Learn why it is so important to plan in advance for your health success

When it comes to healthful living, knowing what to do isn't always enough! Translating good intentions into good behavior can be hard to do. One of the biggest obstacles to healthful living is the problem psychologists refer to as "channel factors."  To understand what is meant by "channel factors," think about how water runs down the side of a mountain. It "channels" itself into the path of least resistance, doesn't it? Even minor obstacles, such as a small rock in the path, can "channel" the water into a different direction. Psychologists have noticed something similar in human behavior: Behavior has a strong tendency to be channeled into paths of least resistance. In fact, studies have shown that often seemingly minor situational factors or obstacles are actually major determinants of what people do in real life.  This is a very important lesson for those of us who are pursuing better health. We must pay attention to these "channel" factors because they can dramatically influence whether or not we actually engage in health-promoting behavior that we know is so important.

A surprising study

Psychologists John Darley and C. Bateson decided to investigate this "little factors are important" aspect of channel factors in a study on helping behavior. They based their study on the parable of the "Good Samaritan," using young seminary students at the Princeton Theological Seminary as subjects. The students were perfect subjects because in class they had been studying the parable of the Good Samaritan, a man who stops to help a stranger in distress.

Here is how the study worked. Students were called in - one by one - by the experimenter. Each student, in turn, was told that he was to give a brief talk in a nearby building on the Good Samaritan parable. What the students didn't know was that they were secretly being divided into two experimental groups.

Seminarians on the run

When a student from the first group was called in to the experimenter, he was told, "It will be a few minutes before they're ready for you, but you might as well head on over." When a student from the second group was called in to the experimenter, he was told, "You're late; they were expecting you a few minutes ago, so you'd better hurry." Except for these two different comments about how much time they had, the instructions were exactly the same for all of the students.

On the way to the other building, each of the students came upon a man slumped in a doorway, head down, coughing and groaning...clearly in need of assistance. What do you think happened?

Of the students who were told that they had "plenty of time," 63% stopped to offer assistance. Only 10% of the students who were told they "were late" stopped to help, and some of them even stepped over the body of the person who was "in their way"!

This study demonstrates that "niceness" was not the primary determining factor in whether or not assistance was offered. The main determining factor was a channel factor, a subtle situational factor: "you have plenty of time" vs. "you are late" that largely influenced whether or not the needed helpful behavior actually took place. The seminarians who "were late" would have been six times more likely to stop if they only "had more time."

Making the time for health

When assisting people in making the transition to healthful living, the most frequent problem I hear is frustration with what I call "convenience factors." At the Center for Conservative Therapy and at our Health Promotion Clinic, I conduct group therapy workshops to assist people in planning successful lifestyles.

Among the issues on which we focus our attention and take very seriously are these subtle situational channel factors. We have found that if people don't get themselves organized, they simply "won't have time" to live healthfully, and we all know where that leads. Some of the strategies we utilize are discussed below.

Some helpful strategies

One key strategy to eating more whole natural foods is to make sure that an abundance is available! People have a natural tendency to not want to waste food, and whole natural foods will eventually "go bad" if not eaten. That is why so many people in the world are eating mostly processed foods - because these foods are convenient and are rarely "wasted." If you look on some cereal boxes, the manufacturers suggest that the food is so well preserved (with chemicals) that it will be good for a couple of years!

One "channel factor" issue to work in your favor is to have an abundance of whole natural foods in the house. If you have to run to the store every time you want to make a healthful meal, the "channel factors" will very often defeat you. That is why it is so important to keep plenty of healthful food in the house, even if it means you buy too much at first and you have to throw some away. You may feel uncomfortable throwing food away, but until you get adept at buying the right amount, it is just part of the price of healthful living.

Some of our patients get hungry in the car, and the ease of pulling into a fast-food driveway to satisfy their hunger is just too easy, relative to the hassle of ferreting out a healthy meal or snack. Once again, planning ahead for these moments can really improve your health habits. Keep a small cooler or other container in the car, with some healthy snacks tucked away. Some of those snacks might be apples, oranges, cashews, or cold baked potatoes or yams. One of our patients packs a small bottle of low-sodium ketchup to go along with her baked potatoes, and she raves about it.

A weekly menu plan also can be helpful. If you have a standard weekly menu, with a corresponding shopping list ready, it can make your week sail along, meal after healthful meal, according to a preset schedule. Of course, if you want to deviate from the schedule, feel free! But the idea is that the more habitual we make good habits, the easier they are to follow, and the more often healthy behaviors will result. If you are planning and shopping every few days, with everything different, the decisions and hassles can become channel factors, and then it can get easier to "slip."

Finding your own way

The above suggestions aren't meant to be prescriptions for how you should do things. Everyone needs to find his or her own way. But if you are having trouble staying on track, these kinds of ideas might well be worth a try. If you are "slipping" a lot, it may be partly because of some subtle situational factors. And getting more control of these "channel factors"  can sometimes make the difference between success and failure.

Stroll through any modern bookstore's psychology/self-help section, and you will see numerous books addressing concerns about stress management. People in today's society are often stressed out, and the authors of these books offer their thoughts about how to correct the situation.

Some of these books make many fine suggestions, such as encouraging people to learn relaxation techniques, and to look at life's stressors more critically to determine if a particular stress response is truly indicated. This latter technique can be most useful, since people are able to make mountains out of molehills quite easily in our modern environment. By contrast, in my grandmother's day, she and her family really did have to worry about having enough to eat, and enough wood for the Idaho winter. Today, our worry-responses sometimes can be out of proportion.
 
Buffer zone approach

Although techniques such as relaxation training and perspective-taking can be useful, there is an entirely different approach to stress management that is rarely discussed. The techniques of this approach involve making life choices in a manner that leads to reducing the probabilities that stress responses will occur in the first place. I call this the buffer zone approach.
 
