Rome Wasn’t Built in a Day

No automatic alt text available.One morning last week I went to jump out of bed as usual, ready to start the day in a rush. I had lots to do to get ready for my yearly holiday open house and had to start planning. I love mornings because that is when I have the most energy, however this one morning I encountered a little problem. I couldn’t walk. When my feet hit the floor and I began to move toward the bathroom door, I felt severe pain in the back of both calves that caused me to freeze in that spot and not move. What on earth is happening? That is what I thought at first, but then I paused to recall all of the probably stupid things I might have done to affect my calves like this. And then it came to me: lunges. My daughter had tried to show me the appropriate way to do lunges while we were hanging out in the kitchen, I was probably cooking (can’t remember, just that we were not exercising, just chatting). Somehow we got onto the subject of strength, flexibility, endurance, getting older and what was more important, etc. Anyway, I must have tried a lunge or two. Apparently, I did not get it right, and clearly, I probably need to do more as doing only a few affected my severly inflexible and weak calves in a major way. I was thrown because it really hurt. Needless to say, I limped toward the bathroom and vowed to fix this.

The funny thing is I actually have been making an effort to stretch and do yoga-y kind of things in the morning while I am watching the news because things like this have happened to me before. I am a happy slow jogger/walker/biker kind of exerciser, anything mindless that does not involve counting or time or thinking and serves to relax me. Plus my more aerobic types of activity have served me well over all these years, both keeping me sane as well as giving me a good amount of endurance (more than a lot of people my age I have noticed). I can work for hours moving wood, gardening, cleaning, shopping, you name it, I don’t usually poop out…..and I love that feeling. But, lately more than ever I have been experiencing things I really don’t love such as knives stabbing me in the back of my legs simply from getting out of bed. I need to fix this, that is what I thought.

As usual, experiences like this help me relate to a lot of people who are trying to change and become healthier. It is not easy. I started to think about all of the things people want to change like eating habits, drinking habits, sleep and fitness habits. What is so hard about it, and how long does it take? As the New Year rolls around and you start thinking about resolutions, I think it is so important to give yourself a reality check.  I see people make some common mistakes the serve as a guarantee that in a year from now they may be in the same spot. Here are some things that i have noticed and some suggestions on what may be a better way:

