Self-Actualization journey.
Positive Psychologist Nico Rose conceptualizes Grit and Flow as alternating stages on the road to achievement.He also compares the working relationship of the concepts to the interchanging phases in the process of breathing -complementary opposites that work together to sustain life (or in this case achievement), just like inhaling and exhaling [37].Grit takes intense effort, while Flow is effortless.Gritty perseverance through adversity, failure, and distraction can be a torturously trying experience, while experiencing Flow has been equated to floating in ecstasy [34].Flow requires regular task-related feedback to stay engaged and attuned, while Grit does not require task-related feedback, as passion is the combustion that propels action.We cannot breathe without inhaling and exhaling, and we may very well fail to achieve our highest potentials without Grit and Flow.
What unites the two constructs is a future-orientation towards an identified passion.Gritty individuals are able to maintain their strivings because their long-term goals are so important that their attainment is worth years of continuous effort despite obstacles and setbacks.Autotelic personalities well-suited to experience Flow have clearly defined future goals [36] and are naturally disposed towards engaging in intrinsically motivated Flow-promoting activities that advance the achievement of those goals.Thus, the foremost step in our journey of Self-Actualization may be to identify a subjective passion so valuable and inherently rewarding that it takes precedence over the various competing interests and distractions of life.

CONCLUSION
As we have seen in Grit and Flow, the dogged pursuit of our life's passion may be so engrossing that we occasionally forget Physiological and Safety Needs farther down on Maslow's hierarchy, such as the need to eat, sleep, drink, and look after our health.Psychologist Michael Lerner warned us about the danger of having any one activity become our entire emotional life.A healthy, flourishing, and emotionally stable life requires a proportional balance of relationships with others, engagement, meaning, and achievement [38].However, in order to maximize our abilities as human beings in this unique station of our species' history -where we have unprecedented cognitive abilities to flex and a secure sense of safety from predators -some highly selective focus and abdication of comfort is required.How we conceptualize the difficulties inherent in our striving towards our passion will inform its achievement.If we adopt a deficit-orientation, lingering on the failures implicit in Self-Actualization's perilous journey and accepting temporary limitations as "just the way things are", we are unlikely to live up to our potential.However, if we view these difficulties and challenges through a strength-orientation, seeing obstacles as an opportunity to employ our Grit, and using Flow as a way to elevate our abilities to their highest level, we give ourselves the greatest opportunity to become Self-Actualized.
Healthcare professionals must help facilitate this reframe for individuals who are seeking their care.When patients and clients attempt to address deficiencies in their lives respond to burdens and concerns, their clinicians have a duty to not only alleviate their symptoms, but to add to their previously established baselines of wellbeing by helping to orient them towards their passions.This enables individuals to tap into their internal reservoirs of Grit while prescribing corresponding activities that promote Flow.Additionally, healthcare professionals can utilize the ethic of Grit and Flow-promoting activities of serving others for their own Self-Actualization.This may be achieved by connecting with their motivation to work in the helping professions and elevating their level of practice by continued striving towards maximizing their professional and personal utility.The path of Self-Actualization will be different for each individual, but Grit and Flow can be applied to any challenge or endeavor.What Maslow found to be achieved by less than 1% of the population can