The National Institute of Whole Health (NIWH) | Pioneers of Whole Health Education® and Whole Person Care
December 1, 2015

What Really Nourishes

By Georgianna Donadio, MSc, DC, PhD

Nutrition is today’s new religion. How we chose to eat provides a sense of control and predictability in a world that is often out of control and not predictable. People find comfort, stability and reassurance in the regimen of adhering to a certain diet and what they believe it will do for their well-being and longevity.

The future of health promotion needs to address that while nutrition is one of the five major necessities of life our relationships (after survival needs are met) are the #1 most critical component to health – and for health promotion. Currently, the way we treat each other at work, in the media, politics, and in our homes, speaks of an underlying pathology; a lack of respectful communication, widespread cultural discontent and alienation.

In 1980, TIME magazine published a survey asking if people were happy or content and felt purposeful in their lives; 80% responded positively. Just over 10 years later, TIME magazine published another survey. This time there was only a 20% positive response.

The timeline of the epidemic of obesity in the U.S. runs parallel with the epidemic of discontent that was ushered in with the “Life Styles of the Rich and Famous” in the mid-to-late 1980’s; followed by an exploding economy fueled by mega-rich real estate, dotcom and investment billions. No one wanted to be left behind in keeping up with the new, very rich “Jones”.

Drive and ambition ripped across all sectors of our society; lifestyles were transformed with 2 paycheck households, over 50% of meals eaten outside the home, leisure time slashed. We felt the pressure to keep up, to belong to this explosion of plenty and in that process lost our collective sense of contentment and purposefulness.

Health promotion in the future will be about addressing the needs and drives of the whole person, not just the fuel that runs their engine. Promoting awareness that we all want and need to be valued and to make a meaningful contribution to others is an important starting point. So much of the disease, obesity, depression, unhappiness and untapped potential can be reversed by being valued and respected; when our cultural focus is less on conflict and competition – and more on respectful behavior and cooperation, health promotion will be the organic outcome of our mindful behavior towards ourselves and others.

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April 2, 2015

Doctor-Patient Communication is the #1 Problem in Medicine

By Georgianna Donadio, MSc, DC, PhD

At the 2015 National Health Policy Conference held in Washington, D.C., members of the Agency for Healthcare Research and Policy agreed that the need for research focusing on the doctor-patient relationship was urgent in order to address the current crisis of patient dissatisfaction, medical-error, malpractice claims and physician burnout.

Patients are not happy, doctors and medical teams are not happy, and the health care system is struggling to adapt measures to turn the tide of this growing problem. The 2012 Institute for HealthCare Communication (IHC) report regarding research on the impact of poor communication revealed the following:

  • Research conducted during the 10 year period of 1995-2005 has demonstrated that ineffective team communication is the root cause for nearly 66 percent of all medical errorsduring that period.
  • This means that when healthcare team members do not communicate effectively, patient care often suffers.
  • Further, medical error vulnerability is increased when healthcare team members are under stress, are in high-task situations, and when they are not communicating clearly or effectively.

The research from the IHC reports cites that 50% of all malpractice is the result of poor communication between doctor and patient.

The IHC report states: “Research evidence indicates that there are strong positive relationships between a healthcare team member’s communication skills and a patient’s capacity to follow through with medical recommendations, self-manage a chronic medical condition, and adopt preventive health behaviors. Studies conducted during the past three decades show that the clinician’s ability to explain, listen and empathize can have a profound effect on biological and functional health outcomes as well as patient satisfaction and experience of care.”

IHC goes on to make an alarming statement that “Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”

And, while the addition of nurse health coaches to the medical team has been viewed by some as a solution to the communication problem, the relationship between the physician or primary care provider and the patient cannot be corrected by these additional team members. In fact, not addressing the underlying cause of doctor-patient discomfort may even increase the distrust and discomfort the patient experiences with their doctor or primary care provider.

As physicians, physician assistants and nurse practitioners are the diagnostic experts in our medical care system, ensuring the communication between these providers and their patients is critical, as research data demonstrates.

A recent pilot study, conducted through Central Michigan University (CMU), on the effects of a communication model, Behavior Engagement with Pure Presence, on patient and physician satisfaction has just concluded, and will be published shortly. The study was funded by Blue Cross and Blue Shield Foundation of Michigan.

The Primary Investigator (P.I.) of this study, Dr. Christine Clipper, wanted to thoroughly test the Behavioral Engagement model by including renowned endocrinologist, Dr. Opada Alzohaili, who was trained in the model’s communication skills and had previously earned high patient satisfaction survey ratings. Dr. Alzohaili’s post-pilot patient satisfaction scores were significant, revealing 100% improvement on all measures of patient perception of relational empathy during their encounter with the doctor, in contrast to his pre-pilot patient satisfaction scores.

Dr. Clipper’s research data demonstrated that Behavioral Engagement with Pure Presence has “…a psychological effect on the patient’s perception of the patient-provider relationship. The patient perception of relational empathy with their doctor increased through improved provider communication skills through applying the Behavioral Engagement model.”

Further research on the application of the model includes a pilot study on the Behavioral Engagement model in Electronic Medical Record Communication, funded by the U.S. Department of Health and Human Services/ MI Dept. of Community Health;
and a randomized controlled clinical trial study with funding from major national health care organizations.
Dr. Georgianna Donadio is the Director of the National Institute of Whole Health and author of the multi-award winning, Amazon bestselling book, Changing Behavior.

