Synergies #6: Changing The Shoulds To Wants


Everybody knows what we “should” be doing to be healthy. This goes for all of us, “patient” or not. Exercise, proper nutrition, healthy sleep habits, pacing ourselves, taking time for relaxation and de-stressing—creativity, working on relationships with family and friends, and working with our spiritual strengths and deficits. There is accumulating evidence that active lifelong upkeep in these areas reduces emotional and physical illnesses, and keeps our body and brain working better longer.

A great place to start when we want to change our behavior is awareness of the language we use in our head when we talk to ourselves (and our patients). Revising language is central to motivation. For example, when we tell ourselves we should do something that we’re not doing, we’re telling ourselves that there’s something wrong with us. This fuels shame, guilt, and low self-esteem.  Shoulds are listed as one of Dr. Burns’ 10 forms of twisted thinking. Shoulds come from superego and can create persistent low self-esteem and stuckness.  Instead we want our ego or “healthy adult” to buy into the benefits of behavior change, to see it as a possibility and to want it.

Motivating people from the inside consists of:

1)      Connecting with them empathically and with common positive goals

2)      Helping them see that little by little they can change their behaviors with assistance and “coach ability” despite how they feel about themselves or how busy they are

3)      Regular attention to roadblocks and obstacles

4)      “Learn to swim” metaphor—you can talk about how to swim but until you get into the water and practice your stroke nothing will change

5)      Repeatedly pressing on positive reasons to change:

  1. Reduction/prevention of depression and overwhelm
  2. Less stress and anxiety
  3. Be able to do more with their lives and be more fulfilled
  4. Positive outlook
  5. Improve physical and mental health, reduce wear and tear on the body and mind
  6. Better relationships with others
  7. Consistency and treating medical problems such as managing medications
  8. Overcoming low self-worth
  9. Better time boundaries and prioritization

6)      Focus on mindfulness practice as foundation for change.

Once we get the behavior change momentum going, we also see the benefits. For example, exercising regularly starts to pay off with increased energy, weight loss, less aches and pains, and a sense of accomplishment. Likewise, we see what happens when “wellness activities” are skipped. Many of my patients tell me they know that if they skip one wellness activity, i.e. exercise, they’ll be okay, but if they skip two, i.e. exercise plus therapy group, they get depressed.  For me, if I don’t exercise for three days I get back pain. Otherwise I rarely do. Identifying these patterns can be very motivating!

We also want to re-orient our language towards the present, and away from judging.  Getting stuck in the past, worrying about the future, judging whether we’re ok or not all distract us and can cause suffering.  Mindfulness practice reminds us to focus on the present, our priorities, and to label our judgments and biases as such, freeing up our mind for greater productivity and focus. This practice will continue to reduce language which discourages and deflates.

Modification of language is an important link in the synergy chain.   We’re moving away from the language of “fixing what’s broken” to that of building routines and skills for a better life.

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One thought on “Synergies #6: Changing The Shoulds To Wants”

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