Three key life values

Threats to three particular areas of life consistently cause stress. These key areas are health, wealth, and reputation. When any of these areas is threatened, stress responses naturally result, as they should. Stress responses are built into our natural psychology in order to help us deal more effectively with threats to important values! Stress responses such as increased vigilance, worry, rumination, and heightened arousal are potentially useful. Our ancestors were people who worried and got very focused when important values were threatened. Stress responses helped to increase their survival prospects. Less concerned people were less successful biologically.

Stress responses are an important component of our biological heritage, and can serve us well. If a person quits his job because he doesn't like the boss, but has no way to pay his rent or feed himself in the interim, he doesn't have an effective stress-response system. If a person takes a short-cut down a dark alley in a big city late at night in order to save a few steps, she may pay severe consequences for her lack of a sufficiently pessimistic imagination, a useful component of the stress response.

Health protection

In nationwide surveys aimed at determining the most important factors influencing human life satisfaction, health consistently comes out on top. It is the number one factor associated with psychological well-being. This is probably not due to the fact that everyone thinks about his or her health very much. Rather, it is probably because when health is seriously threatened, the stress response is so great that it tends to dominate the person's overall quality of life experience, as it should! Therefore, the number one key to stress management is to make healthful living a top priority.

No one needs the stress of discovering a growth or a tumor, and then hoping it is benign; or discovering that one's shortness of breath is the result of one's arteries being almost completely clogged. In my view, the best stress-management technique is to avoid health-related stress altogether, if possible! You can do this by making daily choices to maintain, or even improve, your health.

Don't be content just because you are not obviously ill. What you want to do, ideally, is to build a buffer zone around your health, your most precious asset. You want to make it as unlikely as possible for any accident or short-term illness to end in disaster. If you don't take care of yourself, at some point, even a subtle stressor may result in serious, permanent problems.

Many people are walking time bombs, so vulnerable that even a short-term stressful event can result in a heart attack or a stroke. One woman of my acquaintance was so unhealthy that one fateful day, when she sneezed, she experienced a paralyzing stroke. Now, she and her family must live, every single day, with the consequences of her previous lifestyle habits, which caused her health buffer zone to become paper-thin. A key stress management strategy is to consistently invest in your health, so that you have some leeway in your health buffer zone when life sends you trouble.

Wealth protection

Today, people spend a good deal of time and energy worrying about money. This isn't surprising, because so many people have a paper-thin financial buffer zone! If you don't have a few months, savings in reserve, each time the boss looks a bit displeased, stress responses, such as anxiety and tension, can result. If you need a reliable vehicle to get to work, but cannot afford potentially expensive repair and maintenance bills, every strange noise your car makes can initiate a stress response.

Building a sufficient financial buffer zone is one of the most effective things a person can do to reduce his or her life stress. You can do this with a very simple philosophy. Make a habit to consistently produce more than you consume!

Regardless of how much or little you can afford, start saving this month. If you can save $300 per month, in a year you will have saved $3,600. With interest earned, at that rate you will have saved over $20,000 in less than five years. Through the consistent practice of a prudent philosophy, you will have succeeded in building a very substantial buffer zone into your financial life. This will reduce your stress in many ways.

Reputation protection

Your reputation, what those who know of you think about you, can be either a tremendous asset, a serious liability, or anything in between. What others think of you is beyond your direct control. You can influence what they think, however, in reasonably predictable ways.

For example, by making a habit of regularly doing a bit more than is expected, and by always striving to be honest and fair, one can build an excellent reputation over time. This can act as a stress-reduction strategy, since a fine reputation can act as a buffer zone should your judgment, or motives, ever be called into question.

A man of my acquaintance once told me that he had made a regular habit of showing up for work early, for seventeen years. I asked him what others seemed to feel about this. Curiously, he said that he was both admired and envied.

Co-workers observed his unusual habit of doing a bit more than was expected, and this simple strategy had contributed to the development of his remarkable reputation. I asked what he thought would happen if his judgment were ever called into question, or if he needed time off because of a family emergency. He laughed, and said that he was certain his employer would be there for him. It is an insurance policy that he hopes he never needs to use. But should he ever need it, he expects that it is there. That knowledge provides him with a reputational buffer zone each and every day of his life.
 
Perfection not necessary

The buffer zone approach to stress management does not demand that we seek perfection in our lives. We cannot always make the most healthful choices. We cannot always save more than we spend. We cannot always do more than is expected. Perfection is not the point. The buffer zone approach is part of a philosophy that encourages us to consistently seek to invest in our health, wealth, and reputations, so that should life send misfortune or difficulty in our direction, we are better prepared, and have a greater margin of protection. Some may call this approach old-fashioned, but in my practice as a psychologist, I continue to relearn timeless and valuable ideas. Sometimes simple ideas are the most profound, and an ounce of stress prevention is often worth many pounds of cure.

A significant source of stress in life can come from struggling with major decisions. Complex decisions, such as whether or not to change jobs, to make particular investments, to agree to a recommended surgery, or to stay in a relationship, can result in increased tension, confusion, and psychological distress. While we cannot avoid making such decisions, we can learn how to make them in ways that can minimize the stress.

Major decisions in life sometimes can be clear-cut and easy to make. When I was offered my first "real" job as a psychologist, I was thrilled. I jumped at the offer, which represented both an increased income as well as a greater level of professional responsibility. I had prepared for such an opportunity for years. When it finally arrived, I had no second thoughts, just pure excitement. But, not all major decisions are nearly this easy or clear-cut.

Real-life issues are often complex. They can involve situations in which we have important values and priorities on opposing sides of a decision equation, situations where we are not certain of what we will care most about in the long run. Our internal psychology has a way of letting us know when we are in such situations. During such times, we tend to ruminate, worry, procrastinate, and change our minds (perhaps several times). These processes are indications of dissonance, a psychological process that results from being forced to make a choice between two or more alternatives, where the choice is not clear-cut, and where the choice may result in some degree of psychological, physical, or financial distress.

Dissonance is not limited to unpleasant circumstances, such as considering whether or not to realize a loss on an investment or trying to decide whether to end a personal relationship. It can result even from very positive situations.

