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How does Gross National Happiness offer an integrated perspective linked with health, economics, and nature?

Published onAug 22, 2022
How does Gross National Happiness offer an integrated perspective linked with health, economics, and nature?

[This article has been originally published under a Creative Commons License (CC-BY-NC-ND) in the journal J-AIM, 2022. DOI:]


In this paper, my interest is in drawing out what is distinctive about the Gross National Happiness (GNH) experiment in Bhutan, and how this distinctiveness offers parallels with holistic health traditions. I explore how a full appreciation of what GNH has to offer requires more than replacing economic growth with well-being but points to a reorientation in economic thinking and practice. In so doing, I hope to shed light on how GNH offers an integrated perspective linked with health, economics, and nature.

Keywords: Gross national happiness, Well-being economics, Phenomenology, Ayurveda, Traditional Chinese medicine, Epistemology

1. Background

How does Gross National Happiness (GNH) offer an integrated perspective linked with health, economics, and nature? In this piece, I offer my response to this question by reflecting on my own lived experience as a practicing economist, also as a scholar and practitioner of holistic health, and as a facilitator of learning programs about GNH.

In recent years, most Western economies have increasingly focused on the narrow pursuit of economic growth with its unintended and undesirable impacts on the well-being of people and planet being well-documented [12,30,9]. This has led to the growth in ‘alternative economics’ [37,11,20] that addresses these critiques and proposes new economic models. Many of these replace the goal of economic growth with the thriving of well-being of people and planet [[2], [8], [10], [25], [33]]; accompanied by different indicators to measure progress. For example, Kate Raworth [33] introduces a range of indicators to measure planetary and social boundaries,1 the Government of Bhutan has developed a national programme of indicators to measure Gross National Happiness [1]; The Happy Planet Index [16] measures progress in life expectancy, inequality, ecological footprint, and qualitative indicators of well-being; and the OECD has launched its Better Life Index [29].

The global COVID19 pandemic, accelerating climate crisis and growth in social unrest has ushered in a heightened interest in these models, with a particular focus on well-being economics. For example, the Wellbeing Economy Governments partnership (WEGo) brings together national and regional governments to deepen their understanding and share expertise in growing well-being economies in their own countries. The alliance2 currently includes Scotland, New Zealand, Iceland, Wales, and Finland.

This global interest also extends to Gross National Happiness (GNH) in Bhutan that is a living experiment at a country wide level, deeply rooted in the culture, values, traditions and practices in Bhutan over many decades.

In this paper, my interest is in drawing out what is distinctive about the GNH approach (section 2), and how this distinctiveness offers parallels with holistic health traditions (section 3). From here I go on to explore how a full appreciation of what GNH has to offer requires more than replacing economic growth with well-being but points to a reorientation in economic thinking and practice (section 4). In so doing, I hope to shed light on how GNH offers an integrated perspective linked with health, economics, and nature.

2. Reflections on Gross National Happiness

What is GNH and why is it different to other well-being economy approaches? Gross National Happiness is the guiding philosophy of Bhutan’s development process. It seeks to balance the four pillars of GNH comprising: Sustainable Socio-Economic Development; Preservation and Promotion of Culture; Environmental Conservation and Good Governance.

It is the growth in GNH and not Gross Domestic Product that is at the centre of Bhutan’s economy. However, it is Bhutan’s understanding of happiness and well-being that distinguishes it from other well-being economy approaches. In the words of Bhutan’s first Prime Minister Jigme Thinley:

“True abiding happiness cannot exist while others suffer, and comes only from serving others, living in harmony with nature, and realising our innate wisdom and the true and brilliant nature of our own minds”. ([14]; 23).

