Comforting Lies vs. Unpleasant Truths

Comforting Lies vs. Unpleasant Truths

I was looking through my notes from the recent - and amazing - Fusion 2.0 Conference and was reminded about this cartoon that Robert Kegan, one of the conference’s keynote speakers, used in his presentation. (Side note before this post goes further: if you ever have the chance to hear Robert Kegan speak, don’t miss it!)

This cartoon made me laugh out loud and nod my head in that knowing way we do when we can totally relate to something.

How many times in life have you doled out a comforting lie because it would feel too uncomfortable or risky to speak the truth? And how many times have you accepted something you thought might not be true because it was easier and simpler to do so than to buck the status quo or investigate further?

If you’re like me, you’ve done this a lot. If you’re not, awesome for you. Seriously. But keep reading anyway.

Choosing or accepting the comforting lie is a natural human tendency that has consequences in all aspects of our lives, business being no exception. I would venture to say that every professional industry in existence has some comforting lies floating around among the members of that industry - those “facts” and ideas and theories that are false but rarely questioned. Comforting lies get accepted and passed on, sometimes intentionally by people who feel the need to protect or preserve something, and sometimes unintentionally by people who have no idea that the ideas they "know" and share aren't true.

The wellness industry is no exception.

Here are a few comforting lies that come to mind, followed by their associated truth, which may feel unpleasant to acknowledge or difficult to address.

Comforting lie: By offering the right mix of health screenings, programs, challenges and incentives, our employee base will become healthier, happier, more productive and engaged.

Unpleasant truth: Creating a workforce where the majority of people are offering the best of themselves is complicated, time-consuming and involves systemic changes that go beyond individual wellness services. Whether your employees are eating five servings of fruits and veggies and exercising regularly is actually less important than whether they feel valued and respected at work, are emotionally resilient and able to contribute meaningfully (just to name a few).

Comforting lie: If we can get enough people in our workforce to reduce their risk factors and improve their health habits, our healthcare costs should level off or even decrease.

Unpleasant truth: Even if you do find a way to sustainably change the lifestyle behaviors of a significant portion of your workforce (challenging at best), your healthcare costs won’t be noticeably affected. Our healthcare system is expensive because it’s designed to be expensive. Nowhere in the list of the top drivers of healthcare costs do we see the words “individual health behaviors”. Suggesting that changing health-related lifestyle behaviors will significantly reduce healthcare costs is a silly simplification of a complex problem. The sooner we can come to terms with this, the faster we can get to work implementing some systemic solutions that will actually have an impact on costs.

Comforting lie: Paying people to participate in wellness programs improves not only participation, but also “engagement” and outcomes.

Unpleasant truth: If you want people to show up for an event or complete a simple task (for example, to get a flu shot), by all means, give them a little financial carrot and you’ll get more people to show up or complete. But participation at events is not the same as engagement in health or the workplace – not even close. And if the outcomes you’re aiming for are adaptive challenges that take place over time, require persistence, intrinsic motivation, and the development of new skills and tools (the very definition of sustainable lifestyle change), then financial incentives are a waste of money and counterproductive. They not only don’t work; they often lead to unintended negative consequences such as short-term thinking and cheating that undermine the essentials of meaningful behavior change and a humanistic culture.

I could go on, but you get the point.

I said earlier in the post that I’ve chosen the comfortable lie over the unpleasant truth many times, and that’s true.

Years ago in one of my professional health promotion roles, I worked in an organization that was tying Body Mass Index to a financial incentive. This meant that people were being judged as healthy (or not) and receiving their Health Savings Account reimbursement (or not) based in part on their BMI which, as we all know, is an extremely poor indicator of health and has no scientific or theoretical backing. I knew enough about BMI and incentives to know this was problematic - and it didn't feel right to me at a heart level - but it took some time before I had the courage to push back.

Around that same time, I was the one who actually designed the executive summary report for clients that generated all sorts of misleading numbers about how much money “could be saved” if only employees’ biometric risks went from high to low. I knew those numbers wouldn’t stand up to rigorous scientific review, but it was the same type of thing most wellness programs I knew of were doing – and clients were asking for it – so I did it. By the time I understood just how misdirected that thinking was, I was bothered by so many other things about the industry, I was already out the door to a new role in health promotion that wouldn't require me to work against the real evidence.

So, yes, I told and accepted the comforting lies earlier in my career – not because I’m a bad person or had sinister intentions. But because, like many of you, I was caught up in a paradigm that had taught me a bunch of things that simply weren’t true. And because sometimes it's easier to just ride on the barge in the direction it's going, rather than try to change it's direction.

But as I got frustrated (and curious), I did my due diligence. I dug past the headlines and deep into the research on health and behavior change and incentives and healthcare costs and weight loss to see for myself. I talked with people who were saying something different than the norm. I read and listened and learned as much as I could – and was blown away at how different the truth really was from what I had been taught in my formal health education and the mainstream wellness industry.

Now, I don’t consciously tell or accept the comforting lies. I can’t stand to! It feels like a complete lack of integrity and a total waste of time. I think it’s better to go straight to the unpleasant truth, speak about it, share it with others, and figure out what to do differently that’s in alignment with the truth. Personally, I feel like I can handle anything - as long as I actually know what I'm dealing with. It's the not knowing that's the worst.

And, really, the two most difficult things about encountering unpleasant truths are that: 1) they're, well, unpleasant at first; and 2) they mean you have to make a decision about whether you want to speak up and be a change-agent ... or stick your head in the sand. Other than those two difficulties, facing the unpleasant truths can actually be a gift. Once you acknowledge that what you thought you knew isn’t really true, you can embark on the interesting and rewarding work of change. You can grow and learn as a person and a professional. You can be part of the next generation who knows better now and does things differently.



 

Amanda Pavlich

Southern Charm Doula Services, LLC at Southern Charm Doula Services

5y

Rebecca, you are so on point with this article!

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Excellent post. Your critical assessment, expressed clearly and without apparent bias, is powerful. This approach should be the norm, not the exception, regardless of subject.

Sandy Blood

Health Promotions Program Manager at Blue Cross Blue Shield of Florida

5y

Morning Rebecca!  Wow did your article resonate with me.  I can say I truly know exactly what you are speaking to.  Please reach out as it's been way to long since we've seen one another. Merry Christmas to you and your's and thanks so much for sharing your expertise and wisdom.

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Linda Riddell

Population Health Scientist and Poverty Educator

5y

Fabulous post!  I just put up an article about our love affair with lies, based upon a study in Science of 126,000 stories.  Fake news goes further, faster, and more broadly than real stuff.  Discouraging, but people like you keep up the faith! 

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