Before diving into this subject matter, I would like to clarify the reason why “Medication” is in quotes in the title line. I am not by any means talking about taking any kind of actual medication, but merely using it as a metaphor for the content of this blog post. I am a Personal Trainer by trade and will be mindful of my “scope of practice”, but I do have a strong interest in how the mind works in regards to choice, decision making, habits and habit formation, addiction and other behavioral psychology concepts. In this blog post I would like to talk about these concepts and how they relate to what I see and do on a daily basis, in addition to recommending a paradigm shift in our thought processes surrounding wellness.
What Do We Know?
I think when it comes to determining which maladies impede the overall health, wellness, and longevity of us in the “developed” world, there is a relative scientific consensus as to what those things are. I want to emphasize here that I am talking about those of us living in the relative comfort of a “developed” nation, where a pertinent malady would be a preventable metabolic disease such as diabetes, instead of maladies encountered in a “developing” nation, such as malaria, civil war, or malnutrition.
That being said, I think we can all agree with relative certainty that as a whole, we move too little, eat too much, stress too much (about things not worthy of a biological stress response), and sleep too little. All of these things are interrelated in many ways, and I don’t think you could find any reputable scientist or scientific organization that would disagree that a majority of our population is enduring at least one or more of these states. I’ll take that a step further, as the awareness of these realities doesn’t stop with the scientific community; I’d be willing to bet 50 burpees if you walked down the street and asked 100 strangers to define ultimate causes of a majority of healthcare/sickcare spending, all 100 would answer at least two correctly. I emphasized “ultimate” because I think some clarification is warranted between something being an ultimate vs. a proximate cause.
- Proximate Cause- The cause or event mostly closely (in context) related to a perceived result. (i.e. The man’s proximate cause of death was a heart attack)
- Ultimate Cause- The higher-level cause of a perceived result. Sometimes considered the “real” cause. (i.e. The man’s ultimate cause of death was a combination of a lifetime of smoking, eating a diet comprised of ultra-processed foods, chronic sleep deprivation, and little to no exercise, which led to a heart attack.)
The reason I think this is important to note, is that it seems like the things we already know are good for us, are being perpetually “reinvented” for reasons I have yet to find out or refuse to acknowledge (profit maximization, shocker). Most “breakthroughs” in the wellness space are at best, slightly modified but exponentially more expensive takes on currently existing knowledge or technology. Oh, it’s good to lift weights? How about a “revolutionary” new weight machine that counts your repetitions and wirelessly connects to some other underutilized piece of expensive gadgetry? It’s safe to say we know what we should be doing to live long, healthy, vibrant lives, but why exactly is it so damn hard to do those things? Why have so many of us (including me) become beholden to seemingly extraneous routines or habits that derail our progression of health? This leads to the importance of understanding the mind, more particularly your own, and how it fits into the abundance of choices and options that we are fortunate to live in.
Feeling Good and Habit Formation
We are hardwired from birth to identify things that make us happy or feel good, and continue to (selfishly) pursue those things until hopefully our parents and/or guardians guide us away from acting upon the impulses of our lizard brain (the most primitive part of the brain, which deals mostly with basic survival instincts). Think about a child at Halloween, who after walking around the neighborhood (hopefully, instead of being driven by parents), begins an all out binge on his or her sugar stash until they more than likely get sick. All that sugar lights up the reward center in their little developing brains, and this is by no means an accident or lack of willpower. It’s a wicked combination of positive reinforcement and evolutionary predisposition.
When our ancestors from thousands of years ago were busy staving off predators and trying to survive in the wild, the ones that were adventurous enough to try the furry, red, bulbous things sprinkled throughout a bush, only to realize they were actually ripened, tasty, and most importantly, sweet, raspberries, were the ones most likely to survive. Calories were sparse in 40,000 BC, and in that time, sweetness meant calories, and calories meant survival.
Fast forward to today, in a world where excessive sweetness is literally everywhere, and it’s no mistake that our candy craving goblins and ghouls consume Halloween candy ad nauseam, because their lizard brains were programmed to. Something that at one point was an evolutionary advantage is now the bane of our existence (at least those lucky enough to be born into an area code with plenty of calories to go around). Good thing you get to choose which city, which neighborhood, which set of genes, and which parents (or lack thereof) you’re born into, oh, wait a second…
But I digress. The fact of the matter is that we are literally biologically programmed to seek out things that make us happy or feel good from birth, so unless your prefrontal cortex decides to defy physiological norms and develop twenty years earlier to help you mitigate your urges to act on your lizard brain, you’re at the mercy of your support system (family, social group, environment, etc.) to help you make it to your 20’s without having a full-blown addiction, or to put it lightly, a bad habit. Replace “consuming sugar” with other things that make you feel good, such as sex, gambling, or getting a “like” on social media, and combine it with positive reinforcement, and you can see how easy it is to become “addicted” in a behavioral or neurochemical way.