In particular, happiness in Bhutan is not seen as a ‘feel good’ feeling or state that can be achieved at an individual level. Rather it recognises the deep interconnectedness of all beings and emphasises that true happiness is about living in harmony and developing our own potential, wisdom and awareness in service of the well-being of others. This requires a balanced approach between mind and body and between spiritual and material needs. It emphasises the importance of sufficiency, inter-connectedness, service and self-cultivation. The purpose of GNH that guides government policy is to create the conditions (both internal and external) for this type of happiness to flourish. Here, external refers to the conditions in our outer environment—such as social inequality, biodiversity loss and climate change. Whereas, internal refers to aspects of mind that forms perceptions, values, worldviews and ultimately informs action.

If we look more closely into the GNH framework and measurement index, we find familiar indicators that are common to many well-being indexes. For example, literacy rates, household incomes; and environmental impact. But we also uncover some more unusual indicators, say for example that relate to gift giving; respect for the sacredness of nature and internal practices for cultivating awareness, compassion, and wisdom. These indicators reflect and are deeply embedded in the values and cultural traditions of Bhutan with its Buddhist and ancient indigenous roots [35]. They keep alive the traditions and practices that work at the level of shifting perception by recognising that the way we pay attention to the world changes the world we pay attention to.

“The mind not only perceives but assembles the reality we see, hear and feel; shaped always by pre-existing tendencies that direct our foundational faculties of attention and receptivity” ([7]; 5).

The central importance of how we perceive and relate to the world has long been recognised within Bhutan’s program of Gross National Happiness. This makes GNH in Bhutan clearly distinct from other well-being economic approaches by highlighting the importance of practices that cultivate the extraordinarily sensitive and advanced awareness with which human beings are endowed [40]; 9). This is now being acknowledged within academic research, policy circles and inter-governmental bodies who point for example, to a vicious circle between mind and climate and explicitly reference the importance of ‘inner transformation towards sustainability’ [41,19].

Cultivation of these capacities points to a form of ‘leadership of the self’ captured in an address by His Majesty the 5th King of Bhutan who urges citizens to live their lives guided by values of kindness, integrity, and justice. To bring positive change in the world—to eradicate poverty, reduce inequalities, reverse environmental degradation, and improve healthcare—we need to actively seek out “leadership of the self”, rather than leaders to lead the masses [42].

Particularly since the adoption of the UN Resolution “Happiness: Towards a holistic approach to development” [39] there has been growing interest in GNH and how it can be adapted to other countries, cultures, and contexts. My interest is in how this international adoption and adaption is taking place. In particular, my intention is to show how a full appreciation of what GNH has to offer requires more than replacing economic growth with well-being by importing and adapting the external economic forms and tools of GNH (including the conceptual model, the policy framework and screening tool, and the measurement index). It requires broadening our understanding to encompass the underlying thinking, perception and values that underpin GNH, pointing to a whole re-orientation in economic thinking and practice.

Here I draw parallels and important lessons from the international adoption and adaption of holistic health traditions to other countries and contexts.

“The recent dominance of medicalisation on health systems and policies on the global scene has sadly also impacted Ayurveda, encouraging a shift towards medicalisation which is visible in its current practice. In this process of separation from its ecological moorings, its traditional wisdom is being constrained and fragmented. The process has not only neglected the regional local knowledge and practices of Ayurveda but also their use of ecosystem specific and ethnic community-based practices for the health of plants, humans, animals and crops”. ([32]; 3).

A word of caution is expressed about how the body of knowledge and practices of Ayurveda have been undermined by disconnecting from their ecological context and local traditional knowledge and practices. This resonates with my own observations of how some branches of acupuncture have become divorced from their ontological roots. The risk is that these holistic health traditions are being applied and practiced in an instrumental and symptomatic way, without challenging the foundations and practices of Western biomedicine.

Likewise, there is a risk of seeing GNH as a final product, model or framework that can be de-contextualised and instrumentally applied elsewhere. I am interested how we can appreciate GNH more fully and what this means for shifting to GNH inspired well-being economies. I see two challenges. The first challenge is re-purposing the economy from economic growth to health and well-being (as in the GNH model). The second and less recognised challenge, is re-orientating our ways of thinking and practice more in alignment with ways of thinking and practice that underpin health and well-being in Bhutan, and other holistic health traditions. This epistemological challenge is explored further in the next section.