  1. Having really unrealistic goals. You know what I am going to say here. “Lose 10 pounds a month”. “Go to the gym every day after work”. “Run a mile in 7 minutes”.  “Stop skipping meals”. When you set lofty goals you are setting yourself up. How do you know if it is a “lofty goal” or unrealistic? Ask yourself if you have set this same goal before and failed. That might tell you something. Instead of doing the same thing year after year, why not stop and reflect on the true behaviors in your life that really do affect how you feel and even your health. For example, if you smoke cigarettes I think we all could agree that you are risking hurting your health and you definitely do not feel as good as you should. If you have tried to quit before by saying “I am quitting on Monday” and then slipped back to your old smoking habit, then chances are it may happen again. Instead, think about other options. Reading a book on quitting or checking into classes for quitting smoking is still a step toward accomplishing your goal (even if you don’t stop suddenly like you wish you could). The point is to move in a direction. Educating yourself and exploring your options is much smarter than doing the same thing over and over. When it comes to dieting and weight loss, if you have dieted before and it “worked” but somehow you have gained weight back, there are several questions you may want to ask yourself. The first being, why are you trying to lose weight? You know my thoughts on this, not everyone is supposed to have the same body. If your weight has been stable for years and you feel good and are healthy, then instead of jumping on the diet bandwagon, why not take time to reflect on where you want to be for the rest of your life? Could there be a different goal instead of changing your weight? Can you envision yourself years from now preparing healthy meals, being in tune with your hunger and fullness, freeing your mind to focus on learning how to eat healthier instead of counting calories? Following a “diet” may be helpful to some (so I have been told, and I never knock what someone chooses for themselves or what they find helpful). But, in the end, if you want to be your best and healthiest self ever, the diet won’t do it.
  2. Having a “start date”. I have noticed when people say “starting Monday I am going to blah blah blah” they tend to really overdue whatever it is they are stopping on the days and weeks before that magical date. Wouldn’t it be better to avoid this altogether by doing your research on the direction you want to go instead of doing the same thing over and over? For example, if your original goal is to lose weight, but you have decided to take the plunge and focus on eating healthier instead, why not pick something you know is not the best in your diet and focus on that? For example, if you want to drink less soda do some taste testing of flavored waters or experiment with infused waters (adding different fruits to water to flavor it). Then start by decreasing the amount you drink by increments you can handle. It is so easy to tell someone who drinks 8 cans of Coke a day to stop because it is bad for you. Have you ever had that habit? Personally, I dislike the taste of soda however I have known people who really feel they need it. They just can’t stop cold turkey but I have seen people do very well with weaning themselves off it they find a good substitute. So having a “start date” sets you up for overindulging as well as failure. Instead, looking at your long-term goals and moving in that direction is much more doable.
  3. Having self-expectations. Although I have decided I need to work on flexibility I have not given myself any specific expectations. I did that once and almost killed myself (I was going to be able to do a back bend by Christmas). It didn’t work and I could have hurt myself for life. Now, I go with the flow, sometimes taking more time in front of the morning news and other times just a few minutes because I did not get done what I needed to the night before. It doesn’t matter because I feel really good in that I am slowly developing this habit, this association between the morning news and stretching which has now become fun and enjoyable. I don’t need to do a back bend, ever. If you just let yourself move in a direction, just start something without imposing these crazy expectations on yourself, in a year from now, who knows where you will be? And if I ever am able to do a back bend, trust me, I will brag about it……but is is not my goal anymore.
  4. Defining what means “success” or “progress”. This is kind of related to number 3. When we impose ridiculous expectations on ourselves, we are almost guaranteed to feel unsuccessful.  I feel like I have made progress over these past months because my definition of success has evolved into a more realistic one. Are there things in your life that you are trying to change but don’t give yourself credit for? For example, having a goal of eating more fruits and vegetables is a smart goal for your health however expecting yourself to eat 5 cups every single day is hard. Just adding something to your lunch (like a fruit) is success. The more credit you give yourself for even small positive changes, the better your feel and the more likely you will keep doing it.
  5. Taking out instead of adding in. I can’t tell you how many times I have heard people say “I am giving up sugar”. Or coffee. Or soda. Or bread. Or carbs. Fast Food. You name it. Getting rid of unhealthy things in your diet doesn’t sound like a bad idea, but often this leads to the “all-or-nothing” thinking. So when a situation arises, and that person eats or drinks that forbidden thing they not only feel like a failure, they tend to give up on their health goals. Instead, try thinking about “adding in” instead of “taking out” For example, for the soda person, carrying some water bottles with you might help to quench that thirst and prevent a trip to the vending machine. For the sweet tooth, having some extra fruit in your lunch, or even purchasing “Fun Size” candy bars instead of giant ones may help move in the right direction. Not to say you can’t enjoy a jumbo candy bar when you really want one. It is just the mindless habits of buying things and then thinking you can magically eliminate them from your life that doesn’t work. And instead of “cutting out pasta” why not “add in vegetables” to your dinner? Adding in the healthy instead of unrealistically cutting out all of the other stuff makes more sense. (Note: the exception to this is people who truly can’t control eating sweets or other things if they are around and this leads them to binge eating. You know yourself best and you need to do what you need to do for YOU. These suggestions are for the average “dieter” mindset. We are all different and need to respect these differences).
  6. Comparing self to others. I know lots of women my age who can do a lunge without paralyzing themselves the next day. I know women who are yoga teachers who can touch there toes to their heads and even stand on their heads. This will probably never be me. If you compare yourself to others you are setting yourself up to feel inadequate (not always, but sometimes). We are all unique in what we enjoy, how we like to move, our sleeping habits and foods we like to eat. Block everyone else out of your mind and think about where YOU are personally and where YOU want to be.
  7. Cultural ideals over personal needs. Things change year to year when it comes to what is cool to eat (right now it is pink salt and coconut anything). You also have the diet fads and exercise trends that are easy to get caught up in. Try to be aware of the goals you are setting for yourself, and ask yourself “am I choosing this just because everyone else in the world is doing it? Or is this something I want to do because it makes so much sense to me and I feel so much better when I do it this way? Have you done the research into the facts about whatever it is you are starting to try? Instead of jumping on the band wagon, again, think about where you want to be years from now (not next month). If it is truly not you, skip it.

