Is it time for the fitness industry to add happiness to the health equation?
Do you know how happy your clients are? And are they happy to see you? As the old joke goes, “Some people cause happiness wherever they go; others whenever they go.” But seriously, in which category would your clients put you?
As it turns out, happiness is no laughing matter. Your clients’ health and longevity—not to mention their quality of life—are linked to it. You probably spend more time on your clients’ core strength than on their core values, but that focus may shift as we find out more about the role well-being plays in optimal health.
“Our mission to Inspire the World to Fitness® has rapidly grown to encompass a much broader picture of wellness and wholeness,” says Peter Davis, IDEA co-founder and the creator of IDEA’s Exercise Your Happiness program. “We’re also expanding how we view our role in facilitating greater health for clients,” says Davis. “Our goal is to create not just a healthier world but a happier one. In order to transform the lives of clients, fitness professionals in the future may view themselves as happiness professionals. And it isn’t just about helping our clients be happier—we need to become happiness experts in our own lives first.”
Some health advocates are calling for positive well-being to be incorporated into health care and public policy worldwide. In “Happy People Live Longer: Subjective Well-Being Contributes to Health and Longevity”—a 2011 review of more than 160 pertinent studies—researchers Ed Diener and Micaela Chan conclude, “In light of the evidence it is perhaps time to add interventions to improve subjective well-being to the list of public health measures, and alert policy makers to the relevance of subjective well-being for health and longevity.”
In his book, Happiness: Unlocking the Mysteries of Psychological Wealth (Blackwell 2008), Diener, a University of Illinois, Urbana-Champaign, psychology professor and senior scientist for the Gallup Organization (he’s also known as the “Jedi master of happiness studies”), envisions a time when doctors’ common health questions to patients will include asking how happy, optimistic and satisfied they are.
“This is a big new direction,” Diener tells IDEA. “I just took a health questionnaire at the grocery store on a machine, and it asked if I had been depressed lately. But it did not ask if I had been experiencing a lot of enjoyment and joy lately. From our review of research, we know that positive emotions will predict health and longevity as well as or better than negative characteristics, and often better than many of the traditional health behaviors, such as eating vegetables, for example.”
Diener and his colleagues are creating an improved health questionnaire for medical purposes, and he sees similar implications for the fitness industry. “Fitness professionals focus on physical health through exercise and diet. They also often include psychological and spiritual aspects, such as meditation, yoga and stress reduction. But these tactics tend to focus on eliminating the negative (stress, anxiety, excess weight), and that’s only part of it,” Diener says.
“Adding to positive well-being helps both health and quality of life. Since the positives are such good predictors of health and longevity, fitness professionals could focus on areas such as enjoyment and joy; finding meaning and purpose in life; using strengths and talents; choosing activities that are fun rather than just lucrative; and developing supportive relationships. One of the big lessons we’ve learned from positive psychology is that it’s as important to love and support others as it is to receive love and support—and much of this is in our control. Fitness pros can make a difference by giving positive feedback, for example, and expressing praise and gratitude frequently.”
Contrary to old notions that happiness is frivolous, shallow, naïve or a waste of valuable time, there is a growing body of evidence that happiness is beneficial for morbidity (risk of illness), survival of illness and longevity (Diener 2011).
Researchers know that negative emotions such as sustained stress or fear can contribute to heart disease, stroke and diabetes; that chronic anger and anxiety can hasten atherosclerosis and increase systemic inflammation; and that early-childhood “toxic stress” from neglect or abuse has harmful effects on the brain and other organ systems (Rimer & Drexler 2012). In the Harvard Public Health Review (Rimer & Drexler 2012), researcher Laura Kubzansky notes that happiness appears to have a positive health benefit independent of the impact of not having negative mental health factors. “It looks like there is a benefit of positive mental health that goes beyond the fact that you’re not depressed. What that is is still a mystery. But when we understand the set of processes involved, we will have much more insight into how health works.”
