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Designing for Health and Happiness
David S. Sobel, MD, MPH
Regional Health Education
The Permanente Medical Group, Kaiser Permanente Northern California
Telephone: 510.987.3579, david.sobel@kp.org
Follow me on Twitter @KPhealthyfun
Healthy Pleasures
©The Permanente Medical Group 2014
2
Questions
1.  Are people unmotivated?
2.  Does pleasure and happiness
matter for health?
3.  How can we design for
happiness and amplify pleasure?
3
Are people unmotivated?
Consequences:
§  Attempt to increase motivation
§  Prescribing behavior change (i.e.
often failure)
§  Frustration and cynicism
þ  But do we really know what
motivates people?
þ  How can we make it easier for
people to do what they already want
to do?
þ  Have we identified and celebrated
successes?
4
Shifting the Curve
Target the Ready & Willing:
Help people do what they already want to do.
Where to focus? Which curve can you shift?
5
What do people really care about?
“Healthy
Lifestyles”
“Real Life”
Sleep
Sex
Stress
Exercise and
healthy diet
Preventive
screenings
6 n= 1064
The “Unmentionables”
7
Pleasure and Passion:
Missing Ingredients in Motivation
þ  understand whole person
þ  screens for depression
þ  align with intrinsic motivation
þ  bright spot for clinicians
What do you
Really Enjoy?
8
There’s no improvement, Henry.
Are you sure you have given up everything you enjoy?
9
Types of Pleasures
Sensory Pleasures
q  5 Senses
Non-Sensory Pleasures
q  Achievement (competence*)
q  Autonomy*
q  Activity (process of activity, not outcome)
q  Neuromuscular (arousal and relaxation)
q  Esthetic (nature, beauty, etc.)
q  Humor
q  Social Pleasures (relatedness*)
Frijda, N. (2010). On the nature and function of pleasure. In M. L. Kringelbach & K. C. Berridge
(Eds.), Pleasures of the brain (pp. 99–112). New York: Oxford University Press.
Biswas-Diener, R. Pleasure: An Initial Exploration. J of Happiness Studies, 2014.
*Self-Determination Theory
10
Finding Pleasure: Enjoyment as a Vital Sign
ü  List 10 activities that are fun for
you. What brings you joy? What
that makes you feel happy? It can
be anything- walking the dog,
talking with friends, working in the
garden, listening to music, writing
a letter to someone special,
watching your children play, fixing
a special meal…
ü  What prevents you from doing
more of the things you really
enjoy?
Pleasant Events Schedule
Peter Lewinsohn320 items
11
Questions
1.  Are people unmotivated?
2.  Does pleasure and happiness
matter for health?
12
Are Happier People Healthier?
"During the past 4 weeks, have you been a happy person?"
“All things considered, how satisfied are you with your life?”
Siahpush Am J Health Promo 2008;23:18-26
§  People with higher happiness and
life satisfaction 2 years later
reported 50% better health and
less long-term, limiting health
conditions.
n=10,000
13
Are Happier People Healthier?
A long-term study of nuns
discovered that those who wrote
autobiographies at a young age
reflecting happiness, love and
hope had a 2.5 time lower risk of
dying than their gloomier
counterparts.
Danner J Pers Soc Psych 2001;80:804-13
14
Health Benefits of Happiness
Seven types of evidence are reviewed
that indicate that high subjective
wellbeing (such as life satisfaction,
absence of negative emotions,
optimism, and positive emotions)
causes better health and longevity….
the evidence is clear and compelling.
Deiner, Applied Psych 2011
15
SAVOR YOUR SENSES: In Touch
§  Infants (preterm and term)
§  Pregnancy and childbirth
§  Diabetic and asthmatic children
§  Adolescent psychiatric patients