The bottom line, as my mom always used to say “Rome wasn’t built in a day!” I never really thought about what she meant when she said it, but now I think I get it. We don’t need to set deadlines for change, we don’t need to have unrealistic expectations, we need to stop putting time limits on ourselves. Instead, habits take time to change. We used to think it took 21 days but according to Psychology Today it is more like 66 days. Yes, change takes time, but is also takes falling on your face and failing . You learn something when you get out of bed and can’t walk to the bathroom because you were stupid enough to think you could do a lunge when you haven’t done one in…well, ever. I know I have learned I am much less flexible than I thought and at the rate I am going, it may take a few years to be able to be as flexible as I want to be. But I feel good because I have been able to incorporate it into my life. Even those 10 minutes a day is a huge success in my mind. It is a great feeling to have low expectations sometimes. I still feel like I am moving in a direction, and that feels good.

Happy New Year and here’s to you and your healthier direction, whatever that may be!!!

Self-Sabotage or YOLO:Intrepreting That Voice in Your Head

Spending too No automatic alt text available.much time in Italy can really ruin you. After a wonderful 3 week trip over a year or so ago, to celebrate our friend’s 25th anniversary it was not easy to transition home to New England. There were no platters of beautiful homemade pastries and espresso to wake up to every morning. No liter jugs of amazing red wine sitting on the table at lunch time. No longer did we have 2 hours to linger over dinner. Back to rush rush rush. With the exception of one little habit I seemed to have fallen into. Wine.

As most people know we Italians love our wine, especially red wine. As a dietitian I have rationalized how good it is for me (and probably the reason my HDL level, the “good” cholesterol, is out of sight). The problem was, during that vacation we drank wine pretty much daily. We did not drink excessively, just often. When a liter pitcher of wine is 4 dollars, why not have it with your pizza while sitting outside under an umbrella in the sunshine on a cliffside in Cinque Terre, or while watching the children chase the pigeons at an outdoor cafe on the island of Murano? After all, You Only Live Once.

When I got home, a meal no longer felt complete without a glass of good wine. Oh, and of course I needed to find one of those glass pitchers that were all over Italy (and no where to be found in stores in CT). I finally found one on-line and was all set. Unfortunately, the reality that I was no longer in Italy and had to go to work took a while to sink in. I found myself sleeping poorly. People think alcohol makes you relaxed and sleep better, but it actually interferes with sleep. And for me, someone who needs to remember to drink water, I found myself getting somewhat dehydrated on a daily basis. Not good.

Since then, I have obviously had to readjust to real life. As I was working on easing back into a healthier lifestyle, I noticed some very interesting things going on in my head. You know, that voice we all have in our minds, often referred to as “self-talk”. I have written about self-talk before, and how important it is to be aware of what you are saying to yourself, as thoughts affect mood and moods then affect behavior. When there is a constant negative dialogue going on, eventually negative, or non-supportive, and often unhealthy behavior results. So, as I have been reflecting on this wine “habit” I have come to the conclusion that it is very difficult to distinguish between when this voice is giving appropriate advice, or when it is basically trying to undo all efforts and progress to a healthier lifestyle. I am passionate about savoring life and all it has to offer. I absolutely LOVE the expression You Only Live Once (YOLO). I don’t believe in rigid anything. Rigid diets, rigid exercise plans, rigid house cleaning, rigid schedules. When life gives you the opportunity to experience something awesome, I say go with it. For example, I was planning on getting some work done last Saturday, but then found out there was a Women’s March in my state that I had the opportunity to join. The work could wait. Sometimes, if I come home from work after a long day and tell myself I need to rest, and my husband had a hard day at work and wants to go our for dinner, I quickly change my mind about that rest. I love rolling with it all. You know, YOLO.

But sometimes, I may come home from an especially chaotic day at work, feel emotionally drained, and cracking open a bottle of wine makes lots of sense. The dialogue in my brain may go something like this: “You deserve it. You only live once!” When this same dialogue happens more than once in awhile, well, an unhealthy habit is formed. That YOLO language sounds more like sabotage.  One definition of sabotage: “any undermining of a cause”. I came to the conclusion it is not always obvious or easy to keep a healthy balance in life when it comes to living that happy-but-healthy-ish lifestyle we all want. How do we find that balance, and know for sure that we need to go for it (YOLO), or that we need to make a different choice because in reality we are sabotaging our efforts, or “undermining our cause”of wanting to be somewhat healthy?

After much reflection, here is my advice to those who can relate to this, and also struggle with the balance between enjoying all life has to offer, yet maintaining healthy balance in life. Remember, this is my experience only. Yours may be different.

