Thoughts On Well-Being

It’s dark and quiet. The boys are asleep and it’s mid-September so 5:45 am seems like the middle of the night. I just wrote 3 pages, stream of consciousness, sipping coffee, curled on the couch with a nightlight for guidance.

I need this time before my day starts. It’s integral to my well-being. And yet, how do we study this? How do we capture this messy moment? Is it in the literature? I went to PubMed in search of morning pages and found nothing.

This is where I am finding struggle and tension in teaching health. The health behaviors that reduce the risk of chronic disease, which we invest millions of research dollars in, are well-defined and well-known. My students know that they are supposed to eat fruits and vegetables and not smoke and not drink a ton and move their bodies. This knowledge alone doesn’t change behavior.

What the literature fails to capture, at least what I can find, are all the facets of being human and what contributes to well-being. Maybe this is why the wellness industry is flourishing. You have researchers sequestered at universities, publishing mostly unintelligible papers, and studying what they want to study or what will provide the most funding. I know many researchers who set out to make the world a better place and contribute to knowledge. But what I am saying here is that knowledge doesn’t do much in the realm of behavior change. You have to get your hands dirty. You have to roll up your sleeves and work with the behavior.

The wellness industry knows this, if not on purpose then by profit. They sell interventions. They sell if you do this then you will be healthy. They basically sell action. And with no concrete, easy-to-follow steps, armed with only knowledge and admonishment from the scientific community, humans do what humans do - look for the easy way to get their desired outcome. It doesn’t have to be evidence-based. The evidence is behind a paywall, hard to read, and overwhelming and contradictory. And I think we all intuitively know that we can’t measure everything.

Sources:

Why is changing health-behavior so difficult?

Well-Being Concepts

One Of The Books That Changed My Life

There are a few periods in my life where I can look back and see that on the spectrum of “normal” eating and disordered eating, I was closer to the disordered side. There’s no substitute for professional treatment and I worked with my share of therapists. Yet I can credit one book, Women, Food, and God by Geneen Roth, for doing more for my relationship with food than therapy or degrees in nutrition ever did. When I first read it in 2010, I read it, and then I read it again, and then I bought the audiobook and listened to it over and over and over on my 2-mile walk to work and back. It’s not hyperbole to say that it changed the trajectory of my life.

There’s one quote I remember taking my breath away:

“It's never been true, not anywhere at any time, that the value of a soul, of a human spirit, is dependent on a number on a scale. We are unrepeatable beings of light and space and water who need these physical vehicles to get around. When we start defining ourselves by that which can be measured or weighed, something deep within us rebels.” Geneen Roth

My entire college career centered around the number on the scale. Not just from an aesthetic standpoint, but from a scholarly one as well. In nutrition, our professors taught us how to calculate ideal body weight. If the calculation revealed someone to be out of the ideal range, they gave us another set of calculations for how to prescribe a diet that might get their body to that range. As far as I can remember, there were no public discussions of what that might do to a person. Of what it was doing to us. We were a room of mostly thin white women and it seemed fine to tell someone else that their body was unhealthy and they needed to lose weight. We were thin, therefore we were healthy and our eating habits were fine. Someone who needed to lose weight was unruly and had to be tamed. We were there to help.

I realize I’m recounting my experience 15 or so years ago as an undergraduate. My memory is tainted by time. Nutrition education has evolved. But the message I got from my undergraduate education was that the number on the scale matters a lot. It's a proxy for your health. Women, Food, and God put a human between the number and the nutrition recommendations. I can revisit this topic further but it was time to put it out there, to come back to my roots as a writer, and to share the book that the academic in me is ashamed of (my inner critic cringes at the use of God in the title).

Lesson One

After the first couple of class periods, once the thrill of back to school has tampered down a little bit, I “start teaching”. By which I mean I start engaging students in content and skills relevant to the health standards. I ask them to define health and wellness and articulate the difference between them. They talk to one another and air their responses, and then I show them the definition of health from the World Health Organization:

“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

We contrast this with wellness. If you Google wellness (go ahead, do it), you get different definitions and numbers of dimensions, but they all center on wellness being an active process to get to health. I hate the word wellness. I removed it from the title of the class on the grounds that the standards are called health standards, not health and wellness standards. Wellness, to me, feels loaded and vague. There are “wellness retreats” and endless products that promote wellness. It’s commercialized and commodified - an industry that like all others is racist and capitalistic. When I see the word at school, I cringe. Wellness Committee. Student Wellness Clubs. Is it that thing where if you say and hear a word too many times it loses its meaning and starts to seem fake and made up because it all is fake and made up?

Sometimes, I imagine that I walk around with a giant neon sign pointing to me that says something like, “I teach health. Please tell me about your diet, your exercise routine, your mom’s issues with smoking, and then ask me what I think and I will have the answer.” I do not have the answer. I used to pretend like I had the answer but now I stare and nod with a tight smile, looking for a quick exit. If I knew what to teach, do, say, etc, to help people eat more fruits and vegetables, I would not be teaching health in the basement of a high school in central Massachusetts. I don’t say this to my students. Instead, I put on an air of knowing and we dissect the meaning of health versus wellness. Because it’s so early in the year, they spit back at me what I said to them. Wellness is an active process that one takes to get to health. Health is feeling good about your mind, body, and relationships, not just the opposite of being sick.

I suppose it comes down to this - I want a shred of dignity for my profession which feels like it occupies the bottom rung of the ladder in the school hierarchy. That starts with parsing out language and being really intentional with the words we use and what we call things. It starts with recognizing that we teach skills systematically, like an art teacher teaches drawing or a biology teacher teaches the scientific method. If I could just tell people to eat fruits and vegetables or reflect on what they had for dinner and make them magically do it, there would be no need for any of this. But it is not that simple. It’s like how Dr. Laurie Santos teaches that what we think about happiness is wrong - the things we think will make us happy don’t.

This is long-winded and tangential. I’m learning how to weave school and story together. Today, we examine social determinants of health. That’s lesson two.