The case for root cause analysis for wellbeing

Riikka Jalasvirta
Written by Riikka Jalasvirta

Over the course of our lives, most of us have probably tried several ‘quick fixes’ with the aim of improving our wellbeing. This might have taken the form of short-term fad diets, over-the-counter drugs, trying the trendiest personal care products, an intense exercise regimen over a few weeks, or even escaping on a weekend getaway with the hope of returning to more peaceful relationships with those around us.

But not long after implementing these approaches, we began to notice that the extra weight started to creep back; the anxiety was still buzzing in the background; the acne did not go away; going to the gym started feeling like a dreaded chore; and our relationships were still not fulfilling.

So why is it that these kinds of ‘quick fixes’ often fall short of their intended results?

The intention behind the above approaches is often well and good, as their aim is to help you tackle genuine challenges and feel better. We certainly do need healthy food and eating habits, regular movement, and adventurous fun where we can enjoy life as well as forget and/or gain new perspective on our challenges for a while. However, there are two underlying challenges with the term ‘quick fix’ in this context.

Firstly, intense, large-scale overhauls in a short time period that place too many restrictions on our lives are often overwhelming for our brains to adapt to. When implementing new, healthier habits into our lives, these changes are more likely to be successful and maintained for the long-term when we take small, gradual, consistent actions that come from a place of compassion rather than restriction. This is the brain’s preferred approach to enable neuroplasticity – the brain’s ability to change its neural pathways.

Secondly, these types of short-term ‘quick fixes’ are often symptom management in disguise – like taking a painkiller for a headache. In other words, they may temporarily relieve symptoms, but they do not address the source of the issue: where the symptoms are coming from, and why. Therefore, if we do not understand or address the source of the issue, the same and/or additional symptoms are highly likely to recur in the future. This means that managing symptoms consequently neither ‘fixes’ the issue, nor can the issue be resolved ‘quickly’ because symptoms continue to recur. In acute conditions – such as dealing with a broken bone after an accident – treating symptoms directly and undergoing immediate surgery can certainly help to commence the healing process. But chronic conditions – such as depression, obesity, or recurring headaches – develop over time, and therefore often require a more in-depth analysis and longer-term approach to rebalance.

Herein lies the importance of root cause analysis for wellbeing.

When it comes to addressing the source of our symptoms and improving our wellbeing, we can apply the same framework that is vital for improving occupational health and safety in an organisation. Wellbeing and occupational health and safety are closely linked, after all. This framework is called Domino Theory. It allows you to work backwards from undesired downstream events to understand what upstream events caused them. The framework analyses five sequential stages, which fall under two overarching approaches for management intervention.

These are:

Reactive approaches:

1. Loss – injuries, illnesses, property damage
2. Accident – the undesired event resulting in loss

Proactive approaches:

3. Direct causes – the agent of harm
4. Underlying causes – the unsafe acts or conditions
5. Root causes – management planning or organisational failings

Source: Astutis (2017)

‘Domino theories of accident causation suggest that accidents result from a chain of sequential events like a line of dominoes falling over. When one of the dominoes falls, it triggers the next one, and the next, eventually resulting in an accident and injury or other loss’ (Astutis 2017). Therefore, taking a proactive approach and addressing the root causes of poor occupational health and safety is a critical investment that will, in most cases, reap much larger benefits to the organisation and its stakeholders than reactive approaches. Firstly, it will normally reduce undesired events – i.e. fewer accidents and losses down the line which can be extremely costly. And secondly, it also tends to boost the desired conditions – i.e. improved employee morale, retention, resilience, productivity, and engagement, as well as corporate reputation.

So how does Domino Theory apply to wellbeing?

We could say that ‘reactive approaches’ represent symptom management as discussed above, while ‘proactive approaches’ represent addressing the source of those symptoms.

Let’s take a look at each stage, using a theme which many people nowadays are familiar with: stress.

In this case, the chain of events might look something like this:

Reactive approaches:

1. Loss – severe gastrointestinal issues
2. Accident – stress and burnout

Proactive approaches:

3. Direct causes – excessive workload
4. Underlying causes – maladaptive interpersonal relations, such as a lack of healthy boundaries
5. Root causes – unresolved trauma from an Adverse Childhood Event, such as abuse

It is important to keep in mind that there can be multiple descriptors in each stage – for example, multiple root causes (sources) of one particular loss (symptom), and also multiple losses from one particular root cause. However, for the purpose of simplifying the example, the above takes a linear perspective and includes only one descriptor for each stage.

So, if we apply reactive approaches to manage the symptoms in the above example, we might wish to remove inflammation promoting foods and take gut health promoting supplements to improve our gastrointestinal issues. We might also take steps to ensure adequate sleep and practice regular meditation to reduce the impact of our stress and burnout. These are all valid and important techniques that we can incorporate into our lives to alleviate our symptoms and maintain our health. However, the key takeaway here is that if we do not go further upstream in the chain of events, the stress, burnout, and gastrointestinal issues are highly likely to continue.

Thus, it is essential to take a proactive approach and understand where these symptoms came from in the first place. Burnout may have resulted from an excessive workload, which resulted from not implementing healthy boundaries with colleagues in the workplace. And most importantly, the root cause of all of the above events may be unresolved trauma from physical, mental, and/or emotional abuse by primary caregivers during childhood. This abuse may have led the dependent child to form a maladaptive belief that basic human needs such as safety and love were not guaranteed or unconditional, and that they instead had to be earned through ‘good’, submissive behavior as well as extra effort on their part. This root cause would then act as the initial trigger of the domino cascade since Adverse Childhood Events such as abuse have been shown to be strongly correlated with multiple health risk factors later in that individual’s life.

Therefore, this framework can help us to begin connecting the dots between what symptoms we are currently experiencing, and what might be causing them. But this process can often feel daunting and time-consuming to do alone. This is precisely where a Certified Holistic Health Coach comes in. They support clients with the full spectrum of the dominoes and beyond: understanding what symptoms a client is experiencing; uncovering the root cause of those symptoms; providing coaching, guidance, resources, and tools to resolve those root causes through appropriate means; and in this way helping the client to become self-empowered so they can reach their desired health and wellness goals. Holistic health coaching therefore means looking at an individual as a whole – mentally, physically, emotionally, and spiritually – as an imbalance in one area typically has ripple effects across all others. Importantly, holistic health coaching is also forward-looking. While due consideration is given to past events and circumstances to understand how they have shaped an individual’s life, the goal is to move them from where they are, to where they want to be.

Thus, upon returning to the initial discussion on ‘quick fixes’, improving wellbeing also does not need to take years or months. Rapid approaches to improving wellbeing do exist – such as working with a Certified Holistic Health Coach – and they can be rapid and effective precisely because they target root causes of imbalance.


Astutis (2017), NEBOSH International General Certificate in Occupational Health and Safety: Unit IGC1 Management of International Health and Safety.

Main photo by Oleksandr Canary Islands