How to Escape from the Behavioral Roach Motel

In John Gottman's book The Science of Trust, he talks about “absorbing states” that are hard to extricate oneself from.

He's referring specifically to “nasty/nasty” couples' interactions – that is, when both partners are being nasty to each other. His research shows that logic isn't at play – no one likes being in this state.

Happy couples spend relatively little time in “nasty/nasty” and get out quickly once they find themselves there.

In contrast, unhappy couples get into the “nasty/nasty” state more frequently, and stay there longer. For them, the “nasty/nasty” interactions are like a “roach motel: they check in, but can't check out.”

In other words, the “nasty/nasty” state has become, for some couples, an absorbing state.

That reminds me a lot of my own relationship with healthy diet and lifestyle choices.

Sometimes I get into a healthy groove – exercising, eating lots of veggies and avoiding junk. And sometimes that healthy groove reinforces itself, so that temptation to be lazy or cheat doesn't pull me off course.

And sometimes I take a wrong turn in my health habits but bounce right back up again.

Other times, however, that first cheat or missed workout draws me into my own version of the “nasty/nasty” state. A place that feels terrible, but doesn't motivate me to leave.

So here's my question: what factors in my control determine whether my absorbing state (my default, if you like) is nice or nasty? How can I make it more likely to “get stuck” in heaven than in hell?

That's my personal research project for the next few weeks. If you have your own experiences to share, I'd love to hear them.

How to Overcome Partner Resistance to Healthy Change

Doug Lisle, psychologist at True North Health and coauthor of The Pleasure Trap, argues persuasively in his talk “How to Get Along Without Going Along” (excerpted here on YouTube) that the biggest reason people are hostile when we start eating better is that they perceive a threat to their status.

As I was discussing this theory, stream-of-consciousness fashion, on my online TV show yesterday, I stumbled upon the conclusion that this is correct, and incomplete.

Status is important to us, but it's not the only thing. David McLellan's Three Needs Theory posits two additional drives: affiliation (love, friendship, closeness, affection), and achievement (accomplishing meaningful goals).

When we improve our diets, our partners can legitimately worry about suffering in those domains as well.

They may worry about us not being able to go out to the same places and enjoy the same social scenes anymore.

They may realize that eating differently requires shopping, prepping, and cooking differently, and that they lack competence in the new ways of doing things.

According to McLelland, each of us has a motivation profile, made up of different valences of the three main drives. So if you focus on assuaging your partner's status shortfall when they are actually driven more by affiliation, you could be missing the most important part of the equation.

Lisle's advice – humble yourself and do what you can to restore their perceived status – holds for affiliation and achievement as well. Reassure them that the relationship will only grow stronger, and that their strengths and skills will be important to you as you transition to a healthier way of eating.

Once the perceived threat is neutralized, the rest is just details.

Loving and Hating Food

Researcher John Gottman argues in his book The Science of Trust that the biggest predictor of relationship success is the ability to stay emotionally neutral during conflict.

While most therapists focus on fostering niceness and eliminating nastiness, Gottman shows that neutrality – almost a kind of computer-like detachment – can keep conflicts from spiraling into negative feedback loops that destroy trust.

Loving and Hating Food

I think the same thing is true of our relationship with food. When people shift to a plant-based diet, they often do so fueled by the conscious fumes of hate and love.

Many plant-based converts focus on the terrible consequences of meat and dairy: animal cruelty, environmental degradation, compromised health.

On the flip side, they post adoring encomia to the health benefits of cruciferous vegetables, the beauty of salads, and the stunning physical beauty and vitality of star members of the plant-based tribe.

That’s all fine. The zeal of the new convert is a powerful force to combat the inertia of decades of contrary habits. Both in identifying with the new and rejecting the old.

But we don’t want to live at those extremes.

Achieving a Steady State

Ultimately, the goal of our relationship with food is a steady state, no-nonsense, neutrality. We don’t get fired up about it most of the time. We just eat food that we enjoy and that makes us feel good.

Occasionally, a tirade is OK. Just like a fight in a relationship is OK in moderation.

