14 Oct Making a Plan to Improve Your Wellbeing | Part One
Dr Richard Pile, a doctor and GP, shares his thoughts on how making a plan contributes to long-term lifestyle changes.
When broaching the subject of making a plan in my early days as a GP, I decided that many of my patients who needed to make lifestyle changes also had undiagnosed conditions that resulted in problems with their planning processes. Some cases stood out, like the man who was still popping out for fag breaks in between ward rounds on the coronary care unit after he’d had his heart attack. Or the elderly lady with furred up arteries in her legs who looked me straight in the eye and told me that she was more scared by the thought of life without cigarettes than she was by the below knee amputation that she was heading relentlessly towards. Surely the only explanation was stupidity or a death wish? Or so I thought.
Years have gone by and I have learnt a lot about people, which is an inevitable and highly desirable side effect of working in primary care. I have spent time talking these things through with patients. I have read round the subject of behavioural psychology and spent time discussing these issues with psychologists and other colleagues. At One You East Sussex, we are working with the Centre for Behavioural Change to ensure that all our practitioners are appropriately skilled in this area to help their clients, offering a service that is more than just education about giving up smoking or losing weight.
For the purpose of today’s blog post, I am going to share with you a small but important part of what I have learnt over the years. It’s not very clever or surprising. Neither is it difficult. Everyone can do it. It’s about having a plan.
Why do we need a plan?
Humans are not rational creatures. We assume that because we have been well in the past we will be so in the future. We cleverly avoid joining the dots with all that we know about what is likely to happen as we get older. We know that there are theoretical risks of things happening, like heart attacks and cancer and road accidents, but we assume that somehow we as individuals are exempt from this risk, unlike everybody else in the world around us. I’m sure you can see the potential flaws in this reasoning. When things unravel, they can unravel quickly. Even when things are not yet seriously unravelling health-wise, people are often still aware of their wellbeing issues.
When people fail to make changes that are needed, it isn’t because they don’t know what to do. It’s because they either don’t know how to do it, or they do know how to but have no plan in place to make it happen. I know that I would like to catch up with my brother for breakfast over the next few weeks. I also know based on the endless games of message-tag we play that via text, facebook messenger, what’s app and email unless we actually make a plan, it will never happen.
Do wellbeing plans work?
Plans are not foolproof. Otherwise we wouldn’t refer to the best-laid ones or talk what the road to hell is paved with. They do, however, increase our chances of making and sustaining the changes that we want to. There are various reasons for this.
Accepting the need to make changes
Firstly, making a plan to change means that we have generally (perhaps grudgingly!) accepted that there is a change that needs to be made. Maybe you’ve been along to see your GP, practice nurse or health care assistant and a few issues have been raised that you concede might be worth a look at – that weight you’ve been meaning to lose for years, your need to quit smoking or reduce your drinking because of the effect it’s having on your health, or perhaps your worries about getting a bit fitter as you move into middle age.
Being specific about the changes
Vague plans are not much good. “I will lose weight/eat fewer biscuits/do more exercise” might work for a small minority, but for more people it will never translate into anything. Why? Because they have leapt straight to the desired outcome and are too vague. We need to be clear about what we are going differently that will result in those outcomes. Each step in the process needs to be considered, broken down into even smaller steps if required, to see how realistic it is and what needs to be done in what order. A plan makes it easier to achieve than a one-off mental note to self or vague intention.
A plan makes us accountable for the changes
If we have a plan, it means that we are accountable. Not just to ourselves, which helps a bit, but potentially to others, which significantly increases our chances of success. Letting other people know what you are doing and even asking one or more of them to be a referee and hold you accountable means you are more likely to follow through.
A plan helps us to measure success as well as failure
If we have been specific in terms of what we want to achieve, how we will achieve it and how we will measure our success, then this will help us by encouraging us when we achieve what we have planned (which increases the chances of making further changes and sustaining what we have already done) as well as maybe challenging us with the areas where it hasn’t quite worked out yet. The plan can always be changed when we learn as we go. Putting rewards into the plan for when we achieve each stage of success can be quite motivating as well.
Keep an eye open for part two if you want to find out my top tips for making your wellbeing plan. If you don’t want to wait sign up to One You East Sussex for free access to a health coach who will create a wellbeing plan that’s tailored to you.