The Introverted Doctor

The Four Core Areas that Creates Lasting Change or Impedes it – Dr. Lalit Chawla MD, CCFP, FCFP

If there is one thing I’ve learned both in my personal life and my professional life, is that helping facilitate behavioural change in others, or myself, can be very challenging; yet it can be one of the most rewarding things I’ll ever do. Have you ever personally struggled to make a change, or improve something in your life, whether it’s eating better, exercising, getting to sleep on time, or cutting back on Netflix, and then, after a few days or weeks of making that change, you noticed a positive impact in your life?   Did you see ripple effects in other areas of your life, and that just made you feel empowered?!! 

I’d like to share with you a model that I, and many patients, have found helpful. There are four core areas that are always influencing a person’s life (refer to Fig.1):


In anybody’s existence, I believe that there are two areas that are always influencing a person’s behaviour, thoughts, and overall wellbeing. The first is a person’s Internal World, (which is comprised of two core elements that impacts wellbeing and self-concept). The second is a person’s External World, which consists of two core elements which affect their health, the way they are experiencing their life, and how they contribute to the world.

The first core sphere of our Internal World is our inner psychology. This core sphere consists of our values, beliefs, emotions, rules, memories, imagination, and philosophies. Essentially, this makes up our view of the world as we believe it to be.

We know people have very different rules and value systems. Conflict or disagreements occur when we encounter people that are very different from ourselves, because we are seeing them through our lens of understanding, or we choose not to agree with their view for a multitude of reasons.

The second sphere consists of our Physical Body; our brain patterns, immune system, ability to heal, the number of limbs, eyes, ears, muscles, nerves, etc.

The type of physiology we have determines how we can carry out what we want to do. We all come into this world with varying degrees of physical ability and limitation. And, if you’ve ever been sick or have injured a body part, you know that it can affect your psychology or ‘state of mind’ as well. Conversely, you can have all the winning attitude, the right psychology, beliefs etc., but if you don’t have the physical wellness, you can’t do what you want or what you need to do. The mind and body, are intimately connected.

That’s why, when we change our physical position, an actual change takes place in our mental wellness. Studies have shown the benefit of exercise in terms of decreasing anxiety and depression. One study even showed that exercise had just as much benefit, as an SSRI (an anti-depressant) in helping improve depression.

The third core sphere, our Physical Environment, is part of our External World. How do you feel when you’ve been through a dark, cold winter and then you open the door and all of a sudden it’s a beautiful sunny day with a nice gentle breeze? For most of us, it creates a sense of relief, joy, and vibrancy. What if you’re bored, down in the dumps and you eat something that you love, no doubt you will momentarily feel better. These are examples of how our physical environment influences our thought patterns and well-being, which ultimately affects our behaviours. Our physical environment consists of things like weather, physical space, air quality, pictures on the wall, what we eat, our water intake, nutritional food vs. junk food, etc.

Personally, I’ve followed the lead from some of the secretaries and nurses I’ve worked with – how they’d spruce up their work area by putting up photos of their children, or inspirational quotes etc. Are you optimizing your physical environment?

The fourth sphere is our “People” Environment: Millionaires hang around millionaires; musicians hang around musicians; birds of a feather flock together, and misery loves company. This area is easily neglected. That’s why parents are so rightfully concerned by who their children’s friends are. When you surround yourself with negative influence, it will affect your psychology and belief system and vise versa.

There are so many people that have difficulty leaving an unhealthy state because of the people that are in their circle. Sometimes we have little choice with the type of people we have around us, whether it’s a relative or a work colleague, but a great deal can be done by how much time or energy we give them.

Make the time to connect with people who lift and recharge your mental, emotional, and spiritual energy. Create growth friends – see my podcast or blog on how to do that (episode 13,

Take a look at your life and see which one of those four areas you can change and leverage for your advantage. One change in one area creates a ripple affect in the other areas. You don’t have to change all of the areas to create a change that makes an incredible impact.  We are all one change away from living a better life. Be your own change agent! We all deserve to live our best life!


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