And it’s wonderful to go all rapturous about a beautiful plate of veggie sushi or a stunning chickpea water meringue every once in a while. Just like our relationships need regular romance and flowery expressions of love to stay juicy.

But neither the fights nor the lovemaking predict the staying power or overall satisfaction with the relationship. Rather, it’s the neutral, matter-of-fact, daily interactions that determine whether we stay or go, thrive or suffer.

Here’s where the healthiest, happiest, most effective practitioners of nutritional excellence end up:

“This is what I eat. I like it. It’s no big deal.”

When is alternative medicine a good idea?

Modern medicine doesn't have much to offer people who suffer from chronic conditions brought on by poor diets and stressful, sedentary, emotionally unfulfilling lifestyles.

Drugs and surgeries may be necessary once things progress to the point of emergency, but as methods of disease management, reversal, or prevention, they are largely useless.

Once you arrive at that conclusion, then what?  There are a lot of non-traditional modalities, often labeled “holistic,” “alternative,” or “complementary,” that promise a safer, gentler, and more humane experience of health care.

Trouble is, they may still not get at the cause. Which, if you'll recall from the first paragraph of this article, is poor diet and stressful, sedentary, emotionally lifestyle.

So when is chiropractic, or naturopathy, or Reiki, or past life therapy, or aromatherapy, or drumming, or whatever the modality, a good idea?

Here are three criteria:

The modality can't be harmful, even if it's less harmful than the medical alternative

When we compare holistic treatments to medical ones, it's tempting to choose the lesser of two evils. So thermography to screen for breast cancer is less dangerous than mammography. But it still involves risks.

Glucosamine is less toxic than NSAID pain killers, but still can lead to side effects.

There has to be some evidence of efficacy

The thing with many alternative practitioners is that they are really good people who care deeply about their work, and about helping others. Yet they may be practicing a modality that simply doesn't work. Or doesn't work better than placebo.

Thermography doesn't reduce the risk of dying of breast cancer. Glucosamine can reduce arthritic symptoms, but doesn't improve outcomes. In fact, the reduction in pain can allow the underlying disease to progress even faster and more profoundly, since the patient no longer is motivated to solve the problem.

The treatment must either address the cause or buy time for the patient to address the cause

Just as drugs and surgery target symptoms, or secondary mechanisms, most supplements and manipulations also deal with the “downstream” effects of root causes. A chiropractic adjustment of the bones may offer relief, but what caused the bones to misalign in the first place? If you don't solve the postural and structural and mobility issues that engender misalignment, you're not making progress.

Some therapies can be very helpful in bolstering your mindset, so that you are better able to improve your habits and lifestyle. Used in that way, many mind-body therapies have a valuable place at the table.

Talking with alternative and complementary practitioners

Basically, ask them the same questions you would (or should!) ask any healthcare practitioner:

  • What are the risks and benefits of this treatment? (ask for evidence: clinical trials, case studies, traditional uses; and be aware of the difference between stories and science).
  • What's the root cause of my condition, and how does this treatment deal with that?
  • If it doesn't directly address the root cause, how will you help me do that?

Most of the time, the real danger of holistic healthcare is that it's a kinder, gentler distraction from the real work of getting well: cleaning up the diet and improving lifestyle.

Save money on your prescriptions: eat salmon

A soon-to-be-published study conducted by the National Oceanic and Atmospheric Administration found bioaccumulated pharmaceutical drugs in the tissue of salmon in estuaries in the Seattle area, including “sertraline, triclosan, estrone, fluoxetine, metformin, and nonylphenol.”

Which makes salmon an excellent choice for depressed, germ-phobic, prediabetic women who don't want to get pregnant now but want children with birth defects eventually.

Now, as a health advisor, I will be sharing this information with my clients and students who ask about the relative health benefits and risks of wild-caught salmon.

But even if I could get everyone to stop eating fish, it wouldn't solve the public health problem.

I studied public health in grad school. The more I've seen, the less sure I am about the dividing line between public health and individual health. Is it even possible to be a healthy person on a sick planet?

