Forgiveness, Compassion, and Health Behavior Change

Forgiveness, Compassion, and ChangeBack when I used to work on digital health coaching programs, one frequent question we got had to do with whether people self-reported their health data honestly. Could we count on someone with a health issue to tell the truth about lousy eating habits, sedentary lifestyles, or skipping prescriptions? Research suggests that people are at least somewhat truthful when self-reporting their health behaviors, and discrepancies are often the result of comprehension issues rather than deceitful intent. Still, in designing a program that measures “non-healthy” behaviors, there are ways to encourage people to be more truthful.

One of the senior psychologists I used to work with put it like this: We know from data that medication adherence is pretty bad across the board. And patients know that anyone with a medical background is going to disapprove of their non-adherence, so they’re already on the defensive when they get asked how often they take their medication as prescribed. So why, said my colleague, don’t we frame the question with compassion? His suggested wording when we asked about medication adherence was along these lines:

“We know it can be hard to take your medication as directed, and in fact, a lot of people don’t. Can you help me understand how often you take your medication as prescribed?”

While this doesn’t necessarily eliminate social desirability effects, it sets the stage for compassion. If the person admits to imperfect adherence, there is an opening to have a conversation about barriers and change, rather than scolding. And by normalizing (though not necessarily approving of) non-adherence, you can also help the person you’re talking to feel a little bit of relatedness.

I thought of this in reading Gretchen Rubin’s thoughts on self-forgiveness during the habit formation process in Better Than Before. She writes, “People who feel less guilt and who show compassion toward themselves in the face of failure are better able to regain self-control, while people who feel guilty and full of self-blame struggle more.”

The lesson, I think, is that while we strive toward “good” behavior for ourselves and others, as effective coaches we also have to approach failures and setbacks with forgiveness and compassion. This lets us talk about a path forward instead of dwelling on a past problem.