§  Post-traumatic stress disorder
§  Eating disorders
§  Migraine headache and low
back pain
§  HIV+ adults
§  Breast cancerTouch Research Institute, University of Miami
School of Medicine
Field TM Touch Therapy 2000.
16
When looking at Nature:
§ More positive feelings
§ Reduced negative emotion
§ Lower physiological arousal
§ Higher alpha brain waves
§ Quicker recovery from
stress
SAVOR YOUR SENSES: Nature vs. Urban
17
Postsurgical patients in a room
with a view of nature (vs. a brick
wall) had:
ü less distress
ü required less pain medication
ü discharged 1 day sooner
“Nature-Deficit Disorder” -“No Child
Left Inside” (R. Louv)
Ulrich R: Science 1984:224:420
SAVOR YOUR SENSES: Looking at Nature
18
SAVOR YOUR SENSES: The Case for Wine
(and Alcohol)
C 1–2 drinks per day for women
C 2-4 drinks per day for men
is associated with:
§  18% lower total mortality
§  30% lower risk of coronary heart
disease and type 2 diabetes
§  higher “good” HDL cholesterol
.
Di Castelnuovo: Arch Intern Med 2006;166:2437, Koppes LL: Diabetes Care 2005;28:719,
Mukamal KJ: JAMA 2010;303:2065
19
Chocolate eaters may enjoy:
§  27% lower relative risk of death and an extra year
of life (Lee I, BMJ 1998)
§  Lower blood pressure (Taubert D, Arch Intern Med. 2007)
§  47% lower mortality rate in men (Buijsse B: Arch Intern
Med 2006)
§  35% less likelihood of hospitalization or death from
heart disease in women over 70 (Lewis JR Arch Intern
Med. 2010)
§  20% lower rate of stroke (Larsson, Neurology, 2012)
§  decreased insulin resistance, high HDL and lower
LDL cholesterol, reduced blood platelet adhesion,
protection arterial wall lining, etc (Corti R: Circulation,
2011)
SAVOR YOUR SENSES: Life is Sweet
20
CENSORED
The risk of death in men who
had sex twice or more a week
is half that of men who had
sex less than once a month.*
Davey Smith G: BMJ 1997;315(7123):1641-44
SAVOR YOUR SENSES: The Benefits of Sex
* After adjusting for age, social class,
smoking, blood pressure, and existing
heart disease
21
§  Men taking a siesta were
30-50% less likely to have a
heart attack
§  24,000 people over 6 years:
§  Occasional nap: 12%
reduction in coronary
mortality
§  Frequent naps: 37%
reduction
Trichopoulas D: Lancet 1987;2:269
Naska, A: Arch Int Med 2007;167:296
PRACTICE HAPPINESS: Siestas
22
Hearty Laughter
Heart attack patients
Rx: 30 min/day humor video
§  fewer irregular rhythms
§  lower blood pressure
§  lower stress hormones
§  less medication
§  one-fifth rate recurrent heart
attacks
Tan SA: Can J Cardiol 1997
PRACTICE HAPPINESS: Humor Matters
23
Pets
In the year following a
heart attack, pet
owners have one-fifth
the rate of recurrent
heart attack.
Friedmann E, Public Health Reports 1980;95:307
INDULGE IN ALTRUISM: Selfless Pleasures
24
INDULGE IN ALTRUSIM
Giving Better than Receiving
Mortality risk reduced by nearly half in seniors giving social support
while increased in those receiving support.*
Brown SL Psych Sci 2003
* After controlling for age, gender, health status, socioeconomic
status, health behaviors, and personality
25
Questions
1.  Are people unmotivated?
2.  Does pleasure and happiness
matter for health?
3.  How can we design for
happiness and amplify pleasure?
26
Think of a change you made…
q  Did your plan out and write down
specific small steps and/or have
feedback of performance data?
q  Did a major life event trigger an
epiphany/breakthrough change?
q  Did you change because your
environment required or invited the
change?
q  Did you just change the behavior
because it felt good?
27
Roads to Behavior Change
§  Incremental	
  Planned	
  Change	
  	