As Charles Eisenstein points out, when the public health threat is external to ourselves (a terrorist, a virus, a foreign dictator), the government and media mobilize to publicize and combat the threat. But when it's us doing it to ourselves (or us doing it to fish, who then do it do us when we consume them), these stories tend to be ignored, buried, denied, downplayed, and quickly forgotten.

We love the “command and control and dominate” solutions that seem so appropriate to viruses, terrorists, and dictators: quarantine, starve, bomb, vaccinate, etc.

But we can't use those approaches to solve issues like pharmaceutical drugs in waste water getting into our food supply, or lead-laced water being piped into our inner cities, or unstable weather patterns leading to droughts and floods and failed crops.

If you stop to think about it, you may come to the same conclusion as Charles Eisenstein: that the domination strategies don't really work against terrorists, dictators, or viruses either. In fact, these phenomena usually come about as unintended consequences of our attempts to dominate nature and others.

And back to the microcosm: we've “dominated” diseases in the medical model for the past 70 years or so. The result of our antibiotic war against bacteria has been an epidemic of resistant “superbugs”like MRSA. The result of the chemical war against cancer has been a death rate that hasn't budged in 40 years. The result of our pharmaceutical war against diabetes and hypertension is a nation with 50% of adults diabetic or prediabetic, and 67% hypertensive or prehypertensive.

It's time for humans to evolve a new relationship with the earth and each other. (Actually, it's quite an old relationship, but it needs a modern twist.)

We need to be able to see systems. To see patterns. To see leverage points.

Otherwise we're just chasing the bubble of wallpaper around the room, creating new problems (and worse ones) while we attempt to solve the old ones.

That's a tall order, but each of us can (and must) start with ourselves.

Once we identify and adjust the underlying patterns in our lives that lead to disease and dysfunction (from diet and lack of movement to poor posture and paucity of social relationship), and we experience real improvement – only then can we truly believe that there are alternatives to “command and control and dominate” out in the wider world.

As within, so without.

Are You Well Endowed?

In 2004, a professional car wash in a big city gave away 300 loyalty cards with spaces that would receive stamps upon subsequent washes. 150 customers got a card with eight empty spaces, and the other 150 got a card with 10 spaces, two of them already stamped. The rules: a fully stamped card entitled the holder to a free carwash.

(Here's a link to the PDF of the study.)

Objectively, each group had to do the same thing – get eight more car washes – to earn a free wash. So assuming true random distribution of the cards, there should have been no difference in the customers’ behavior between the groups, right?

Actually, one group got more washes and more stamps. Can you guess which one?

It was the group with 10 spaces, two of them already filled. After 3 and a half months, 34% of this group filled up their card, vs. just 19% of the 8-space group.

Why on earth?

The Endowed Progress Effect

The researchers surmised that the group with 10 spaces felt like they had already made progress toward their goal – 20% of the way, in fact. While the other group, which needed only eight stamps, was starting at zero.

They termed this phenomenon the “Endowed Progress” Effect.

That is, the researchers endowed the 10-space group with the idea that they had already moved partly along the road to redemption (of the free car wash, that is).

Application of the Endowed Progress Effect in Health Improvement

Why is this insight so important to those of us trying to improve our diets and lifestyles and working to help others improve theirs?

Simply this: the more progress we think we’ve already made, the more invested we become in continuing the journey. We feel the momentum, we don’t want to lose what we’ve already “gained,” and we continue on the path.

Most of my clients, when we begin working together, think that they’re starting at zero in at least one domain of their life:
“I don’t exercise.”
“I don’t eat healthy food.”
“I’m always sleep-deprived.”

Sometimes that assessment is largely correct. I read clients’ food journals and marvel at how little whole plant food they’re consuming. But that doesn’t matter.

Coaching to Endow Progress

My job, if I want them to change, is to show them how much progress they’ve already made. If all they eat is Big Macs, I go through the 1970s jingle that still runs on an endless loop in my brain: “Two all-beef patties, special sauce, lettuce, cheese, pickles, onions on a sesame seed bun.”

“Hey, you already eat lettuce, onions, and sesame seeds.”

I find the spinach in their lasagna, the carrots in their carrot cake, the rice and bell peppers on their fajita platter. I show that they already eat lots of whole plant foods during their day. I give them two stamps, in other words, rather than insisting they start from zero.