3. Holistic health and well-being

‘We can’t solve problems by using the same kind of thinking we used when we created them’. Albert Einstein

This famous quote by Einstein refers to the scientific domain but illustrates what I am referring to as the epistemological challenge that currently faces us in the economic domain, as we adapt lessons from GNH and apply in our own contexts.

In this section 1 draw parallels with the re-orientation in thinking and practice that I experienced when first encountering another way of understanding health and dis-ease. I use personal narrative to show my own experience of encountering a different epistemology in my study and practice of holistic health in Japanese and Chinese traditions.

Some years ago, I studied and practised Japanese Shiatsu and then went on to study five element and Traditional Chinese medicine and acupuncture. It was an experience that changed the whole direction of my life as I became exposed to a completely different way of thinking and practice. I learnt that health was about restoring dynamic balance and was defined as:

“The ability of an organism to respond appropriately to a wide variety of challenges in a way that insures maintaining equilibrium and integrity. Dis-ease represents a failure to adapt to challenge” ([4] ;36).

Living organisms were formed of a network of mini ecosystems embedded within larger ecosystems, right up to the planetary scale. Health was about maintaining dynamic relationship between our interior ecosystem and the exterior ecosystem. Patterns of health and disease were described in environmental and elemental terms such as invasion of wind cold or summer heat. At times, I felt I was in a poetry class, particularly when encountering names of acupuncture points such as ‘silk bamboo hole’, ‘eight winds’ and ‘heavenly appearance’ [27]. At other times, completely frustrated at an acupuncture point that had apparently contradictory actions of calming and invigorating, for example.

After a while, I just had to abandon my usual way of sense making, letting go of concepts, frameworks and analytical thinking and opening to a different type of knowledge. This involved cultivating my senses (touch, hearing, smell, sight, taste); beginning to look for repeating patterns and rhythms; and working dynamically with the emerging pattern and it’s unfolding. These became the embodied skills of the practitioner and from which the practice of diagnosis is founded.


I first came across this way of writing diagnosis during my studies of Chinese medicine. It emphasises the origins of the word:



Through knowing. Our tutors in Chinese medicine used to say that Western medicine took a long time to learn, but a short time to practice before you became a fully qualified doctor. Whereas Chinese medicine took a short time to learn, but the practice was a lifetime’s work. It was through the practice, that knowledge was revealed.

Here I recall some of my personal experiences of my practice within a mental health clinic. On one occasion I had two different people diagnosed with depression, reporting low levels of energy and on the same anti-depressant prescription. However, the shiatsu diagnosis and treatment revealed very different energetic patterns. The first patient although exhausted, revealed energetic congestion, and a tightness and stiffness in the body. Here the work was around releasing and moving. The second patient showed a very different pattern of energetic collapse and weakness requiring support and nourishment.

These examples revealed to me how ‘invisible’ mental and emotional states are expressed through the body in physical form. Within many holistic health traditions, the emphasis is on noticing repeating patterns (whether through memory or habit) and to take seriously the gesture towards eventual manifestation in physical form. Working within this invisible forming process sees disease as deeply relational, person specific and always in dynamic movement.

After being introduced to phenomenology through Henri Bortoft [6] sometime later, I began to liken the practice of Chinese Medicine as seeing ‘upstream’. The early movements of the invisible qi, the blood, the liquids of the body not yet settled or congealed in form. But moving towards. Emergent.

By learning to see the phenomena of health and dis-ease in this way and its ‘movement’ enabled an early intervention. This also took the form of movement. By introducing acupuncture needles to redirect the invisible qi, to direct awareness to this part of the body, thus attracting the blood. The healing was a form of ‘showing’ to the patient. It did not have to be explained in theories, words or diagrams, the method trusting the innate knowledge in the body, and its own tendency towards self-healing. Thus, working more as a catalyst through awareness than a medical prescription. This tendency towards self healing has long been recognised within Ayurveda and other holistic health traditions. However, the significance for greater self reliance within our wider health systems has recently been highlighted [28].