In a study that followed more than 6,000 men and women, aged 25–74, for 20 years, Kubzansky and Thurston (2007) determined that emotional vitality—a sense of enthusiasm, hopefulness, engagement in life, and the ability to face life’s stresses with emotional balance—appears to reduce the risk of coronary heart disease.
According to a meta-analysis of 83 studies, optimism is a significant predictor of positive physical health outcomes related to mortality, survival, cardiovascular outcomes, immune function, cancer outcomes, outcomes related to pregnancy, physical symptoms and pain health (Rasmussen, Scheier & Greenhouse 2009).
Diener and Chan’s 2011 review—the most comprehensive of its kind—concludes, “All of these different kinds of studies point to the same conclusion: that health and then longevity in turn are influenced by our mood states.” The studies suggest that high subjective well-being may add 4–10 years of life compared with low subjective well-being (and the years will also be more enjoyable than they would have been for less happy people, the authors note!).
One of the studies reviewed followed nearly 5,000 university students for more than 40 years and found that those who were most pessimistic as students tended to die younger than their more optimistic peers (Brummett et al. 2006). An even longer study that followed 180 Catholic nuns from early adulthood to old age found that those who wrote positive autobiographies in their early 20s tended to outlive those who wrote more negative accounts (Danner, Snowdon & Friesen 2001).
Moods and emotions are consistently associated with biological measures such as blood pressure, cortisol and inflammation, as well as disease indicators such as artery wall thickening, say Diener and Chan (2011). Moreover, greater subjective well-being is related to significantly stronger immune function; people with high levels of positive emotion develop fewer colds and are less likely to get flu (Herbert & Cohen 1993; Cohen et al. 2003; Howell, Kern & Lyubomirsky 2007; Marsland, Pressman & Cohen 2007).
Diener concludes that while happiness is not a magic bullet and of itself may not prevent or cure disease, it does change your odds of getting disease or dying young. The evidence that positive emotions and enjoyment of life contribute to better health and a longer lifespan is stronger than the data linking obesity to reduced longevity, the 2011 review points out. Diener and Chan note that current health recommendations focus on avoiding obesity, eating right, not smoking and exercising—and suggest it may be time to add positive well-being to the list.
Another meta-analysis of 70 studies of both healthy and diseased participants found that healthy people with high well-being are 18% less likely to die of any cause than those with low well-being. Among sick people, that difference drops to a still significant 2% (Chida & Steptoe 2008).
In his book, Flourish: A Visionary New Understanding of Happiness and Well-being (Free Press 2011), Martin Seligman, PhD, widely recognized as the father of positive psychology, notes, “All studies of optimism and cardiovascular disease converge on the conclusion that optimism is strongly related to protection from cardiovascular disease.”
The impact on cancer, however, is not as clear. In their 2009 meta-analytic review, Rasmussen, Scheier and Greenhouse state that more optimistic people have significantly better cancer outcomes, but other studies show no impact. Seligman suggests in his book that highly optimistic people may have a lower risk for developing cancer and that positive well-being may have beneficial effects for cancer patients when the disease is not extremely severe.
Happiness appears to contribute substantially to health for older adults. A recent study followed 3,853 older men and women, aged 52–79, for 5 years. Participants’ feelings were monitored several times a day. Results indicated that older people who are happy could have a 35% lower risk of dying over a 5-year period than unhappy people. The results endorse the value of assessing well-being and offering interventions that promote happiness in older populations (Steptoe & Wardle 2011).
If the health benefits of happiness are not enough to make you smile, the success benefits might. Positive feelings broaden your horizons and build your social, physical and intellectual skills (Fredrickson 2000). Researcher Sonja Lyubomirsky, PhD, of the University of California, Riverside, notes in her book, The How of Happiness: A Scientific Approach to Getting the Life You Want (Penguin 2007), that “happiness byproducts include higher income, superior work outcomes (greater productivity, higher quality of work), larger social rewards (more satisfying and longer marriages, more friends, stronger social support, richer social interaction), more activity, energy and flow and better physical health (bolstered immune system, lowered stress levels and less pain) and even longer life.”
