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My Conversation with New IPPA Health & Wellness Division President, Dr. Liana Lianov, MD. (Interview)

Interviewer, Dr. Elaine O’Brien (EO). Liana, congratulations. We are thrilled to have you as our new IPPA Health and Wellness (H&W) President-Elect. I have been following your brilliant career, dedication to positive health and medicine, (attending your webinars and presentations), and trajectory around advancing Lifestyle Medicine. You are the former President of the American College of Lifestyle Medicine (ACLM). Can you please share your mission as new President-Elect of IPPA’s Positive H&W Division? What are you most excited about?

Interviewee, Dr. Liana Lianov (LL). Thank you for the kind words, Elaine. Yes, I’m excited to have the opportunity to serve as President-Elect and then President of IPPA’s Health and Wellness Division. A major goal that I hope to achieve is to advance collaboration between the positive psychology community and the health care community. Having this official role with IPPA, while also serving as the chair of the ACLM’s Happiness Science and Positive Health Committee, will uniquely position me to facilitate such collaboration. Lifestyle Medicine leaders are beginning to take action and championing the integration of habits based in positive psychology principles, not only to promote behavior change, but also as an additional key element of a lifestyle that directly enhances health outcomes.

EO. As a leader in the field of Lifestyle Medicine, can you please define the movement, and also, offer any takeaways from your time as a President of the ACLM?

LL. The Lifestyle Medicine movement is the newest area of health care specialization—that focuses on healthy, whole food plant-based nutrition, physical activity, adequate quality sleep, avoidance of risky substance use, and managing stress/emotional well-being. The goal is to minimize the use of medications or invasive treatments that have side effects and are costly. Many well-meaning health providers are minimally aware of the benefits of a healthy lifestyle, which is usually thought of as the main prevention approach. Most providers are not aware and/or have not fully embraced that a healthy lifestyle alone can treat and even reverse most chronic diseases—which underlie at least 80% of the cause of morbidity and mortality in developed countries and increasingly in developing countries. Hence, we have a huge job to do to bring the science of Lifestyle Medicine to health systems across the globe. 

We are making headway through the educational programs provided by ACLM, and the new physician and health professional certification offered by the American Board of Lifestyle Medicine (ABLM), for which I serve as Vice-Chair. The certification examination by the latter for physicians and by ACLM for other health professionals is now being given in at least two dozen countries. What I noticed during my years as a leader in the field is that the Lifestyle Medicine interventions for stress management and emotional well-being were minimal. Yet, positive psychology research is showing significant health benefits as a result of practicing habits based in these principles. Although, we have much more research to do, we can begin to develop and disseminate positive psychology tools for health practitioners to utilize as part of comprehensive Lifestyle Medicine aimed at total well-being. Closer collaboration in translational research and clinical practice between individuals in the positive psychology and health care fields will make a huge difference towards achieving this goal.

EO. What recommendations do you have for members of IPPA around advancing positive health, medicine, and wellness to those we serve?

 LL. Members of IPPA can take an active role in their professional networks to initiate and/or expand the dialogue about the key role that positive psychology has in health care and health. Even sharing articles, blogs and other science-based materials with people in our personal networks could be very helpful. If we, patients in general and the public demand high quality care from our health systems that offers comprehensive healthy lifestyle prescriptions, including habits based in positive psychology, to promote well-being, then the health systems will need to pay attention—and respond to changing times.

EO. Where do you get your passion in promoting positive psychology and Lifestyle Medicine? How can we spread that to help lift up people and communities?

LL. My passion comes from an understanding that the main way out of our current health care and public health crises is through, as noted earlier, comprehensive healthy lifestyles that emphasize habits based in positive psychology. Lifestyle Medicine and positive psychology are linked. Happy people are more likely to eat healthy for example. These lifestyle treatment approaches are low-cost relative to traditional medicine, have very few side effects, and offer amazing benefits in terms of health, quality of life, and happiness. The US and most other countries burdened with chronic diseases cannot afford to continue offering costly traditional medicine. Moreover, a whole-food, plant-based diet is good for the environment—protects the only planet we can call home, mother earth.

EO. What positive health, medicine, and wellness applications are you most excited about?

LL. I am especially excited about the positive psychology research that shows how people with positive emotions can experience unconscious motivation for healthy habits. Although, for the past few years, health coaches have increasingly been incorporating positive psychology into health-behavioral-change facilitation, we know that conscious attempts at behavioral change are challenging. So, if we can point the way for patients to take on activities that they are already motivated to do, such as practicing mindfulness, gratitude, forgiveness, and flow-producing activities, that result in greater inner peace, joy, happiness, etc., and potentially boost unconscious motivation towards healthy habits—our work as health providers will be easier and more effective.

