The brain is often thought of as the command center for humans that ultimately controls our body. There appears to be an interdependence at play between the mind and the body, which both can influence each other and therefore influence our health and well-being. Several theories within health psychology, such as The Theory of Planned Behavior, the Transtheoretical Model, and the Health Belief Model each approach how mental attitudes can predispose, enable, or reinforce how people manage their health behavior. (Straub, 2017)
The emerging field of Health Neuroscience also aims at taking this a step further to investigate specifically “bidirectional and dynamic brain-behavior and brain-physiology relationships that are determinants, markers, and consequences of physical health states across the lifespan.” (Erickson, et al., 2014). Insights from these models suggest that psychosocial factors such as self-efficacy and self-enhancement may prove to be a better approach for shifting health behaviors. How do we recalibrate our thoughts and behaviors to recover from illness, but also strengthen and enhance our resilience to truly flourish and thrive?
According to Achor’s talk on the Happiness Advantage, the lens through which our brain views the world shapes our reality. This approach aligns with the idea of shifting our focus from a loss-frame messaging perspective to a gain-frame messaging perspective. Different researchers have tried to answer these same questions, but a common theme is that more positive feedback that engages neuroendocrine responses enable our mind and body to better maintain a state of homeostasis. (Achor, 2012)
There are two models that have shaped how we engage in health behaviors by identifying and formulating probabilities: the Health Belief Model and the theory of Planned Behavior. The Health Belief Model is explained as “four factors that influence decision making regarding health behavior: (1) perceived susceptibility to a health threat, (2) perceived severity of a disease or condition, (3) perceived benefits and barriers to the behavior and (4) cues to action.” (Straub, 2017,. Pg. 146) The model focuses on the causes of a person’s course of action, which most of the time is based on avoiding “illness-inducing conditions.” Perceived benefits and barriers to the behavior does show that people calculate their decisions based on pros and cons, but there’s still a fixation on barriers. One of the barriers noted is “the belief that people are not capable of changing their behavior.”(Straub, 2017) While this model is helpful for identifying problematic areas, it misses the mark on prompting or guiding how to meet health goals.
The theory of Planned Behavior is a model that seeks to identify problems and predict health behaviors based on 1) the attitude toward the behavior, 2) the subjective norm regarding the behavior, 3) perceived behavioral control. With a strong emphasis on planning and intentions, this model is “most accurate in predicting intentional behaviors that are goal-oriented and fit within a rational framework.” (Straub, 2017,. Pg 148) However, our personal attitudes can often be irrational for a number of reasons, and that’s especially true in the younger stages of life.
In contrast, the Transtheoretical Model adopts stages as a way to classify variables that influence health-related behavior. The stages are: 1) Precontemplation; not thinking about making changes or acknowledging that change is warranted. 2) Contemplation; acknowledging a problem and seriously considering changing behavior. 3) Preparation; thoughts and actions that will help equip an individual for a planned change. 4) Action; the process of changing behavior and upholding the process. 5) Maintenance; Sustaining the efforts of the transformation. This model differs from the previous two models; it provides strategies for success, acknowledges the struggle of adaptation, and recognizes that many people do not progress in a non-linear fashion. It also has a more inherent biopsychosocial approach with processes such as consciousness raising, counterconditioning, and reinforcement management, however there is still a preoccupation on risk instead of perceived benefits. (Straub, 2017)
What is a more beneficial model? Perhaps one that focuses on more positive values like prevention, pleasure, enhancement, and vitality. It’s telling that we don’t have a term for “the co-occurrence of human strengths” unlike its antonym co-morbidity, which describes multiple states of disease occurring simultaneously. (Straub, 2017)
As humans, we want to do more than just survive; we want to thrive. Substandard responses to fear and threats may be a type of survival, but it sure doesn’t sound ideal. It’s truly far from ideal that, “chronic exposure to environmental stressors leads to the development of depression like responses, heightened HPA activity, overeating, social avoidance and shrinkage of the hippocampus.” (Keller et al,. 2017) In the absence of access, awareness, and coping mechanisms, many people are expediting their aging process and increasing their likelihood of disease.
The idea of overhauling nationwide health systems to adopt new interventions may seem daunting, but studies show how a simple intervention can have an enormous positive impact. For example, the North Karelia Project aimed to launch an informational campaign for rural residents in Finland that had a very high incidence of coronary heart disease.