Positive psychologists are often reluctant to use the universally understood (but overused and vague) word happiness. People instinctively know what the term means, making it useful for general discussion, but scientifically measuring happiness requires more specificity. Many academic researchers prefer the term subjective well-being, denoting a broader range of positive perceptions and more engagement with the world. Other related and overlapping terms commonly used in the positive psychology field include positive well-being, life satisfaction, emotional vitality, positive emotions, positive health, positivity, flourish and thrive.
Today, happiness—or well-being—is scientifically measured in a variety of ways; biological measures include brain images and hormone levels. Most typically, happiness research relies on self-reporting, through techniques such as listing daily thoughts or feelings; citing memories of how many positive or negative events can be remembered in a specific time frame; or reporting thoughts or feelings at various times throughout the day.
In Flourish, Seligman presents his new, broader model of well-being theory, called PERMA, which encompasses five measurable elements that constitute human flourishing: Positive emotions, Engagement, positive Relationships, Meaning and Accomplishment. The model represents Seligman’s evolution since his landmark book Authentic Happiness: Using the New Positive Psychology to Realize Your Potential for Lasting Fulfillment (Free Press 2002).
While the goal of positive psychology has most commonly been to increase happiness/subjective well-being through measuring self-reported life satisfaction, Seligman describes a new expanded objective of increasing human flourishing through the five pillars of PERMA. He proposes a measurable global mental health goal (PERMA51): Have 51% of the world’s population flourishing by 2051. Currently, among 23 European Union nations the average percentage of citizens who are flourishing ranges from 6% to 33%, according to Huppert and So (2009).
Many positive psychology researchers are exploring a broad range of happiness aspects that go beyond a buoyant mood. Although positive feelings are of themselves valuable to health, researchers agree that such feelings do not solely describe the whole picture of positive well-being. Diener notes that real happiness is not a continual state of bliss or an absence of all unpleasant feelings—and that pursuing intense highs and avoiding all unpleasant feelings is not healthy.
Diener defines happiness not as a goal but as a process that requires positive attitudes about life and continuing fresh involvement with activities. “A life full of meaning and values, supportive social relationships and rewarding work is the framework for a happy life. The processes of happiness within that framework require positive attitudes, spiritual emotions such as love and gratitude, and material sufficiency.”
“Many valued activities even when unpleasant can increase our long-term life satisfaction, even if they lead to less pleasure in the moment,” he explains. “Happiness allows for a small dose of negative feelings while we are frequently experiencing positive ones. The balance, however, should heavily tilt in favor of the pleasant emotions.”
In his best-selling book, Be Happy: Release the Power of Happiness in You (Hay House 2009), Robert Holden, PhD, describes happiness as the journey from the “ego-mind” to the “heart of your unconditional self.” Writes Holden: “Happiness is your true nature, who you are, what you experience when you accept yourself.”
Holden points out that every person defines happiness for him- or herself and that the definition impacts every aspect of one’s life. Despite the importance of happiness, however, most people devote very little time to thinking about what it means to them. He suggests conducting a “happiness interview,” asking:
- What is your definition of happiness?
- Are you living it?
- Who is the happiest person you know?
- What has this person taught you about true happiness?
Lyubomirsky is one of the world’s leading researchers on happiness and has worked with thousands of research participants. In The How of Happiness, she provides a framework for understanding and applying what science has learned about happiness.
She explains that about 40% of our happiness is within our power to change through the ways we act and think (Lyubomirsky, Sheldon & Schkade 2005). Another 50% can be attributed to a genetic set point, or baseline, that acts similarly to the set point theory in weight management (Lykken & Tellegen 1996).