  
§  “Baby	
  Steps”	
  
§  “Small	
  Steps”	
  
§  “Simple	
  Steps”	
  
§  “Tiny	
  Steps”	
  
§  “Starter	
  Steps”	
  
§  “Success	
  Steps”	
  
§  “Mastery	
  Experiences”	
  	
  
§  Breakthrough	
  Change	
  
§  Environmental	
  Change	
  
§  Pleasurable	
  Change	
  
28
Health Behavior Change
What if small steps
do not lead to
sustained behavior
change and health
habits?
29
Small Steps to Health
Small Steps
Sustained Health
Habit
Improved
Health
Small Steps
Success
Experience
Improved
Health
ü Confidence
ü Optimism
ü Self-Efficacy
ü Mood/Affect
ü Pleasure
ü etc.
ü Exercise
ü Healthy Eating
ü Smoking
ü Preventive Care
ü etc.
Behavior Matters Mood Matters
30
Segar M et al. Rebranding Exercise. International Journal of Behavioral Nutrition and Physical
Activity 2011, 8:94. http://www.ijbnpa.org/content/8/1/94
Failure and Success
http://michellesegar.com/organizations/
31
Celebrate
Design with Pleasure: Amplifiers
Focus
PrimeReframe
32
Celebrate
Design with Pleasure: Amplifiers
Reframe Prime
Focus
33
Ingredients of Sensory Pleasures
Good
Sense+
Mindful
Attention+ Pleasure!=
What do you need for pleasure to happen?
Good
Stimulus
34
PRACTICE HAPPINESS
A Wandering Mind is an Unhappy Mind
What are you feeling, doing, and
thinking right now?
2250 people
Killingsworth, Gilbert: 2010. Science 330:932.
www.trackyourhappiness.org
§  Mind wandering: 50%
§  People happier when their mind
was NOT wandering during all
activities, pleasant or unpleasant
§  What people are thinking is better
predictor of happiness than what
they are doing
35
A Call to be Present
TELEPHONE RING
Distraction? Interruption? or
Call to be present?
(  First ring: Smile. Breathe. “Listen,
listen. This wonderful sound brings
me back to my true self.”
(  Second ring: Smile. Breathe.
(  Third ring: Be fully present as you
answer.
Thich Nhat Hanh, Peace is Every Step
36
Celebrate
Design with Pleasure: Amplifiers
Focus
PrimeReframe
37
YOU ARE HERE
38
Amplifying Pleasure with Scarcity
The last piece of chocolate on earth…
39
Celebrate
Design with Pleasure: Amplifiers
Focus
Reframe Prime
40
The Power of Priming
Priming make us
more sensitive to
and aware of:
§  opportunities
§  events
§  interactions
§  triggers
41
What 3 things happened
today that I am:
§  grateful for?
§  curious about?
§  surprised by?
§  learning something new?
Emmons RA, J Pers Soc Psych, 2003
Emmons RA, Thanks! 2007
Priming for Gratitude, etc.
42
What do you take for granted?
43
What to call it?
§  “Priming Behaviors”
§  “Ripple Behaviors”
§  “Cascading Behaviors”
§  “Domino Behaviors”
§  “Keystone Behaviors”
44
Design with Pleasure: Amplifiers
Focus
PrimeReframe
Celebrate
45
Celebrating Unexpected Pleasures
46
Design with Pleasure
þ  Emphasize more proximal, immediate satisfaction,
mood, and feelings
þ  Focus on present experience
þ  Don’t be senseless (invite sensual pleasure)
þ  Celebrate (even small) successes
þ  Include unexpected surprises, delights
þ  Change the focus/perspective/filters/frames
þ  Identify “priming” and “cascading” behaviors
47
Thank you…
48
Healthy Pleasures: 5 Part Online Video Program
or	
  search	
  
YouTube	
  
for	
  
“Healthy	
  
Pleasures”	
  
49
Twitter @KPhealthyfun
50
Resources for Happiness
51
Can judge a book by it’s cover?
52
Resources and References (1)
Ben-­‐Shahar,	
  Tal:	
  Happier:	
  Learn	
  the	
  Secrets	
  to	
  Daily	
  Joy	
  and	
  Las@ng	
  Fulfillment.	
  McGraw-­‐Hill,	
  2007	
  
Boronson,	
  Mar;n:	
  One	
  Moment	
  Medita@on.	
  Winter	
  Road	
  Publishing,	
  2009.	
  
Burns,	
  David:	
  The	
  Feeling	
  Good	
  Handbook.	
  Morrow,	
  1989.	
  
David,	
  Susan,	
  et	
  al.	
  Oxford	
  Handbook	
  of	
  Happiness.	
  Oxford,	
  2013	
  
Davis,	
  Martha;	
  Eshelman,	
  E;	
  McKay,	
  M:	
  The	
  Relaxa@on	
  &	
  Stress	
  Reduc@on	
  Workbook.	
  New	
  Harbinger,	
  2008.	
  
Diener	
  ,	
  Ed	
  and	
  Biswas-­‐Diener,	
  Robert	
  .	
  Happiness:	
  Unlocking	
  the	
  Mysteries	
  of	
  Psychological	
  Wealth.	
  Wiley-­‐Blackwell,	
  2008.	
  