EO. With our IPPA H&W past president Dr. Gail Ironson, and fellow board member Kathi Norman, Noemie Le Pertel, and myself, last year we were able to join forces with you and other health and medicine leaders, like Drs. Ed Diener, Michael Steger, Rhonda Cornam, at Dell Medical School, and were hosted by the American College of Lifestyle Medicine. What were some of the initiatives, actions, and/or results from the inspiring think tank? What’s next? How do you see it unfolding?

LL. Our inaugural Summit on Happiness Science in Health Care was an amazing opportunity to bring together some of the bright minds in lifestyle medicine, positive psychology, and health care innovation to discuss strategies for better integration of positive psychology into health care. A number of recommendations were made that one would expect, such as the need to aggregate and disseminate the best and most relevant research publications and expand translational research so that we can offer truly evidence-based tools and approaches to health care settings (summarized in a journal paper now being submitted for publication). But first and foremost, the summit attendees agreed we need to address the burnout crises within the physician and health care professions. Physicians have some of the highest suicide rates. Many nurses drop out of their profession within a year of graduation. The evolution of health care systems and the associated stressors are monumental. Hence, the Positive Health and Happiness Science Committee is beginning to seek funding and plan for a health provider well-being online program and pilot workshops at medical society meetings and academic institutions. We’ll look at current best practices in provider well-being, promote them, and improve on them by making sure positive psychology and emotional well-being interventions are emphasized. We’ll also begin to seek funds for a comprehensive conference for health providers and researchers to learn about the role of positive psychology in health care. Of course, I’m hoping to involve our H&W Division members in this event!

EO. Can you discuss the intersection of Positive Psychology research, theory, and practice?

LL. Others might have varied views about this intersection. For me, positive psychology research, theory, and practice are closely linked and impact each other. Research is based on testing current theories. As we obtain and analyze results, we adjust our theoretical frameworks and research those adjusted theories. As this research evolves, it’s essential to be applying it into practice. In the case of our health and wellness field, that means developing guidance and tools based on research that we all can use in our personal lives, as well as professional lives. An important step is to test these tools to show how they impact happiness and health outcomes in order to develop a true “evidence-base” that can be taught in medical/health training and become standard of care.

EO. How do you define positive health and wellness?

LL. Terminology is a challenge. There is more work to be done so that we can arrive at consistent terms and definitions—important to research and practice, especially across the fields of psychology and health. At the summit, the group preferred to use the term emotional well-being for the purpose of engaging health care providers—many of whom are unfamiliar with the term positive psychology and/or might not associate a term like happiness with science.

In our post-summit paper, we’re using Martin Seligman’s definition of “positive health.” Positive health stems from positive psychology practices leading to an additional health asset that produces longer, healthy life, and lowers disease risk and health care costs over and above disease-risk factors addressed by traditional medicine.

“Wellness” is a broad term that I tend not to use. Instead, in the article, we’re using the term “total well-being,” which includes physical, mental, emotional, social, and positive health.

EO. What about the role of “fitness,” a truly positive approach and intervention, in Positive Psychology?

LL. Every element of a healthy lifestyle, including physical fitness, healthy plant-based nutrition, sleep, and avoidance of risky-substance use improves total well-being that includes positive health (as just defined). And vice versa, positive psychology practices boost healthy lifestyle practices. That is why I’m working so diligently to promote awareness and training among health professionals on this essential link. Of these healthy lifestyles, the literature on physical fitness and its role in mental, emotional, and psychological well-being is most robust. This element might be most ripe for development of practical clinical and self-care tools that emphasize the dynamic interplay (pun intended) between these well-being elements.

EO. Liana, is there anything you’d like me to ask you, or that you would like to share?

LL. Thanks for asking. I think these questions were great and helped me cover a lot of ground and hopefully have provided some good insights for readers.

EO. Thank you Dr. Liana Lianov!

 

References:

American Journal of Lifestyle Medicine: Positive Psychology in Lifestyle Medicine and Health Care: Strategies for Implementation [April 2019, 13(241), doi 10.1177/1559827619838992] on the role of health care systems and providers in promoting positive psychology in health care.
 
Translational Behavioral Medicine (in press)
 
Roots of Positive Change: Optimizing Health Care with Positive Psychology will be released at LM2019 and will be widely available by early 2020. The book targets medical practitioners, offering practical tips on leveraging positive psychology in busy health care settings, in medical/health professional teaching and in personal well-being.

End Note: For more information about Dr. Liana Lianov’s extraordinary vision and contributions, you can visit https://www.ippanetwork.org/divisions/healthdivision/ or http://www.truehealthinitiative.org/councils/liana-lianov/

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