What Is Wellness?
Experts share their views on the meaning of wellness and how to make wellness meaningful to clients.
In Chicago you can reserve a “wellness suite” at the Marriott Fairfield Inn and Suites, complete with organic cotton bedding, aromatherapy dream sachets and a healthy minibar. If you’re in danger of defaulting on your student loan, you can participate in American Student Assistance’s “wellness” program for repayment. And if your dog’s coat is a little dull, you can get Old Mother Hubbard® Wellness® Pet Food supplements (with broccoli, cauliflower, kelp and garlic—yum yum!).
Your clients have no shortage of “wellness” opportunities, but they may be mystified by what the concept of wellness really means. “The word has been co-opted for so many purposes, including some that are the opposite of what wellness is,” says wellness pioneer Donald B. Ardell, PhD, of Tampa, Florida, who wrote High Level Wellness: An Alternative to Doctors, Drugs, and Disease (Rodale 1977), the first mass-market wellness book. He has since written more than a dozen books on wellness and writes a daily essay connecting what he calls “real wellness” with current events and health issues, available at www.seekwellness.com/wellness.
“In the 1960s Halbert L. Dunn [a physician] was the first to use the term wellness, referring to a lifestyle approach that pursued elevated states of physical and psychological well-being. He described it as a disciplined commitment to self-mastery,” recalls Ardell. “Since then, the term has gotten confused with holistic health, disease prevention, health education and health promotion. Somehow wellness got ‘stuck’ in the health field, which has more of a disease/treatment framework. But wellness could just as well be founded in psychology, sociology or even public policy. I think it’s often easier for people to think of wellness in terms of ‘quality existence’ rather than health.”
Ardell defines wellness as “a choice to assume responsibility for the quality of your life.” The areas most closely associated with wellness, says Ardell, are “self-responsibility; exercise and fitness; nutrition; stress management; critical thinking; meaning and purpose, or spirituality; emotional intelligence; humor; play; and effective relationships.” (See “The Don Ardell Wellness Model,” here.)
The National Wellness Institute defines wellness in a similar way, as “an active process through which people become aware of, and make choices towards, a more successful existence.” The institute identifies six dimensions of wellness: physical, spiritual, intellectual, social, emotional and occupational. (See “The Six-Dimensional Wellness Model” on page 104.)
Ardell concedes that despite our focus on wellness, people are not getting well. “Based on the evidence, we’re going downhill. Expecting more of themselves than is realistic or healthy overwhelms people. [Corporate coach] Grant Donovan and I have created a new concept, called ‘I Can’t Do It,’ that encourages people, with a lot of humor, to recognize that they can’t do it all, and to start focusing on small, realistic things they can do.”
Kate Larsen, PCC, founder of Winning LifeStyles Inc., in Minneapolis, also emphasizes small but significant changes to enhance wellness—but she’s reluctant to use the “w” word. Larsen is an adviser, a faculty member and a mentor coach for Wellcoaches® (see “The Wellcoaches Behavioral Change Pyramid” on page 105) and has been a lifestyle and business coach for more than 12 years. Her new book is Progress Not Perfection: Your Journey Matters (Expert Publishing 2006).
“I prefer to use the word well-being, rather than wellness,” she says. “Wellness seems like such a corporate word. People light up when I talk about well-being, but when I use the word wellness, I can practically see them sink down in the chair. Right away they start talking about how they’re not eating right, they don’t exercise enough—they feel they don’t measure up. Wellness sounds like there are grades of it that you can pass or fail, and that you can compare yourself to others. But people get that well-being is only determined by you, and that it includes happiness, contentment, having the capacity to be flexible, creative, patient—all the things that make up physical, mental, emotional and spiritual well-being.”
Most experts agree that well-being—or wellness—is different for everyone and is constantly changing. “Life is constantly changing,” says Carrie Myers Smith, of Landaff, New Hampshire, coach, personal trainer and owner of Women in Wellness. “To be well is to take control of what we can at any given time, but also to be able to go with the flow and be the best we can be in any given situation.”
