Megan felt completely blindsided. After their breakup, the two remained friends on social media, and Megan found herself in the habit of compulsively checking in on Scott's life and his new relationship. As a result, Megan was depressed and having difficulty concentrating on tasks at her new job. She was also having trouble eating and sleeping, and she was drinking alcohol more frequently than usual. At the time he refuses to admit this experience at face value, because it is too threatening to his self-organization. He denies the fault, rationalizes the criticism. But later, alone, he rethinks the matter, accepts the criticism as just, and revises his concept of self, and consequently his behavior, as a result. For experiences which are deeply denied, however, because they are deeply inconsistent with the concept of self, this does not avail. It appears possible for the person to face such inconsistency only while in a relationship with another in which he is sure that he will be accepted. To leave this discussion with a somewhat simpler example, the child who feels that he is weak and powerless to do a certain task, to build a tower or repair a bicycle, may find, as he works rather hopelessly at the task, that he is successful. This experience is inconsistent with the concept he holds of himself, and may not be integrated at once; This is the normal way in which, free from threat, new perceptions are assimilated. But if this same child is repeatedly told by his parents that he is competent to do the task, he is likely to deny it, and to prove by his behavior that he is unable to do it. The more forceful intrusion of the notion of his competence constitutes more of a threat to self and is more forcefully resisted. By not naming this in my first article, I entrenched the problem. When not properly contextualized, a self-help article like the one I wrote takes responsibility off our culture's shoulders. The shame I carry now is that this individualized response to health and eating, which I promoted in my first article, is still strongly embedded in many people's conception of the Health at Every Size(R) movement. The ethos in my second article, Body Respect, coauthored with Lucy Aphramor, is different. It grounds the Health at Every Size concept in a social justice/systems-oriented frame. These newer ideas are supported and actively endorsed by the Association of Size Diversity and Health (ASDAH), the organization that has trademarked the HAES name, yet this approach does not have full traction in the HAES movement.

I urge people who advocate for HAES to adopt this more updated understanding and to recognize the interplay between the personal and the political as we conceptualize healing. This requires a radical revisioning of health care and recognizing that it is not possible to define a health practice divorced of social context. As Lucy Aphramor and I discuss in Body Respect, a focus on behavior change deflects attention from the more pernicious problem of systemic injustice, obscuring the reality that lifestyle factors account for less than a quarter of health outcomes. It puts the burden on the individual to assume personal responsibility for discomfort around food and weight and disease and adds a new stressor on one's health, because it lets people be blamed for not doing more to manage or improve their health issues. Her constant checking was not only causing her to feel more stressed, it was also interfering with her ability to properly grieve. Sound familiar? Megan's experience is a common one. A recent survey conducted by the American Psychological Association found that more than eight out of ten Americans are attached to their gadgets. Of those surveyed, 86 percent say they constantly or often check their People who constantly check their gadgets are more stressed and anxious than those who do not use technology and social media as frequently, and this added stress compounds mourning. This connection to technology denies us the time to mourn and detach from our romantic relationships. When we do not allow ourselves this time, major losses--like the end of a relationship--will snowball into more serious problems, preventing us from living the fulfilling life we envision for ourselves. In order to properly mourn a loss, we must allow ourselves physical and digital space from former partners. Constant checking isn't the only thing that can inhibit the mourning process. It is clear that a more refined analysis is needed of the exact conditions which are necessary to permit a reorganization of the self-concept and the assimilation of contradictory experiences. We know one way in which this reorganization may be brought about, but the conditions which are crucial for this type of experience are not sufficiently known. It should also be obvious that what is being described here is a learning process, perhaps the most important learning of which the person is capable, namely the learning of self. It is to be hoped that those who have specialized in theory of learning may begin to utilize the knowledge from that field in helping to describe the way in which the individual learns a new configuration of self. XVIII) When the individual perceives and accepts into one consistent and integrated system all his sensory and visceral experiences, then he is necessarily more understanding of others and is more accepting of others as separate individuals. This proposition has been felt to be true in our clinical therapeutic work, and is now supported by Sheerer's research investigation (188, 189).

