“I know what I need to do, I just don’t do it.”

I hear this from patients regularly.
Translation: I don’t want to talk to the dietician or exercise physiologist; they’re just going to tell me what I ‘should’ be doing and I’m just going to feel bad that I’m not already doing it.

My colleagues and I talk all the time about judgment and how to avoid and manage it in our practice. We are human and thus subject to social norms, pressures, and biases of weight, physical appearance, etc. And yet I know of no other group of people who practice self-awareness and self-regulation more consistently and humbly. Our objective is always to meet you wherever you are, and help you get to wherever you tell us you want to go, with realistic, sustainable suggestions and support. Still, we cannot control anybody’s response to our consults and feedback.

It feels defensive, the ‘I just don’t do it,’ and ‘I don’t want to talk about it’ responses. Maybe people judge themselves harshly, and also anticipate judgment from us? Who wants to bring that on themselves if they can help it? It makes me wonder, when I get defensive about something, what’s behind it in me? How am I filtering an otherwise benign or even benevolent message? My colleagues and I understand the myriad extrinsic barriers to ideal habits, and how thin the threshold can be between doing something healthy and not. For example, a bowl of whole fruit may sit on the kitchen island for days, untouched. Cookies and candy are much easier to grab and go. But when someone cuts the apples and peels the oranges, they disappear in minutes. Where can we each find our cut fruit equivalent for health habit (or any habit) change?

As I completed another amazing conditioning workout at Ethos this weekend, lying on my back feeling where my paraspinals were tightening and recalling some knee swelling of late, I thought back to the one stretching session I did at home in the last week. DUH, my back felt better in subsequent days. Coach Ryan taught me how to do knee CARs months ago, and it always helps. It occurred to me there, recovering on the floor, that I just forget to do these very helpful things. It’s not that I don’t want to feel better, it’s not that I don’t care about my health; it’s not that I don’t believe that stretching and rotating will reduce pain and swelling. It’s just that I haven’t yet made them into a habit. I do cat-camels and CARs before every workout at the gym and at home, just not at any other time. I might do a few standing quasi-knee CARs in the elevator on the way to the office in the morning–why it only occurs to me to do it then, I have no idea. But it occurs to me sometimes, yay!

This realization came with no shame or guilt, no self-flagellation or judgment. “Huh, that’s interesting,” was my main takeaway. And now I’m wondering how many months of aches and pains I could have saved myself before now. So as I write tonight, I consider how I might create cues to get on the floor and take care of my body in this way more regularly. I can make progress, and that’s what matters. Even once a week will be better than what I’m doing now, and I know I’ll feel better after only a few sessions.

Tomorrow when I see and talk to patients, how can I show up so we can all stand in the ‘Huh, that’s interesting’ perspective, and brainstorm together, with curiosity and possibility, how to bridge the ‘know what to do–actually do it’ gap?

We’re all here doing our best. Assessment of current state–what’s already good and what could be better–can be done without shame, guilt, judgment, or negativity. And everything doesn’t always need to be better! Satisfaction and reveling in what’s already great today has absolute value. So if someone tells me they’re good where they are, I’ll stand with them and bask in the goodness. And we can always reassess later–or not.

Off to stretch my back and rotate the knees, my friends! Have a great week!