Debbie Rosas, of Portland, Oregon, co-creator and founder of The Nia Technique, a body-mind-spirit fitness and personal growth program that integrates martial arts, dance arts and healing arts, adds that wellness is self-defined. “Wellness is a resonance, a vibration and a state of being. It is also a perspective that is very subjective and may not look like our preconceived notions. One person says, ‘I’m well,’ while another person might say, ‘You’ve got to be kidding!’ But it’s how they’ve defined wellness for themselves. Perhaps they’re not totally well, but they’ve stopped smoking, for example, so they have improved their wellness. It’s not something anyone else can define for you.”
Larsen notes that her own recent bout with cancer expanded her view of wellness. “I was on chemotherapy, my aerobic capacity was diminished, I gained weight from the drugs, I had lots of exercise limits, and my body and skin aged 10 years. I had to ask myself, ‘How’s your well-being now that you’re sick as a dog and can barely move? If my wellness is only about physical attributes or the ability to excel, then it’s all gone. Instead, I learned that well-being changes as your life changes. It’s fluid, flexible and evolving.”
Larsen’s life-threatening experience also gave her a new perspective on clients—and gave clients a new appreciation of her. “I was able to talk about how important it is to be authentic, and that authenticity is more than looking perfect on the outside. And I could make the point by taking off my wig and showing my bald head with a 5 o’clock shadow,” she laughs. “Not every speaker can do that!”
Larsen says, “Now I relate better to clients who don’t want to or can’t work out, or who are coming back from ground zero. I know what it’s like to go to the gym to work out, get exhausted from just walking up the steps and have to turn around and go home.”
Gloria Keeling, founder of the Strong, Stretched and Centered mind-body training program and now owner of BeFitAfter
Fifty.com, a personal training business, says, “I work with a lot of clients in their 50s, 60s, 70s and 80s, and I see that wellness is about doing the best [you can] with what you’ve got at the moment. For younger clients, wellness might be more about goal setting and ambition, but it changes with age. Some people in their 80s run marathons; others are happy to walk a few blocks. But few people get through that last third of their lives without some major health challenges, even if they’ve taken good care of themselves. Wellness is learning how to reach past the challenges and limitations and find the joy. It’s amazing to watch what people go through and see them come out the other side. A lot of wellness is about the tenacity of the human spirit.”
David-Dorian Ross, life coach, personal trainer and the wellness manager at Montage Resort & Spa in Laguna Beach, California, views wellness as one of four paths of self-care:
1. therapy, the “fixing” model that is most typical of medical care and various therapeutic approaches
2. fitness, the path of optimizing performance or appearance
3. wellness, the path of making behavioral lifestyle choices to keep onself in balance
4. health, the comprehensive and all-inclusive path of inner wholeness
“Each of these approaches implies a different relationship between the client and the trainer or coach, and [the four options] allow people to make choices,” say Ross. “When I meet a client, [there often seems to be] a big bubble over [the client’s] head that just says, ‘Help me!’ It’s up to both of us to determine which path or paths are right for that client at that time. A therapy approach may be best for a client rehabbing from an injury. For some clients, a straightforward fitness-based approach may be fine. But many clients want and need more. They want to be educated, and to be empowered, for when the coach or trainer isn’t going to be there with them.”
Ross points out that the root of the word health is “to be whole.” He believes that health is less about what you’re going to do than about altering your awareness or experience of yourself. “You can have a terminal illness but be healthy because your experience of yourself is healthy, or whole. You can never be less than whole as a human being, but we often experience ourselves as broken, or as having something missing. Wellness and ultimately health practices lead us to a deeper awareness that we are complete, perfect and beautiful just as we are.”
Megan Scott, PhD, of Mill Valley, California, agrees. A doctor of integrative medicine, sports rehabilitation and clinical psychology, specializing in advanced healing techniques, she says, “Wellness is not about trying to live up to somebody else’s point of view about what beauty or health are; it’s about living up to ourselves. . . . We have an internal guidance system that will keep us well and make quality choices for us, keeping us aligned with our own divine nature. That’s the pure form of wellness.”
Scott explains that energy medicine, or shifting and aligning energy frequencies of the mind and body through intentional practices such as yoga, meditation and energy healing, can be an important part of wellness for clients who are receptive to it. “Energy medicine is gaining more acceptance, but the idea is anything but new. My father was a trainer for U.S. Olympic teams, and I grew up seeing how athletes use intention and self-mastery techniques to achieve goals. Now I use biofeedback or microcurrent therapy as a technique for pain management with clients. These are just a few examples of how energy healing works.”