Dunn	
  EW,	
  Akmin	
  LB,	
  Norton	
  MI.	
  (2008).	
  Spending	
  money	
  on	
  others	
  promotes	
  happiness.	
  Science,	
  319,1687-­‐89	
  
Emmons	
  RA,	
  McCullough	
  ME	
  (Eds.)	
  (2004).	
  The	
  Psychology	
  of	
  Gra@tude.	
  Oxford	
  Press.	
  
Emmons,	
  RA	
  (2007).	
  Thanks!:	
  How	
  the	
  New	
  Science	
  of	
  Gra@tude	
  Can	
  Make	
  You	
  Happier.	
  Houghton	
  Mifflin	
  
Howell	
  RT,	
  et	
  al:	
  (2007).	
  	
  Health	
  benefits:	
  Meta-­‐analy;cally	
  determining	
  the	
  impact	
  of	
  well-­‐being	
  on	
  objec;ve	
  health	
  outcomes.	
  Health	
  
Psychology	
  Review	
  1(1),83-­‐136	
  
Kabat-­‐Zinn,	
  J:	
  Wherever	
  You	
  Go	
  There	
  You	
  Are:	
  Mindfulness	
  Medita@on	
  in	
  Everyday	
  Life.	
  Hyperion,	
  1994	
  
Kringelbach,	
  M	
  (ed):	
  Pleasures	
  of	
  the	
  Brain.	
  Oxford,	
  2010	
  
Lyubomirsky,	
  S	
  .	
  The	
  How	
  of	
  Happiness.	
  Penguin	
  Press,	
  2008	
  
Lyubomirsky,	
  S	
  .	
  The	
  Myths	
  of	
  Happiness:	
  What	
  Should	
  Make	
  You	
  Happy,	
  but	
  Doesn't,	
  What	
  Shouldn't	
  Make	
  You	
  Happy,	
  but	
  Does.	
  
Penguin	
  Press,	
  2013	
  
McKay	
  M,	
  Davis	
  M,	
  and	
  Fanning	
  P:	
  Thoughts	
  and	
  Feelings:	
  The	
  Art	
  of	
  Cogni@ve	
  Stress	
  Interven@on.	
  New	
  Harbinger,	
  2007.	
  
Neele,	
  Daniel:	
  Happiness:	
  The	
  science	
  behind	
  your	
  smile.	
  Oxford	
  University,	
  2005.	
  
53
Resources and References (2)
Ornstein,	
  Robert	
  and	
  Sobel,	
  David:	
  Healthy	
  Pleasures.	
  New	
  York:	
  Addison-­‐Wesley,	
  1989.	
  
Ornstein,	
  Robert	
  and	
  Sobel,	
  David:	
  The	
  Healing	
  Brain.	
  New	
  York:	
  Simon	
  &	
  Schuster,	
  1987.	
  
Pennebaker,	
  James	
  W.	
  Opening	
  Up:	
  The	
  Healing	
  Power	
  of	
  Confiding	
  in	
  Others.	
  Guilford	
  Press,	
  1997.	
  	
  
Posi;ve	
  Psychology	
  Center,	
  University	
  of	
  Pennsylvania.	
  hep://www.ppc.sas.upenn.edu/	
  
Seligman,	
  Mar;n:	
  Authen@c	
  Happiness,	
  Free	
  Press,	
  2004	
  
Seligman,	
  Mar;n:	
  The	
  Op@mis@c	
  Child.	
  Mariner,	
  2007.	
  
Seligman,	
  Mar;n:	
  Flourish.	
  2011.	
  
Sheldon	
  KM,	
  Lyubomirsky	
  S:	
  	
  Is	
  It	
  Possible	
  to	
  Become	
  Happier?	
  (And	
  If	
  So,	
  How?)	
  Social	
  and	
  Personality	
  Psychology	
  Compass	
  1/1	
  
(2007):	
  129–145,	
  	
  
Siahpush	
  M,	
  Spieal	
  M,	
  Singh	
  GK:	
  Happiness	
  and	
  Life	
  Sa;sfac;on	
  Prospec;vely	
  Predict	
  Self-­‐Rated	
  Health,	
  Physical	
  Health,	
  and	
  the	
  
Presence	
  of	
  Limi;ng,	
  Long-­‐Term	
  Health	
  Condi;ons.	
  American	
  Journal	
  of	
  Health	
  Promo;on:	
  September/October	
  
2008;23:18-­‐26.	
  	