Research suggests that only about 10% of our happiness is associated with life circumstances (money, health, beauty, marriage, etc.), which means that many changes we create in our lives can make us only 10% happier at most (Diener et al. 1999). The fact that we tend to look in the wrong places for happiness is the subject of Dan Gilbert’s popular book, Stumbling on Happiness (Knopf 2006). A body of research has shown that we routinely make mistakes about what will make us happy (Wilson & Gilbert 2005).
Lyubomirsky has conducted numerous intervention studies on what actually works to increase happiness above an individual’s set point, and says, “It’s in our power to achieve real and lasting happiness. It’s not something outside of us—it’s inside—a way of perceiving and approaching ourselves and the world. But one thing we’ve learned from research is that it takes work.”
“Fitness is actually a good analogy for the process of creating more lasting happiness,” she explains. “[Fitness is] a lifelong endeavor, and it’s the same thing with emotional goals. You need to work at it every day of your life, but once it becomes a self-reinforcing habit, it becomes easier. Consider how much time and commitment many people devote to physical exercise, whether it’s going to the gym, jogging, kickboxing or yoga. If you desire greater happiness, you need to go about it in a similar way.”
She adds that permanent changes to happiness can require “intentional, effortful activity” every day of your life. The good news is that you can start small and often see immediate results. For example, in one study described in Seligman’s book, Authentic Happiness, severely depressed people went on a website daily and did just one exercise—recalling and writing down three good things that happened that day. Within 15 days, participants went from severely depressed to mildly or moderately depressed. Ninety-four percent experienced relief from depression.
Lyubomirsky’s recent research has shown that to sustain long-term happiness, you need “a will and a way”; that is, you must be highly motivated (the more motivated you are, the more successful you’ll be at becoming happier), and you must find the right strategy (Lyubomirsky et al. 2011).
Lyubomirsky has outlined effective strategies to immediately boost your feelings of well-being (see the sidebar “Happiness-Enhancing Strategies”). She says that exercise may well be the most effective instant happiness booster of all activities: “Exercise makes people happier, but people often think of it as a chore or something they really don’t want to do—maybe we need to convince them that exercise will make them happier.” (For more on research linking exercise to happiness, and how to help clients savor the experience of exercise, see part two in our next issue of IDEA Fitness Journal).
“What works best depends on the person,” says Lyubomirsky. “Just as it does with exercise or diet, but when we research strategies, the two that are often at the top of the list are physical activity and acts of kindness. They seem to work better because they’re more tangible.” Of all the aspects of well-being, Seligman also notes that doing a kindness produces the single most reliable momentary increase in well-being of any intervention he has tested (Seligman 2009). A related exercise that he recommends is to do one wholly unexpected kind thing tomorrow and to notice what happens to your mood.
While various strategies can create momentary happiness, Lyubomirsky believes that the most important challenge is creating lasting or “abiding” happiness. She lists five characteristics that determine the effectiveness or sustainability of happiness strategies:
- frequency of positive emotions
- optimal timing and variety (keep strategies fresh and find timing that works for you, such as every morning or night, once a week, etc.)
- social support, such as buddies, mentors and support groups
- motivation, effort and commitment, as with pursuing any goal
- development of new habits that become easier to maintain
Says Holden in Be Happy: “The intention to be happy is what changes everything. When you decide with all your heart to be happy, you are calling upon the grace and power of your original nature to help you out.”
Holden believes that when you choose to be happy, “you are not trying to create something that doesn’t exist; you are choosing to be yourself again.” He adds that the happier you are, the more you will express these natural qualities: presence, acceptance, selflessness, authenticity, equanimity, wisdom, altruism, enthusiasm, kindness and love.
Fitness and happiness share important common ground. Both contribute to significantly better overall health, and both are lifelong processes that create lasting change. For fitness and wellness professionals who are already dedicated to guiding clients on a path of transformation, integrating strategies to develop greater emotional well-being may become a natural, powerful (and joyful!) fit.