  1. Ask yourself: do I have a “cause”? By this I mean a health goal. Is there something your doctor may have identified (high blood pressure, a need to decrease salt), or maybe a health goal you have for yourself (increase physical activity, decrease alcohol, etc). If something jumps to mind right away, then you know what it is. You must also ask yourself it this cause or goal is healthy and realistic. For example, if it is an extreme weight loss goal or anything to do with perfectionism, then it may not be a healthy cause. A true cause typically is more about clear-cut and damaging behaviors you may have fallen into and really do want to change (plopping on the couch, grabbing a drink, etc).
  2. If you have identified a specific behavior you want to change, and it is a realistic goal (litmus test: do most people agree this is a healthy goal?) take the time to identify your triggers. For example, for me, having an open bottle of my favorite wine in the fridge is not too wise, and may be referred to as a “sabotaging environment”. For the person who really needs to increase physical activity for health reasons, putting on your jammies the minute you walk in the door is also self-sabotage.
  3. Once you identify your triggers, modify your environment towards being more supportive. Make it doable. For the person who wants to increase activity, put on sneakers instead of slippers. Start small.
  4. Pay attention to your dialogue without judgement. Notice how hard it is to ignore. Even if you give in (I am putting on my PJs, I deserve it! YOLO!) don’t judge yourself. Instead, reflect on the reality (how many days are you actually putting on those PJ”s, and are you expecting too much to stop this behavior every single day? Can you modify your goal to make it doable?) If you change your dialogue to one of acceptance and learning (“wow, that was harder than I thought. Let me readjust this. On Tuesday and Thursdays I am putting on sneakers). In my world, Friday happy hour is totally good with me. And if a friend I have not seen in awhile invites me to happy hour during the week, I am going. This is not about being perfect. It is about gradually changing bad habits.
  5. Substitute a new behavior for the old one you want to change. Omitting something from your life leaves a huge void. You need to fill it up with something equally enjoyable but more supportive of your goals for health. For me, having a constant cup of hot herbal tea is symbolic of relaxation and serves a similar purpose as that wine. I feel like I deserve it and it represents nurturing.
  6. Instead of jumping right into your old behavior when it feels like a YOLO moment, take 20 minutes to stop and think. Postpone it, take a long hot shower and relax and think about your goals for yourself. Then make a decision without judgement. Is this just an automatic impulse, or is it truly an opportunity that arose, or a true need (you really may be exhausted and need to go straight to that couch). Some days are like that and it’s all good.
  7. Remember, it is repetition that creates habits, both good and bad. Once you get a few weeks under your belt of a new healthy behavior, you do feel better, both physically and emotionally. After a month or so, some new habits will take hold. After this, when you feel a YOLO moment coming on, go for it! Once it is a mindful choice and not just an automatic conditioned habitual response, then it truly is ok to totally enjoy every moment of every day. But, you want it to be your choice, not mindless.
  8.  Give yourself time. Don’t give up! Remember, it is all a learning experience.

I will always want to enjoy as much of every day as I can. I light candles for ambiance, even if nobody is home. I have “happy clothes” which I put on the moment I walk in the door. I may take hours to cook a single meal on Sunday because I enjoy every minute. But, these things don’t interfere with my health. Lack of sleep and dehydration definitely do. If you have something that makes you feel less than optimal, don’t beat yourself up or expect change tomorrow. But do start paying attention to that dialogue in your head. THAT is where to start, the rest will eventually fall in place. And if not, seek help. Life is too short and remember….YOLO!

 

Feeling Stuck and Corn Stalks: Visualizing Change

Clouds and corn“I chopped down a corn stalk yesterday!” my patient (I will call Susie) said as she sat down for our session. She had binge eating disorder, and was in the habit of restricting her intake severely during the day, then after work she would pull into the drive-through of several different fast food establishments on her way home. First for several double burgers, fries and giant milkshake. Then, Dunkin Donuts for a bagful of donuts and large coffee drink. She would gobble this down with predictable feelings of guilt and remorse afterwards. No matter how much resolve she had the next morning (“that’s it! I am starving myself today, I don’t deserve to eat. I will make up for it. And today, I won’t do it” ) by the time 5 pm rolled around, her starving body screamed at her and her conditioned brain went into automatic pilot. Her car just seemed to turn automatically into that darn entrance with the sign that said “Drive-Thru Entrance Here”along with the giant yellow arrow to be sure you do not miss it.