  
Sobel,	
  David	
  and	
  Ornstein,	
  Robert:	
  The	
  Healthy	
  Mind,	
  Healthy	
  Body	
  Handbook	
  (also	
  published	
  under	
  the	
  ;tle	
  The	
  Mind&Body	
  
Health	
  Handbook),	
  Los	
  Altos,	
  CA:	
  DRx	
  1996.	
  	
  
Sobel,	
  David:	
  Rethinking	
  Medicine:	
  Improving	
  health	
  outcomes	
  with	
  cost-­‐effec;ve	
  psychosocial	
  interven;ons.	
  Psychosoma@c	
  
Medicine	
  57:234-­‐244,	
  1995.	
  
Sobel,	
  David:	
  The	
  cost-­‐effec;veness	
  of	
  mind-­‐body	
  medicine	
  interven;ons.	
  In	
  The	
  Biological	
  Basis	
  for	
  Mind	
  Body	
  Interac@ons,	
  
Progress	
  in	
  Brain	
  Research,	
  Vol	
  122,	
  E.A.	
  Mayer	
  and	
  C.B.	
  Saper	
  (Eds.),	
  Amsterdam:	
  Elsevier	
  Science,	
  2000:393-­‐412.	
  
Wiseman,	
  Robert:	
  59	
  Seconds:	
  Think	
  a	
  Li^le,	
  Change	
  a	
  Lot.	
  New	
  York:	
  MacMillan,	
  2009.	
  

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HxRefactored - Kaiser Permanente - David Sobel