Suppose that you have been considering a job change, and have sent out a few resumes. Then, suppose that a few weeks later, two companies make very similar offers that are substantially superior to your present situation. You are delighted and excited, of course. But, when you have to choose between the two offers, you may well experience psychological exhaustion as you fitfully consider the two appealing, but perhaps nearly equivalent, alternatives.

Invaluable guide for action

The experience of dissonance, the tension, worry, rumination, and confusion that are characteristic of a difficult choice situation, is an adaptive process. Just as physical distress can be an invaluable guide for health-supportive action (such as when the pain from a broken ankle signals us not to walk on it), so, too, can psychological distress. The dissonance experience is a special kind of psychological pain. It might be described as "integrity pain," because it specifically signals to us when we have closely equivalent values on the various sides of a decision path. Integrity is about attempting to keep one's actions integrated with one's most important values. A dissonance experience can be a signal indicating that finding the highest integrity path is going to require careful consideration.

By stating that dissonance is an adaptive process, a potentially very useful process, I do not mean to suggest that we have to like it. The pain of a sprained ankle is very useful, but certainly not pleasant. Likewise, dissonance is useful. But, as with physical pain, it should signal us to seek appropriate methods of distress reduction. We can accomplish this by following a decision-making method, which takes into account a modern understanding of how the human mind works.

Neural circuits

Our minds are made up of many millions of neural circuits, most of which are essentially independent of one another. For example, you have circuits that monitor the temperature of your big toe. And should you stick your big toe into a Jacuzzi filled with overly-hot water, those circuits will activate evasive, pain-avoidance behavior (you will jerk your toe out of the water). You have neural circuits that are noting things like the scent of nearby flowers, the angle of the sun in the sky, and how long it has been since you have last eaten. All of these circuits are evaluating different pieces of information, all of which may be important; and they essentially are doing this independently of one another.

Consider what happens when you are trying to make a tough decision. As you imagine the impact of making various potential decisions, numerous independent neural circuits start firing. You then try to "read" the feelings associated with these imaginings ("Should I step into this hot Jacuzzi?"), in order to get a sense of your long-term best interests. This use of fantasy (our imaginations), in order to get a sense of how we might feel, given the likely consequences of alternative courses of action, is a powerful, and perhaps uniquely human, capability. Very often, these fantasies are all that we need to help us decide, with confidence, which path to take.

Sometimes, however, using imagination is not enough. Even after much rumination and imagination, we sometimes cannot decide with confidence and inner peace. We still have dissonance, with all of its unpleasant characteristics of genuine confusion and psychological distress.

Decision-making strategy

In order for you to make good decisions when you experience dissonance, it can pay to utilize a sound decision-making strategy. The general strategy that I use in my practice to help clients with critical decisions is a marriage of both general modern psychology theory and specific personal decision-making research.
 
Three basic principles

This strategy utilizes three basic principles: (1) Make the least risky moves first; (2) Use experiments whenever possible; and (3) When all else fails, go with your "gut."

1. Make the least risky moves first. Suppose that Mary is very unhappy in her current job, and wants very much to quit. She dislikes her boss, and believes that she is being exploited. She hates to get up in the morning, and dreads facing another day at the office. She ruminates continually about winning the lottery, quitting immediately, and never working another day in her life.

Mary heard a television self-help guru explain that in order to get anywhere in life, you sometimes have to "go for it," "take risks," and "not give in to your fears." She is starting to consider quitting her job, and then looking for her "dream." She feels great anxiety when she thinks about quitting. But, this is balanced by moments of euphoria that sometimes come from imagining being free of this particular workplace. She is experiencing dissonance, and is under great psychological tension.

By using the first principle, Make the least risky moves first, Mary should not make quitting her job her first move. There is no need to quit her current job before finding out what the realities are for her in the marketplace. It may be that currently she is overpaid, not underpaid. After getting feedback like that from other potential employers, she may not feel so exploited after all! This data alone may shift how she feels, and make her current job situation quite tolerable. Hopefully, however, Mary will discover that she can improve her situation. By shopping the market, while continuing in her present job, she will eliminate the need to make any major decision until the evidence favoring a decision becomes more clear-cut!

Sometimes, however, you cannot get the crucial information you need without actually making changes; and, thus, making one or more significant decisions. In such cases, you should attempt to utilize the second principle for making major decisions: Use experiments whenever possible.

2. Use experiments whenever possible. One reason we experience dissonance is that we often don't have enough information to predict our future satisfaction of a choice with confidence. Whether we are trying to choose between two cars, two job offers, or two prom dates, dissonance can result when we are uncertain of how much we will like a given choice, relative to possible alternatives. Sometimes we have to make a difficult choice. But, we often can reduce the tension around a big decision by making smaller, temporary decisions, in order to gain additional information.

For example, suppose that a successful couple who love sailing have decided that they are "tired of the rat race," and want to move to the Caribbean to semi-retire. They plan to operate a small business, taking tourists out on their boat for snorkeling and diving. They envision a relaxed, low-cost, low-stress lifestyle, one that in fantasy seems infinitely preferable to their current way of living. They plan to quit their jobs and make the bold move. However, in the process of making plans, they experience considerable dissonance.

While their imaginations may be indicating a need for a serious life re-evaluation, the couple might benefit from running a time-limited experiment. Instead of making a full decision, one that might burn bridges and unnecessarily eliminate alternatives, they might decide to experiment with their "grand plan." Perhaps they could take a leave of absence from their current employment, and offer to work for a company doing their "dream" work, at a low fee. In doing so, they might be able to conduct a relatively inexpensive experiment, lasting a few weeks or months, which could help clarify what would bring them the most happiness.

Using experiments is a way to learn more about the realities of your alternatives, including your own true valuations. An experiment is a way to discover these facts while attempting to limit risks. In this way, the use of experiments is really just a variation on the first basic principle: make the least risky moves first.

