I received an email weeks ago from a woman expressing frustration about her partner not sharing the same value about healthy behaviors: “It’s hard living with a noncompliant diabetic. I eat healthy; he does not.”
Diabetes directly afflicts a quarter of the Rio Grande Valley, according to a 2006 estimation by the University of Texas-Pan American Border Health Office. But in the past, when thinking about the notoriously poor health outcomes in the Valley, I’ve never considered the family and friends who watch their loved ones continually contributing to their deteriorating well-being.
“For some people, the easiest way to protect themselves is to not engage at all with it — to quit hoping that they can change a person and just give up,” said Melanie Espinoza, instructor with South Texas College’s Department of Psychological Science.
Espinoza said her Ph.D research focuses on health behavior and how to change it. While it can be frustrating seeing a loved one engaging in unhealthy practices, she says that wellness is a team sport.
“Down here, not enough people are on that team,” she said.
Specific to dealing with a non-compliant partner, Espinoza said every relationship takes work. Helping a loved one starts with a conversation, an agreement that change is needed, and a negotiation what adjustments will be made, she said.
“The partner has to be brave enough and at a place in their relationship where they can say, ‘I can’t accept no as an answer to me helping you,’” Espinoza said.
It could be something as small as volunteering to track their meals, working together on a grocery list or committing to eating more food at home.
“Social psychology tells us if you get someone to agree to something seemingly lacking in value, … they’re more likely to agree to more things,” she said.
Having shared goals can be the most satisfying part of a relationship, she said, and lacking them can be the the most destructive.
But sometimes people aren’t in the state of mind to make a change, Espinoza said, according to one theory.
“There are these stages of change that they have to move through in order to get to a point where they’re going to engage in a new behavior,” she said. “Depending where they’re at, you’re really just trying to move them forward on their continuum.”
It’s possible someone isn’t even considering altering their actions. A lot of people, either needing to engage in healthier habits or someone wanting a change for a loved one, suffer from “learned helplessness,” she said.
“When it appears to you that no matter what you do, nothing is changing, then what happens is people just stop. They give up because they know … nothing helps,” she said. “Why should I do anything, because the outcome is not changing? It’s insane to keep trying when nothing is working.
“Learned helplessness can be very destructive because in essence it’s like you’re telling yourself a lie. You’ve become convinced you’re helpless when really you have power.”
Espinoza suggests a regiment of consistent reinforcement with rewards and incentives.
“At the beginning, reinforcement has to happen almost every single time you do something,” she said. Gradually, rewards can be spaced out over time.
Social factors are constantly at play influencing behaviors, she said.
“This is the subject of some research I’m starting. We have rich cultural traditions and values around family time,” she said. “This extended family network that is so strong, you have every holiday, event or opportunity for celebration is typically expressed through food.”
She gave an example of someone who did well on their diet during the week, but then had a birthday party on the weekend.
“So they’re being influenced socially not to do what they’ve been doing all week,” she said.
But these same social pulls can be used for good.
“Social support is key. Reinforcement is the key, and often times you can’t get that for yourself,” she said. “You need to get it from other people before you yourself feel like they have the resources to reward themselves.
“They need social support a lot in the beginning.”
While Espinoza is hopeful that adults can become healthier, her hope for a larger shift is in the children because of their “crucial age for building (healthy) values.” She commended schools that used tools, like gardens, to install healthier habits in kids, but stressed that successful programs include parents.
“They’re in control of the food,” she said. “So the kids are going to be raised in an obese-friendly environment … or a health-conscious environment.
“The more tools people have, the more education and awareness that is out there, the more people have that, the more that the social landscape is going to start to change. It usually takes one or two generations.”
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