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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

An Unkind Word or Two About Prevention (Encore)

Sunday February 24, 2002

I once wrote that I would like to eliminate all prevention programs! This seemed a shocking form of apostasy to many of my health education friends, but of course I was only partly serious.

My lack of enthusiasm for prevention is due to the fact that such efforts stop short of promoting health -- the whole idea of prevention is negative, thus, it doesnâ€™t motivate effectively. Prevention strategies usually lack imagination and rarely entail visions of or goals for health beyond the margins of just not being sick. As a verb, to prevent means to keep something from happening, to hinder, hold or restrain, or to interpose an obstacle.

Contrast that with wellness/self-management, which is not about preventing something bad from occurring (a disease, excessive weight, or a bad attitude) but encouraging attractive states to occur (increased fitness, better body image, more fun, and improved sense of meaning). Given the choice between avoiding an unpleasant outcome (prevention) and pursuing a desired goal (wellness), which would YOU choose? The answer seems obvious -- self-management is a process for seeking the positive, whereas prevention is one of seeking to minimize the negative.

Parkinson noted, in another context, that â€œIt is better to travel hopefully than to arriveâ€Â and, as the lead character in the French film L'Eleve (the Pupil) replied when asked where he will go next, intones grandly: â€œThe point of the voyage is hardly the destination.â€Â Just so! This distinction is critical for improved outcomes in efforts to motivate and support behavior change.

There is an added bonus to dumping prevention in favor of wellness: When folks act in a fashion that promotes the experience of positive, sought-after resolutions, the prevention goals are realized (illness or other negative states are avoided) as part of the deal, without the worry and fuss.

Now you know why I wrote a few unkind words about prevention. It's because I'm so enthusiastically for wellness. If an ounce of prevention is worth a pound of cure, then a pound of wellness is worth a ton of prevention.

Be well.

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