If small experiments are not enough to help you to clarify your feelings, you may need to use increasingly risky experiments. A couple contemplating marriage, for example, may discover that one or both persons are experiencing considerable dissonance. A series of experiments: couples' counseling, a short "break" in the dating relationship, or perhaps a decision to date others for a while, may be necessary to help clarify each person's alternatives. While such experiments are potentially "risky," they also may be useful in helping to clarify the most important values in a given decision situation.

3. When all else fails, go with your "gut." Suppose you have studied a difficult situation, used (and overused) your imagination to help guide you, consulted knowledgeable people, and made all the lower-risk moves you can think of, yet your feelings are still not clear. You still aren't sure which house to buy, which job to take, or whether to marry. At that point, the best advice is probably to distract yourself for a period of time, relax and rest, and then make a "gut" decision.

This homespun-sounding advice actually has been well documented in the psychological laboratory of Professor Timothy Wilson, of the University of Virginia. For more than 20 years, Dr. Wilson has conducted research on choices and choice-satisfaction, with a particular emphasis on what strategy is used to make choices. Dr. Wilson has been able to show that, in general, people who go with their "gut" reactions wind up more satisfied with their choices than those who attempt to carefully analyze their reasons.

The reason why "gut" reactions so often work best is not clear. But, it may be because they are responses to a more complete set of all of the relevant neural circuits in a decision, compared with a more analytical approach. Exhaustive analysis may inadvertently lead us to focus on just a few considerations, and to cause us to lose "touch" with other overall relevant values.

An inescapable part of life

Making major decisions is an inescapable part of the process of living. Dissonance, the psychological pain that accompanies many of these decisions, is a natural and useful signal that the decision in question involves a difficult and complex assessment of the involved values. This need not overwhelm us, nor cause us to be fundamentally tentative in our decision-making. And, like ankle pain that recedes when the healing has been mostly accomplished, dissonance tends to recede once we have truly decided on a course of action.

In my work as a psychologist, I often am called upon to assist clients in making critical decisions. This "critical decision counseling" often is very short-term. Generally, one to three sessions or phone consultations are enough to map out an effective decision-making strategy.

Like most psychologists, I generally try to avoid giving decision advice. But, I have no such hesitance about helping clients to formulate a decision-making strategy in an effort to help them get to a psychological place where their decisions become much less difficult to make. I have found the three principles outlined above to be very helpful in this process.

An important factor in determining whether we are successful or not when undertaking a difficult endeavor is our own confidence that we have what it takes. Psychologists call this self-efficacy, a term coined by eminent Stanford University research psychologist Albert Bandura. Bandura and other investigators have repeatedly shown that if you believe that you can accomplish something, it is much more likely that you will.

What is being suggested here is not some sort of magic. It is not an attempt to sell you the idea that if you can believe it, you can achieve it. That type of thinking is obviously incorrect. For example, a schoolboy might truly believe that he can run a mile in under four minutes, but an unfounded belief cannot alter true physical limitations. What is being suggested by self-efficacy theory is that if you really have the innate capability to do something, but you don't believe that you can do it, then you may unnecessarily fail!

Math lesson adds up

One experiment that Bandura and his colleague Dale Schunk conducted helps to demonstrate the importance of self-confidence. Students who were having difficulty in arithmetic were selected for special help. These students were each given a self-instruction booklet, which contained 42 pages of instruction and related exercises. Students were then randomly assigned to one of two experimental groups. In the first group, students were told that a reasonable goal was to try to complete the 42-page booklet by the end of seven study sessions (one study session per school day). We might describe this first group as being the One Big Goal Group because they were oriented towards thinking that the goal was to finish the entire booklet, rather than to work toward smaller subgoals.

In the second group, students were told that a reasonable goal would be to complete six pages of the booklet per study session for each of the seven days. We might describe this group as the "One Step at a Time Group." Other than these instructions, there were no differences in help given, answering of questions, or any other difference in the treatment of the two groups. Because students were randomly assigned to one of the two groups, there were no initial differences in overall ability between the two groups.

Bandura and Schunk suspected that they were helping the students in the "One Step" group by mentally breaking up the overall goal into smaller goals. They therefore expected that these students would gain confidence by taking the overall task just one section at a time. The authors expected that these students would work harder, persevere more often through difficulties, and ultimately learn and achieve more than students assigned to the "One Big Goal" group.
 
One step at a time

The results were clear, and astounding. On an achievement test used to measure students, mastery of the material, those in the "One Step at a Time Group" substantially outperformed the "One Big Goal Group." The average student in the "One Step at a Time" group was able to obtain an 80% score on a mastery test, whereas the average student in the "One Big Goal" group was only able to answer 40% of the problems correctly. Just as important, students in the "One Step at a Time" group wound up with much greater ratings of self-confidence, and were much more likely to persevere when a difficult problem was presented! The reason for the differences between the two groups was that students in the "One Step" group were much more likely to methodically work their way through the instruction booklet, and thus developed greater mastery.

These results give us clear evidence of an important insight into human motivation. If a problem seems "too big," we often won't stick with it, and lose our confidence. Alternatively, if we can find creative ways to chop big problems into a series of smaller ones, our confidence, motivation, and efforts, and thus our results, can improve dramatically.
 
Obstacles to healthful living

Living a healthful lifestyle in the modern environment can present a formidable challenge. There are several major types of obstacles in our way, each of them alone being enough to knock us off course. One of the most important of these types of obstacles is what we refer to collectively as channel factors. These are factors in our real-life situations that can make it more difficult for us to actually do the sorts of health-promoting behaviors that we intend to do.

Channel factors can be surprisingly important in either promoting or derailing behavioral intentions. For example, when soliciting business by mail, one of the most important factors is whether the business owner includes a postage-paid envelope! No matter if what is being sold costs over $100, and the additional cost of the stamp to the potential customer is negligible, the would-be customers are much less likely to buy if they have to go to the slight additional effort of finding a stamp.

With health behavior, these "channel factors" are almost always in opposition to our good intentions. The most convenient, and most socially acceptable, foods are usually the least healthful. Eating wisely usually requires more planning, more time and energy, and some additional skill development. In addition, because healthful foods can take longer to prepare, we often face a longer period of time between the impulse to eat and when we actually start eating.

