INTERVIEW WITH DR LISA GREEN
Psychology for long-term health: how lasting change really works
In a previous interview, we explored Dr Lisa Green’s background in clinical psychology, psycho oncology, and systemic family therapy, as well as her work at Buchinger Wilhelmi over more than a decade. We also discussed why fasting can offer a particularly valuable opportunity to look inwards. This conversation builds on that foundation. With the New Year as a moment of transition, it focuses on the psychology of habit change, the role of psychotherapy in supporting sustainable change, and practical starting points that can help align everyday behaviour with long term health goals, both at home and within our clinic setting.
Since we last spoke, what feels most important about the role of psychotherapy within the Buchinger Wilhelmi fasting programme today?
What feels most important to me is strengthening the connection between mind and body in people’s understanding. Historically, medicine and psychology have been treated as separate disciplines, but that split is quite artificial. In many traditional medical systems, such as Ayurveda or traditional Chinese medicine, the mind body connection was never separated in the same way.
My mission here is to help guests reconnect these pieces, not only intellectually, but in a way that translates into practice. Many people come with a very physical focus, often linked to weight, metabolic parameters, or a desire to manage conditions naturally.
Those can be valid motivations, but fasting is much more than a physical intervention. Sustainable lifestyle change goes deeper. Psychological support helps guests understand that stress, tension, and many symptoms are not random, they are indications. They can be the body and mind saying, something needs to change. That is where psychotherapy and coaching become relevant, not as an optional extra, but as part of a whole approach.
Many guests arrive with a strong desire for change. What psychological patterns do you most often encounter at the beginning of a fasting stay?
People often arrive with a clear, outward goal, such as weight loss or improving certain health markers. Very quickly, however, it becomes apparent that sustaining change is not only a question of behaviour, it begins in the mind.
A pattern I see frequently is that people are living according to internalised expectations, ideas about how they should live, perform, or meet the needs of others. These beliefs often stem from family, culture, or long-standing roles and can persist well into later life.
This misalignment creates ongoing pressure, which often manifests physically as tension, stress, or symptoms. Many guests only become aware of this once they reach a point of exhaustion or dissatisfaction. When values, needs, and daily life are better aligned, both psychological and physical balance tend to improve.
Why is changing habits in everyday life so difficult for many people?
Habit change is difficult because our behaviour is shaped and maintained by the systems we live in. We are not just individuals making isolated choices. We are embedded in systems, our inner psychological system, our family, work, social circles, and wider culture. Habits often develop as adaptive responses to these systems.
Many habit cues arise from a combination of environment and emotional state. For example, drinking wine at the end of the day may be linked not only to routine, but to how a long workday is experienced emotionally. Willpower can initiate change, but it rarely sustains it on its own.
I often explain this using two systems. One is rational and goal oriented. The other is emotionally driven and pleasure oriented. The rational part can decide, no more chocolate, no more wine, and it sounds sensible. But if the emotional system associates chocolate with reward, comfort, or relief, then you are relying on self-discipline alone. Self-discipline costs energy, and energy runs out.
Lasting change tends to happen when motivation becomes intrinsic, when the goal is aligned not only with what we think we should do, but with what we genuinely want. If that alignment is missing, the emotional system eventually leaves the party, and the old pattern returns.
What makes a fasting stay a particularly favourable moment to interrupt old routines and try something new?
A major factor is that guests remove themselves from the environment that normally maintains the habit. They are not at work, they are not in the same routines, and they are in a context that supports change. People often say, fasting is easy here, at home I could never do it. That is because the environment is different.
The second factor is that many usual coping strategies are removed. People are not using food, alcohol, or constant busyness in the same way. The clinic creates a quiet space, with less noise. That makes it much easier to notice what is really going on internally.
And the third factor is willingness. People come voluntarily, often with a genuine desire to change. That combination, distance from everyday systems, removal of crutches, and a supportive setting, creates a powerful window.
What role does psychotherapy play when emotions or inner resistance arise during fasting?
During fasting, people often become more aware of their emotional states, partly because everyday distractions and compensations are reduced. With less external noise, emotional signals become easier to notice.
Psychotherapy helps guests learn to recognise what their emotional responses are signalling. The emotionally driven system communicates through the body and through feelings. Many people have not been trained to pay attention to these signals, or to interpret them.
When guests begin to recognise what their emotions are indicating about unmet needs, resistance can be understood as meaningful information rather than a problem to overcome. This allows responses that are more supportive of long-term health goals, rather than short term relief.
