By the age of 50, you would have a lot of experience in dealing with personal health issues. Chances are you have experienced a chronic disease or the conditions that lead to these such as excess weight, low physical activity or less-than-healthy eating habits. You may have tried many times to address these issues without success. Not surprising, as research over the past decades tells us that as much as 70 per cent of persons attempting lifestyle changes fail. But don't be discouraged.
Having seen Mrs T for her annual check-up and identified the list of threats to her health, it is easy to now tell her what she needs to do. Her husband quickly chips in with a smug smile, "Yes Doc, you need to tell her to lose that weight." We have a long tradition of doctors telling patients what they need to do! "Honey, it's the same thing I have been telling you all along, but maybe now you will listen to the doctor" prods Mr T. At the core is a failed approach to changing behaviour. Telling you that you need to do it won't necessarily do it!
Getting into these later years of your life, you by now have a sense of what works for you. There is something inside of you struggling to break through, but it just hasn't happened yet! Back in the '70s, researchers Edward Deci and Richard Ryan summed it up in a theory called self-determination. They say to be motivated from within to do an activity, three basic needs must be met.
- Autonomy - the choice to do it was made by you, not somebody else.
- Competence - you know what you're doing, or are at least becoming better at it.
- Relatedness - the activity connects you in some way to other people.
What is really needed to help persons like Mrs T is a bit more challenging and sophisticated. On a busy day, it is quick and easy to say 'this is what you need to do!' But our roles on the outside, whether as partner or doctor, are more to work with individuals to foster those three basic needs. That will involve some sharing of knowledge, but more importantly, nurturing support to address challenges that eat away at self-determination. When it comes to motivation, finding that internal passion trounces intimidation any day of the week!
On a personal level, if you want to stick with your plans for 2017, then ask yourself why are you doing it at all. If it is that somebody in your life is complaining, then you are likely to continue failing. So work on your self-determination. Choose a lifestyle intervention that you really want to do, learn about, and keep learning to do it better, at and lastly, foster links with others. Don't get rid of your partner or your doctor in all of this. They can still be helpful, but they too, may need to change how they work with you!
- Dr Tomlin Paul is a family physician and university lecturer and author of the book, 'Detailing Doctors!' Email yourhealth@gleaner.com [2].