Hella Healthy

Research in psychology has given us many insights into the process of self-regulation, which is the process by which we manage our thoughts, feelings, and behaviors in order to achieve the things we desire. The process of self-regulation can be grouped into two main categories: goal setting and goal striving. Each of these categories has different factors that are important.

Goal setting should begin with clarifying your personal values. This will ensure that the goals you set, and the ways you choose to pursue them, will align with your values. Next, think of the broad goal intention. That intention should be matched with goal commitment. Commitment to goals is most helpful when shared with one or two close others who can hold us accountable.

Translating goal intentions and commitment into action requires setting specific goals. You are most likely to be successful when you set goals that are framed in terms of approaching a desired behavior rather than avoiding an undesirable one, based on mastery of skills and not performance of a particular standard, fairly challenging, driven by healthy (internal) motivation, and SMART (specific, measurable, achievable, realistic, and timed).

Factors that increase the likelihood of success when striving after the goals you have set include action planning, if-then planning, automating behaviors when possible, time management, minimizing effortful inhibition, and knowing when to abandon goals versus push through setbacks. 

There is abundant evidence that body weight is important to health, but it is overly simplistic to think smaller bodies are healthier and larger bodies are unhealthy. There are two primary pathways that link body weight to health outcomes: the negative physical effects of having a very high body fat percentage, and the negative psychosocial impacts of internal and external weight stigma. Both pathways contribute significant health risk. Because the stigma associated with heavier weights is so strong, all discussions of weight and health must be handled with great care. We can do more harm than good when we focus solely on the physical pathway and negative effects of excess body fat. It is worth emphasizing that weight is only one small aspect of physical health, and physical health is only one aspect of overall health. Instead of focusing on weight as a key indicator of health, we should consider that messages focused on body size or body fat percentage can often do more harm than good. For people who might benefit from reducing their body fat, it is not simply a matter of will power. Many factors impact health behavior and influence the likelihood of successfully adopting new habits. All discussions of body composition and health should be founded on an appreciation for the complex biopsychosocial nature of health.

On this episode I cover how people can use evidence about health risks to make more informed health choices. First, you must clearly understand your health goals and values. What matters most to you? Which outcomes are most valuable to you, personally? Which concerns are most paramount to you? Two types of risk to consider when it comes to health are the risk of under- and overdiagnosis. Underdiagnosis is missing a true health problem and allowing it to worsen. Overdiagnosis is treating a health abnormality that would not have gone on to become any real health problem. There is a tension created by trying to avoid both under- and overdiagnosis. Once a person knows their health goals and values, and really understands both of these potential outcomes, they can use evidence to make informed choices. I cover how to interpret the evidence using absolute risk reduction, relative risk reduction, and number needed to treat as key indicators. This is a truly vital skill for good scientific and medical literacy.

Why are some people able to change their behavior, while others are not? This is a very important question, especially when it comes to health. We are increasingly coming to appreciate the importance of lifestyle and behavioral factors in influencing health outcomes. On this episode, I discuss theories of behavior change and the factors researchers have found are most important in driving health behavior. I discuss some popular psychological theories that have successfully been applied to health behavior. These theories include: The Health Belief Model, The Theory of Reasoned Action, The Theory of Planned Behavior, The Transtheoretical Model of Change, Social Cognitive Theory, and Ecological theories. Together, these theories form a broad picture of which psychosocial forces most impact people’s health behaviors, including their ability to change and adopt healthier habits.

Prioritizing relational health is important, but how many of us think of our relationships as part of our health? In fact, relationships are strongly linked to health outcomes, to the degree that they are on par with traditional risk factors like smoking and exercise. How do we know that relationships matter to health? What have we learned about the pathways that connect relationships to health? Importantly, how can we prioritize our own relational health while also being socially responsible and protecting the health of our local community during this difficult pandemic? Discover the history of this field of research, and learn about some of the newest and latest findings, as we explore the answers to such questions on this important and timely episode of Hella Healthy.

If you would like a link to any of the studies mentioned on Hella Healthy, please email Dr. Serenity at [email protected]

There has never been a more pressing time to deepen your understanding of what stress is and how it can pose a risk to your health. When we experience repeated or irresolvable stressors it puts us at risk for disease. What do we really understand about how and why stressful life events negatively impact health, and what do know about stress management techniques that might help? This episode covers findings from various lines of research linking stress to health, including epidemiological, psychological, and biological studies. Together, these lines of research demonstrate the stress process, and show that stress is an important risk factor for disease. Learn about which diseases have been most strongly associated with stress, and discover how researchers were able to show these important links between stress and health. Finally, hear about the techniques researchers have found work best in fighting stress.

Links:

Dr. Sheldon Cohen’s Website

Dr. Sheldon Cohen’s Google Scholar Page

Dr. Sheldon Cohen’s Covid-19 Paper

Free Online MBSR Program

Jon Kabat-Zinn’s Website

On this episode Dr. Serenity talks about how to be a savvy health consumer in our current, confusing, capitalist health care system. She discusses important ways to make informed health choices, and some of the things that can make it challenging to prioritize health day-to-day. Explore what it means to find good health information and qualified experts to help you along the way, whether you want to maintain good health or are facing chronic health concerns.

We all know how frustrating it can be to deal with health issues. Any person who has gone through our health care system in any significant way knows that our version of modern medicine can present us with repetitive, frustrating, expensive, confusing, and emotionally draining experiences. In other words, getting help isn’t easy. American health care costs us time and money, and can be a real pain to navigate.

The dynamics of doctor-patient relationships push us to only discuss physical aspects of health, which as we know is only a part of our health story. It misses some really important information. Leaving out the psychosocial aspects of our health inhibits doctors from being able to treat the whole individual.