With all of these forces pushing against us, it is little wonder that our best intentions often fall short. The greatest danger, however, lies not in our short-term failures. The most critical damage that these "Channel factor" problems can cause is the damage to our self-confidence! When our good intentions are consistently derailed, we can start to believe that we simply "don't have what it takes" to live healthfully. To adopt this belief would be a serious mistake.
 
Personality and behavior

One of the most important discoveries in social science in the past few decades has been the finding that people believe too strongly that personality differences are responsible for the behavioral differences they see between individuals.

By contrast, people typically underestimate the importance of situational forces that give rise to individual behavior. This can be a dangerous error when it comes to health behavior. People often think that if they have failed to live healthfully, the reason is that they lack some essential personality characteristic!

They may feel they are a "bad" or a "weak" person. They often fail to appreciate that subtle situational forces have conspired to disrupt their efforts. This belief that personality characteristics are the key feature in determining behavior can act like an optical illusion. It can cause us to make mistakes about how reality really works, and lead us to underestimate the importance of paying attention to situational influences. An example may help to illustrate this "personality" versus "situation" illusion.

Personality vs. situations

If you were trying to get college students to contribute to a canned food drive, which would be the most important task: finding people with helpful personalities, or creating situational forces that would make contributions more likely? Professor Lee Ross and his colleagues at Stanford attempted to find out, and the results of their investigation are instructive.

Their study was designed to examine both personality and situational factors in determining behavior, and also to examine which of these two types of factors is most important. The researchers divided students into four groups and studied their responses to a common request: to contribute to a canned food drive.

How the study worked

Students were asked to nominate their classmates for either one of two groups. One group was for those considered "most likely" to contribute to a canned food drive. The other was for those considered "least likely" to contribute. Once the nominations were completed, the investigators divided each of these groups in half. One half of the "most likely" students was assigned to an "assisted" group (group 1), the other half to an "unassisted" group (group 2). The same procedure was carried out with the "least likely" students (groups 3 and 4). (See Chart 1.)

The students in the two "assisted" groups were provided with specific situational forces designed to make it easier for them to contribute. Each student received a letter that addressed him or her by name; they were given specific instructions as to what foods were being requested; and they were given the address and a map to where the contributions could be dropped off. In addition, these students were given a "reminder" phone call during the week of the event. All of these factors were designed to facilitate behavior, rather than to impede it.

By contrast, the students in the two "unassisted" groups were provided with general information designed to make it slightly more difficult to contribute, so that the likelihood of contributing would be based primarily on their personalities. These students also were sent a letter, but this letter was merely addressed to "Dear Student," and there were no specific recommendations about which foods to bring. Likewise, the address to where the contributions could be dropped off was listed, but no map was provided. Finally, no "reminder" phone call was placed. These situational factors were designed to subtly impede contributing behavior.

Student predictions

How do you think each of the various groups contributed? The results may surprise you. They certainly surprised students who were asked the same question.

Students, none of whom were in any of the four groups, were apprised of the study's design. Afterwards, they were asked to make their best guess as to what percentage of subjects in each group would contribute to the food drive. A lot can be learned from their predictions. (See Chart 2.)

Students predicted that 82% of the students in the "most likely/assisted" group would contribute. They predicted that 80% of the students in the "most likely/unassisted" group would contribute. By contrast, they predicted that only 17% of the students in the "least likely/assisted" group would contribute, and that 16% of the "least likely/unassisted" group would contribute.

Clearly, these predictions indicate that students believed that personality factors, and not situational "channel" factors, were by far the most important issues in predicting behavior! The students showed almost no consideration for the situational forces that might be at play. Instead, they believed that the "most likely" students could reasonably be expected to contribute, regardless of situation, about 80% of the time. Likewise, they predicted that the "least likely" students would contribute about 16-17% of the time, regardless of situational forces. The students guessed wrong.
 
Surprising results

The results were much different than most people would reasonably predict. (See Chart 3.) Students considered "most likely" to help who were in the "assisted" group contributed only 42% of the time. Furthermore, students considered "most likely" to help who were in the "unassisted" group contributed a mere 8% of the time. Just as surprising were the results for "least likely" students. Those in the "assisted" group contributed a remarkable 25% of the time, while those in the "unassisted" group contributed 0% (that's right, zero percent) of the time.

These results provide a terrific example of not only the importance of situational forces in behavior, but also serve to highlight our natural tendency to overestimate personality factors in behavior. Note that the results show that the so-called "least likely" to help students in the "assisted" group were more than three times more likely to contribute than the "most likely" to help students in the "unassisted" group. The message is clear: situational forces are very powerful, and underestimated, sources of influence in our behavior.
 
You do have what it takes!

In my work as the psychologist for the TrueNorth Health Center, one of my main tasks is to help patients understand our most fundamental psychological message: You have what it takes to live healthfully! Not uncommonly, patients come to the Center after a period of getting off track, to get a period of rest, healing, and psychological rejuvenation. Often, when patients are nearing the end of their stay, they become concerned that they may somehow be missing some special characteristic, some kind of personality magic, that separates those who seem to keep on track from those who stumble.

An important task we have at the Center is to convince each patient that the power to live healthfully is already in his or her own hands. The "Big Goal" is to live healthfully, and that may seem overwhelming, and perhaps beyond one's capacities. But we take pains to explain and convince our patients that the "Big Goal" is just a target, and that it is really made up of a series of little goals. For example, getting used to fixing oatmeal and fruit for breakfast; planning a weekly menu; preparing a permanent shopping list to help make shopping and meal planning less mentally taxing; and carrying healthful snacks in your car so that you have something to help you resist the "pull" of unhealthful convenience snacks. Likewise, you can plan to do a "big cooking" once or twice a month, when you make soups and other entrees in bulk, and freeze some of the extra food for later convenience.
 
