Sustaining Lifestyle Transformation: Staying on Course for the Life You Want

Change is not merely necessary to life – it is life.  Alvin Toffler

Change and transformation are part of every moment of all our lives.  Whether we recognize it or not, our bodies, our emotions, our minds, our spirits are changing every day:  cells are replicating, growing, performing their functions, and dying; our minds and hearts are perceiving, forming opinions and feelings, learning, and developing; our souls and spirits are experiencing this world, interacting with it, and evolving.  Our health is no different.  Whether we choose it or not, our body systems will alter over the course of our lives, gradually shifting in function and physiology as we mature, express the fullness of the life force, naturally decline and transform into non-physical energy as we leave this plane of existence.  What we do have influence over is the rate of change and the form this natural process will take  –  to a great extent, the trajectory of our health and the quality of our life experience are a matter of choice.  We can choose the path of “disease expectancy” our society has embraced, with declining health and an increase in medications and procedures starting in mid-life or even earlier; or we can follow the lead of cultures throughout the world (so-called “Blue Zones”) in which vitality and health persist far into the later years, and decline occurs only at the end of the lifespan.

Most people know, both instinctively and from available information, the outlines of the lifestyle that will create a healthier, more vital trajectory for their lives.  But as too many of us are aware, intellectual knowledge often submits to deeper, more powerful forces in the body and the psyche when real transformation appears on the horizon.  What is necessary is nothing less than a metamorphosis, a kind of death of the old self and emergence of a new one, and as we move closer to it this can bring up fears, resistance and encounters with parts of ourselves we have done our best to avoid, what the poet and writer Robert Bly calls the “human shadow”.

The shadow contains for each of us the parts of the personality that are hidden from us – we are often encouraged to turn away from shadow aspects of self by family, teachers, society, and cultural or religious institutions who themselves are uncomfortable with their shadows.  The shadow isn’t bad, however, it’s just human, and as Bly points out, the less we acknowledge it, the larger it grows.  Much as we would like to leave it behind, it is part of us and will follow us everywhere. When we embark on a plan of lifestyle change, shadow elements appear to whisper in our ears, urging us to do the very thing we have firmly resolved not to do: smoke a cigarette, take a drink, or eat that humongous piece of chocolate cake that has been beckoning us all evening.   This urge to sabotage our highest and healthiest intentions has been termed the “counter intention” by the life-coach Joe Vitale, and to persist in the work of successful lifestyle change we must engage with our counter intentions and shed light on our shadow.   Dialogue processes (such as Voice Dialogue techniques), journaling, working with a life-coach or therapist, and group support can give us tools to explore the underpinnings of such resistance to positive change.

It’s not that some people have willpower and some don’t.  It’s that some people are ready to change and others are not.  James Gordon, M.D.

Commitment to and patience with the process of change is integral to any serious program of lifestyle transformation.  After the “New Year’s resolution” phase has passed, we are left with the challenging and often merely tedious reality that many steps lie between us and the realization of the vision which first got us started on this path toward a healthier version of ourselves.   Rather than allow this to cause us to lose momentum (or give up on our dream entirely) it is helpful accept that behavioral change (which is what lifestyle transformation comes down to) takes time; it’s a process of learning how not to do what we have done habitually in the past, and instead learning new skills for living – eating, drinking, exercising, sleeping, resting, playing, thinking, working, interacting – that support a fuller, higher functioning life.

Change is a process, not an event.  James O. Prochaska, Ph.D.

Understanding more about how real change happens allows us to reframe the journey toward our vision from being goal-oriented to becoming process-oriented, from an unrealistic and perfectionist belief that our progress must be linear to an acceptance that movement “directionally in the right direction” may seem slower but is more aligned with realities of human nature and therefore ultimately more successful.  It allows us to take our dream out of the world of fantasy and the future and to bring it to earth in this moment and, step by step and over time, to make it real.

Man can alter his life by altering his thinking.  William James

The psychotherapist James Prochaska and colleagues developed a theory of behavior change that has come to be known as the “Stages of Change” model.  Originally applied to the field of substance addiction treatment, it has been shown to be a successful tool for many areas of behavior transformation, from bullying prevention to weight management.  Determining where in the stages someone is guides the approach to helping them move through each stage, from a state of denial about the risks of their behavior, to the point at which the new, desired behavior has become a habit.  These stages are 1) Precontemplation: the person sees no need for change, despite negative effects of the behavior; 2) Contemplation: the behavior is recognized as undesirable. The person is not ready to change yet and focuses on the difficulty of changing, but is thinking about it; 3) Preparation: not ready to take action yet to change the behavior, but taking small steps in that direction: a smoker tells family and friends they intend to stop smoking, and starts thinking about the benefits of not smoking; 4) Action: the person has changed the behavior (ie. they have stopped smoking), but the change is recent (6 months or less) and they are at risk of returning to the old, unhealthy behavior; 5) Maintenance: the new, healthy behavior has been practiced for more than six months.  It has become a healthy habit, replacing the old, unhealthy one. The risk here is that stressful situations or an environment that  triggers the former behavior, can contribute to a relapse, so ways of reinforcing the new behavior are essential to its maintenance.

You always pass failure on the way to success.  Mickey Rooney

It is perhaps frustrating, but true to realize that just about everyone who undertakes a significant lifestyle change will move back and forth within these stages, sometimes many times in various permutations, before the new behavior and its benefits are firmly in place.  But there are strategies that can make progress more sustained, more “directionally in the right direction”, that abbreviate time spent in the inevitable relapses, and allow for a shorter road to successful transformation.  Prochaska calls these “Processes of Change”, and learning and practicing these tools is integral to many effective programs of addiction treatment and lifestyle change:

1)      Consciousness raising: becoming aware of and informed about the unhealthy behavior (the health risks of overweight, for example) and the positive aspects of the healthy behavior (such as the benefits of exercise).  Reading books on the subject, doing internet research, talking to people who have changed the behavior in question, getting feedback from people in your life about their feelings toward the change you are making, can bolster your motivation to change.

