Health Wise
A health & wellness column by Victor Acquista, MD
Director Pathways Integral Health & Wellness, LLC; Author Pathways to Health: An Integral Guidebook
Get Motivated, Stay Motivated
Recently, I wrote a column on Lifestyle and Health and commented that much of chronic disease is related to lifestyle choices. Making decisions and keeping them with respect to lifestyle choices that affect health often comes down to motivation and sustaining that motivation which is all about discipline. This column will address some ideas and offer you some suggestions about how to get motivated and stay motivated to be healthier.
Understanding Decisions
A good place for us to start is understanding how we go about making decisions. In a very simplified way, we have two parts of our brain informing us about what we should and should not do. The emotional part of our brain is often decisive in controlling out decision making. We have needs and desires; we make decisions to satisfy those needs and desires. Some decisions make us happy, others make us sad, or angry. The decisions leave us feeling satisfied or not. This is all based on emotion and emotional fulfillment. If I desire chocolate and eating chocolate is the only way to feel better, then chances are I’ll go eat some chocolate regardless of the long term consequences. Such a choice is based on short term emotional decision making. This part of our brain can often be impulsive.
Contrast this to the other decision making center of our brain, i.e. the rational brain. That’s the part of our brain that uses logic and weighs out the pros and the cons of alternatives. Our rational self is not concerned about emotions and remains cool, calm and collected when figuring out the best choice. This part of our brain is much better at weighing out the long and the short term consequences of our actions.
When the emotional part of our brain and the rational part of our brain are both aligned then decision making is easy. It’s kind of a no brainer to make a choice that is supported by both brain decision centers as it represents a win-win situation. But what happens when the emotional and rational parts of our brain want different things? In the case above, what happens when emotional you wants chocolate and rational you says that will cause weight gain or be bad for my diabetes? This kind of conflict is common. Poets and philosophers have referred to this as the war between passion and reason. When it comes to health, how do you make healthy lifestyle choices when part of you is “arguing” to do something which is unhealthy. Eating a calorie rich dessert when you are trying to lose weight because at the moment you are more concerned about enjoying dessert than losing weight is a good example. Sitting down and watching TV because you are tired and want to rest instead of heading out to the gym or going for a walk is another good example. Here I have illustrated the conflict around common health choices about diet and exercise. I am sure you can relate to these examples.
Good news—there is a third part of the brain that helps to mediate this conflict between the emotional and rational parts of our brains. This is the volitional brain, the seat of our willpower. Think of the volitional brain as a referee who helps you to decide what choice you will make.
Understanding Motivation
We are all motivated by a set of internal and external factors. These are individualized, but are best understood by examples. I may be motivated to lose weight because I understand that my current weight is unhealthy and puts me at risk for diabetes and high blood pressure (a rational argument). Or, I may be motivated to lose weight because I don’t like the way I look (an emotional argument). In both cases, these are internal motivators.
You might be motivated to stop smoking for some very good internal reasons such as its bad for my health or it costs a lot of money. But you might also have some good external motivators such as, I promised my spouse that I would quit and I don’t want to disappoint him/her. Or, I want to set a good example for my children. In either case, these represent external motivations. You might consider not wanting to be late for work because I might get in trouble as a prototypic example of an external motivator. How about, I want to stop drinking because if I am caught operating a vehicle, I might lose my license and land in jail. That represents pretty strong external motivation not to drink!
I like to encourage people to think of motivators in terms of rewards and punishments which both represent reinforcers. Things which reward you represent a source of positive reinforcement, while things which punish you represent types of negative reinforcement. These reinforcers are the carrot and the stick which often underlie our motivation.
Bringing it all home
One very useful exercise is to sit down and list the health behaviors you would like to adopt or change and then to detail the internal and external motivators which support your decision making. Study the list and see if you can develop some reinforcers to support you. Think in terms of internal and external motivators as well as positive and negative reinforcers. For example, if you want to lose weight, you can reward yourself with a new outfit after losing 10 pounds. Or, if you want to exercise more often, enroll a friend to be your gym buddy who can encourage you when your motivation fails.
And your motivation will fail from time to time. No matter how committed you are to a particular health choice, you may slip up from time to time. Having a plan in advance on how to deal with temptation is advisable. Have a health sponsor that you can call when you are feeling weak. Put a picture of your children or loved ones in your wallet and look at the picture when you are thinking of breaking a health promise. Bring out the list you made and review it every day. Post it on your refrigerator or on the mirror to look at when you are washing, shaving, or brushing your teeth.
Having good intentions about your health is a good starting point, but keeping them is all about sustained motivation and discipline. Perseverance or stick-to-it-tiveness will be the challenge. That’s where your volitional brain will ultimately decide your success.
As we approach the New Year, think of your New Year’s resolutions as your good intentions. Understand the source of your motivation to achieve your health goals. Follow through by being resolute and maintaining your willpower. Like the Nike commercial says, “Just do it!”
Be healthy…
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