Fear of death is a powerful, but often only temporary, motivator. When the swine flu frenzy subsides, people will go back to their normal behavior. That includes going to work sick and forgetting about all the hand-washing — even though the threat of getting sick with many diseases still exists.
Doctors have observed the same pattern in many post-heart attack patients. Studies show that within a few months as many as 80%1 of patients go back to the same behaviors that landed them in the hospital.
This suggests that doctors have little success scaring patients into changing destructive behaviors. Permanent behavior change comes from a change in perspective, not fear.
Live sooner
Dr. Dean Ornish2 is an expert in changing at-risk patient behavior. His groundbreaking 1993 study revealed two factors in successful behavior change: (1) focusing on positive, immediate results rather than the avoidance of negative consequences; (2) fostering willingness to adopt immediate, radical change.
His study put 333 patients with severely clogged arteries on a rigorous program that included diet and exercise coaching and emotional, psychological and spiritual support. In the study, 77% of participants completely avoided the bypass and angioplasty surgeries they would have likely needed to save their lives.3 They also maintained those lifestyle changes for five years or more after the program ended. That’s nearly three times the average success rate of other diet and exercise programs.
Why? Patients made radical changes to their lives and almost immediately saw results. “These rapid improvements are a powerful motivator," says Dr. Ornish. "These are people who can't work or even walk across the street without intense suffering. When they find that they are able to do all of those things without pain in only a few weeks, they often say, 'These are choices worth making.'"
Dr. Ornish focused on changes that led to patients’ ability to enjoy their lives. “Joy is a more powerful motivator than fear,” Dr. Ornish says. Patients were temporarily fixated on dying sooner. Dr. Ornish refocused them on living sooner.
Go big or go home
Dr. Ornish’s study also revealed another pattern: Small, incremental changes in diet or exercise were unsustainable for some people. They got the worst of both worlds: They didn’t see measurable results fast enough to help them focus on the positive (“living sooner”), and they felt deprived along the way.
This pattern also holds true in patients taking statin drugs (which are highly effective at reducing cholesterol). Many of Ornish’s other studies show that more than half of patients prescribed statins stop taking them after a year. Why? Because it doesn’t make them feel any better. The results are “invisible.” Radical changes — with measurable results — were, surprisingly, easier to adopt and maintain.
The first step to 10,000
For most adults, experts recommend getting between 30–60 minutes of exercise a day for good health and weight loss. Another way to think about it is 10,000 steps a day, or around 5 miles of individual steps. Dr. Ornish’s study suggests that for some, trying to “baby step” to this goal (simply parking further from your destination, taking the stairs) can lead to failure. The results simply don’t support the effort.
So commit. Think about the positive consequences of shooting for every single one of those 10,000 steps a day. Playing with your kids without being winded. Fitting into your goal jeans. Coming off expensive medications. After consulting with your doctor, don’t be afraid to jump in with both feet and make radical changes.
Set a goal of one month. Stick with your radical changes — eating a super-healthy diet and exercising every day — for a month. Take stock of the positive results you see. Success is a much more powerful motivator than fear. And joy trumps them both.
1Dr. Raphael "Ray" Levey, founder of the Global Medical Forum, an annual summit meeting of leaders from every constituency in the health system. Quoted in “Change or Die,” Fast Company, December 2007.
2Dr. Dean Ornish is a professor of medicine at the University of California at San Francisco and founder of the Preventative Medicine Research Institute in Sausalito, California.
3D. Ornish, L. Scherwitz, J. Billings, et al. Intensive lifestyle changes for reversal of coronary heart disease. Five-year follow-up of the Lifestyle Heart Trial. Journal of the American Medical Association. 1998; 280: 2001-2007.
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