Not Feeling Bad and Habit Formation
Just like we seek things out to make us happy or feel good, we can just as easily seek out things to make an uncomfortable feeling subside or decrease in intensity. That “feeling” can be physical, such as nausea, insomnia, or pain from a third-degree burn, but it can also take the form of an emotional “feeling” such as sadness, anxiety, or grief. Both physical and emotional pain share similar pathways in the brain and the process of seeking out things to decrease these states of pain can feed the process of negative reinforcement.
Similar to how consuming sugar, having sex, or getting 30 “likes” on your most recent selfie (see the Greek Myth of Narcissus) all create a feel-good sensation, and prime us for subsequent repetitions of those behaviors via the feedback loop of positive reinforcement, negative reinforcement feedback loops work much in the same manner. For example, I feel emotional pain stemming from the anxiety that arises as I enter a wedding reception with 300 strangers, so I head to the open bar and quickly down a glass or two of wine and voila, the alcohol increases the release of dopamine and decreases my inhibitions to socialize. Because dopamine is involved, your brain files away that behavior as beneficial, at least in the context of immediate fight or flight response, and the next time you’re faced with anxiety, you’re more likely to follow the same pattern.
Both forms of reinforcement deal with feedback loops, and subsequent habit formation in the same manner. Here are examples of each-
- Habit Formation via Positive Reinforcement
- Trigger- After dinner = dessert
- Behavior- Consume chocolate cake
- Reward- Dopamine release, feels good
- Repeat- File that behavior away as rewarding, do it again after dinner next time
- Habit Formation via Negative Reinforcement
- Trigger- I feel anxious
- Behavior- Consume alcohol
- Reward- Dopamine release, decrease inhibitions, I no longer feel anxious
- Repeat- File that behavior away as rewarding, do it again next time I feel anxious
Every time one of these loops is completed, with any behavior, and with any type of reinforcement, there is a higher likelihood that the same loop will be completed next time. I am reminded of a metaphor I have read in many psychologist’s works regarding habit formation and the sledding hill. When someone travels down a hill of freshly fallen snow, the initial path is formed freely and seemingly at random but when the next person travels down that same hill, he or she is likely to inadvertently slip into that same path. Person after person travels down the hill, some may stray, but most will follow the trail previously blazed, further packing the snow and preparing it for the next sledder. Each trip down the hill is the same “trigger” and every time it becomes easier and easier to follow the same path or “behavior”, to perform the same act, take the same substance, or eat the same food. The habit has been formed.
What’s Your “Medication”?
The goal of this post was to try and draw one big circle around all of us dealing with bad habits of varying intensities, day in and day out, and to help identify how we all self “medicate”. How one person began their struggle with overeating and subsequent weight gain could be very similar to how another person began their struggle with alcohol consumption, or obsessively checking and/or posting on their Facebook feeds. Obviously drug dependency and addiction have potentially life-threatening side-effects and I don’t mean to marginalize the struggle that anyone is going through, but what I do mean to do is shed light on the fact that all bad habits are formed in very similar ways. The difference lies in the amount of social stigma associated with each one, and how we treat people with varying habits and addictions.
Does a bad day at work trigger the consumption of a six pack of beer or a six pack of donuts?
Does a feeling of anxiety trigger marijuana consumption or prescription opiate abuse?
Does a feeling of insecurity trigger working late nights or endless self grooming?
I’d like to issue a call to action for those trying to break free from a habit, or even just better understand how it was formed in the first place. No need to invest more money in products, fad diets, or new technology. Firstly, I recommend to all that we better understand our own minds, our own triggers, our own behaviors, and our own habits. Secondly, we are all “medicating” with something at some point, whether it is to escape a feeling or to capture one and I think it’s time for all of us to confront what that “something” is. Stop blaming and start helping, we’re all in this together.
Yours in Wellness,
Sam
Prevention over Treatment