2)      Dramatic Relief:  feelings of fear and anxiety about the unhealthy behavior (for example, people who have had a close call with their health – a heart attack or cancer experience, are often highly motivated to replace unhealthy with healthier behaviors); conversely, feelings of hope and inspiration in learning about others’ successful journeys to healthy behavior deepens commitment and joins knowledge with desire and belief in the possibility of change. Twelve-Step and other group meetings are excellent ways to obtain this kind of support.

3)      Reevaluation:  realizing that the healthy behavior expresses who you really are and the person you want to become; also seeing how the unhealthy behavior affects those around you, and the positive effects on others of the new behavior.  Seeing that society as a whole supports the healthy behavior.

4)      Self-Liberation: belief in your power to change, and acting on that belief : “Yes, I Can!”

5)      Helping relationships: seeking out people who support your process of change.  In my work, I have observed that many people want to “go it alone” and resist the idea of joining groups or seeking the support of others in their lifestyle change programs; yet I have seen even the most adamant loners find such support to be invaluable and a source of compassionate camaraderie for every phase of their transformation.  And I have noted that those who insist on going it alone often lose momentum and when difficulties arise, they are less likely to persist and succeed in the desired change. So, depending on your area of needed lifestyle change, here are some options for finding helping relationships for your process:  join a twelve-step program, or a support group (or form your own – online groups are an option); find one or more “buddies” among friends or in your community for mutual encouragement in your change process; work with a counselor or therapist with expertise in the area of your behavioral change; take a class that supports the kind of lifestyle change you are working on, such as a healthy cooking class.

6)      Counter-conditioning: developing healthy ways of acting and thinking to replace unhealthy habitual thoughts and actions.  (Example: having a cup of chamomile tea and a hot bath when you get home from a stressful day instead of a glass of wine as you watch the anxiety-inducing evening news.  Or, take a meditation or mindfulness class and learn how to reduce stress and anxiety with your breathing and awareness instead of with a cigarette or pie a la mode.)

7)      Reinforcement: rewarding yourself for healthy behavior and letting go of rewards associated with the unhealthy behavior. (Example: recognizing how great it feels to once again fit into clothes from a slimmer past, vs. the temporary satisfaction of your favorite self-sabotaging “comfort food”.)

8)      Controlling stimuli:  replacing reminders for unhealthy behavior with cues for healthy behavior.  (Example: Clearing your kitchen counter of sweets; replacing them with a bowl of fruit.)

One should eat to live, not live to eat.  Benjamin Franklin

Just as our psychology can help or hinder our motivation for lifestyle change, so can our biology and biochemistry support or undermine our commitment.  Unhealthy lifestyle behaviors do more than limit our enjoyment of life and put us at risk for chronic disease later – for everything from atherosclerosis and arthritis to diabetes and dementia has roots in lifestyle choices – they insidiously drive the very behaviors we want to change, skewing the healthy function of body systems designed to keep us in balance.

So one of the most important aspects of sustainable lifestyle change is regaining and supporting balanced body function and biochemistry.  Whether the goal is to put the smoking habit in your past, to lose weight, or to maintain sobriety, proactively using healthy eating, exercise, nutrition and stress reduction eases the transition to healthier behavior and raises the threshold for relapse.  In my work I use a program of therapeutic lifestyle change (TLC) which features a low Glycemic Index, modified Mediterranean-style diet and incorporates exercise, stress reduction, detoxification and nutritional support for balanced movement toward healthier lifestyle habits.

In addition, I evaluate and treat imbalances in systems whose proper function is crucial to supporting a particular lifestyle change:  for the overweight, we may look at insulin and thyroid function, test for food sensitivities (whose addictive component can sabotage dietary change), and measure stress hormones and neurotransmitters (brain biochemicals which modulate impulse control, mood, and motivation). We evaluate body composition (the percentages of fat and lean muscle) at the program’s start and throughout, to objectively track change and provide motivation to continue.  Nutritional support tailored to the individual helps to normalize biochemistry thrown off-balance by years of poor diet and depleted by the increased nutrient demands of unhealthy habits.

The only person we can truly change is our self.  L. Hunter Louins

By the time people present themselves in my office looking for guidance for lifestyle change, they’re often demoralized by repeated, failed past attempts. One of the questions I ask them is, “What do you think will make this time different?”   I ask this somewhat provocative question in order to confront and activate their core desire for authentic change.  If we keep using strategies which have been unsuccessful in the past, it’s unrealistic to expect a different outcome.  To create successful, sustainable lifestyle transformation we first need the touchstone of a deep desire for change; then we need to learn from our relapses, get support for each stage of the change process, and practice doing things differently long enough for a desired, healthy behavior to become a habit.

Resources

www.bluezones.com Tips for health and happiness from the world’s most vital cultures.

A Little Book on the Human Shadow, by Robert Bly

Zero Limits, by Joe Vitale, Ph.D.

www.delos-inc.com for information and books on Hal and Sidra Stone’s Voice Dialogue technique

Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your life Positively Forward, by J.O. Prochaska, J. Norcross, and C. Di Clemente

The Pathway: Follow the Road to Health and Happiness, by Laurel Mellin

 

Debra Gibson, N.D. practices naturopathic family medicine in her Ridgefield, CT office.  She can be reached at 203-431-4443 or at drgibsonsoffice@sbcglobal.net.