It is hard to know how to best empower patients to make healthy choices on their own, when they are out of the doctor’s office. Doctors are historically used to patients relying upon their expert evaluation of the evidence to determine the diagnosis and method of treatment. But when treatment recommendations are made without any explanation as to why this is the best course of action, which is often the case in doctor-patient relationships, the patient is left relying on the doctor to make their decisions rather than being brought on board with that decision. They are treated as a passive recipient rather than a valued partner, and the underlying assumption becomes that for patients to achieve health they must simply adhere to their doctors’ recommendations. 

This paternalistic nature of medicine is dysfunctional and problematic. Ultimately, it creates health consumers who are largely unable to advocate for themselves. Many doctors today work hard to try and avoid paternalism, but it is baked into the system itself. They must work against the system. Doctors and patients must commit to a system of shared decision making where both are active participants in choosing treatment options.

Ideally, our health choices would be informed by evidence. We have more information than ever before to help us make good health choices. Doing this requires being very savvy, however, because there is also more misinformation than ever before. Savvy health consumers need to have basic scientific literacy, but they need not be fully trained scientists. A big part of being savvy is also being able to find good professionals to rely on, and how to spot when a seemingly good professional throws up some red flags.

Savvy health consumers use competent experts and scientific resources to make health choices that are most likely to be beneficial and move them toward their goals. This means knowing your goals, generally speaking, and being clear about your health values. Each of us will have different things that matter most to us.

People need to be properly taught how to question things and think critically using reasoning and evidence. Being savvy means asking why a particular set of health advice is being given or evaluating the evidence for oneself when you have good scientific literacy. But this can lead us down the wrong path when seeming experts or what passes as science is pawned off on unknowing consumers as being legitimate. What is an average health consumer to do when even physicians disagree about the evidence or apparent experts present persuasive but contrasting opinions?

A huge weakness in our current system is that consumers are often unable to discern which self-proclaimed experts have valid qualifications and are deserving of their trust versus which are simply trying to profit or who have no legitimate expertise at all. Often, the true experts on a particular topic are siloed in their professional or academic communities, while pseudo-experts flood social media and local communities claiming to have mastered complex health topics.

Lots of people attempt to sell health because they are personally interested in it. You can find a gazillion wellness influencers who combine tips and tricks for eating well, staying active, and practicing self-care. Their advice may be sound in principle but is much better sourced from trained physicians, psychologists, dietitians, occupational and physical therapists, or other properly trained allied health professionals who have the training and education to understand the evidence and theories underlying their advice. A savvy health consumer must carefully evaluate the qualifications of any professional before handing over money for a health-related service or product. 

You deserve health professionals who are properly trained. Take the time to review the qualifications of any potential or current health professional. Given how many highly qualified people now offer affordable and accessible services like weekly newsletters, apps, blogs, or consultations, why would you waste your time and money on someone who is underqualified?

When you want to work with someone one-on-one regarding your health, ask yourself these kinds of questions: Does this health professional possess the proper expertise and clinical experience necessary to understand and evaluate my health and advise me? What evidence is this person using to make their recommendations? Is this person more committed to science and integrity or making money? Can this person clearly articulate why this is the best course of action for me using an evidence-based approach? How much will this cost me in terms of time, money, energy, and emotional distress? How invasive are the recommended treatments? (The more invasive the higher your bar for evidence should be.)

There are some wonderful resources for people who want to improve their ability to advocate for themselves and make informed health choices. One initiative I like because it is straightforward and easy to remember is the Ask Me 3 campaign. There’s a great channel on YouTube called The Psych Show that teaches many things about psychology and mental health. There’s an organization called the Society for Participatory Medicine that works to empower doctors and patients to work together as active participants in medical care. There is another website called Science Based Medicine featuring thoughtful and informed articles on a variety of topics written by legitimate scientific experts. These are just a few of the resources available to you that come from highly educated and properly trained professionals.

There are many well trained and passionate people from a variety of professional and educational backgrounds who have the proper skills to help you understand and improve your health. Find a health professional who can clearly explain how their recommendations are made using clinical expertise and best available evidence, and who can tailor their recommendations to your personal goals and values.

This episode covers the timeline of key ideas and events that shaped the field of health psychology. How and when did we begin to understand the complex ways psychological and social factors impact health? Includes an introduction to the biopsychosocial model and social determinants of health, two key theories informing our current understanding. Health is very complex, and discovering which factors drive it to improve our understanding is extremely complicated. To grasp the complexity of health, we must start with an appreciation for the scientific method as a means for discovering truths about our world. In this episode we discuss how the rise of empiricism enabled us to better understand health, and why it is vitally important that we continue to rely on it as the supreme method of discovery.

Dr. Serenity Della Porta received her B.A. in Psychology from California State University, Fresno and her Ph.D. in Social and Personality Psychology from University of California, Riverside where she researched how things like personality and relationships impact health and longevity. She has taught university courses on Health Psychology, Health and Behavior Change, and Statistics; and currently works to educate individuals and help organizations improve their understanding of the complex biopsychosocial nature of health.

In this episode, Dr. Serenity explores the historical context in which our current emphasis on health and wellness developed. Surprisingly, this increased interest in improving health through changing our behaviors is relatively new. Only for the past 60 years has there been a serious conversation about health habits such as diet and exercise. It’s been fewer than 30 years of mainstream interest.

A general discussion of how we came to understand the causes of disease, and how this shapes our current views on health to this day, sets the stage for future explorations into our current culture of health and what we know about its links to psychological and social factors.