What motivates you?

What motivates you to get out of the bed in the morning, to take on the world, to be present? The answers to these questions are vast and diverse. Our motivations are highly personal and stem from a complex interplay of our unique experiences, singular beliefs and values. I think about motivation a lot. This is especially true when I am in clinic listening to patients: I try to understand their point of view, their values and what their health goals are and why.

Make yourself accountable to you. Write a letter to yourself about your goals, your motivations, and why you want to be healthy. Be real and raw. Be honest.

In preventive medicine, the goal obviously is to prevent disease. In the United States, a large burden of disease derives from lifestyle-related causes, or what is known in low-income nations as non-communicable disease (as opposed to communicable diseases like infection). In the United States, millions of people live with chronic diseases such as hypertension, heart disease, type II diabetes, liver disease and obesity. These are all preventable.

To be an effective clinician, I often think about how to counsel patients. How do I motivate them to change their behaviors to meet their health goals? Using techniques of motivational interviewing, we clinicians attempt to engage and understand patients’ motives for their behaviors. After some time, I noticed a few patterns emerge. To be successful in helping patients have motivation, we need to assess and understand their point of view.

Anecdotally, I’ve learned a few interesting things from my patient experiences about motivation:

  1. Autonomy is important. Patients are more motivated to implement healthy behaviors when they psychologically feel in control of their lives. This is an especially real challenge for patients who have developed a learned helplessness from years of trauma, childhood abuse or domestic violence. Feeling powerless is a motivation drain. The challenge for the clinician here will be to address the underlying issues of powerlessness and make sure the patient has the emotional support system and resources to help them through.
  2. Value is important. Patients are more motivated to change their habits if the change is aligned with their personal beliefs and values.
  3. Feeling capable and competent is important. When patients feel they are able to execute their goals, they are more likely to carry them through.

All this talk of motivation gave me pause to reflect on my own motivations, and how I maintain motivation in my own life. And I will be perfectly honest: my motivation to practice health is hard to keep when I’m tired, sleep-deprived, stressed, feeling overwhelmed, agitated, hangry…which tends to happen on a daily basis. So, even though I counsel patients on how to stay motivated and on the importance of healthy lifestyles, I am honest with my patients and myself that healthy can be hard work, and sometimes the well of motivation runs dry in my camp, too.

How do I maintain healthy habits when my motivation is running low:

  • Automate behaviors that my future self will thank me for: The summer before I started medical school, I took up running. I started small with 5 minutes of just jogging around my lock and gradually worked my way up to running 2 miles every other day. It was a conscious choice to take up running in preparation for the physical, mental and emotional stress I knew the experience of medical school would be. I wanted to create healthy practices that became so second-nature to me that NOT doing them wouldn’t fit with the lifestyle I had created and grown accustomed to. It paid off! I kept up running while in medical school and actually found solace in my daily runs as they would often be the only times I wouldn’t be sitting in the library or in a lecture hall. I had automated exercise, and my future self now reaps the benefits with low blood pressure and being able to keep up with my varsity track runner brother!
  • Create efficiency through organization: We create a lot of inefficiency when we lose moments in our day looking for misplaced keys or when we forget about an important task on our to-do list. My solution is to dedicate some time every day to organize: prepare your work bag, choose and lay out your outfit, write or type out a to-do list of all the important things you need to do (this is an especially great exercise because you feel like you’re emptying your head of soon the little things you need to do and putting it on paper), prepare your lunch or prep all your meals on the weekend. The point is organization and planning helps free up time and makes you more efficient and productive. It’s a no brainer, I know. But in practice it’s easier than done. So how to motivate yourself to stay on task and organize: think about how stressed you would be if you didn’t, project to the future and imagine how you would feel  if you prepared and if you didn’t. Would you feel confident, satisfied, enthusiastic OR would you feel frazzled, anxious, overwhelmed?
  • Limit my choices to healthy options: This one is in specific relation to food. I stock my fridge and pantry with healthy foods…mostly (…the big tasty bag of vegan marshmallows is staring lusciously at me as I write this…). The reason I do this is to limit my choices to healthy ones, and that makes it easier for me to decide what to eat; it essentially removes the burden of temptation and teaches me to start craving the healthier options.
  • Make yourself accountable to you: Write a letter to yourself about your goals, your motivations, and why you want to be healthy. Be real and raw. Be honest. This is a letter TO YOU and FOR YOU. This is a letter to your future self in distress or panic or depression when or if the time comes. Keep the letter in an envelope and set it aside. When all else fails, and you totally have no motivation to do what you set out in your goals, read the letter. And hopefully it will bring you back to your goals and to remind you the reason behind your motivations.


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