As part of my profession, I’ve learned a lot of techniques that are not only useful in helping my patients change, but that are useful to help anyone change, including myself.

Today I wanted to highlight how one change technology is particularly useful for instigating and guiding positive changes in ourselves. I’m speaking of motivation enhancement techniques. Allow me to run you through the steps that use MET using a common example. Let’s say I wish to become more fit – improve my health and lose some weight.


To help build my motivation for change – let’s assume I’m ambivalent about embarking on my fitness quest – I need to be clearer on my goals and their benefits.

I can start building my motivation by considering all the downsides of my current state of health. I can contemplate my low energy level, feel embarrassed that by 9pm I’m pooped like somebody’s grandfather, recall that my pants and shirts don’t fit me because of the weight I’ve put on, and remind myself that I can’t run around practicing soccer with my son because my stamina is so low.

Next I can consider the benefits of my new healthier state. I visualize how svelte I will look and how much energy and stamina I have. I list to myself all the projects I’ll complete once I’m able to remain awake and alert past 9pm in the evening. I imagine how much fun I’ll have playing ball with the kids.


Now that I’ve got myself excited about making some changes in my life, I have to define these changes, that is, I need to set some goals. I’m likely to start by thinking, “I want to lose weight and become more fit.” That’s a good first step, but these goals remain vague. I have to add detail and ‘operationalize’ them, if you will, by defining success. So I decide that I will lose 15 pounds in the next 6 months, I will lower my cholesterol level by 15%, and I’ll be able to jog 3 miles – without it leading to hospitalization and arterial grafts.


Now I have some clearly defined goals. However, I’m here at point A and I wish to end up reaching my goals, my point B. The question must be answered, “How do I get there?” The answer, of course, is you have to develop a plan.

I like to tell people that if you have goals without a plan, what you have are wishes that are likely to remain wishes to your dying day.

So, I ask myself, “How will I lose 15 pounds? What exactly do I have to change in order to bring down my weight safely and permanently?”

It makes sense that I start with the easy stuff. And the easiest way to start losing weight – my tip to you – is to change what you drink. Many of us can easily shave 15% of our daily calories by decreasing (or eliminating) fruit juices, sodas, coffee loaded with cream and sugar, and alcohol.

That sounds ‘sound’ but still is not specific enough. I have to think through, “I have a large coffee in the morning with 3 creams and 3 sugars. What will I replace it with? If I decrease the number of creams and sugars, I don’t think I’ll like it. Perhaps drinking a small coffee with 1-2 creams and 1-2 sugars is the better way to go?

So, you see, every point of possible change must be considered.

Here’s another common example of a goal, “I’m going to jog 3 times a week with an eventual goal of jogging 3 miles each time.” That sounds good, but you must follow up with, “When will I squeeze in this jogging regimen? Am I willing to get up early? Oh, and by the way, how much time will it take me to jog up to 3 miles? Hmmm … with putting on jogging clothes and shoes, getting out of my house, running, then getting home and showering … Hmmm .. that’s an hour at the very least. Am I willing to get up an hour earlier? Or is another time of day better for me? …”

I included the above fictional thought process vignette to illustrate that achieving success demands attention to detail. It demands the making of exquisitely specific decisions that almost always include tradeoffs.


Now that I have goals and plan, I have to start acting on them. At this point – I hate to admit it – my motivation is beginning to wane because this process of change is becoming complicated and not that much fun. So I gather up my resolve and let the world know that I’m on my way to a better me! This way if I fail I’ll be just a little bit embarrassed and my fear of embarrassment might help maintain my motivation when the going gets tough – like on the second day.

Perhaps I join a group of like-minded individuals that makes a mutual commitment to reaching their individual goals and helping maintain their motivation.

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As I mentioned, as a person goes through their process of change or accomplishment, their motivation will likely wax and wane.

There are actual websites and apps designed to help you maintain your motivation and commitment by making you pay a price for failing. StickK is an app that allows you place money on the line: if you fail, the money you put up gets donated to charity. And to make that donation unattractive you can choose a charity that is most abhorrent for you to donate to. Donald Trump for President perhaps?


Another thing to incorporate into your change strategy is an openness for learning and making adjustments. I may find that the time of day I chose for jogging, for example, really doesn’t work for me. Or I may find that jogging 3 times a week was simply an unwise commitment for me to make – it’s too much! Rather than throwing in the towel and declaring defeat, perhaps I can adjust my commitment to two or even a single run a week. It’s important to be consistent and build a new habit. It’s better to succeed at a smaller goal than fail at a larger one – at least initially. If I can succeed jogging even once per week with consistency, then I have something to build on. Perhaps after six months of once per week, I can expand to twice a week and do that for 6 months, and then re-evaluate my next steps.

Another aspect of change is that no one is perfect. For example, I’m likely to ‘slip’ and miss some jogging sessions or end up going out and way overeating. This is par for the course. I must accept periodic failure and not allow it to derail my overall plan. I can develop a plan for my inevitable ‘slips’ and ‘inoculate’ myself against feeling despair or giving up when the inevitable setback occurs. I can even develop a plan (perhaps pay a penalty or have a plan for make-up sessions) if I miss a workout or a jog.

I’ll end here. I’d like to ask you to email me with your own change strategies, and any examples and lessons from your life when attempting change.

Until next time,

Dr. Jack


Oxford Dictionary Adds Fun New Words – Butt Dialing and Manspreading

In the news today: Oxford Dictionary added new words. Do you know what manspreading is? Or how about mic drops? Or awesomesauce? How about Mx?

Check out the Oxford Dictionary blog to see explanations.