Reason for confidence

If you have struggled and stumbled from time to time on your way to healthful living, take heart! There is no "personality part" that you are missing that you must somehow cultivate. You don't need a year of group therapy, or some special psychiatric "self-discipline" pill. You already have what it takes to make your healthful lifestyle happen.

When you stumble, pay attention to what small factors conspired to defeat you, and steel yourself to find a solution. Piece by piece, and battle by battle, you can put together a winning formula. Don't think that a bad day or a bad week means that you don't have what it takes to succeed.

You do have what it takes. And you will discover this if you will just have a bit of patience with yourself, and keep at it, one step at a time.

Techniques to help you overcome the social roadblocks to health

Hygiene - the science of health-provides us with powerful principles that help us understand how to live healthfully and happily. But, remarkably, even though many people have an intellectual grasp of these principles, they do not put them into practice consistently. This is true even among those who have recovered from serious illness through Hygiene, and among those who have observed this inspiring drama in someone else's life.

As a psychologist, I feel this inconsistency demands an explanation.
 
Difficulties we face

There are several reasons why people who understand Hygiene may not consistently live their lives healthfully. Each situation is unique. However, in my practice at the TrueNorth Health Center, I have the opportunity to conduct the Healthy Habits groups, which are therapy sessions directed at helping people sustain positive changes. In these groups, members share their difficulties and successes in their efforts towards healthful living.

Group participants report that three types of problems account for most of the obstacles to healthful living: (1) cravings for the excitement and novelty of processed foods, (2) the convenience of "fast" foods, and (3) the social pressures from friends, family, and others about this "unusual" way of eating.

While cravings and convenience issues are important obstacles in their own right, my focus here is on the problem of adverse social pressure. For many people, social pressure is the most difficult of these three formidable obstacles to healthful living.

Need to be accepted

The crux of the social pressure issue is that we care what others think. Why should this be?   Experiments by social psychologists over the past 40 years have pointed to the answer: Our natural history is one of small-group living; thus, our natural psychology is to "get along" with others. We become concerned when others are upset or alarmed, particularly in response to our behavior. And people naturally get upset whenever we stray from the socially-accepted norm.

Any significant deviation from "normal" is generally enough to cause concern, comment, and social pressure to "conform." Something as trivial as a woman choosing to wear tennis shoes with an evening gown, for example, would be considered "unthinkable" by many people. If she tried to defend her choice by saying, "But these shoes are more comfortable than my high heels," her explanation would fall on deaf, and possibly angry, ears. She may be labeled as a "nut" and will be socially punished as long as she continues to dress in an "unacceptable" way-and probably for some time afterwards, as well.

We care about what others think because in our natural history, our ancestors relied on small-group support systems for sharing resources and trading specialized talents. These small groups needed social harmony to stay together, survive, and thrive, so internal group conflict was (and is) viewed as a serious problem. Such conflict can disrupt important life-enhancing exchange and cooperation. Little wonder, then, that groups didn't (and don't) easily tolerate unusual ways of doing things.

Reducing social pressure

A key strategy for reducing social pressure is to help others increase their tolerance for how we do things. Unfortunately, trying to do this directly often leads to failure. Consider the following interchange:

Flesh-eater: "Where do you get your protein? A person can't survive eating the way you do-it's unhealthy. You'll get sick and die. You're a nut."

Hygienist: "Why don't you leave me alone and be tolerant of our differences? I won't say another word about your clogged arteries and your overly ample proportions, and you can quit calling me a 'nut.' How about it?"

Flesh-eater: "You're a nut."

An approach that works

This direct approach tends not to work. More often than not, it is better to take an indirect approach when trying to reduce the social pressure from others to conform. We cannot expect tolerance from others. But we can make what we think and do seem less bizarre, outrageous, or threatening to them. We can accomplish this by answering questions with tentative responses, rather than definitive ones. Here is an example of an approach I frequently suggest to members in our Healthy Habits groups:

Flesh-eater: "Where do you get your protein from? A person can't survive eating the way you do-it's unhealthy. You're going to get sick and die. You're a nut."

Hygienist: "Well, my diet might not be right for everyone, but it seems to be working for me. My doctor says it seems to make sense. And if it doesn't work out, I can always go back to how I was eating before."

Husband now supportive

The effectiveness of the indirect approach was demonstrated by the experience of a woman who came to the Center earlier this year. She was suffering from some rather serious health problems, and chose to undertake a therapeutic fast and to make subsequent health-promoting dietary and lifestyle changes in order to recover her health. She was under considerable stress, however, when contemplating returning to her family and trying to maintain healthy habits. Her husband was disturbed by her visit to the Center, and was openly hostile about this approach to health recovery.

In our group work, we coached her to use an indirect approach with her husband. It was most gratifying to hear from her a few weeks later. She reported her success with great pleasure. She had recently overheard her husband on the phone with one of his friends, saying how "good his wife looked," and that "the reason was probably her new diet." The new diet was "unusual," he was explaining, but that "it seemed to make sense."

Planning for success

Health results from healthful living. But sometimes this knowledge alone is not enough. Learning to overcome the social roadblocks to health can make the difference between success and failure when it comes to health and happiness.

An interview with Dr. Alan Goldhamer by James Michael Lennon

How did you first get interested in Natural Hygiene?

When I was 16 years old I was exposed to the philosophy of Natural Hygiene through the writings of Herbert Shelton. I was also influenced through my interaction with Dr. Gerald Benesh, of San Diego. I was fascinated by the concept that health and disease were understandable and predictable phenomena.

You are a licensed doctor. Where did you do your training in Natural Hygiene?

After I graduated from Western States Chiropractic College in Oregon, I had the privilege of completing a residency program at the Arcadia Health Centre in Australia under the instruction of Dr. Alec Burton.

When did you open the Center for Conservative Therapy?

After returning from Australia in 1984, my wife, Dr. Jennifer Marano, and I opened the Center.   During the past 10 years we have supervised the care and fasting of thousands of patients from around the world. Operating a residential health care program is an intense and demanding experience, but an extremely rewarding one.