  • 1. Designing for Health and Happiness David S. Sobel, MD, MPH Regional Health Education The Permanente Medical Group, Kaiser Permanente Northern California Telephone: 510.987.3579, david.sobel@kp.org Follow me on Twitter @KPhealthyfun Healthy Pleasures ©The Permanente Medical Group 2014
  • 2. 2 Questions 1.  Are people unmotivated? 2.  Does pleasure and happiness matter for health? 3.  How can we design for happiness and amplify pleasure?
  • 3. 3 Are people unmotivated? Consequences: §  Attempt to increase motivation §  Prescribing behavior change (i.e. often failure) §  Frustration and cynicism þ  But do we really know what motivates people? þ  How can we make it easier for people to do what they already want to do? þ  Have we identified and celebrated successes?
  • 4. 4 Shifting the Curve Target the Ready & Willing: Help people do what they already want to do. Where to focus? Which curve can you shift?
  • 5. 5 What do people really care about? “Healthy Lifestyles” “Real Life” Sleep Sex Stress Exercise and healthy diet Preventive screenings
  • 6. 6 n= 1064 The “Unmentionables”
  • 7. 7 Pleasure and Passion: Missing Ingredients in Motivation þ  understand whole person þ  screens for depression þ  align with intrinsic motivation þ  bright spot for clinicians What do you Really Enjoy?
  • 8. 8 There’s no improvement, Henry. Are you sure you have given up everything you enjoy?
  • 9. 9 Types of Pleasures Sensory Pleasures q  5 Senses Non-Sensory Pleasures q  Achievement (competence*) q  Autonomy* q  Activity (process of activity, not outcome) q  Neuromuscular (arousal and relaxation) q  Esthetic (nature, beauty, etc.) q  Humor q  Social Pleasures (relatedness*) Frijda, N. (2010). On the nature and function of pleasure. In M. L. Kringelbach & K. C. Berridge (Eds.), Pleasures of the brain (pp. 99–112). New York: Oxford University Press. Biswas-Diener, R. Pleasure: An Initial Exploration. J of Happiness Studies, 2014. *Self-Determination Theory
  • 10. 10 Finding Pleasure: Enjoyment as a Vital Sign ü  List 10 activities that are fun for you. What brings you joy? What that makes you feel happy? It can be anything- walking the dog, talking with friends, working in the garden, listening to music, writing a letter to someone special, watching your children play, fixing a special meal… ü  What prevents you from doing more of the things you really enjoy? Pleasant Events Schedule Peter Lewinsohn320 items
  • 11. 11 Questions 1.  Are people unmotivated? 2.  Does pleasure and happiness matter for health?
  • 12. 12 Are Happier People Healthier? "During the past 4 weeks, have you been a happy person?" “All things considered, how satisfied are you with your life?” Siahpush Am J Health Promo 2008;23:18-26 §  People with higher happiness and life satisfaction 2 years later reported 50% better health and less long-term, limiting health conditions. n=10,000
  • 13. 13 Are Happier People Healthier? A long-term study of nuns discovered that those who wrote autobiographies at a young age reflecting happiness, love and hope had a 2.5 time lower risk of dying than their gloomier counterparts. Danner J Pers Soc Psych 2001;80:804-13
  • 14. 14 Health Benefits of Happiness Seven types of evidence are reviewed that indicate that high subjective wellbeing (such as life satisfaction, absence of negative emotions, optimism, and positive emotions) causes better health and longevity…. the evidence is clear and compelling. Deiner, Applied Psych 2011
  • 15. 15 SAVOR YOUR SENSES: In Touch §  Infants (preterm and term) §  Pregnancy and childbirth §  Diabetic and asthmatic children §  Adolescent psychiatric patients §  Post-traumatic stress disorder §  Eating disorders §  Migraine headache and low back pain §  HIV+ adults §  Breast cancerTouch Research Institute, University of Miami School of Medicine Field TM Touch Therapy 2000.
  • 16. 16 When looking at Nature: § More positive feelings § Reduced negative emotion § Lower physiological arousal § Higher alpha brain waves § Quicker recovery from stress SAVOR YOUR SENSES: Nature vs. Urban
  • 17. 17 Postsurgical patients in a room with a view of nature (vs. a brick wall) had: ü less distress ü required less pain medication ü discharged 1 day sooner “Nature-Deficit Disorder” -“No Child Left Inside” (R. Louv) Ulrich R: Science 1984:224:420 SAVOR YOUR SENSES: Looking at Nature
  • 18. 18 SAVOR YOUR SENSES: The Case for Wine (and Alcohol) C 1–2 drinks per day for women C 2-4 drinks per day for men is associated with: §  18% lower total mortality §  30% lower risk of coronary heart disease and type 2 diabetes §  higher “good” HDL cholesterol . Di Castelnuovo: Arch Intern Med 2006;166:2437, Koppes LL: Diabetes Care 2005;28:719, Mukamal KJ: JAMA 2010;303:2065