Meaning and Purpose
Paula Correia, MS, whose master’s degree is in spiritual psychology, works as a spiritual counselor in Los Angeles. “Spiritual wellness is transforming victimhood into taking full responsibility for ourselves. It’s not so much about fixing things, but about overcoming fear and getting to the next step of healing. Life is a journey of healing. You need to feel the pain and have those dark nights of the soul. Then you heal, and you get to feel the joy. Ultimately, spiritual wellness is about being of service and helping people.”
Says Keeling, “Having a larger perspective is an important part of wellness—being able to look outside of ourselves and serve the world, not just our clients. What is wellness if you’re a U.S. Marine in Iraq or a mother in Darfur? For many people in the world, wellness may just be trying to stay alive, to get enough to eat or stay out of the path of a bomb. We’re privileged to be in an affluent culture, but while money and privilege do alleviate deprivation and suffering on many levels, they don’t bring true happiness or wellness. I have proof of that all around me in Los Angeles. Nothing outside of yourself ever brings real happiness.”
Keeling adds that the experience of true wellness may be universal. “I don’t believe that what brings true, deep well-being is ever going to change. It comes only from doing inner, self-actualization work. It’s inner peace. It’s finding joy in being alive. It comes from finding a way to fully experience the moment, whatever it is, without judgment.”
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MEANING & PURPOSE
of WellnessEmotionalIntellectual© 1979 B. Hettler M.D. Co-founder NWISocial
Most experts agree that wellness is a matter of choice and responsibility, but behavior change is rarely easy. “Physicians can be pretty bad at creating lasting behavior change,” says David Scharff, MD, of Baltimore. “Often patients come to me with an arbitrary weight goal from a cardiologist or want to get into a bathing suit, but once the goal is reached, they go back to old habits.”
Scharff’s wellness approach emphasizes positive enjoyment rather than deprivation. “I tell patients to eliminate the soda and junk food they’re just eating automatically but not really enjoying. Most people are not very aware of what they put in their mouths. If a patient really enjoys ice cream, I tell him to split it into small portions and savor it. For lifestyle modification to work, people need to enjoy themselves and develop a sense of wellness about their choices and activities. Guilt and helplessness just make people want to give up.”
Scharff, a competitive cyclist, is also a role model to his patients. “I try to be a living example—I’m the crazy doctor who bikes back and forth to work.”
Judith Hibbard, Dr.PH, of Eugene, Oregon, a professor at the University of Oregon, is currently conducting research on behavior change models with LifeMasters Supported SelfCare, a Los Angeles organization that provides disease management programs. “We’re interested in how a patient’s knowledge, skill, confidence and beliefs impact the management of their health,” she says. “We want to measure these traits, monitor them and tailor intervention accordingly to make gradual progress. Often people feel overwhelmed with change, and they need to take small steps to experience success and build self-efficacy. For example, if you have hypertension, the smallest change is to take your meds. It takes more ownership to monitor [the condition] yourself, and even more to keep a diary of it. We want to help people move through levels like these. People also have a difficult time sorting out what’s the most important change to make first. Trainers and coaches can help people
set priorities, and work in
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Amy Hendel, of Encino, California, is a personal trainer and a registered physician assistant with a physician-referred family lifestyle therapy practice. “As trainers or coaches, much of what we offer our clients is reflective of our own wellness beliefs and behaviors. For example, trainers with eating disorders can use their profession to maintain unreasonable exercise and nutrition habits, and then advise clients to follow unsafe diet and exercise regimens. That’s an insult to wellness.”
In her own practice, Hendel emphasizes to clients that an important part of wellness is knowing your “core numbers”: blood pressure, pulse, height/weight, cholesterol (HDL and LDL), body mass index, number of hours of sleep, caloric intake, target heart rate, bone density and any other necessary medical test values. “Wellness depends on the clients’ proactive involvement in all sectors of their health. . . . Lifestyle management is a very personal journey. Perhaps the most important thing is that we listen to clients—and listen without judgment.”
Behavioral Change Pyramid
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