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Behavioral fitness is a comprehensive approach to mental healthcare that makes a core assumption that one’s psychological health is directly and unavoidably related to one’s relevant biological capabilities. It further assumes that targeted training of one’s biological capabilities is an unavoidable aspect of optimizing psychological well-being.
The bulk of therapeutic modalities address emotions that come up, the patterns of thought and behavior that reinforce them, and/or the lifestyle circumstances and relationships that play their roles in the client’s level of well-being.
What they fail to address in most cases is the fundamentally biological nature of the problems, and thus, the biological nature of the solutions. To be blunt, as mental health practitioners, we are painfully ignorant of the biological mechanisms responsible for emotion, cognition, habituation, and environmental adaptation. We are at least, if relying solely upon what we were taught in our formal education. If I had the power to address changes in how clinicians are trained, I would demand at least a singular organic chemistry and neuroscience course be part of every accredited program.
As such, clinicians will pick one or some combination of theoretical orientations, most of which are at best tangentially aware of the mechanistic realities, frequently totally detached from them, or worse, in direct contraindication of mechanistic reality. A clinician’s theoretical orientation can become their brand or team, with more loyalty to its principles than to observation and experiment. Some more modern modalities are even greatly aware of the mechanisms at play. But there is a gap when it comes to facilitating proper training and conditioning to make the most of that knowledge so that therapy’s outcomes can drive forward as intended.
Looking at this problem, as well as our collectively abysmal outcome metrics in behavioral healthcare, I knew that I had to do something differently. It occurred to me that if I wanted to make my work about maximizing the help I provide to clientele, I had better do the common sense thing and make my interventions follow mechanistic realities, rather than make the clients’ needs fit to my personal whims of style or brand.
This is not to invalidate the importance of rapport, of supportive and challenging investigation through talk therapy approach styles, and of the relevance of family systems, subjective expression of experiences, or of person-centered and ethical means of interfacing in the therapy room. And for the job of cultivating surface cognition insight, holding accountability, and providing support, the vast majority of therapists and modalities are perfectly sufficient, and sometimes downright excellent. The issue I take is primarily with the failure to prime the human machinery before relying upon its capacity to run with the discoveries and support gathered on the therapy couch.
But these alone do not optimize the body and mind to overcome their challenges and to sculpt their lifestyle to more closely resemble their ideal circumstances. Lacking clarity on how to drive these changes reliably and effectively, the conversation in therapy shifts too often to perpetually tolerating low performance and subpar mental and physical conditioning, and somehow expecting emotional, social, economic, or environmental improvements to reliably happen anyway. Oftentimes there is some benefit despite these inefficiencies, but what a rough road to travel!
Being in a state of poor physical fitness will erode the energy to take optimal action or to remain an enjoyable, value-providing personality along the way, to say nothing of its effects on confidence in oneself and in others’ perception of another’s capabilities. Having a withered focus, sloppy memory, or easily agitated mindset due to stress chemistry overload or absent/lacking training in concentration practices is going to invalidate most good information and supportive goodwill in the pursuit of achieving goals or taking difficult steps in changing one’s lifestyle. And understanding that distortions or irrational views exist will mean nothing if the machinery lacks the capacity to drive improvements through repeated action until conditioning is attained.
So while our field preaches biopsychosocial comprehension, collectively, we deeply neglect the biological, except vague platitudes about improving activity and nutrition, or displacing someone to psychiatric medication regimens, often unnecessarily. And this is a grave disservice to outcomes for those who trust us, given that the psychological and social aspects are outflows of the physical machinery which props up the capacity to perceive the world or thoughts at all.
We do things differently here. Targeted meditation and logic exercises train attention, awareness, guard against distraction and mental dullness, and smooth the conditioning procedures to generate spontaneous and efficient insights through training interoception and exteroception. Fitness regimens train physical strength, mobility, muscle endurance, cardiovascular as well as anaerobic performance, and drive immune health and baseline energy and mood. Nutrition protocols minimize global inflammation and activation of stress-inducing nervous system triggers, provide ample substrate for the creation of healthy cells and tissues, and ease the process of body recomposition into an optimal state.
And only once we get this right, can we then see the beautiful aspects of talk therapy truly take root and help a client bring their mind and their worlds to their highest potential.
