don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

A foundation principle of the wellness philosophy is and always has been personal responsibility. This means, among other things, a resistance to making excuses, playing the blame game or looking for ways to shift accountability. For instance, if you think you're fat, but you are an enthusiast for wellness, you would not attribute your weight problem to genetics, society, your parents or McDonald's. Instead, your wellness-friendly interpretation of the situation would be to take steps to become more fit. No hemming and hawing, no ifs, ands or buts. Your focus: To improve overall health (especially fitness) while losing excess pounds. The same positive orientation to do what it takes that YOU can control to make things better would apply to medical problems, relationship crises, business setbacks or anything else.

Victim blaming is tempting, in some cases. Take the example of heart disease. It is well known that smoking, a high fat diet, lack of exercise and unmitigated stress are risk factors in all forms of cardiovascular disease. "What," you might ask, "is so unreasonable about pointing the finger at heart attack sufferers who manifest all the risk factors just noted, especially smoking?" Isn't it true that they bring about or at least contribute mightily to their own dissolution? Why is it so UN-PC to point this out, particularly if NOT done in a confrontational, graceless "I-told-you-so" manner?

One reason is that it does not help, and just might hinder a person's recovery and likelihood of reforming his or her own life. Most people seem to do better without being humiliated or nagged by others. Another reason might be due to the fact that the sufferer might NOT have brought on the problems and thus "victim-blaming" would be unjustified as well as cruel. Recent evidence has surfaced suggesting that more than poor lifestyles or worseness alone are at work in creating heart disease. A NY Times piece by Denise Grady ("Unblame the Victim: Heart Disease Causes Vary," September 11, 2004) notes, in the context of former president Bill Clinton's recent open heart surgery, that "experts differ as to whether it is scientifically valid or fair to assume that Mr. Clinton, who has a family history of heart disease, brought on his illness. Studies of large groups show that diet does play a role in coronary disease, but it is harder to prove that link in individual patients." This observation applies equally to the hundreds of thousands of other, less famous sufferers of heart disease. 

Heart disease is most common for people with high total cholesterol levels, particularly with high LDL., or low-density lipoproteins (the "bad" form of cholesterol). The purpose of omnipresent statin drugs is to lower cholesterol levels. Evidence from several longitudinal studies suggests that more factors are at work linking cholesterol and heart disease risk than just diet (in other words, fats consumed) or other lifestyle behaviors. The top doctor in charge of cardiac surgery at Vanderbilt University Medical Center looked at the evidence and concluded, "I think it's just plain silly to blame the patient." He went on (in the NY Times piece cited above) to explain that lifestyle reforms enable the body to make modest adjustments but not completely turn around the destiny set by family history and genetic predisposition. Another expert on heart disease at the Cleveland Clinic offered a similar assessment of the science of causation: "Dietary indiscretion is a risk factor, but it is not the cause of coronary heart disease. In the South Asian Indian population, there are vegetarians who get coronary heart disease." He claimed the key variables are a genetic predisposition plus environmental factors. Another remarked that blaming the victims is "emotionally destructive, socially scapegoating and morally deplorable."

Why do we have a tendency to blame the victim? As noted, one reason is the obvious correlation between health-damaging behaviors and heart disease, not to mention obesity, diabetes and all the rest. Poor genetics is not something we can identify so readily. A psychologist discussed the need people have to feel safe, control anxiety and match events and causes. Random happenings are unsettling, he noted. Another therapist, the clinical director of The Victim Center in Springfield, MO, wrote (in a News Ledger article on September 1, 2004 entitled, "Before blaming victims, learn more about issues"), "Blaming the victim is one way we distance ourselves from the uncomfortable feeling that we cannot control everything that happens to us. We would like to believe that if we use good judgment and do the right thing, nothing bad could happen. That may be one reason the water cooler discussion often centers around why the victim went where she went, dressed how she dressed, looked how she looked, or made a careless choice. Blaming the victim is one way we reassure ourselves that we are different. We are safe." 

Ira Chernus, a professor of religious studies at the University of Colorado at Boulder, wrote: "Blaming the victim is a very old game here in America. Sadly, much of our public swallows it whole. And there is no end of it in sight. The only question is which victims we will be blaming next."  (See "Blaming the Victim is an Old Habit," CommonDreams.org, April 8, 2003.)

Whatever the issue, be it medical causation or something else, be hesitant about blaming, focusing instead on identifying the complexities of the situation and strategies, especially personal actions, that can make things better. 

All the best, be well and look on the bright side of life.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of lifestyle habits. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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