Including you and Dr. Marano, there are now nine doctors associated with the Center For Conservative Therapy, all certified by the International Association of Professional Natural Hygienists for fasting supervision. That is quite an accomplishment.

The Center set out to attract doctors with specific skills that complement each other. No one individual can have all the skills necessary to provide optimum care. In addition to his broad hygienic knowledge, Dr. Sultana is a board certified family physician, and an expert in helping patients evaluate and, when possible, eliminate unnecessary medication and medical treatment. Dr. Isabeau is trained in sports medicine and fitness. Dr. Kim, Linzner and Dina supervise  the day-to-day activities

Having so many hygienic physicians in one place brings benefits to patients and doctors alike. Because the doctors can easily consult with one another, they can make their combined experience and expertise available to patients.

People have raved about some of your recent talks, where you have emphasized the importance of understanding the genetic influences that affect our behavior.

I think it helps people better understand some of their eating tendencies and cravings, especially with their desire to eat concentrated foods-such as meat, fish, poultry, eggs, dairy products, oils and processed refined foods.

We are made up of trillions of electrochemically interrelated cells. Each of our cells contains 46 chromosomes which are in turn made up of millions of genes. The gene is the basic unit of heredity and determines much of who we are. For example, the genes contain the information that determines the color of our eyes and skin, how tall we can grow, even how intelligent we can become. Genes are responsible for our strengths and weaknesses and influence virtually every part of our lives, including our behavior tendencies.

Genes affect our behavior?

Our genes determine which of our cells become muscle, bone, nerves, organs, etc. They control the growth and replacement of cells. The gene represents accumulated adaptive information that has been selected over biological time. Genes that promote behavior and characteristics that favor survival are passed on from generation to generation.

Genes survive by promoting behavior that favors survival and reproduction of the individual. To the individual, survival means getting enough to eat and not getting eaten.

In addition to passing the adaptive traits through our genes, human beings have developed another powerful means of passing on accumulated knowledge-language.

Not getting eaten implies not only avoiding being eaten by other animals trying to survive, but also avoiding bacteria, viruses and other entities that would be more than happy to try to make you their supper. Not getting eaten, in the broadest sense of the term, also means avoiding cars that might try to run you over and other dangers of modern life.

How does this tie in with human eating behavior?

Most animals spend virtually all of their time trying to get enough to eat and avoid being eaten. Human beings, owing to our sophisticated mastery of language, have been able to gain control over our environment such that, at least in the developed countries, we have been able to get enough to eat and still have some time left over. But we still have a natural craving for concentrated foods, foods that have high amounts of fuel or calories. We crave the tastes of sugar, salt and fat.

In a natural setting this desire to eat as much concentrated food as we can get serves us well. Animals whose genes promote feeding behavior live to reproduce. In a natural setting, there are no chocolate chip cookie trees or candy bushes. There are no heated, beaten, treated, refined foods. But in many countries today, these processed foods are everywhere, and they are designed to appeal to our genetically driven instincts. They fool our natural senses.

Some of my patients tell me that some junk foods have even learned to speak. In fact, I've had many reports that some flavors of ice cream (the ultimate combination of sugar, fat and salt, all in one) will actually learn to speak their name. At night the ice cream will call out to them begging to be eaten. Sometimes they have to eat it just to shut it up.


I know you are just kidding about the talking ice cream. But it sounds like since we can't change our genes, we'll have to change our environment?

If we wish to survive and live happy, meaningful lives, we must adopt a strategy for achieving happiness that compensates for the changes we have created in our environment.

People often confuse happiness with pleasure. Pleasure is a response of our nervous system to specific stimulation. Food, sexual activity and even drugs can stimulate our nervous system in such a way that we experience pleasure.

Happiness is a word we use to describe a mood that occurs spontaneously when we perceive the balance of our experiences as highly positive.

Many people mistakenly assume that if they are not happy, they must lack pleasure in their lives. They assume they have a pleasure deficiency and go about trying to stimulate their nervous system.

Cocaine addicts are an excellent example. They will flush their entire lives down the drain to induce the pleasurable response associated with the use of cocaine. Some crack addicts have reportedly sold their infant children for a few rocks of cocaine. But no matter how much cocaine the addicts use, they will never be happy.

To achieve happiness requires a happiness strategy. It means being able to delay gratification and not being driven solely by short term, instant gratification, pleasure seeking behavior. We need to understand the difference between happiness and pleasure.   

As Printed in HEALTH SCIENCE SEPTEMBER/OCTOBER 1998 updated 2005
Alan Goldhamer, D.C., is the president of the International Association of Hygienic Physicians. He is also the director of the TrueNorth Health Center. The Center, which is located in Penngrove, Calif., specializes in fasting supervision, and is one of only two in-patient facilities in the world that trains and certifies physicians in that specialty. Dr. Goldhamer completed his chiropractic studies at Western States Chiropractic College in Portland, Oregon, and completed his internship in fasting supervision at the Arcadia Health Center in Australia, under the direction of Dr. Alec Burton. Dr. Goldhamer is the author of The Health Promoting Cookbook, co-author of The Pleasure Trap, and he recently participated in the production of two new videos on vegan cuisine and fasting.

How did you first become interested in Natural Hygiene? In 1976, after reading several of Dr. Herbert Shelton's books, I met Dr. Gerald Benesh of Escondido, Calif., who, along with Dr. Shelton, was one of the founders of the American Natural Hygiene Society. I was very impressed with the health philosophy of Natural Hygiene. Dr. Benesh told me that a doctor who used Hygiene-the science of health-as the basis of his or her practice had the best job in the world. He said, "That's because the body does all of the healing, the patient does all of the work, and the doctor gets all of the credit." I decided then and there that that was the job for me.

What is involved in becoming a Hygienic physician? Any licensed primary care physician [medical doctor, chiropractor, osteopath, or naturopath] is eligible to undertake an internship in fasting supervision under the auspices of the International Association of Hygienic Physicians. Successful completion leads to certification in fasting supervision.