  • 19. 19 Chocolate eaters may enjoy: §  27% lower relative risk of death and an extra year of life (Lee I, BMJ 1998) §  Lower blood pressure (Taubert D, Arch Intern Med. 2007) §  47% lower mortality rate in men (Buijsse B: Arch Intern Med 2006) §  35% less likelihood of hospitalization or death from heart disease in women over 70 (Lewis JR Arch Intern Med. 2010) §  20% lower rate of stroke (Larsson, Neurology, 2012) §  decreased insulin resistance, high HDL and lower LDL cholesterol, reduced blood platelet adhesion, protection arterial wall lining, etc (Corti R: Circulation, 2011) SAVOR YOUR SENSES: Life is Sweet
  • 20. 20 CENSORED The risk of death in men who had sex twice or more a week is half that of men who had sex less than once a month.* Davey Smith G: BMJ 1997;315(7123):1641-44 SAVOR YOUR SENSES: The Benefits of Sex * After adjusting for age, social class, smoking, blood pressure, and existing heart disease
  • 21. 21 §  Men taking a siesta were 30-50% less likely to have a heart attack §  24,000 people over 6 years: §  Occasional nap: 12% reduction in coronary mortality §  Frequent naps: 37% reduction Trichopoulas D: Lancet 1987;2:269 Naska, A: Arch Int Med 2007;167:296 PRACTICE HAPPINESS: Siestas
  • 22. 22 Hearty Laughter Heart attack patients Rx: 30 min/day humor video §  fewer irregular rhythms §  lower blood pressure §  lower stress hormones §  less medication §  one-fifth rate recurrent heart attacks Tan SA: Can J Cardiol 1997 PRACTICE HAPPINESS: Humor Matters
  • 23. 23 Pets In the year following a heart attack, pet owners have one-fifth the rate of recurrent heart attack. Friedmann E, Public Health Reports 1980;95:307 INDULGE IN ALTRUISM: Selfless Pleasures
  • 24. 24 INDULGE IN ALTRUSIM Giving Better than Receiving Mortality risk reduced by nearly half in seniors giving social support while increased in those receiving support.* Brown SL Psych Sci 2003 * After controlling for age, gender, health status, socioeconomic status, health behaviors, and personality
  • 25. 25 Questions 1.  Are people unmotivated? 2.  Does pleasure and happiness matter for health? 3.  How can we design for happiness and amplify pleasure?
  • 26. 26 Think of a change you made… q  Did your plan out and write down specific small steps and/or have feedback of performance data? q  Did a major life event trigger an epiphany/breakthrough change? q  Did you change because your environment required or invited the change? q  Did you just change the behavior because it felt good?
  • 27. 27 Roads to Behavior Change §  Incremental  Planned  Change     §  “Baby  Steps”   §  “Small  Steps”   §  “Simple  Steps”   §  “Tiny  Steps”   §  “Starter  Steps”   §  “Success  Steps”   §  “Mastery  Experiences”     §  Breakthrough  Change   §  Environmental  Change   §  Pleasurable  Change  
  • 28. 28 Health Behavior Change What if small steps do not lead to sustained behavior change and health habits?
  • 29. 29 Small Steps to Health Small Steps Sustained Health Habit Improved Health Small Steps Success Experience Improved Health ü Confidence ü Optimism ü Self-Efficacy ü Mood/Affect ü Pleasure ü etc. ü Exercise ü Healthy Eating ü Smoking ü Preventive Care ü etc. Behavior Matters Mood Matters
  • 30. 30 Segar M et al. Rebranding Exercise. International Journal of Behavioral Nutrition and Physical Activity 2011, 8:94. http://www.ijbnpa.org/content/8/1/94 Failure and Success http://michellesegar.com/organizations/
  • 31. 31 Celebrate Design with Pleasure: Amplifiers Focus PrimeReframe
  • 32. 32 Celebrate Design with Pleasure: Amplifiers Reframe Prime Focus
  • 33. 33 Ingredients of Sensory Pleasures Good Sense+ Mindful Attention+ Pleasure!= What do you need for pleasure to happen? Good Stimulus
  • 34. 34 PRACTICE HAPPINESS A Wandering Mind is an Unhappy Mind What are you feeling, doing, and thinking right now? 2250 people Killingsworth, Gilbert: 2010. Science 330:932. www.trackyourhappiness.org §  Mind wandering: 50% §  People happier when their mind was NOT wandering during all activities, pleasant or unpleasant §  What people are thinking is better predictor of happiness than what they are doing
  • 35. 35 A Call to be Present TELEPHONE RING Distraction? Interruption? or Call to be present? (  First ring: Smile. Breathe. “Listen, listen. This wonderful sound brings me back to my true self.” (  Second ring: Smile. Breathe. (  Third ring: Be fully present as you answer. Thich Nhat Hanh, Peace is Every Step
  • 36. 36 Celebrate Design with Pleasure: Amplifiers Focus PrimeReframe
  • 38. 38 Amplifying Pleasure with Scarcity The last piece of chocolate on earth…
  • 39. 39 Celebrate Design with Pleasure: Amplifiers Focus Reframe Prime
