The truth is, change is hard. We accumulate knowledge and patterns of behaviour over time (for some of us it can be decades), and reality is that it takes time for change to occur. I was listening to the Brene Brown podcast, Unlocking us, and her interview with the amazing Marc Brackett. As they talked about his book Permission to Feel, Marc discussed the process of change requiring unlearning an old behaviour, as well as learning the new. If you haven’t listened to this one, it is worth checking out.
Making change is strongly linked to understanding why we want to make a change. The ‘why’ is different for everyone, and there is no wrong answer in this space. When I work with people experiencing drug and alcohol addiction the desire for change might be motivated by wanting to be better for their family, to feel good when they wake in the morning or because they are tired of the cycle of dependence. Smokers talk to me about the cost and wanting to save for something for the future (a new car, their first house). Helping them to estimate the money that they will save if they quit smoking (an example is here) can help them move towards their goal.
Each fortnight I meet with a patient who wants to get his weight to a healthy range. Each time we meet we explore what is working well for him, where he feels he needs to make more or different changes and what his goals are. In an early consult he described a desire to walk into a room and not have to look for something to lean on for support. He has also told me that he wants to be able to run around with his daughter. His weight loss has been very successful so far (down 20 kilos), and we have had to readjust his goals a few times to push his excellent progress. Others have described a desire to lose weight to reduce the pain in their knees, to help them feel like they have more energy or reduce their risk of diseases like diabetes.
Another important aspect of behaviour change is understanding what we liked about the old behaviour. It might be the mouthfeel of the doughnut and the dopamine rush as the sugar hits. It might be the that being a smoker allows the time out from your desk, that chance to stop for a few minutes. When people stop drinking alcohol they describe a loss of social connection – they don’t get invited for the beer at the pub anymore. By acknowledging what we give up when we change our behaviour we can identify ways that the benefits can be kept in our lives in different forms. We might just have to be a little creative.
When we understand what we like about the old behaviour it is possible to start to identify new ways that our needs can be met without compromising on our goals. We can identify what we might like about the new behaviour – feeling stronger as we increase our daily exercise, better quality sleep when we reduce our alcohol intake, knowing that our risk of diabetes or heart disease has decreased by improving our vegetable intake. We can explain to our friends that we don’t want to drink alcohol, but that we would love to go for coffee. We can get the dopamine rush from completing our weekly Parkrun event. We can improve our connection with a family with a walk after dinner each night.
So what to do next? Take some time to write it down. Be honest with yourself about what you want to achieve, and the steps that you need to take to do it. Make a plan for the new habit you want. Set yourself some goals. Put the goals and the plan somewhere that you can see it. Looks at it daily. Revise it when it doesn’t work, reinforce it when it does. There are lots of models that you can use, this is one that I saw at the RACGP Conference in 2019.
| Old Behaviour | New Behaviour | Actions for change | |
| Positives | |||
| Negatives |
Overall, be kind to yourself, and don’t aim for perfection. A little bit of change each day can add up to a lot. Some days it is okay to skip the run, eat the doughnut and start again tomorrow. Also take note of when you eat the smaller serve, skip the cigarette or take a walk with the dog.
Dr Kerrie Aust 