So, why can’t he do the simple task of putting his trainers away when he comes home from work every evening?!! (Yes, that’s his habit, sorry to disappoint the gossip mongers amongst you!) He spends his life training other people to make lifestyle changes yet he can’t train himself to undo the laces, take the trainers off and put them in the appropriate place. To other people this is an automatic response, not difficult, needs no thought or training ;door open, shoes off, tidy house, tidy mind!
Everyone’s a winner, but how can Chris be helped?
The most important factor in making lifestyle changes to lose weight , be more active, quit smoking or any other factor to improve your health (or put your shoes away!) has to be your decision, not your other-half’s, your friends or your GP. You will not have the right mind set to be successful; you have to want to do it for yourself.
Within Exercise Referral schemes across SLL centres we see many patients who are sent to us by their GP. The first question they are asked is “Who’s idea was it to come here today?” If the reply is “My Doctor” we know that we usually have a tougher job than if they actually asked their GP if they could attend. The advice will be taken on board that the GP has said that exercise and healthy eating will help with their medical condition and they will come and see us but it will be because they’ve been sent!
The hardest case to crack is the husband who is dragged by his wife! During a consultation questions which are directed to the husband are answered by the wife, we are all trained in diplomacy to ask the wife very politely to allow him to answer the questions!
Every day, within the fitness industry motivational interviewing (MI) will be used to help people to strengthen their motivation and commitment to change. MI helps people to discover their own interest in making a change or a commitment to losing weight, becoming more active or managing symptoms of physical or mental illness.
The key to helping people to make a change is to get them to express in their own words their desire to change rather than putting suggestions to them. For example, in Chris’s case, “why do you want to put your smelly disgusting trainers away? How do you think this would make you feel? How do you think this will improve your life?”
Here’s what he came up with..
- Improve mental health ;His wife wouldn’t nag him to put them away, he would revert back to the person she married, he knows he’s let himself go – marriage saved
- Improve health; by decreasing the risk of the family injuring themselves due to the trip hazard
- The house would improve; it would be more fragrant
- His trainers wouldn’t run the risk of injury due to his children flushing them down the loo/ filling them with mud/ using them as transport for Micky Mouse
- It will save him time; He would spend less time in the morning trying to find them
We then need to look at his ambivalence about the change, why does he doubt his ability to change?
- It has been a gradual thing, he started off putting them away but it just crept up on him, before he knew it they were in the middle of the hall
The next step is to improve his confidence in taking action and noticing that even small incremental changes are important to strengthen his commitment to change.
We can then discuss a plan to help him to reach his goal of putting the trainers in the correct place, the decisions are made by Chris so that it appears to be his idea, not mine and he feels that it will achievable.
Day 1. Undoing the laces before taking the trainers off but still leaving the in the middle of the floor
Day 3. Undoing the laces, taking the trainers off, putting them to one side of the front door
Day 6. Undoing the laces, taking the trainers off putting them in the shoe rack- goal achieved!
We will then meet at day 7 to see how he is getting on and if there have been any relapses. There will be plenty of encouragement and motivation from my part.
We see this all the time with customers, (I don’t mean not putting trainers away!) It’s a step by step process; sometimes they come to us with a particular reason that they need help with and they actually manage to achieve other successes which hadn’t been their priority.
A good example of this is when I had a consultation with a lovely man who presented with complex health issues; he’s got angina, had suffered a stroke, had chronic kidney problems, he was diabetic, morbidly obese and had high blood pressure. When I asked him if he smoked he admitted very reluctantly that he had a habit of 100 cigarettes a day. I was pretty shocked but I didn’t want to show it! He said he felt ashamed and he was waiting for me to tell him off, I told him not to worry about that, the fact that he had actually come into the gym was a great step in the right direction and that we’d talk about smoking at a later stage, the priority was to build his confidence up to exercise regularly not lecture him on what the ciggies were doing to his health, he already knew that. I wanted him to feel positive from the start, not a failure.
Instead we spoke about why he had asked his GP to refer him, what he wanted to achieve, how did he think it would make him feel and what obstacles were in his way from achieving his goals. At the end of the MI session he said that he couldn’t wait to get started. It wasn’t easy for him over the weeks; he was very emotional some days and he could only manage a matter of minutes of CV exercise. But as time went on his fitness improved dramatically so that he could manage a 60 minute session, he lost 10 stone in weight and he gave up smoking with no other help other than he saw how silly he was to keep the habit going when he could see that his health was improving so much through healthy eating and exercise, amazing!
The key to MI is to express empathy, (I struggle with you Chris!)
Roll with resistance, there will be barriers and reasons why they feel they won’t be able to lose weight, get fitter, stop smoking, put their shoes away
Develop discrepancy – they may be inconsistent with their training or eating habits, Chris may put the trainers away one day, lapse the next, as will the person who is trying to lose weight; if they have a blow out one day, just get back on track the day after, don’t see it as a failure. It’s important that after a relapse people are supported and motivated to start again.
Support self-efficacy –they may question their worth or value, they will need your support
So, Chris leads a very healthy lifestyle and is confused as to why he can’t do a simple task (you should see his desk too!) We all need help in certain areas of our lives should we choose to seek it. I am very self -disciplined with exercise and nutrition, I can even put my own trainers away but what I struggle with is screwing lids on properly! I simply can’t be bothered!!
The final message goes to Chris’s long- suffering wife; if all else fails; throw the trainers out, with him in them!!!!!!