are you ready for change? 2016

Health related New Year resolutions, like weight loss, often fizzle out by this time of year. Was there something wrong with the goal? Or was it the plan? Or maybe you "don't have the willpower"!
Change is rarely a linear process, life meanders, things come up, circumstances change, you constantly need to adjust your course.

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Whatever you are telling yourself right now you need to check in with your emotions and assess your readiness for change.

Bellow are some important lessons no matter where you are along your transformation journey.

Lessons from models of change and stages of grieving when setting health goals.

As a Functional Medicine Practitioner working with my patients to overcome their health challenges and create positive change, I have to be aware of mind set and my expectations regarding their wants and needs.

It is never as simple as “tell me what to do and I’ll do it” or “this is the plan and these will be the outcomes”.

Creating health is really about changing lifestyle and that involves transformation of not only the physical, but the mental and spiritual practice that we engage in every day.
 
If you have had involvement with Psychotherapy or studied psychology in school you may have heard of the following two models. While I have not studied these in depth I have used these to help myself and my patients understand where they are in their desire to change.
No matter how much we associate transformation with what we do i.e. exercise, diet, sleep, therapy etc there is no denying that how we feel about the process is more telling of our future success or failure.

What has grief got to do with change?

First introduced by American Psychiatrist Elisabeth Kubler-Ross in her 1969 book On Death and Dying, the 5 stages of grieving has been useful in navigating people through the grieving process.  While these stages are not meant to be a complete list of all possible emotions people will experience, they are helpful when facing a life-altering undertaking such as losing 100 pounds for example.

In the Transtheoretical model (TTM), change is a process involving progression through various stages. When setting goals that are life changing people forget to take into account the process and commitment that is involved. I feel that frequently checking with oneself and visiting these various stages can be helpful in committing to the process and realizing one's goals.

While both models are controversial in their validity I feel that both patient and practitioner can use these stages to gauge commitment and track change so as to best reach their goals.

 

• 1.     Denial & Precontemplation - Individual is not ready for change
  

The person is trying to shut out the reality or magnitude of his/her situation, and begins to develop a false, preferable reality. People are not intending to take action in the foreseeable future, and can be unaware that their behavior is problematic. Unfortunately, this is where most people sit for too long until their health affects them negatively daily. For example a patient who is insulin resistant but not yet diagnosed as diabetic – “They have pills for that – I’ll be fine.”

• 2.     Anger & Contemplation - In this stage the person is "Getting Ready" to make change in their life
  

People are beginning to recognize that their behavior is problematic, and start to look at the pros and cons of their continued actions. They recognize that denial cannot continue and may become bitter, the patient is very difficult to reason with due to misplaced feelings of rage and envy. The patient can be angry with self, or with others, especially those who are close to them. Certain responses of a person undergoing this phase would be: "Why me? It's not fair! I don’t want to give up my wine"; "Why do I have to do this. Jane lost weight without having to do any of this!” A common situation in my practice.

• 3.     Preparation & Bargaining - A person in this stage is Ready but constantly negotiating.

Patients intend to take action in the immediate future, and may take small steps toward behavior change. This often involves bargaining where the patient hopes that they can somehow avoid going down the path the practitioner has chartered for them. Seeking to negotiate a compromise is normal and it is important for practitioner and patient to truly examine whether this patient is ready for the next stage. Example “OK so I’m cutting out sugar but chocolate brownies made with honey are fine! Right?” This stage can go on for many months.

• 4.     Depression & Action– Strong personal emotions can drive change.
  

I know this sounds like a stalemate but I often see patients acquiring new healthy behaviors only to withdraw. “What if I succeed in kicking my diabetes?” “What if I really do lose 100 lbs?”  Their friends can change, along with their habits, their clothes, even their problems.
It is natural to feel sadness, regret, fear, and uncertainty when going through this stage. Feeling those emotions shows that the person has begun to accept the situation. Becoming a different person requires an immense amount of courage!

• 5.     Acceptance & Maintenance – This stage starts to feel like confidence.

Patients have been able to sustain action for a while and are working to prevent relapse. At this stage they have come to terms that they are better off this way and the changes have become the new lifestyle. This typically comes with a sense of peace, a retrospective view of self, and a calm stable mindset. I often hear “I can’t believe how much better I feel. I won’t go back to the way I used to eat!”

• 6.     Termination – Welcoming the New You

Individuals have no temptation to return to their old unhealthy habit as a way of coping. They are happy with the path they chose to follow and are comfortable with themselves and have been accepted by their peers old and new. This is ultimately where a good practitioner would want their patients to reach.
While termination sounds final it is here that a doctor and patient build a lasting relationship built on mutual admiration, trust and satisfaction. It is here where the true reward lies.

So, remember no matter where you are in life and in health, be aware of your motivation.

• Set a course
• Create some systems
• Build in rewards
• Keep checking in with yourself
• Be kind to those around you and especially to yourself
• Be brave
• Live life, and
• Stay strong.