Endowing Progress for Exercise

It’s easy to do the same thing with exercise. Even if they don’t work out and sit at a desk all day, they still walk to their desk. They go up and down stairs. They steer their car. Doesn’t matter how little or how silly. The key is to reconceptualize that perceived “zero” as a 20 out of 100.

One study that showed precisely this was conducted by maverick social scientist Ellen Langer. She told a group of hotel room cleaners who did not exercise much (67%) or at all (33%) that they actually were exercising, and gave them precise calorie counts for all their room cleaning activities (vacuuming was clocked at 200 calories per hour, in case you’re interested). And she told them how good exercise is for us.

A second group of cleaners (the controls in the experiment) were given information on the benefits of exercising, but not told that their jobs were considered exercise. Nor were they given calorie counts for their work activities.

The result was fascinating: on average, the “cleaning rooms is exercise” group lost 1.8 pounds over three weeks, while the control group didn’t lose any weight.

And here’s the kicker: the first group didn’t change their exercise patterns. They didn’t work more. They didn’t eat differently. They just… lost weight.

But how? Are bathroom scales susceptible to the placebo effect? Not that we know of.

Chip Heath and Dan Heath, co-authors of Switch: How to Change Things When Change is Hard, offer the Endowed Progress effect as an explanation: once the room cleaners believed they were already exercisers, they were already 20% of the way to 100%.

So now, perhaps, they scrubbed sinks more vigorously, took multiple trips to the linen cart, engaged in squats (and I like to think pirouettes) as they vacuumed, and generally burned more calories.

Maybe they started adopting other “regular life as exercise” habits like parking farther from the entrance and taking stairs instead of elevators.

You have probably made more progress than you think

So if you’re trying to get fit and well, why not endow yourself with some progress? Often, all this entails is cutting ourselves some slack, relegating the Vicious Inner Critic to a corner, and realistically assessing how far you’ve already come.

Sometimes, you might have to engage in “creative reinterpretation” – but that doesn’t make it not true. Unless you’re Lord Kelvin, you have no idea where absolute zero is. All things being equal, it’s much more useful to assume that you’re some way along the path.

If you’re working on your diet, look for and write down all the “good foods” you already eat. Whole grain toast? Oatmeal for breakfast? Salad? Soup with veggies in it?

See, you’re already well on your way. Just eight more stamps and you get a free car wash!

This isn't about “progress, not perfection.” It's about progress TOWARD perfection.

I'm not trying to say that 20% is good enough. The goal of the car wash card wasn’t to stay at 20% stamped. Even 90% gets you nothing but a crumpled card in your wallet. You've got to go all the way to get any tangible benefit.

Rather, the Endowed Progress principle tells us that it’s easier to continue doing something that to start something new. A simple mental trick can overcome inertia, one of the biggest enemies of change.

And hey, good news! By reading this article, you're 20% of the way toward signing up as a member of Triangle Be Well 😉

“Reduce your risk of a heart attack by 36%” – Really?

If you have high blood pressure and/or elevated cholesterol, you're probably taking meds. Is this a good idea?

Depends. If your numbers are through the roof (that's a medical term for “really high”) and they haven't responded to diet and lifestyle changes, then medication is usually called for.

If you're already had a major cardiovascular event (that's medical jargon for “something bad and painful, like a  stroke, heart attack, heart failure, etc.), then medication can help.

But millions of Americans have been put on statins, ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and diuretics who should not be on them.

The side effects and risks of harm so outweigh the benefits, most people shown an honest risk/benefit analysis would say no to drugs.

So how come we swallow all these pills? One big reason is the way the benefits are hyped by drug companies, drug reps, and doctors.

Here's the only bit of medical jargon that you need to take away from this article: relative vs absolute risk.

Once you understand the difference, and know how to talk to your doctor about it, you may decide to reduce your dosages or eliminate some drugs entirely.

Today's TriangleBeWell TV show (see below) is a 7-minute segment on the difference between relative and absolute risk.

Want to get off the pharmaceutical treadmill and achieve true wellness? Start by joining TriangleBeWell and get informed and empowered!