What is a fasting internship like? Mine was an exciting and enriching experience. I worked very hard and was continually amazed at how effective fasting was-in even the sickest of patients. I remember saying to myself, "If this patient gets well, I'll really be convinced." I must have said that two dozen times during my internship. I am grateful to Drs. Alec and Nejla Burton for the opportunity to learn from them how to help sick people get well.

When did you open the Center for Conservative Therapy? My wife, Dr. Jennifer Marano, and I opened the Center in 1984. With our recent remodeling, it has grown to a 22-bed facility. We now have a staff of 22-including a medical director, Peter Sultana, M.D.; a clinical psychologist, Douglas Lisle, Ph.D.; and three IAHP certified Hygienic physicians-Alec Isabeau, D.C., Erwin Linzner, D.C., and Fani Alexandrakais, D.C.-in addition to Dr. Marano and myself. We specialize in the supervision of fasting and in the use of diet and lifestyle modification to achieve and maintain optimum health. We also are excited about our internet website that describes the Center-www.healthpromoting.com.

Is the Center involved in conducting scientific research? Yes, with the help of Dr. Lisle, our new director of research, we just completed a major retrospective analysis of the use of fasting and a health promoting diet in the treatment of hypertension (high blood pressure). We worked with Dr. T. Colin Campbell at Cornell University, and have seen two papers published in the scientific literature.

What are the biggest health challenges that people face? We live in a world that does not promote health, and despite an abundance of credible scientific evidence that points the way, most people seem more interested in pursuing short-term, pleasure-seeking, self-indulgent behavior. Even people who are convinced about what to do find it difficult to "stray too far from the social norm." Pressure from family, plus the difficulty of breaking bad habits, can hold people back. For many people, the most effective way to make the dietary and lifestyle changes necessary to recover and maintain health often occurs in conjunction with a properly supervised fasting and feeding program at a residential health education facility such as the Center. They get started right, and get new patterns established in a supportive environment.

A diet that avoids all animal products including meat, fish, fowl, eggs and dairy products is called a vegan diet. Despite the proven benefits derived from avoiding the use of animal products in the diet, many vegans do not fare as well as they might. Not all vegan diets are created equally. Eliminating animal products from the diet does not guarantee a health promoting diet. Much of the benefit derived from eliminating the risks of animal products in the diet can be offset if the diet is not a health-promoting diet rich in fresh fruits and vegetables, raw nuts and seeds and sprouts and the variable addition of minimally processed whole grains and beans. Potato chips, french fries, alcohol, soda pop and chocolate might all be vegan but that hardly qualifies them as healthy. Vegetarians and vegans often consume large quantities of highly processed foods containing large amounts of oil, sugar, flour and salt. If they believe that their avoidance of animal products alone will grant them dispensation from the devastating consequences of the dietary pleasure trap, they may be sadly disappointed. They say that some vegans get headaches from their halos being too tight. A vegan diet may be undertaken for many reasons: health, social, environmental and/or spiritual. A vegan diet may help you get into heaven, but it will not delay how quickly you get there, unless you avoid some potential pitfalls. In addition to the problems caused by the dietary pleasure trap resulting in the consumption of highly processed foods, vegans are subject to the deficiency of two important nutrients.

Vitamin B12 deficiency Vitamin B12 is produced only by bacteria. Rich sources of bacteria, including animal products, contain large quantities of this essential nutrient. The elimination of animal products in conjunction with modern Hygienic standards reduces the exposure to bacteria and thus vitamin B12. The reduced intake of vitamin B12 can lead to a depletion of vitamin B12 stores and eventually to vitamin B12 deficiency. Although it may take years or even decades to deplete body stores of vitamin B12, we have found this to be common in long-term vegan who do not supplement. A vitamin B12 deficiency can lead to numerous symptoms including neurological disturbances, and increased blood levels of the protein homocysteine. This elevated level of homocysteine causes inflammation in the blood vessels and increases the risk of heart disease. The most accurate way to assess the vitamin B12 status is to perform a blood test measuring homocysteine or methylmalonic acid. These two metabolites will increase when vitamin B12 deficiency is present. Oral supplementation of vitamin B12 in the form of methylcobalamin is thought to be the most efficient way to correct deficiency. A single, daily 1000 mcg tablet is sufficient to correct a B12 deficiency and maintain normal B12 status in most patients.

Vitamin D deficiency Vitamin D is a hormone that is formed naturally when the skin is exposed to sunlight. Thirty minutes of full body exposure can result in the formation of up to 10,000 IU of vitamin D and there is no risk of excess vitamin D forming from this natural route. There is a risk from sunburn from overexposure and burns should be avoided by carefully limiting your exposure to the sun. Sunburn can increase your risk of the formation of skin cancer and can contribute to the premature aging of the skin. The best way to insure optimum vitamin D levels of 35-50 units is by getting regular sunshine. If you cannot get adequate sun exposure a sun lamp may be the best alternative. If for some reason this does not result in a normal level of vitamin D then supplementation of vitamin D is an option. It is important to avoid excess vitamin D supplementation as excess vitamin D from supplements can be toxic. Most individuals can restore their levels with 1000 to 4000 IU per day of vitamin D3 (from either Lichen or sheep's wool). Some individuals may require higher doses in order to replenish depleted body stores. Once normal levels have been achieved, supplementation should be discontinued or reduced to the lowest levels needed to sustain optimum blood values. If at all possible, sunshine or a sunlamp should be used to sustain normal levels. Problems from vitamin D deficiency include: osteoporosis, immune suppression, chronic pain and some cancers, etc. The blood test for vitamin D status is 25-dehydroxy vitamin D. We suggest that vitamin B12 and vitamin D be routinely evaluated by including a homocysteine and 25-hydroxy vitamin D blood test with each individual's periodic health checkup. Alan Goldhamer, D.C., is the founder of TrueNorth Health Center in California. He is the author of the Health Promoting Cookbook and co-author of The Pleasure Trap. Jennifer Marano, D.C., is the co-founder of TrueNorth Health Center. Contact the authors at: www.healthpromoting.com or at 707-586-5555