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We are now into the last area of focus in Lifestyle Medicine: support. As mentioned before, humans are social animals that have a desire to be close with other people or be a part of something bigger. Therefore, it is natural for you to feel needed and be part of a unit, big or small. Having a healthy relationship with others can provide you a sense of well-being and purpose which could add years to your life.
In this article, we will not only explore the links between human relationships and health but also how Lifestyle Medicine incorporates this knowledge into its practice.
The Early Years
In 1905, tuberculosis became endemic in Boston and only the rich could afford the treatment. So Dr. Joseph Pratt, an Internal Medicine physician, asked Elwood Worcester of the Emmanuel Church to support his project of improving the care of tuberculosis patients. While Emmanuel Church provided the meeting place and the funding, Dr. Pratt would gather the eight patients together to educate them about hygiene, encourage rest, nutrition, fresh air, and home visits. Although the group meetings became health education sessions, Pratt realized that the patients found a common bond in a common disease which contributed to the overall success of their treatment.
Definition of Support and Other Terms
We define support as providing assistance to other people in times of crisis to give them focus, encouragement, or positive self-image. Having your own support system enhances the quality of your life and provides you a buffer against adverse stress.
There are other terms that you also need to understand in the context of our topic.
Social isolation refers to the being alone with no relative amount of social relationships.
Social integration refers to your overall level of involvement with social relationships, whether within informal (family) or formal (religious group) groups.
Social network refers to the web of social relationships around you, including the type and strength of each relationship.
Quality of relationship refers to the positive and strained aspects of relationships. Emotional support from significant others is an example of a positive quality. Conflict is an example of a strained quality. Each of these aspects of social relationships affects your physical and mental health.
The Link Between Support and Health
Dr. Pratt’s project became one of the earliest studies on the physical and psychological health benefits of social support. Since then, scientists have studied social and emotional support’s influences on health. Although the long-term effects of such support remain to be determined, these effects show promise in influencing the quality of life in many chronic disease patients. The effects of all the social relationships emerged in childhood and cascaded throughout life providing you the cumulative advantage or disadvantage in your health.
If you will gather all the research studies, their findings would show any of the following conclusions:
Social relationships significantly affect your health;
Social relationships affect health behaviorally, psychosocially, and physiologically;
Social relationships entail costs as it provide health benefits;
Social relationships shape health outcomes throughout life and have a cumulative impact on your health over time;
Social relationships’ costs and benefits are not distributed equally across the population.
Types of Support
There are many ways that you can support one another. So far, much research has been done on the effects of these distinct types of support:
Emotional Support
Emotional support often involves physical comfort such as hugs, holding hands, or pats on the back, as well as listening and empathizing. And speaking of empathy, you need to understand its difference from sympathy.
Sympathy vs. Empathy
Both words have the same root, “pathos” meaning emotions. The Greek “sym” means “together” thus, sympathy is used when you share the feelings of another. For example, when a person experiences grief after losing a loved one, you sympathize. You share the same feeling of grief.
On the other hand, empathy carries an emotional distance or a notion of projection. Thus, empathy is used when you understand or can imagine how someone feels without necessarily feeling it yourself. For example, when a person experiences overwhelm after encountering a stressful situation, you empathize. You understand how he or she feels but you don’t have to experience the same feeling of overwhelm.
In short, sympathy shares; empathy understands.
Esteem Support
Esteem support often involves encouragement or expressions of confidence. When you offer esteem support, you might point out the strengths they might have forgotten, or just let them know that you believe in them. Most life coaches and therapists offer this kind of support which often leads others to believe in themselves more.
Informational Support
Informational support often involves giving advice or sharing information that can help you know what your next steps are. Help desks are just examples of informational support.
Tangible Support
Tangible support involves taking on responsibilities for someone else so they can deal with a problem. They may come in different forms. Bringing food to someone sick is an example of tangible support. There are other ways that you could help others deal with their own issues.
How Do Relationships Benefit Health?
There are three ways how social relationships work to influence health: behavioral, psychosocial, and physiological.
Behavioral Explanations
Regular exercise, eating a nutritionally balanced diet, and adhering to your medical regimen are just examples of behaviors that promote health and prevent illness. Smoking, heavy drinking, and drug abuse do the opposite. Many research studies have provided evidence that these behaviors affect your health.
Social relationships influence health behaviors, in part, because these relationships can provide information, instill a sense of concern for others, and create norms that influence health habits.
Psychosocial Explanations
Psychosocial mechanisms such as support, control, symbolism, norms, and mental health may explain how social relationships promote health.
For example, social support may have indirect effects on health by reducing the impact of stress, or by fostering a sense of purpose in life. Eventually, it results in reduced blood pressure and heart rate which are beneficial to health.