Thus, a simple system to learn but the dia-gnosis was not simple. It involved heightening our sensory capacities, learning to see the smallest of seemingly irrelevant features, taking seriously the arising of images or memories, the noticing of gestures, learning how to touch in a different way—to distinguish the difference between a ‘slippery’ or ‘choppy’ pulse. And gradually beginning to see how this diversity of sensory information or qualitative data ‘belonged together‘ to reveal a coherent picture of dis-ease. And where it is headed though the unfolding movement.

This encounter with Asian traditional health systems showed me a different way of thinking and practice. It distinguishes itself from the epistemological underpinnings of both neoclassical growth economics and the biomedical system that starts with the separation of the observer and observed and ends with standardised solutions.

“In the Indian knowledge systems, unlike modern science and the biomedical approach, the observer is not separated from the observed … These knowledge traditions stress the importance of mindfulness and interconnected self-awareness.” ([32]; 3).

Of particular importance is the cultivation of relational sensitivity in the form of sensory observations, and attunement to patterns and rhythms (in the body, in the rhythms of life and in the cycles in the wider environment). The observer, whether it be health practitioner or economist is no longer separated from the observed (the patient or economy, respectively). Far from it. These knowledge traditions stress the importance of interconnected self-awareness both in terms of cultivating the sensitivity of the practitioner and in catalysing movement towards dynamic balance with external social and natural worlds. The focus is on the person, the particular and the local context as distinguished from standardised and decontextualised interventions.

For example, in Ayurveda wellness is about cultivating resilience and dynamic adaption to the external environment [32]. In Traditional Chinese Medicine, wellness is about cultivating relational sensitivity and adaptability towards harmonious balance between the interior and exterior environment [23]. In Bhutan, the indigenous medical tradition of ‘gSo-ba Rig-pa’ is based on the Buddhist teachings that ignorance of the interconnectedness of life is the root of sickness and suffering [43]. These three Asian traditions all emphasis the importance of cultivating relational capacities rather than applying pre-formed concepts, models, or medical solutions.

4. Towards a Re-orientation in economic thinking and practice

If we re-orientate our ways of thinking and practice more in alignment with these holistic traditions, what are the implications for a new type of economic thinking and practice?

Like the holistic health practitioner, the practitioner of well-being economics does not simply implement standardised solutions or models. Rather the practice is about immersing in the situation, cultivating the capacity to notice the seemingly insignificant, fine tuning our senses to see and hear more, being present to what is happening, noticing patterns and repetitions. Working in this way, enables the economic practitioner to notice, shape and influence emerging processes whilst they are unfolding as well as being shaped and influenced by them.

The practice is deeply contextualised and requires the cultivation of a degree of relational sensitivity that enables the practitioner to respond appropriately to diverse and rapidly changing circumstances. Similar to the practice of many holistic health traditions, skills and knowledge are important, but not sufficient in themselves. Likewise, the practitioner of GNH inspired well-being economics requires a degree of self-cultivation, what the King of Bhutan referred to as ‘leadership of the self’. Table 1 illustrates what a re-orientation in economic practice might look like.

Table 1. Illustrating a new type of economic practice.

Observing the particular

  • cultivating observational capacities in harvesting and interrogating details of the particular context (people and place)

  • immersing in and being attentive to what is already happening, not as an observer but as a participant

  • fine tuning capacities to listen and receive, rather than jumping too soon to constructing, naming and generalising.

  • noticing practices, episodes, encounters and places that are potent and generative

  • being present to what is there, rather than projecting into the future; or imposing external ideas and models onto the present


  • revealing and showing what is otherwise latent, invisible or apparently insignificant.

  • resting with the creative tension of difference, rather than collapsing into lowest common denominator solutions

  • placing particular episodes, narratives or case studies alongside each other to reveal the underlying pattern and movement


  • developing capacities to detect and track emerging forms, whether this be social trends, narratives, ideas, social norms or economic forms

  • noticing repetitions and patterns

  • moving back and forth from the particular to the whole movement; from practice to ideas, from processes to forms, for one to throw light on the other

Navigating and influencing

  • the emphasis is on noticing what is happening, showing, participating in and acting with to shape the invisible forces of the present, the not yet formed.