The Finns had the highest coronary mortality rates in the world. The goal was to reduce smoking, cholesterol and blood pressure levels through informational campaigns. The results demonstrated “a 17.4 percent reduction in the risk factors among men and an 11.5 percent reduction among women. Most significant of all, over three decades, deaths among the working-age population from heart disease dropped by 82 percent.” Who could have predicted that level of success from an informational campaign? It is also noted that coronary disability payments had declined to a point where it was more than enough to pay for the entire community program, a win-win situation from a modest intervention. (Straub, 2017)
An intervention that can easily be implemented to help reinforce a behavioral change is the use of self-monitoring, where individuals keep track of their own target behavior. Today there are many tools, wearables, and ways to do this. Whether it’s using an activity tracker, logging everything you eat or wearing a pulse-oximeter to manage oxygen and heart rate, people are able to get a clearer sense of where they’re starting from and get a better sense of where they’d like to be. According to Patel et al., (2021) the “self‐regulatory process of gathering data and receiving feedback enables individuals to identify behaviors to change and, in doing so, can bring them closer to their health goals. This systematic review demonstrates that engaging in self‐monitoring via digital channels is feasible and effective.” While this study is specifically related to weight loss, it seems that this process could potentially be enhanced for other health behaviors as well.
The previous two examples focused on targeting specific health behaviors. Another important area to take into consideration is our social environment. In a study by Branchi et al., (2013) two groups of mice were subjected to an acute stressor. One group of mice was raised in a social environment where they were part of a nest; while the other group was raised in individual cages. The mice that were part of a communal group were more resilient than the mice in individual cages. (Straub, 2017., pg 165) Almost telling for which countries are handling the spread of covid for better or worse right now, but that’s a topic for another time.
Whether we’re trying to overcome a genetic predisposition, adapt to an environmental stressor, or better cope with a social stressor, one thing is for certain, “overuse or dysregulation of neuroendocrine, autonomic, and metabolic systems lead to allostatic overload and the development or acceleration of many chronic illnesses, from depression to cardiovascular disease.” We cannot sustain prolonged chronic stress. The good news is that we can take steps to retrain our brains in order to seek out positivity, to become more resilient and to engage in healthier behaviors.
Through interdisciplinary study of the neurobiology of resilience, we can empower individuals and communities to embrace preventative care and adapt healthier behaviors to create lasting positive change. Achor point out, “In a meta-analysis of 225 academic studies, researchers found strong evidence of directional causality between life satisfaction and successful business outcomes.”
Life satisfaction is something that might be determined subjectively. Is the life satisfaction that so many of us seek actually self-efficacy? The American Psychological Association defines self-efficacy as “an individual’s belief in his or her capacity to execute behaviors necessary to produce specific performance attainments. Self-efficacy reflects confidence in the ability to exert control over one’s own motivation, behavior, and social environment.” People enjoy the fulfillment of achieving something, but that achievement derives meaning from our social environment as well.
It seems that interventions that help individuals and communities may have a greater positive affect on mental attitudes, mental health, and physical health. As we’re seeing more significance in the interdependence of the mind and body, we are also seeing an interdependence within our communities. Groupthink and confirmation biases effect our decision making; treating whole communities, such as the example of the North Karelia project, may have a greater impact long-term for both individuals and communities.
Achor also reveals several techniques to rewire the brain for positivity. One of them is random acts of kindness. He states that writing one positive email praising or thanking somebody in their support network “not only creates ripples of positivity, but also a revolution”. I believe this reflects the interrelationship between self-efficacy and feeling accepted in our community.
If we can embed healthy values inside and out; then as a society we can be more positive, more resilient, and much healthier. A person-centered approach and a community-focused approach can generate more empathy, more humanity, and more experiences of satisfaction. Adopting these approaches enhances individuals and communities with more opportunities to thrive. So instead of asking, what do we have to lose? We can instead ask; what can we gain when we better support ourselves and each other?
Achor, S. Transcript of “The happy secret to better work”. TED. (2012) https://www.ted.com/talks/shawn_achor_the_happy_secret_to_better_work/transcript.
Erickson, K. I., Creswell, J. D., Verstynen, T. D., & Gianaros, P. J. (2014). Health Neuroscience: Defining a New Field. Current directions in psychological science, 23(6), 446–453. https://doi.org/10.1177/0963721414549350
Keller, J., Gomez, R., Williams, G., Lembke, A., Lazzeroni, L., Murphy, G. M., Jr, & Schatzberg, A. F. (2017). HPA axis in major depression: cortisol, clinical symptomatology and genetic variation predict cognition. Molecular psychiatry, 22(4), 527–536. https://doi.org/10.1038/mp.2016.120
Patel, M. L., Wakayama, L. N., & Bennett, G. G. (2021, February 23). Self‐Monitoring via Digital Health in Weight Loss Interventions: A Systematic Review Among Adults with Overweight or Obesity. Wiley Online Library. https://onlinelibrary.wiley.com/doi/10.1002/oby.23088.
Straub, R. O. (2017). Health psychology: a biopsychosocial approach. Macmillan International Higher Education.