It is one of the unexpected findings that have grown out of the client-centered approach. To the person not familiar with therapeutic experience, it may seem like wishful thinking to assert that the person who accepts himself will, because of this self-acceptance, have better interpersonal relations with others. We find clinically, however, that the person who completes therapy is more relaxed in being himself, more sure of himself, more realistic in his relations with others, and develops notably better interpersonal relationships. One client, discussing the results which therapy has had for her, states something of this fact in these words: I am myself, and I am different from others. Maintaining the primacy of individual lifestyle change is also problematic because it diverts efforts from the more important systems-level issues which might be addressed through collective action. Additionally, it gives the false impression that lifestyle components, like eating and activity habits, are in fact individual choices, while ignoring the influence of social context and how it constrains or supports certain behaviors. Well-intended strategies like advising people to eat a rainbow of foods and prepare home-cooked meals are easier to follow if you have greater resources, like access to nearby grocery stores, money to spend in them, and time to cook up what you buy while it's still fresh. It is well established, too, that lifestyle-oriented changes yield greater health improvement for people with greater privilege in their lives. Paradoxically, some of the downstream methods of tackling inequalities in health can widen the very inequity gap they target. To be clear, behavior change is valuable, but it can't remove the stressors you face. No matter how you change your eating or activity habits, the factors that make up your lifeworld--challenges like stigma, job insecurity, poverty, and caregiver responsibilities--will remain unchanged. Naming inequity and systemically working toward a fairer world is important not just on a systemic level. On an individual level, naming and acknowledging the social roots of health inequities can help a person lighten up on the self-blame, realistically consider their life circumstances, and come up with solutions that best allow them to engage in self-care. While health-promoting behaviors make sense for everyone, for individuals with hard lives, building a fairer society and helping them manage the challenges of poor treatment will matter far more to health outcomes than whether they eat their veggies. Studies show that consuming social media passively--ingesting content by scrolling through news, public posts, broadcasts, and public profiles without interacting with them--is linked to negative well- Passive consumption of social media increases feelings of depression and loneliness. It can also exacerbate feelings of envy and fear of missing out, all of which can damage our self-esteem. In response to Megan's constant checking and passive social-media consumption, in session she and I discussed the idea of taking scheduled breaks from social media throughout the day. At first, she was nervous about the idea and expressed concern that it might make her more anxious and lonely. Megan also knew she'd be left wondering what Scott was doing and was worried about where her imagination might take her.

I explained to Megan that taking conscious and planned breaks from social media is a form of self-care. The break doesn't have to be forever; Any social-media hiatus, whether it be for an hour or--if you're feeling ambitious--a whole day, is time well spent healing from your loss. Taking breaks from social media also helps dissipate strong negative emotions. I am getting more happiness in being myself, and I find myself more and more letting other people assume the responsibility for being selves. If we try to understand the theoretical basis upon which this takes place, it appears to be as follows: The person who denies some experiences must continually defend himself against the symbolization of those experiences. As a consequence, all experiences are viewed defensively as potential threats, rather than for what they really are. Thus in interpersonal relationships, words or behaviors are experienced and perceived as threatening, which were not so intended. Also, words and behaviors in others are attacked because they represent or resemble the feared experiences. There is then no real understanding of the other as a separate person, since he is perceived mostly in terms of threat or nonthreat to the self. But when all experiences are available to consciousness and are integrated, then defensiveness is minimized. When there is no need to defend, there is no need to attack. When there is no need to attack, the other person is perceived for what he really is, a separate individual, operating in terms of his own meanings, based on his own perceptual field. Focusing on systemic roots over individual-level paradigms helps not only marginalized people, but everyone, though the relative impact might be stronger for those who face more barriers. THE SYSTEMIC APPROACH IN PRACTICE If you'd asked me to write a article about behavioral practices for good health a couple of decades ago, I would have led with nutrition and exercise. It's the common expectation--and believing in it is probably why I made it my expertise. When obtaining my PhD in physiology, I specialized in nutrition, and I also have a master's degree in exercise science, in addition to a master's degree in psychotherapy. I even taught college courses in nutrition for fifteen years.

But that's not how I'd do it today. Examining our medical and social institutions' default focus on nutrition and exercise, and my own past orientation, provides a good way to understand both what's wrong with the old way of thinking about behavior change and how a systems-focused approach improves on the outdated models. MYTH-BUSTING NUTRITION First, nutrition. It is when we're in emotionally charged spaces that we're more likely to use social media in hurtful ways or to engage in any number of self-destructive behaviors that hinder our recovery, like drinking too much, overspending, or overeating. Instead, consider the following exercise. Skill-Building Strategies Write your feelings down. Ask yourself, What would happen if you decided not to go on social media when missing an ex-partner? What's the worst thing that can happen if you do not check an ex-partner's social media? Is there something else you can do instead of going on social media, such as taking a walk or calling a friend or family member? The Self-Sabotaging Cycle of Constant Checkers Constant checking, like the habit that Megan was indulging in, reflects curiosity. While this may sound abstruse, it is corroborated by much everyday evidence, as well as by clinical experience. Who are the individuals, in any neighborhood, or in any group, that inspire confidential relationships, seem able to be understanding of others? They tend to be individuals with a high degree of acceptance of all aspects of self. In clinical experience, how do better interpersonal relationships emerge? It is on this same basis. The rejecting mother who accepts her own negative attitudes toward her child finds that this acceptance, which at first she has feared, makes her more relaxed with her child.