  • Experimenting, testing out, noticing what happens, adapting and adjusting.

This epistemological reorientation lays the ground for a new approach to economic practice that may influence the way we perform our economic lives, livelihoods, and the forming of economies of well-being. Eventually as these new ways take root, they begin to shape all manner of structures that we have become used to label as business models, trading and exchange systems, financing mechanisms, policy frameworks and so on. In a complex, uncertain and rapidly changing world we cannot rely on measuring the relics of the past to influence the future. Rather, we must learn to notice, navigate, and shape the invisible forces of the present, the not yet formed or perceived.

This co-evolutionary worldview has long been recognised within the Buddhist and indigenous traditions of Bhutan. But in many other countries, this way of thinking and practice is unfamiliar and long forgotten or discredited. Any yet, within Western cultures we are beginning to see resonant calls coming from the most unlikely of places. For example, Carlota Perez, Honorary Professor at the Institute for Innovation and Public Purpose at University College London, highlights the importance of noticing and working with what is already happening but often not seen or recognised.

“Seeing revolutions, not as forced from above or by violence, but achieved by guiding and intensifying the transformations already occurring within society” [31].

Likewise, Otto Scharmer, Professor in the MIT Sloan School of Management, and co-founder of the Presencing Institute emphasises the importance of cultivating awareness to shift system structures and create new pathways along which economies unfold.

“Form follows consciousness. The structure of awareness and attention determines the pathway along which a situation unfolds”. [36]; 18).

Thus, we are not so much engaged in designing a revolution driven by ideas, theories, or ideology, but rather treading a path of awareness, noticing, and influencing what is already happening. It starts with attending to the detail and taking everyday experience seriously, giving attention to show and nurture small beginnings to grow, manifest and flourish.

4.1. An example in practice

In this final section, I reflect on my experience of facilitating learning programs with the Gross National Happiness Centre in Bhutan in collaboration with Schumacher College in the UK and Windhorse Farm in Canada.

These programs bring together participants from a range of countries and contexts, who set out with a personal inquiry or challenge related to cultivating wellbeing in their own life, workplace or local economy. Participants are invited to observe their current situation and the wider system within which they are embedded. This invitation goes beyond usual modes of intellectual analysis and evaluation; to explore different ways of perceiving and interacting with others. This includes practicing different levels of listening [26]; seeing the wider system through dialogue with different stakeholders; and taking seriously their own embodied experience through constellations and social presencing methods [[5], [17]].

Reorientating perception in this way recognises that the way we pay attention to the world changes the world we pay attention to. It can bring new insight into what otherwise was ignored, latent or invisible. In practice, this involves immersing in the detail of people’s lives, to see more and draw attention to what is actually happening and thus to notice and influence the gesture of the future as it unfolds3. Through engaging with this process, new and often unexpected ideas emerge which are developed into experiments, prototypes or simply refining the next best step that participants can take in their lives, workplace or community. In our experience, these prototypes have taken many different forms as illustrated in Table 2.

Table 2. Participant prototypes.


  • Converted a land estate to become organic (UK)

  • Received a grant for re-wilding land (UK)

  • Applied GNH principles to horticultural apprenticeship program (USA)

  • Initiated workshops for general public examining links between sense of life purpose and environmental responsibility (UK)


  • Trained 120 facilitators to use GNH at work (Brazil)

  • Retrained as a mindfulness teacher for schools. Started a PhD on holistic education (UK)

  • Introduced wellbeing storytelling into educational work (Spain)

  • Re-designed engineering curriculum to focus on green technologies & introduced pedagogies encouraging reflection & cooperation rather than competition (Thailand)

  • Conducted university-wide GNH survey with undergraduate students (Canada)

