Wednesday, January 04, 2012
So, itâ??s that time of the year again: the time of year when we make promises and resolutions to change for the better. Whether it be resolving to finally quit that nasty smoking habit, add a yoga practice, or shed those last few pounds, making the resolution itself is the easiest part of the process. In fact, research suggests that even in those of us who are highly committed to behavior change, it will be difficult to maintain that healthy behavioral patter over time. In fact, the average dieter will fall off the wagon after only 15 days. In my commitment to help my patients achieve and maintain optimal health, Iâ??d like to explore the fundamentals of behavior change and how to increase your chance of success in sticking to that resolution this year!
It turns out that changing behaviors is not just about setting goals itâ??s about changing our consciousness and awareness. When it comes to behaviors we donâ??t perform too frequently, changing our attitudes can motivate change. In these cases, knowledge is definitely power. For example, you may resolve to finally write your will this year (obviously not a behavior which one does very often). Repeatedly hearing a commercial about the benefits of a will for your loved ones and organizations you wish to support or, conversely, hearing of the family arguments or unfulfilled dying wishes of a cousin may indeed inspire you to stop putting it off and take concrete steps to finally take care of that will. The task here is to gather enough information to create an awareness of why the goal is so significant and use that as a motivator for executing the change.
However, once a behavior is repeated often, particularly in the same setting, it becomes tremendously difficult to change the behavior despite the personâ??s best intention. About 45 percent of what people do every day is a habitual behavior which is repeated in the same environment. And it turns out that, over time, our environment tends to shape our behaviors so that our attitudes or intentions may just not be enough to overcome the unconscious behavioral direction we get from our environment. For example, that morning ritual of your cup of coffee at the kitchen table while reading the paper may feel completely automatic and unchangeable until you go on vacation and completely forget about your need for a java fix until much later in the day. Another prime example: if you smoke at the entrance of your office building, walking past your â??smoking cornerâ? becomes a very powerful mental cue for repeating that behavior (often despite our intentions). Over time, these environmental cues become very deeply ingrained and very difficult to resist. To illustrate: heroin is tremendously addictive but research has shown that the addiction can be more successfully extinguished if the addict is removed from the environment in which they habitually â??useâ?. (Heroin addicts returning from Vietnam had a very low relapse rate because the environmental cues back home were so vastly different from those at war).
Researchers have found that, in order to overcome a negative behavior, whether habitual or not, conscious thought and effort are required. Education, goal setting, planning, supports, and, sometimes even environmental changes are helpful in increasing your chances of successfully changing your behavior. So, if youâ??ve resolved over and over again to make dietary changes, to actually use that gym membership, or to meditate before bed, you may want to incorporate the following strategies:
1)Â Â Â Â Focus on a single behavior youâ??d like to change: research suggests that even in highly motivated people, change is often limited to a single health behavior rather than multiple behaviors.
2)Â Â Â Â Set a very concrete, manageable goal: â??I will lose weightâ? is not as powerful a goal as â??I will lose 10 pounds within the next 2 monthsâ?.
3)Â Â Â Â Education and planning are important to motivating and achieving change: gather as much information as you can about why itâ??s important to change and how to go about achieving that change. Plan each step of the process. Writing things down has been shown to be very helpful.
4)Â Â Â Â Break it up: focus on small, manageable steps (1-2lb a week of weight loss) as opposed to the end-goal (fitting into your skinny jeans).
5)Â Â Â Â Evaluate past failures and successes: what has worked or derailed your efforts in the past? Knowing yourself and how to anticipate stumbling blocks and move forward in the right direction is critical if youâ??re going to prevent repeating the same resolution year after year.
6)Â Â Â Â Get support: family and friends, a buddy, a support group, your friendly naturopathic doctor can all help you stay accountable and motivated. Remember to also talk with those friends/ family members who may (knowingly or unknowingly) derail your efforts. Is your thin husband a chocoholic? Is your best friend a fellow smoker? Talk to these people so that they are aware of your resolution to change your behavior. Ask for their support too.
7)Â Â Â Â Change your environmental and sequence cues of habitual behaviors: Even a small change in your environment or the sequence of behaviors associated with a habit can be very helpful in consciously disrupting those very strong environmental cues. Even a small change seems to make a difference. It will allow your conscious mind to reassert control over the ingrained reflexive behavior. Think about the automatic sequences and environmental cues which may be at play and then try to make some changes. For example, take the back door to avoid the work entrance at which you often smoke. Eat treats only with your non-dominant hand. Put a water pitcher beside the office coffee pot.
8)Â Â Â Â Reward your successes and anticipate some setbacks: the path towards your goal is not straight- there will be challenges and â??bumpsâ? in the road. View your change as a process. View your relapses as an opportunity to learn and continue to progress rather than getting stuck in the guilt. Reward your successes with rewards not directly associated with the behavior youâ??re trying to change (so, donâ??t give yourself a piece of chocolate if you lost a pound this week- go for a long bath, a manicure, or a date night).
9)Â Â Â Â Keep frequent reminders of why youâ??ve resolved to make this change in view. Know that your motivation may wane over time. Find sources of inspiration and reminders to help keep you on track. Journaling is a great idea. Sticker charts work well (not just for kids). Set your calendar or alarm to remind you. Post-it notes on the fridge, car dash, and bathroom mirror can all be a help too.
10)Â Finally, if your current approach isnâ??t working: CHANGE IT! Donâ??t give up. Reevaluate your strategy and develop a new plan.
As the National Institutes of Health Office of Behavioral and Social Sciences Research reminds us:
â??Human behavior accounts for almost 40% of the risk associated with preventable premature deaths in the United States. Health-injuring behaviors such as smoking, drinking, and drug abuse, as well as inactivity and poor diet are known to contribute to many common diseases and adverse health conditions. Unfortunately, there are few tried and true approaches to motivate people to adopt and maintain healthy behaviors over time. It is difficult for people to begin to change unhealthy behavior, even when they intend to do so and even more difficult for them to maintain positive behavior changes in the long run. Effective and personalized approaches to achieve sustained behavior change are typically outside the routine practice of medical care.â?
Iâ??m determined to help my patients achieve and maintain better health this year. I am now offering group sessions in FirstLine Therapy- a proved approach to making dietary, exercise, and stress management changes. Iâ??ve seen good success in many of my patients using this approach. The program is personalized and proactive and gives you all the support and the knowledge you need to make the changes you seek a reality. To learn more, call 201-757-5558 for a complimentary 15 minute phone consultation.
Best wishes for a healthy and happy 2012!