  • 40. 40 The Power of Priming Priming make us more sensitive to and aware of: §  opportunities §  events §  interactions §  triggers
  • 41. 41 What 3 things happened today that I am: §  grateful for? §  curious about? §  surprised by? §  learning something new? Emmons RA, J Pers Soc Psych, 2003 Emmons RA, Thanks! 2007 Priming for Gratitude, etc.
  • 42. 42 What do you take for granted?
  • 43. 43 What to call it? §  “Priming Behaviors” §  “Ripple Behaviors” §  “Cascading Behaviors” §  “Domino Behaviors” §  “Keystone Behaviors”
  • 44. 44 Design with Pleasure: Amplifiers Focus PrimeReframe Celebrate
  • 46. 46 Design with Pleasure þ  Emphasize more proximal, immediate satisfaction, mood, and feelings þ  Focus on present experience þ  Don’t be senseless (invite sensual pleasure) þ  Celebrate (even small) successes þ  Include unexpected surprises, delights þ  Change the focus/perspective/filters/frames þ  Identify “priming” and “cascading” behaviors
  • 48. 48 Healthy Pleasures: 5 Part Online Video Program or  search   YouTube   for   “Healthy   Pleasures”  
  • 51. 51 Can judge a book by it’s cover?
  • 52. 52 Resources and References (1) Ben-­‐Shahar,  Tal:  Happier:  Learn  the  Secrets  to  Daily  Joy  and  Las@ng  Fulfillment.  McGraw-­‐Hill,  2007   Boronson,  Mar;n:  One  Moment  Medita@on.  Winter  Road  Publishing,  2009.   Burns,  David:  The  Feeling  Good  Handbook.  Morrow,  1989.   David,  Susan,  et  al.  Oxford  Handbook  of  Happiness.  Oxford,  2013   Davis,  Martha;  Eshelman,  E;  McKay,  M:  The  Relaxa@on  &  Stress  Reduc@on  Workbook.  New  Harbinger,  2008.   Diener  ,  Ed  and  Biswas-­‐Diener,  Robert  .  Happiness:  Unlocking  the  Mysteries  of  Psychological  Wealth.  Wiley-­‐Blackwell,  2008.   Dunn  EW,  Akmin  LB,  Norton  MI.  (2008).  Spending  money  on  others  promotes  happiness.  Science,  319,1687-­‐89   Emmons  RA,  McCullough  ME  (Eds.)  (2004).  The  Psychology  of  Gra@tude.  Oxford  Press.   Emmons,  RA  (2007).  Thanks!:  How  the  New  Science  of  Gra@tude  Can  Make  You  Happier.  Houghton  Mifflin   Howell  RT,  et  al:  (2007).    Health  benefits:  Meta-­‐analy;cally  determining  the  impact  of  well-­‐being  on  objec;ve  health  outcomes.  Health   Psychology  Review  1(1),83-­‐136   Kabat-­‐Zinn,  J:  Wherever  You  Go  There  You  Are:  Mindfulness  Medita@on  in  Everyday  Life.  Hyperion,  1994   Kringelbach,  M  (ed):  Pleasures  of  the  Brain.  Oxford,  2010   Lyubomirsky,  S  .  The  How  of  Happiness.  Penguin  Press,  2008   Lyubomirsky,  S  .  The  Myths  of  Happiness:  What  Should  Make  You  Happy,  but  Doesn't,  What  Shouldn't  Make  You  Happy,  but  Does.   Penguin  Press,  2013   McKay  M,  Davis  M,  and  Fanning  P:  Thoughts  and  Feelings:  The  Art  of  Cogni@ve  Stress  Interven@on.  New  Harbinger,  2007.   Neele,  Daniel:  Happiness:  The  science  behind  your  smile.  Oxford  University,  2005.  
  • 53. 53 Resources and References (2) Ornstein,  Robert  and  Sobel,  David:  Healthy  Pleasures.  New  York:  Addison-­‐Wesley,  1989.   Ornstein,  Robert  and  Sobel,  David:  The  Healing  Brain.  New  York:  Simon  &  Schuster,  1987.   Pennebaker,  James  W.  Opening  Up:  The  Healing  Power  of  Confiding  in  Others.  Guilford  Press,  1997.     Posi;ve  Psychology  Center,  University  of  Pennsylvania.  hep://www.ppc.sas.upenn.edu/   Seligman,  Mar;n:  Authen@c  Happiness,  Free  Press,  2004   Seligman,  Mar;n:  The  Op@mis@c  Child.  Mariner,  2007.   Seligman,  Mar;n:  Flourish.  2011.   Sheldon  KM,  Lyubomirsky  S:    Is  It  Possible  to  Become  Happier?  (And  If  So,  How?)  Social  and  Personality  Psychology  Compass  1/1   (2007):  129–145,     Siahpush  M,  Spieal  M,  Singh  GK:  Happiness  and  Life  Sa;sfac;on  Prospec;vely  Predict  Self-­‐Rated  Health,  Physical  Health,  and  the   Presence  of  Limi;ng,  Long-­‐Term  Health  Condi;ons.  American  Journal  of  Health  Promo;on:  September/October   2008;23:18-­‐26.     Sobel,  David  and  Ornstein,  Robert:  The  Healthy  Mind,  Healthy  Body  Handbook  (also  published  under  the  ;tle  The  Mind&Body   Health  Handbook),  Los  Altos,  CA:  DRx  1996.     Sobel,  David:  Rethinking  Medicine:  Improving  health  outcomes  with  cost-­‐effec;ve  psychosocial  interven;ons.  Psychosoma@c   Medicine  57:234-­‐244,  1995.   Sobel,  David:  The  cost-­‐effec;veness  of  mind-­‐body  medicine  interven;ons.  In  The  Biological  Basis  for  Mind  Body  Interac@ons,   Progress  in  Brain  Research,  Vol  122,  E.A.  Mayer  and  C.B.  Saper  (Eds.),  Amsterdam:  Elsevier  Science,  2000:393-­‐412.   Wiseman,  Robert:  59  Seconds:  Think  a  Li^le,  Change  a  Lot.  New  York:  MacMillan,  2009.