How does your work integrate with medical care, fasting, and physical therapies to support holistic outcomes for guests?
The integration is very natural, because emotions often show up in the body. When something is missed emotionally, it can settle physically, as tension, pain, or symptoms. The body is essentially saying, you missed something, go and look.
That is why body-oriented therapies and psychology fit together so well here. Physical treatments can release tension, and that release can bring emotion into awareness. Guests sometimes say after a massage, I did not even know I was angry, or I cried unexpectedly. That gives us something to explore, and it can help connect symptoms to the underlying thoughts, beliefs, and needs.
Psychological health also includes more than emotions. It includes social health, and what I sometimes call spiritual health, meaning a sense of purpose.
If there is a major imbalance in emotional, social, or purpose related areas, it will affect physical health. If those dimensions are ignored, sustainable results become very difficult.
What helps insights gained during fasting translate into changes that remain realistic once guests return home?
This is often the hardest part. Many guests have insights here because they gain distance and can see their life more clearly. But translating a bigger insight into small action takes careful work.
One approach I use is helping guests get a bird’s eye view of their life, for example using systemic tools where we make the invisible visible. Then we explore what balance would look like, and how it would feel. From there we ask, how do we translate that into something concrete?
The key is that changes must be small, specific, and easy. Abstract goals like eat less are not defined enough. People also often want to change everything at once, which tends to fail.
Another important piece is identity. We explore, who is this new person I am becoming, and how would that person live day to day? What do they eat for breakfast, what do they do at lunch, how do they handle weekends, who do they spend time with? Situational variables matter. If all your friends drink heavily every weekend, it becomes very hard to maintain a different pattern without changing the context.
Old behaviours also need substitution in the moment. If a stressful trigger happens at home, people need a concrete alternative, tea, a walk, swimming, sauna, a conversation, something that can replace the old response while new patterns are built.
From your experience, how does fasting influence a person’s sense of self efficacy and confidence in their ability to change?
Self-efficacy is everything. It is the experience that I can drive my own bus, and I can make choices. When people feel they are the architect of their health, they also feel more capable of change.
Part of this is learning that you can choose. Not perfection, but choice. Sometimes you choose the new behaviour, and sometimes you consciously choose not to, without losing the sense of agency. That helps people avoid the guilt cycle. And it helps to normalise setbacks. Nobody is perfect all the time. If you fall off the waggon, you get up, wipe off the dust, and continue.
Learning is repetition. A child does not learn to walk in a day, they try again and again. New habits mean building new neural paths, and that takes repetition, patience, and kindness towards oneself.
At the start of a new year, are there common psychological pitfalls or expectations around change that people should be mindful of?
A common pitfall is setting goals that rely on restriction and willpower alone, rather than on intrinsic motivation. If the emotional system experiences only loss, not gain, it will resist.
Another pitfall is trying to change everything at once or setting goals that are too abstract. Change needs to be concrete and manageable.
Finally, people often underestimate the role of environment. If nothing changes in the systems around you, work pressures, social patterns, daily cues, then willpower tends to fade. Planning for context, substitutions, and realistic steps matters more than aiming for perfection.
At the beginning of a new year, what are a few simple starting points that can help make healthy, holistic change more realistic and sustainable?
There are a few simple entry points that can create momentum. One is regular movement, because it stabilises mood and helps regulate stress. Even a daily walk around the block can make a difference.
Another is aiming for steadier blood sugar. Instead of focusing only on weight, focus on stabilising glucose, because when blood sugar is steadier, mood and focus tend to be calmer too. Some people find tools like continuous glucose monitors helpful for awareness.
A third is journalling, for example noting highs and lows of the day, or a short gratitude practice. This builds self-observation, which supports more conscious choices over time.
For readers who are sceptical about psychotherapy, what is the one thing you would want them to understand?
Psychological support is not only about treating a diagnosis. It is also about prevention and about understanding the factors that drive health and behaviour.
If you ignore emotional health, social health, and a sense of purpose, you may still see short term improvements, but it is hard to make results sustainable. A tense relationship, low self-esteem, or chronic stress can act as powerful cues that pull people back into old coping strategies. If those cues are not addressed, change becomes much harder.
Psychotherapy at the clinic is therefore about helping people see the full picture, and helping them find realistic levers for change, so health improvements can actually last.
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