We are a cool species, engaging with our world in a very different way than any other species of which we know.  We shape our world physically, mentally, and socially to suit myriad fantasies, individually and collectively.  This results in a shifting landscape of reality in which we, as Daniel Kahneman points out in his final chapters of Thinking Fast and Slow, are subject to our cognitive biases that may have positive or negative sway in any given situation.  The key to best engage with that reality on a day to day basis is to recognize these imperfections in our cognitive wiring in a reflective way.

In those final chapters, Kahneman points to a need to recognize, that as remembering beings, our memory often fails us.  It’s subject to outside influence and shortcuts on our own behalf.  Taken together, this means that there is an opportunity for each to shift our remembering self towards a different understanding of an event than our experiencing self, the one that’s actually present during an event.  This is because our memory is subject to duration neglect and a product of our episodic memory – we are prone to ignore duration as opposed to intensity.  If we were to have a true recording of events, we might not remember correctly that vacation taken last year, when it rained for the first three days, but the last day was so gorgeous (and all of our pictures were from that day) that we may remember it more fondly than we experienced it.

What effect does this have on adherence?  Quite a lot actually, and this is where perception has a great opportunity to hop into the world of Behavioral Health and Substance Abuse treatment.  Simply by altering the treatment protocols to take into account this remembering self, it is possible to focus on the peak-end rule.  The peak-end rule says that when we are remembering an event, we more heavily weight the experience of the most painful or pleasurable event (peak) and the last thing (end) that occurred in a timeline.  If a treatment protocol were to decrease the peak of a particular episode and include a positive, context-provoking end to the episode, the remembering self will have a different memory as it progresses towards more positive outcomes.

There is another major implication of this very important understanding of the remembering self vs. the experiencing self and it is related to a concept called Salutogenesis (basically “from health”). Salutogenesis is a concept coined by Aaron Antonovsky, a Medical Sociologist, as a counter to our current health model, which has a pathogenic slant to it.  I would venture that our health system is as much a product of our two selves as potentially influenced by a change in the approach.  Our duration neglect and base-rate neglect lead us to an imperfect memory of the picture of health that we have for ourselves.  This leads us to looking at healthcare as episodic – we go to the doctor in a self-encapsulated event, we get ill, we deal with symptoms.  These are all pathogenic experiences of our overall wellbeing.  If we had a tool that helped our experiencing self more accurately engage with our health reality, that we are always to some level healthy and to some level ill, duration neglect would be mitigated, increasing our ability to engage with our health as if in two realms, time and space, rather than simply in a given moment in time.

So what does a salutogenic framework look like?  Mindfulness, resilience, focus on daily health-promoting activities that increase our ability to get healthier, rather than fend off illness.  Of course, a fee-for-service model doesn’t bode well with this concept, so unless you’re enrolled in a highly visionary health promotion healthcare system, you’re probably on your own – for now.  If so, here are some resources we’ve seen that might be helpful for you to consider when you begin working towards your healthiest self:

SuperBetter.com – This site allows you to engage in a number of different challenge “packs” to help increase your emotional, social, mental, and physical resilience.  You can even invite your friends to help you complete these challenges!

FitBit – not simply a pedometer, this device will help track your sleeping patterns, too, giving you the opportunity to analyze some of your base-rate metrics and progress in your fitness.

Various apps and websites – there are literally thousands of apps out there now for tracking everything from heart-rate to nutrition to fitness to mental resilience to even sobriety (check out sober24, an online community for alcoholics in recovery!).  Keep in mind that when you are looking at these programs, you are more likely to be successful if you are doing it with someone else.  And if you invite someone else to participate, they are as likely to make you healthier as you are to make them healthier!

Your EAP – while most people think of their EAP (Employee Assistance Program) as something they use when things are bad, keep in mind that MINES has many programs that may help you no matter what level of health you’re at – including career coaching, financial coaching for learning to save, and more.  You don’t have to be in pain to give us a call; we’re here whenever you want to talk.

To our health,

Ryan Lucas