The Influence of our Behavior and Finding Optimal Health

How many of you have indulged in ice cream, alcohol, shopping or another gift after a hard day? For many of us, our coping strategies may involve behaviors that reward us during challenging times – sometimes at the level of a mindless reflex. Although these behaviors provide an instant relief to stress, they can potentially sabotage one’s efforts to become healthier.

After all, behavior is the crux of one’s health and the cornerstone to a longevity plan. Studies support that a low-risk lifestyle, e.g. regular physical activity, eating healthy, abstaining from smoking and excessive alcohol, is responsible for a 11 year delay of all-cause mortality. Conversely, harmful behavior is largely responsible for up to three-quarters of chronic health conditions seen in clinical medicine.

A careful look at the world’s centenarian centers, or “blue zones”, reveals many common ingredients to longevity.  The locations include Okinawa, Japan, Sardinia, Italy, Loma Linda California, Nikoya, Costa Rica and Ikaria, Greece.  There is no coincidence that living in these places allows for the similar tenets of a low-risk lifestyle, including regular purposeful physical activity, a wholesome, natural diet, avoidance of smoking, stress management, plenty of leisure time, social support structures and a healthy environment.

Behavior is intertwined with our actions, words and thoughts, as we adjust to real or perceived stressors. Even though we are the vessel of our behaviors and can regulate them, we can become blinded to them.  Behaviors are truly at the crossroads of our conscious and unconscious thoughts and our involuntary and voluntary nervous system.  Actions that result in pleasure or less pain are reinforced and repeated; actions that result in less pleasure or more pain are avoided.

Sometimes, a potentially harmful behavior can become reinforced because of its leads to a perceived positive outcome. One can develop a complex network of thoughts when it comes to addressing these behaviors, sometimes with a blockade to protect from deeper fear or shame.  The emotional response centers react suddenly – even before our logic centers – and drives us to a behavior. Addressing this response can be the first, critical step to managing our behavior patterns.    

The result of a repeated negative behavior can lead to health issues.  A person may come in with a complication, e.g. someone who smokes comes in with chest pain and fears a heart attack, and genuinely wants to avoid health issues.  During a short clinic visit or hospitalization, the behavior is often addressed with a “don’t do that, do this, or else” approach, a method that falls short in motivating behavior change.  The patient may quit the behavior out of necessity for the short term, only to revert to the behavior when they feel better or when the stressors worsen.  A “fear of death approach” is generally not effective, after a person feels better or doesn’t necessary experience ill-effects from the substance or is not motivated to change.

An approach that addresses consequences undercuts the understanding of the origin and reason for the behavior as a coping mechanism.  The patient often meets these questions with a sense of shame and conflict, in some way fueling their fear of no longer having a substance as a coping strategy.  Intertwined with this is the person’s physical dependence on the substance.  The same holds for behaviors other than substances, including food choices, excessive phone or TV, gambling or sexual addictions.   Harmful behaviors have one thing in common – they are resistant to change, even if one has reason and insight on the importance.  

I once evaluated a patient who was a longstanding smoker for a necrotic, vascular insufficiency ulcer – an all-too common risk for infectious complications.  I discussed with her to determine her readiness to quit smoking after she was taken to the operating room to remove the damaged tissue (a debridement).  She stated that if she goes back home, she will start smoking again, regardless of the consequences.  She simply wasn’t able to imagine herself not smoking.  She knew that smoking was harmful to her but conceded to smoking in light of the possible consequence of amputation.

Another patient came in for a new visit and complained of generalized body pains and emotional challenges related to his dog being diagnosed with cancer. After a series of visits trying to assist and counsel the patient, it became clear that his preoccupation centered on whether I could prescribe him more pain medications to assist in his coping.  Ultimately, he buckled under repeated visits and no increase in pain medications with displays of anger, arranging for a new doctor visit in another clinic.  After establishing with a new physician who prescribed him a greater quantity of pain medications, he actually called our clinic and boasted to my medical assistant that he was able to get more pain meds.

Both patients had an underlying drug dependence that affected their behavior and usurped their ability to cope in another manner.  Both patients did not realize that their behaviors were affected by the substance of abuse, whether their dependence was acknowledged or concealed.  A common finding in a person with dependence on substances is that an attempt in coping with real or perceived stressors ropes in a substance that then becomes the favored coping strategy only to later become the central trigger to the stress.

Here are some methods that you can use to address a behavior that you wish to change:

1. Define the behavior that you wish to change and set a goal: Say you want to stop swearing at people when you get angry. Get a good feel as to what level of stress may cause this to happen and realize when this line is crossed.
2. Slow down: Sometimes a delay in the execution of a behavior can allow the judgement centers to take over and stop it.
3. Define a replacement behavior and begin to use it: This is usually trial and error but can sometimes help to supplant the harmful behavior with one that it more positive.
4. Keep practicing and don’t give up: As you are working toward a behavior change, a relapse can occur. This does not mean you are back to where you started. Think about the reasons that a relapse of an old behavior occurred. Work toward improving this.

Refer to The steps to behavior change post for more tips on behavior change. Thank you for reading this post. Please like, comment and share.