When It's Sooo Hard to CHANGE!

Ken Rutgers (not his real name) lifted his shirt over his floppy paunch and stuck a needle into his tummy. He let the shirt slide halfway back into place and then wheeled himself closer to the table, where he proceeded to dive into a Macdonald’s hamburger and a streudal.

“Diabetes is such a drag,” he said to no one in particular. Receiving a sympathetic nod from me, he went on to say that he now has to test himself four times a day and give himself insulin every time he eats.

A few of us had remained in a workshop room at the American Lung Center during a lunch break from a training in Stanford’s Chronic Disease Management Program, which has just been updated. This excellent program is offered all over the country, as well as internationally, and it's free. It can also be taken online.

Ken is a Master Trainer. He is also a Vet, from the Vietnam War I would guess, and he works mostly with other vets through the VA.

Later on, after I led a discussion about what stops us from keeping up our exercise program, Ken offered that he just can’t get himself to exercise.

“I never have liked exercise,” he said. “I’d rather watch a movie.”

“But doesn’t it make you feel better?” I asked.

He shook his head. He has tried it. He’s gone to the pool, and after an hour of pool walking he comes home feeling worse. As for chair exercises, they do nothing for him.

I wondered why he had brought this up, unless it were in hopes of getting some help with this problem, since everyone knows exercise is good for you, especially if you’re dealing with a difficult chronic illness like diabetes. It’s one of the most important things you can do to have a better quality of life with a chronic illness.

The other healthy practices include mindfulness, a good diet, medication and a good relationship with your physician, healthy social interactions, and spending time in nature, fresh air being a great remedy in itself.

Ken knows all this – he teaches it to the Vets in his workshops! But clearly he is unable to do it himself. That might be a good thing, in a way – he certainly can’t look down on the people in his groups who simply can’t get themselves to do things they know are good for them. But it’s not good for Ken!

Exercise is so important for a person with chronic illness. For those of you who are diabetic, you’ll find lots of tips at the Diabetes Self-Management Web site. There’s an excellent book you can order from the site, and it’s only $6. For people in wheelchairs like Ken, there’s specific advice here 

I liked Ken, and I drove home from the workshop thinking about motivation and how it works. I have trouble exercising, but I do it. If I don’t, my back starts to hurt and my gait becomes uneven. When I do my exercises at home or at the gym, I feel much better. My relationship with my physical therapist, and hours of PT sessions over the past three years, have finally convinced me that exercise is probably one of the most important things I can do for myself; and even then, I have trouble working it into my routine! 

My problem has been that morning is the best time for my writing, and typically that is also when I try to exercise. A recent article in the New York Times clued me that afternoon may actually be a better time. The jocks at the health club I go to seem to think it is; that seems to be the busiest time for muscle building! Afternoon exercise is working better with the flow of my day.

Change isn’t easy and requires a lot of motivation or will power. My motivation is a negative and internal one – to avoid back pain. (According to Jim Taylor in his blog “The Power of Prime,” at Psychology Today, there are four types of motivators, positive and negative internal, and positive and negative external.) Taylor is a PhD specializing in the psychology of business.  He says the first step is to make the decision to change.

My guess is that Ken hasn’t made that decision; he is more interested in getting sympathy for his problem. But from his tone it was also clear that he’s uncomfortable with this situation. While not exactly committed to making change, he’d like change to happen.

Discomfort can be one of the primary internal motivators for making change, but clearly, it’s not sufficient in Ken’s case; something else is blocking his willingness to do the work of changing, which Taylor calls “the Grind”; success comes from willingness to do things you don’t particularly want to do, and persisting even when the results are not visible. Here’s where the effort comes in. To triumph, you must be completely dedicated, says Taylor, referring to the third “D” in his Three D’s for change.

Taylor’s scheme is based on will power, and judging from his career, I'm sure his is strong and active. To change a bad habit, say successful people, you summon your will power. Alas, some people are unable to do that. Is that because they are lazy or weak? That is what we tend to think, for it is what our system of Western ethics has taught us to believe, that we have free will and if we don’t use it, “there’s no one to blame but ourselves.”

But Ken does not appear to be lazy. A man in a wheelchair, he manages to get himself to the Vets’ hospital to give these workshops on managing one’s chronic illness on a regular basis; in fact, he has given more of them than anyone else in the program, even when there’s no money to pay his stipend! Like most of us, he’s motivated about some things, but not others.

Here’s where it gets complicated.

Dr. Gabor Mate is a Canadian psychiatrist who works with people addicted to heavy drugs. In an interview on Toronto television, interviewer Steve Pakin asked Mate about the role of will power in overcoming addictions. He said,

“Will power is a complex matter,” said Mate, because “the circuits in the brain centers which make conscious decisions are very weak, and they are much dominated by our impulses, which come from deeper centers in the brain, and the gap between an impulse and a decision is only a split second.”

No wonder it's so hard to change our habits! 

This gap between impulse and decision-making is true not only of addicts, but for all of us. It means that if you think about going to the gym when you'd really like to lie down, the chances are that you will lie down first and then think about going to the gym “later.” No wonder it's so hard to change our habits!

We’ll look at motivational blocks in our next post.