  • Incorporated principles and practices of GNH into educational curriculum (Spain)


  • Adapted GNH survey and framework to a hospital (Brazil)

Community Vitality

  • Established community space in city center offering workshops and events related to wellbeing and sustainability (Hong Kong)

  • Established “Silent Spaces” (quiet, contemplative areas, undisturbed by mobile technology) in 44 gardens across the country (UK)

Business and Finance

  • Hosted Asian Venture Philanthropy event and set up sustainable finance initiative (Hong Kong)

  • Worked with businesses to introduce GNH values & principles (Australia)

  • Launched social enterprise focusing on youth sports to promote global citizenship, conscious leadership and sustainable development (Spain)

Source: [24].

In taking forward these initiatives, the process continues of observing what happens next to adapt, iterate, and make the next move. This is what Otto Scharmer and others refer to as iterative cycles of action-research [34,36].

Practised in this way, pathways of GNH and Right Livelihood are seen not so much as a destination to be reached, but as a living practice of becoming more aware of our responses to the emergent reality of economic life. Hence, the focus moves beyond an analysis of economic life as it is, or visioning how it could be, towards developing the day-to-day practices for a more developed human being living in a more developed economy ([3]; 217).

This example illustrates the two challenges of moving towards well-being economies. Firstly, the re-purposing of economic lives and livelihoods towards putting health and well-being at the centre. Secondly, reorientating our ways of thinking and practice more in alignment with the epistemologies of holistic health and well-being traditions that underpin them.

4.2. The issue of scale

My intention is not abstract key lessons and scale up these individual level initiatives into generalisable models for regional or macro level application. Rather, they point to a more context specific and decentralised focus for initiatives and policy making [13]. Some would go further ‘upstream’ to propose that it is the way of practice (at an individual level, and within communities and organisations at different levels of scale) that is most important. In particular, effective action requires development of our faculties of attention and receptivity in the way we practice.

“The success of our actions as change-makers does not depend on what we do or how we do it, but on the inner place from which we operate … We cannot transform the behaviour of systems unless we transform the quality of attention that people apply to their actions within those systems, both individually and collectively”. [36]; (18–19).

The question is not so much about scaling up from the individual to macro levels, but rather cultivating networks of practice that can join and support each other to create a shared commons. This approach will therefore be of interest to professional economists (working at different levels of scale), whole person approaches to economics education and research, as well as lay practitioners who in practice are trying to create diverse economic forms of an experimental nature.

It may also be of interest to those practicing within fields of alternative economics. For example, there are many initiatives such as the Caring Economy [44] or Degrowth Economics [21], that resonate with the aspiration of GNH. However, they tend to work on transforming the external structures in society (e.g. such as social security, tax systems and fiscal and monetary policy frameworks and environmental technologies). A focus on the internal dimension of transformation is often missing. A GNH inspired approach offers both an external and internal approach to change that not only is critical to creating well-being economies but is also being recognised within the related fields of climate and sustainability policy.

“Most large-scale climate action to date has focused upon technical solutions to physical problems. Increasingly however, voices in the sustainability field warn that neglect of human inner factors driving the climate crisis leaves theories of change wanting; in part explaining the failure of current policies to deliver adequate response” ([7]; 9).

This paper builds on this work by pointing to a re-orientation in economic thinking and practice that is attentive, responsive and context specific.

Declaration of competing interest

This article arises out of doctoral research at the University of Plymouth, sponsored by the Dartington Hall Trust, Totnes TQ9 6 EL, UK. There has been no involvement of the sponsor in the research or preparation of this article.


I would also like to acknowledge and appreciate my work with Julia Kim from the Gross National Happiness Centre in Bhutan (GNHCB) and the work of others that take a phenomenological approach to working within ecological, social, and economic relations including The Presencing Institute;4 Allan Kaplan and Sue Davidoff from the Proteus Initiative5 and the Research in Action community of the Schumacher Society.6 I also acknowledge the financial support provided by the Dartington Hall Trust, UK for my doctoral research at the University of Plymouth.


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