Sunday, November 13, 2011

From Life and Death Motivation to Joy: Changing Diet, Changing Life

I recently recieved the following letter from a reader. I wanted to share her letter and my response because it relates to my own life as well as the reasons I've been unable to post on this blog for some time.

Hi Bob Vance,

I was reading your blog today and wonder you could give me an opinion on a diet/fitness app I'm making right now?

For me, I think the problem with being healthy is motivation. It's an abstract, overwhelming goal. I think the best way to counter this is to have concrete, winnable games and small victories.

So, this app will makes living healthy, and fitness into a RPG game, where users earn points, and "level up' as they achieve their goals. Every time they eat something healthy like vegetables, they earn points. Every time they complete a workout, they earn points. Each level will present different challenges.

The challenges will follow a certain structure. First will come changing your environment such as getting rid of junk food. Then, reducing stress, as stress leads to eating comfort food. Then concrete goals like keeping track of everything you eat, or taking the stairs for a week. Small, concrete goals rather than abstract ones like “be healthy” or “exercise more”.

The whole point is to create a holistic framework/game so people will rely less on willpower, and more on fun, achievement, and changing our environment

What's your opinion on this idea? Would you want to know when I'm done with it? If this sounds too silly, or absurd, just ignore what I just said, hehe =)

Best, Christine



I appreciate your thinking of me for feedback on this project. It is interesting to be approached about this at this time in my life. In the past six months I have lost over 25 pounds. It has not seemed that difficult to do, even though I have worked on keeping my weight down for years, actually since I quit smoking over 27 years ago. Your query got me thinking about why it has seemed so much easier to change my relationship to food now than it has in the past.

I’ve never been horribly over weight and I have exercised regularly and vigorously for almost forty years. I carried my extra pounds quite well, but have known for many years that my family carries a kind of genetic cardiovascular predisposition for early illness and death. Both of my grandfathers died before they were 60. My mother died at 68. So I thought, rightly, that I had to try to get ahead of this issue while I had time. So far so good… until this past spring, when two days after my 57th birthday, while I was swimming my 1.5 mile lap routine, I developed an unusual pain in my chest and back that later that day sent me to the hospital.

Without going into a time consuming and overly detailed account of my heart attack (the result of a clot in my “widow maker” artery that was held back from a deadly course by two peaks of arterial plaque, but still blocked blood flow while I was exercising), I think, for me, your idea that the main obstacle toward developing better health and diet patterns is motivation is right on. That I survived a potentially fatal heart attack (and did so, according to my cardiologists, because I exercised and worked on diet) is, it occurs to me, the only motivation I’ve needed to fine tune my diet, lose the extra weight and improve my overall cardiovascular health as I go into my older age. The motivation I feel is a matter of believing, viscerally, that I MUST improve my diet, that I have no real choices if I want to stay alive. This has worked, so far for me (and really, with no real 100% assurances) because it is everything I can do.

Duplicating this kind of motivation for others who are not confronted so concretely with their mortality seems to me to be the kind of question you are dealing with. You are working on a formula that maneuvers people into flicking the switch of a kind of motivation that takes advantage of their knowledge of the importance of their diet and exercise in very deep and essential ways.

Beyond haranguing people who really do not have a concrete perspective concerning the nature of their own mortality… and haranguing people about the benefits of diet and the negatives of overeating I think usually only creates more motivation to continue to over eat… how can you engage their intellectual understanding of the need for weight loss and over all good health habits in a way that it creates a deeper sensory based motivation toward better diet, weight loss and health?

I think your idea about creating a system of small steps and rewards is a good one. And I think focusing on making it fun, in one way or another, is a good inclination. That being said, I also think you should consider enlarging the scope of what that means to the wide variety of people to whom you want to offer your program.

If you have a good understanding of the nature of individuation, you must also understand that each of your clients will need to be involved in the invention of their own system of steps and rewards, as well as, and perhaps most importantly, in the uncovering of their own particular keys to the kind of motivation that is necessary to make the changes that they have to make. How uncover each client’s will to change? How to help each client understand that their urge to be healthier is indeed a life or death process?

So my next question would be: How can you help your clients uncover their, very serious, will to lose weight and be healthier all while integrating their individual program with the also very serious but more ‘fun’ reasons they want to stay alive? What do they love about life that makes this such a serious “mission”? Each person’s answers may be different, but without integrating that passion for living into the reasons for wanting to be healthier in whatever way shape or form it occurs in each individual life, I doubt that it will be possible to find and add the weight of the motivation needed to make the changes that they want to make. And they really must be ready to find those reasons, make that change and do the work themselves.

Also: For me food is a one of those joys of living. I don’t doubt that I am in rather good and crowded company. Eating is fun and gratifying. It is a social adhesive and a daily reward for the trials of each hour of living. It adds spice to love and succor to sadness. Without recognizing that and including it in a diet and health plan I doubt that I, personally, would get anywhere. How can we integrate someone’s love of food into his or her motivation for needing to have less of it? When does wanting food change from a simple daily joy into an addiction? Is there a concretely defined line between joy and addiction, and if so how do we help clients find it for themselves? If there are only shades of grey, how do we help our clients find their own place of comfort and health in that fog?

So yes: go on with your program of short term goals and rewards, but I would ask that your process include giving most of the responsibility for inventing those goals, steps, rewards and the nature of their motivation toward change to your client. Have a menu, so to speak, of choices plus give them plenty of space and facilitation to discover their own choices. Have your framework ready (it already sounds like you have a good start on that) and facilitate your clients’ exploration of it and help them fill in the details of the tasks that lie ahead.

I hope this helps. You might do some research and reading in the area of Motivational Interviewing, a technique for facilitating behavioral change pioneered by Professor William R Miller, Ph.D. and Professor Stephen Rollnick, Ph.D.. There’s a lot of information on the Internet, and training modules and courses available. It’s a non-intrusive, non-confrontational method of interviewing and counseling that gives responsibility for change to the client through exploring their roadblocks and stagnating ambivalences. You might find it a good companion to your work.