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November 26, 2014

Dealing with Difficult Relationships During the Holidays

By Georgianna Donadio, MSc, DC, PhD

The December Holidays are just around the corner. Some say “it’s the most wonderful time of the year!” Or is it? For many of us, the holiday visits back home to family members is something to be dreaded. While we look forward to the pleasure of celebrating these festive times, there is also the memory of past conflicts and the very real possibility of new confrontations that we find ourselves anxious to avoid. We can tell ourselves that this is the year we will not get stressed out or upset with visits to or from our families. This is what we strive for yet, most often, not how things turn out.

In is common, according to Dr. Jeffrey Fine, Ph.D., Director of the American Foundation for Conscious Parenting that our families can be “a breeding ground for repressed resentments and hostilities left over from childhood.” (Link 1) We might anticipate that once we have grown up and moved away to create our own lives and families that these feeling would diminish but, as many of us experience, unfortunately they do not.

One potential solution to transforming the holidays from stressful to joyful is the application of identified communication skills that have been researched and shown to facilitate changing difficult relationships. Behavioral Engagement is a 12-step set of communication skills that has been the subject of hospital pilot studies over a 32 year period. (Link 2)

The outcomes of these pilots showed the participants experienced a significant improvement in their relational outlook and attitude after interacting with the communication skills model. (Link 2)  Originally developed to enhance relationships between doctors, nurses and patients, the model was also applied and studied with business and family relationships.

James Prochaska, PhD, renowned researcher on behavior change and author of “Change for Good – the Six Stages of Transtheoretical Change” says of Behavioral Engagement that “The process of Behavioral Engagement has the potential to transform relationships that are suffering or struggling to ones that are thriving!”

Generally, one of the most recommended approaches to staving off holiday conflicts is to “try and accept family members or friends as they are”. (Link 3) Unfortunately, this good intention can be easily side-lined without specific communications skills that can help keep us on track.

The 12-Step Model of Behavioral Engagement that Dr. Prochaska endorses offers specific, easy to learn, communication skills that have been proven effective in changing conflicted relationships into compatible relationships based on the understanding that we all want to be valued, respected and listened to.

The steps are based on physical, psychological, hormonal and neurological aspects of human relationships and communication. They start with the understanding that while we cannot change others behavior we can change our own behavior in how we relate to others, which can result in a transformative outcome for all participants.

We can do so by using specific, simple communication skills and following the steps that have been shown to be effective in creating greater receptivity and generating more positive emotions in relationships that have previously been conflicted or stressful.

If you have experienced or are anticipating challenging relationships during the holidays, you may wish to apply these easy steps and see if they can assist you in having happier and even healthier holidays.

Step One – Be physically comfortable when communicating. This removes discomfort that can distract providing your full attention to the person you are speaking with. Distractions reduce your focus on the person you are speaking with which decreases receptivity which sends the message that you may not be listening to them, which can flame the fire of resentment.

Step Two –Understanding what you want. Our intentions are powerful behavior motivators. By understanding what we want from an exchange with another can assist us in communicating more clearly our thoughts and feeling, inviting greater understanding and intimacy. Example – “I really want to understand what you are unset about.”

Step Three – Centered Body Posture. Uncross arms and legs, present open, receptive body language. To send the message that you are respecting the conversation and giving the other person your fully attention, do not play with your watch, glasses, hair or continually look away from the person you are speaking with. Committing to being focused is an important element in communication and sends the message that you value your time with the other person. We can all feel when someone values being with or speaking to us.

Step Four – Sustained, Soft Eye Contact has been scientifically proven to stimulate oxytocin which opens emotional centers of the brain and enhances trust (Link 4) and feelings of love and intimacy.

Step Five – Respectful Inquiry. Asking rather than telling or directing, and using “I” statements rather than “you” statements, creates a safe, non-judgmental environment for the other person to communicate openly.

Step Six – Responsiveness. By using appropriate responses, such as facial expressions, smiling, head nodding and so forth, indicates you are responding to and understanding what the other is saying without interrupting or interjecting. This acknowledges the value you have for their communication.

Step Seven – Pauses between responses, allowing for silence between statements. Instead of immediately speaking as soon as the other person is finished, allowing for appropriate silence when someone has shared a thought or feeling with you is an important part of the experience of being respectfully listened to. It is also a component of being truly present to them.

Step Eight – Non-Judgment. By not allowing your unspoken mental and emotional judgments to invade your attention, you eliminate the unconscious communication that is sent through subtle and gross body language. Unconscious, non-verbal body language is something most of us pick up immediately. They can make or break your communication and relationships.

Step Nine – Leave the ego at the door. Eliminate the push-pull or power struggle of previous relationship interactions by letting go of taking control of the communication and allow for equity between you and the other individual.

Step Ten – Re-Centering when you start to lose focus. Mentally repeating simple words you identify as prompts to get you back to the focus of the conversation is a quick and effective way to get yourself re-centered in the exchange. Example: “back to focus” or “get-centered”.

Step Eleven – Collaborative mindset. Working towards having a win-win outcome eliminates conflict and improves the quality of the relationship in both the short term and for the long term.

Step Twelve – Sacredness of Relationship – Sacredness means “worthy of respect”. When we are aware of appropriate verbal and behavioral boundaries within our communications, we hold the other person in high esteem and create fulfilling, lasting relationships.

When dealing with family holiday conflicts it can be helpful for us to try these simple, proven communications skills, but also to reflect on the wisdom of the question – “would you rather be loved than be right?” Often times when we elect love over being in control or being right then our relationships shift for the better. You can download a free excerpt of the book on Behavioral Engagement by visiting

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