Change, Behavior, CBT, Lifestyle Change
by B. Imei Hsu, RN, LMHC
If you are looking for a scholarly explanation about why it is difficult for so many people to change something in their lives, keep looking. You won’t find that theoretical discussion here.
However, if you are searching for a more pragmatic discourse about why it is so damn hard to change, you’ve come to the right place! Right here, right now, I will serve my observations to you with no holds barred, completely unrestrained, straight up, and the plain and simple truth (with a small letter ‘t’).
To make this easy to read, I’m addressing “people” as “you.” If these points don’t personally apply to you, just remember that I am using the references synonymously. You can project outwards to the general population if it helps you to hear the rationale.
#1. You find change hard because you’re not sure you’re the one who needs it.
Ever ranted to a friend about the state of your relationship, railing about the foibles and weaknesses of your partner, only to have your friend suggest that YOU are the one who needs to work on change?
Yep. It can be a humbling moment.
When you’re at the point where you aren’t even sure if you want change for yourself, you’re in the Pre-Contemplation Phase. An example of a person in the Pre-Contemplation Phase is a smoker who does not wish to quit. When he is enjoying his cigarette with others, he is unaware of his need for change. When his co-worker at the desk adjacent to his complains that his clothing reeks of tobacco and how it makes the co-worker uncomfortable to work in close quarters, his reaction is to believe that his co-worker is the one with the problem, or that his co-worker is exaggerating. He will continue smoking.
The Stages of Change concept was developed for the person in the throes of addiction. Clinicians and coaches were able to identify how these stages apply to most lifestyle processes that require radical behavioral change.
In the Pre-Contemplation stage, a change becomes everyone’s problem but yours. She needs to be more understanding. They need to leave me alone. The world must see things my way. I don’t need to change! Everyone should just leave me alone and let me be me. It’s not so bad. I can quit anytime I want to. I just don’t want to quit right now.
If you hear yourself rattling off the usual excuses, you might want to consider what would happen if you admitted you are the one who could benefit from change.
#2. You find change hard because you haven’t moved from a want to a need.
Ok, so you figured out that you’d like to make a change! You want to lose 45 pounds. You want to become more active. You want to increase your income. You’d find it really cool if you stopped watching a lot of bad television and spent your time learning a foreign language. You really want to quit smoking.
Can you hear all the language of desire in those statements? But desire is still not enough to move some people from inaction to action.
In my observation, you find change difficult because you have a bunch of things you want to do, but that you do not know you absolutely need to do. Change would be….nice. Change might make things a little easier.
Nice and easier are nowhere near the words necessity or need. If you wanted to increase your income because there is a consequence if you don’t (i.e. you will lose your home, you won’t have enough to eat, you can’t send your kids to the summer camp they want to go to next year), the pathway to change becomes clearer. You would do anything reasonable to increase your income in order to avoid the pain of not having enough.
I have seen people understand the moment their desire to lose weight moves from a want to a need. A realization that your pants don’t fit because you can’t button or zip it up can be an eye opening moment, but so can your doctor’s interpretation of your lab results indicating you have crossed over to becoming Type II Diabetic as well as your triglycerides being off the chart. When you can’t walk around the block without feeling like you’re going to barf, this is another wake up call: oh my G-d, I need to lose weight or I am going to be really ill!
Being able to access the pain point — that statement that says what it is you need, or else – will often propel you to declare your intention to institute change in order to get what you need, whether that be a longer life, a healthy marriage, a more stable income, or an active lifestyle.
#3. You have not broken down your need for change into bite-sized, repetitive steps.
Once you’ve declared you need to change, you’ve just reached the half way mark. The other half is the actual execution of a plan to incorporate change into your life. This plan must consist of small and reasonable steps in a consistent forward progress that move you from where you are to where you want to go.
At the end of a session, I may ask a client who needs to initiate change to give me a couple of examples of things he or she can do today before bedtime that can be repeated daily until progress is made. If you wanted to try meditation to reduce anxiety, a small act could be listening to a meditation video while practicing meditation for just ten minutes, and then noting how it felt. A second small act would be program that same ten minutes into the week on the calendar, and treating that time like an important appointment that cannot be missed. A third act is to create a way to track if you feel better on the days you meditate, or more specifically, that you feel either less anxious, or you are able to keep anxiety from arising.
Without breaking these behaviors down into smaller actions, it becomes very easy to be overwhelmed, give up, or feel discouraged because the steps were either too difficult to immediately maintain, or because the positive outcomes of your hard work applied to change are delayed. You may lose hope that your plan is working.
A good example of this is weight loss. You might set a goal to reduce your weight by two pounds a week through diet and exercise; you have 50 pounds to lose, according to your doctor. The first day of your behavior change, you decide to go workout at the gym for two hours, when you haven’t been going regularly for months. Tired but hopeful, you climb onto the scale at the end of day and shock yourself that you weigh two more pounds than you did in the morning, forgetting that you drank a sports drink and extra water, and not understanding that immediate weight loss does not work like that (and the reason why most fitness trainers and nutritionists would not recommend that you weigh yourself more than once a week).
