Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Friday, January 02, 2009
My farewell post to 2008 was a bit gloomy. If that wasn't enough, I came upon this article in the New York Times by Alex Williams: New Year. New You? Nice Try.
It starts with Oprah's re-gained weight (please, everyone, leave poor Oprah alone...she's great at all weights). Nail biters, drinkers, dieters, even those with heart disease trying for healthier diets don't make much progress in Williams' article:
“Most of us think that we can change our lives if we just summon the willpower and try even harder this time around,” said Alan Deutschman, the former executive director of Unboundary, a firm that counsels corporations on how to navigate change, and the author of “Change or Die,” a book that asserts that even though most people have the ability to change, they rarely do. “It’s exceptionally hard to make life changes,” Mr. Deutschman said, “and our efforts are usually doomed to failure when we try to do it on our own.”
There are cases cited of someone who vows to learn to cook, and someone who wants to get a drivers' license.
Is it really all that hopeless? Ranting without data, I don't think so. Weight change is hard-- it's a battle against biology. But in the course of talking with patient about their history, it's not so unusual to hear that someone quit smoking or drinking many years ago, or made a change only after years of deliberation. The woman Williams talks about who vows year after year to learn to cook but still subsists on Honey Bunches of Oats--- my guess is she either likes the cereal better or she doesn't really want to learn to cook. Please forgive me this once for discussing the motivations of someone I've never met, but this was hard to resist, especially given my own preference for Honey Nut Cheerios.
Are our efforts to change really "doomed to failure when we try to do it on our own" as Deutschman, quoted above, suggests? I think it's a skewed population: if you vow to change and do, you don't seek help. You don't enter a study. You just make a change.
And your New Years' resolutions?
Posted by Dinah on Friday, January 02, 2009
Labels: holiday, uncertainty
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That article interested me too. One problem is that people just differ in ways we are a long way from understanding. Just because Susie quit smoking, why should I assume that I "could" as well? My brain could differ endlessly from hers.
And what do we mean when we say that someone "could" change if they only "would?" In some alternative universe? If they were us? It may be more reasonable to think that someone can change when they, in fact, do change, and not before then. In that sense we only know reality after the fact.
I decided to quit smoking on a Tuesday and quit cold turkey on a Wednesday, 20 years ago. But I can't keep the weight off to save my life. I have lost 100 pounds twice in the last seven years, but I gained it back and THEN some. What I am supposed to do? I am miserable, in fact, almost suicidal, over my circumstance, but I can't bear going through the yoyo dieting again. Everyone says it is a clear case of calories in and calories out. Anyone who really knows about weight doesn't believe that anymore.
I absolutely hate myself. I have been in therapy for ten years with the same therapist, so that is not a solution. What to do?
My new year's resolution? Kvetch less.
Or were you looking for a resolution that might actually be kept?
This year's resolution: make no resolutions. Its just a setup for disappointment and failure.
Last January I made 6 resolutions (all tangentially related to my mental health) and failed at them all miserably:
-Live my life according to my values
-Get back into volunteering
-Get out and walk
-Stop being so judgmental
-Meditate every day
Given my hideous success rate with last year's resolutions, I decided to swear off the double-helping of 'life sucks'.
I read that NY Times article and found it annoying because I DO believe in our ability to change even our weight.
I agree that our weight is one of the hardest things to change probably because we are often dealing with both biological and psychological factors, but I don't think it's impossible. When I finally had the greatest success it was done alone. I have concluded that the reason I had the most success alone was that I took full responsibility for something that in the end IS MY responsibility. I had been to a couple of the popular weight loss programs but there was a part of me that expected THEM to carry part of the burden which is a counterproductive premise.
I have changed a LOT of things about myself through the years. I am a former smoker (32 years ago) and have changed occupations and have moved long distances. I know other people who have changed.
I did make resolutions for 2009 which I posted on the refrigerator as a daily reminder. I did NOT label the list "resolutions", I labeled them "Goals". Goals are not something that you wish for or dream about, they are something that you WORK towards one step at a time, bit by bit and day by day.
I don't consider my goal list to be an effort in futility. I believe in change.
Hmm.. an opportunity to discuss the meaning of life perhaps? Or my version at least.
We are capable of changing the things we want - my guess is she either likes the cereal better or she doesn't really want to learn to cook is spot on.
What needs to change is the what we 'want' most.
So, the meaning of my life? - it's whatever it is I want at the time I think about it.
It can, and will, change. (again)
Personally, I bought a bike and resolve to ride it to get fit again and a proper weight.
But this was a resolution from 1995. It just took me this long to 'want' to change. (Cos I'm now over 40 and not ready to die just yet - as my latest meaning of life is 8 years younger than me and everything I wanted - pretty motivating)
Hm... Change is hard, and weight change (my annual "New" year's resolution) is even more difficult.
But I do tell my patients that even small changes can make a difference. To my diabetic patients, I say, "let's start with you bringing in a fasting blood sugar for 5/7 days thiw week" when they're totally noncompliant.
For me? Well, last year, I managed to exercise most days of the week for most weeks of the year (it's no marathon.... but...). This year, I'm going to continue that, AND pay all of my bills on time (it's a bit ridiculous, I have the money, it just doesn't seem to get done, and then all the sudden it's the next month already) by setting them all up on autopay.
My cats want me to resolve to play with them more and bring them more catnip. ;)
Having experienced my first ever episode of clinical depression last year which was utterly debilitating, my new years resolutions are simple:
- having the makings of breakfast in the house
- pay my bills
- do my laundry
as these are all things that I didn’t do when I was in depressed.
And I am going to prove the NY Times article wrong and lose the 50 pounds I gained while I was depressed as a result of psychotic overeating. Seven pounds lost already … only 43 to go.
Therapy Patient - I like the goals vs. resolutions idea but I have to disagree about your assessment of other people's ability to change. Just because you could, it doesn't mean they can.
Weight-loss is tough because there are so many reasons that people lose weight and treating all weight-loss the same assumes that you can attack all those variables the same way and be successful. I would submit that unless you are in their body, you have no idea if it would be easy or hard for you to lose weight as them,.
I have had the dubious fortune of being able to watch many smart capable family members suffer from alcohol addiction and I can say this - some changed and some didn't. The strongest willed, the smartest, were often not the ones who succeeded - for many of them external factors mattered more than anything in putting their addictions aside. Whether or not they lost a job, had a spouse who supported them, who their friends were, what they did for fun had a huge impact on their success. We like to think that will power and choices matter but I would say luck is a big factor in our success, and an uncontrollable one. I think we all need to cut ourselves slack and do the best we can with each day.
Who really knows what "success" is anyway?
I have found that motivational interviewing is often successful for helping people sort out what is relevant and what is irrelevant, in terms of what they consider changing.
Millner and Rollnick were on to something for sure!
For people in the northern hemisphere, January is pretty much the worst time to be trying to lose weight IMO - it's cold, so energy and moods are often a little lower and it's harder to go out and exercise. It's tempting in winter to stay in and eat lots of filling food, so I think a winter plan should be to try not to put on any weight until it gets warmer, when you can think about exercise and reducing diets!
One reason it's so hard to deal with overeating, I think, is not being able to quit altogether - I sometimes wonder how alcoholics would cope being told they have to have two (and only two) drinks every day, and moreover that they must have a wide and balanced variety of different types of drink over the course of the week.
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