Maybe you can’t relate to this behavior, maybe there is some other behavior that you do that you wish you could stop. Bad habits are complicated and more difficult to change than one would imagine. Sometimes, we look at others and think “how could they do that? why don’t they stop ______” Fill in the blank. Smoking, drinking too much, watching too much TV, not sleeping, starving themselves, binge eating, purging……all detrimental to our health. Why can’t we have more willpower? When my patients start bashing themselves (don’t we all feel kind of bad when we just can’t do what we thought we could do?), it typically is a pattern. We get into what you might consider “automatic pilot” mode, both with our thinking and with our behavior. You may have heard of “behavior chains” . Susie’s might look something like this:

Skip Breakfast and Lunch->Leave Work->Drive by McDonald’s->Turn in Drive Thru->Order Food->Eat in Car->Feel Guilty->Drive by Dunkin Donuts->Turn in Drive Thru-> Order Donuts->Eat in Car->Feel Guilty->Go Home->Eat More, go to bed->Wake up, Skip Breakfast, Skip Lunch, Leave Work and REPEAT CYCLE

My patient Susie wanted desperately to change this behavior, but her expectations of stopping totally and miraculously going home to eat a healthier dinner was not reasonable. Part of the reason is NOT lack of will power, but the reality that our brains are not always under our control when it comes to bad habits. To help patients understand this, and also because I am a visual learner, meaning, I need pictures to learn things, I use a “corn stalk” analogy to explain this phenomenon. First, identify a behavior you want to stop (for Susie, she wanted to stop binge eating fast food after work). Next, imagine what healthy behavior you wish you could do instead (Susie really wanted to be able to drive straight home and prepare a healthier and normal sized meal and not feel guilty).  Now imagine your brain as a very thick field of corn stalks. You have to get to the other side to your “behavior” or outcome. You see a beautifully paved path leading somewhere. It is shiny, made out of beautiful marble, glistening in the sun. So of course, you head down this path because it is so easy, and it is actually somewhat enjoyable.

Unfortunately, at the end of the path lies the exact behavior you have been trying to stop. For Susie, at the end of her nice shiny easy path is McDonald’s. And Dunkin Donuts. And binge eating, followed by guilt. What Susie really wants at the end of her path is a nice healthy meal, and feeling good. But there is no path to that scenario. She needs to make one.

Do you think it is easy to make a paved path through a giant field of corn stalks? No, it is not. Neither is changing behavior. Neither can be done overnight. For Susie to forge a different path, she needs to get herself a hatchet and knock down one cornstalk at a time. After lots of hard work, sweat and tears, eventually a path, albeit bumpy and conducive to tripping…well a path will slowly appear. Susie will actually be able to get down that path to the place she wants to be. Her old smooth beautiful path will still be there. But eventually, that old smooth path will start to be less smooth and easy as new baby corn stalks begin to grow. She will still be able to get by, but it won’t feel as easy or right. Eventually, over time, that old pathway will be covered and pretty much gone. The new path will start to be nice and smooth and very easy to walk down. Maybe not made of marble, maybe some smooth sand, but walking down it will feel pleasant and good, not like in the beginning.

How does this look in Susie’s “real” world? Take a look at her “behavior chain”. What Susie did was pick a place in the chain where she felt she could do something different. She told me “I don’t need to go by Dunkin Donuts. That is actually the long way home”. So the first hard work she did, that first corn stalk chopped down was taking a different road home and skipping Dunkin Donuts. She still went to McDonald’s, still ate too much, still was starving during the day, but she was able to make this change. She felt pretty proud of herself and had some hope. The next step was at the beginning of the chain, the skipping of breakfast and lunch. She did not want to eat breakfast, but agreed to starting to eat something at lunch. This helped her be less starving on the way home and eventually she was ordering a smaller amount of food at McDonalds. Another corn stalk down.

I have had many patients like Susie, all with different issues and behaviors they wanted to change. Those who accepted that change did not happen overnight often went on to change their brains by changing one little thing at a time. Most of us are not that patient, it seems, and so we try to change all at once. When we fail, we blame ourselves. Instead, if we stop and think about the corn stalk field in our brains, maybe we can accept that chopping down one corn stalk, changing even one little thing at a time will eventually get us where we want to go.

So can you think of any unhealthy behaviors you want to change? Then pick up that hatchet, it’s time to chop.