A plan that includes small steps towards change will inch you closer and closer towards your goal, build confidence that you can change, and reinforce those changes as slow but steady progress follows.
#4. You think failure at change is an excuse to stop doing what you are doing to change.
Referring back to the Stages of Change, relapse is an important stage to understand. You may sabotage yourself. You may have a loved one who makes it challenging to stick to your plan. You might feel tired, alone, misunderstood, fed up, and sick of your plan.
It happens to the best of us. I really do feel your pain!
Change becomes difficult because you gave up at the first failure. Hello! Get back in there and figure out how to make those fails less likely. Did your failure involve an unplanned stop at the local donut store? Change your route, make sure you have your healthy snacks covered, and move forward. Did you spend money that you didn’t have, and continue to put off paying your credit card debt? Leave your credit cards at home, don’t get a virtual credit card, and program in other activities that don’t require shopping to feed a hunger that doesn’t need feeding.
My point here is that relapse is a part of almost everyone’s change process. My second point is that you should never allow that relapse to be an excuse to not try again*.
#5. You find change so hard because you believe you know everything there is to know about the behavior you need, and you believe at some level that change is impossible.
I often look for the telltale signs of someone who says s/he knows what to do in order to change, but I get a sense that s/he will not be trying any of those actions. The more information you give them, the more head nods, the more, “I knows,” I hear.
What I receive back is resistance.
Instead, I would try focusing on whether or not you actually believe that change is possible for you. If the answer is yes, then I would teach you how to have Beginner’s Mind, so that your bruised ego or disappointment in having to even change at all will not stand in the way of humbly doing what we all must do when we want to see change: take an action.
“I know what’s going to happen if I change my diet. I’m going to work really hard at it for two weeks, gain a bunch of weight from binging because I’m so hungry at night, and I’ll be worse off than when I started.” In this example, you have already decided that you know what is going to happen.
It can be really refreshing to lovingly and gently let go off what you think you know, and place yourself in Beginner’s Mind. At the same time, you can employ the help of an expert in your behavior change, giving you a chance to replace your, “I know, I know”, to “Wow, this can work!” and “I can do this!”
You need to build a pathway through change that helps you see how reaching your goal through change is possible, and then when you make the changes, you’ll see that your goals become reality.
People often ask me how I can resist the temptation to eat foods containing grains, since these carbohydrate-rich foods provide a satiation to our meals, and commercially-made snacks are often processed foods that are tasty but not particularly healthy.
I would be lying if I said that I don’t dream about what it would be like to have a flaky, butter croissant from Bakerie Nouveau. Sometimes, I watch a food program on PBS, and I drool.
But there is no room for error in my nutrition plan. Food is fuel, but it can also be poison if you have Celiac Disease. When I accidentally eat anything with a grain other than rice in it, my autoimmune cells begin attacking the lining of the small intestine, punching tiny holes in it and increasing the intestinal permeability. Then, everything you eat just hurts: cramping, diarrhea, bloating, and inflammation. This is what is known as Leaky Gut Syndrome, and after an accidental gluten exposure, it can take months to years to heal.
Recently, I shared a bit of my struggles with another medical professional. When he asked what it is I could not eat, he exclaimed, “Wow! You’re SOL!” I’m rather glad that I don’t take his point of view too hard. It’s difficult, but there is no luck involved, just careful execution on the avoidance of these foods. Once I learned how to eat safely, I began testing ways that others could learn to do the same.
Changing my lifestyle to prevent accidental ingestion of gluten and my other food allergies has not been easy. It is made easier in that a misstep is painful and has serious consequences that cost me time, money, and my health; my margin of error is so small that I was forced to tighten up the process of avoiding all triggering foods. All I have to do is look at a piece of cheese (dairy) and know exactly where that will land me (i.e. a week of cramping and diarrhea, fatigue, and low energy). Conversely, I can look at whole foods and know that they keep me healthy, strong, and out of the Emergency Room.
After a long year of careful eating and reducing risk of accident exposures by avoiding eating out, I can finally say I am healed of Leaky Gut Syndrome. I’m experiencing health as I have never known it before, and I am able to do things I never imagined, such as finishing my first Half Ironman triathlon, and waking up refreshed instead of exhausted from the fatigue of Celiac Disease symptoms.
How did I incorporate change? Small, repeatable steps. Even the way we wash up dishes in our household had to change. I picked off new goals each week, and applied them consistently before moving on to the next. I asked my husband to join me in supporting my new behaviors. And I stopped feeling sorry for myself if a mistake was made and I got sick; eventually those mistakes helped me improve faster.
Change can be so darn hard, and it can be so worthwhile! Is there a change that you’ve been wanting to make? Can it be turned into a need? Can you see how it is possible? Can you remove your, “I know’s” from your response, and anticipate that a relapse is part of the process?
If yes, let’s see you do put your plan into action. Bring that change on into your life.
* I say never, yet I can think of a few rare exceptions where the changed behavior was somehow life-threatening, and to repeat the behavior could result in illness, injury, or death. For example, if you failed to drop nine pounds because you tried a colonic cleanse program you found on the Internet, repeating it could have negative consequences.