Believing that you have a control over your mind and body influences health outcomes through your actions.
Symbolic meanings of social relationships are linked to health habits. For example, marriage is attached to the responsibility of staying healthy within the family. Another example is when teens point out that their relationship with their peers influence their alcohol, tobacco, and drug use. Thus, health behaviors within the context of social relationships vary.
Social norms and traditions influence health behaviors particularly when your tribe, community, religion, or race practices a specific health behavior that is unique from the rest. For example, there is a religious sect that prohibits its members from eating pork. Another religious sect does not believe in blood transfusion. Therefore, health professionals should be aware of these practices in order to provide proper care.
Mental health, on the other hand, is a pivotal mechanism that works together with each of the other mechanisms to shape physical health. For example, the emotional support provided by social relationships enhances your mental well-being, which, in turn, may reduce your risk of poor health.
Physiological Explanations
Supportive human interactions with others benefit your immune, endocrine, and cardiovascular functions which reflects the body’s wear and tear brought about by your overworked body in response to stresses.
The Dark Side Of Social Relationships
While social relationships are the center of emotional support for most people, social relationships can be extremely stressful. Research shows that marital strain affects health, too, and that its negative effect on health becomes greater with age. The propensity to engage in risky health behaviors in response to stress varies over your lifetime. Admit it, toxic relationships exist, too.
Compounding the problem is the fact that not everyone is in touch with their feelings. Many individuals find it difficult to express their desire for emotional support or fail to recognize how they can benefit from it. Some research suggests that patients may feel ashamed to ask for emotional support, they may believe that they have all the support that they need, or they may not realize how they can benefit from emotional support.
For example, a person trapped in an abusive relationship may not recognize the red flags or hesitant to ask for help because of fear. Be aware that there are support groups or help desks that could help you get away or heal from this relationship.
That is why it would be better for me, as a physician, to ask, “Do you know what you really want?” or “Can you describe what you’re feeling?” rather than ask, “What do you want?” or “What do you feel?”. Because some people might just be blinded by fear and need to know the difference.
Conclusion
Social networks, whether formal or informal, provide a sense of belonging and security. Support, whether from a valued group or individual, has been shown to influence health and there are behavioral, psychosocial, and physiological explanations for this. Scientific studies show that social relationships affect a wide range of health outcomes on mental and physical health, health habits, and mortality risk.
When being in a group, make sure you feel comfortable with the group's beliefs, practices, and expectations. But do not expect that you will never experience any disagreements. That would be unrealistic. Just remember that spending time with them should make you feel accepted, energized, peaceful, and not coerced, pressured, or anxious.
Surround yourself with trustworthy people who can support you through your journey. Identify your support system and maintain these relationships well to reach their full benefits. Remember that support, just like communication, is a two-way street. Communicate openly with them with trust and respect but without judgment. Be open to their feedback even if they tell you tough truths. It is the only way for you to see other options and perspectives.
If you're the type of person who prefers being alone, that is fine. You are probably an introvert who can still maintain a small set of family members and friends to have healthy close relationships.
If you are having questions regarding support, feel free to schedule a consultation. I will help and work with you and suggest changes that would help you. Who knows? Our Group Starter program might suit your needs. Or if you want to hear from me talk about Lifestyle Medicine, feel free to listen to our podcast or contact me using the contact form below.
Sources:
Cunningham, Jean, Donald Strassberg, and Howard Roback. 1978. “Group Psychotherapy for Medical Patients.” Comprehensive Psychiatry 19 (2): 135–40.
Kowitt, Sarah. 2013. “What Do We Mean by ‘Emotional Support’?” peersforprogress.org. University of North Carolina at Chapel Hill. October 24, 2013.
Lee, Aaron A., John D. Piette, Michele Heisler, Mary R. Janevic, and Ann-Marie Rosland. 2019. “Diabetes Self-Management and Glycemic Control: The Role of Autonomy Support from Informal Health Supporters.” Health Psychology 38 (2): 122–32.
Marksberry, Kellie. n.d. “Emotional and Social Support.” The American Institute of Stress.
Merriam-Webster. 2019. “What’s the Difference between Sympathy and Empathy?” Merriam-Webster.com. 2019.
Reblin, Maija, and Bert N Uchino. 2008. “Social and Emotional Support and Its Implication for Health.” Current Opinion in Psychiatry 21 (2): 201–5.
Umberson, Debra, and Jennifer Karas Montez. 2010. “Social Relationships and Health: A Flashpoint for Health Policy.” Journal of Health and Social Behavior 51 (1_suppl): S54–66.