Has your doctor told you that you are making yourself sick, that your pain or disability will continue to get worse until you change your lifestyle?  Perhaps you have had trouble complying with doctor’s orders about alcohol, cigarettes, street drugs, prescription pills, physical therapy, losing weight, getting exercise, eating a balanced diet, or changing your high-stress lifestyle.

If you read the rest of this article and get turned off, I hope you will at least have the courage and wisdom to ask yourself the question at the end of this article.  Meanwhile, if you have tried over and over without success to change your ways, if your loved ones have asked you repeatedly to stop what's making you sick, if you know deep down inside now that you are your own worst medical enemy (and perhaps also your family’s), these insights and suggestions are for you.

Up Front Motivation

1.  Ask your doctor to predict your medical future, both if you do and if you don't shape up.  Ask for specifics, about months and years, about the predicted dates of losing this or that ability or freedom, and about how the doctor believes it will affect your friends and family one way or the other.

2.  Ask the doctor if there are any cost-effective ways to encourage or measure your compliance:  nicotine substitutions, weighing daily on a digital scale, blood or urine tests, physical therapy reports, new medications for alcohol abuse, etc.  Does the doctor know any other people who have made similar lifestyle changes, and would be willing to support you in this change of lifestyle?

3.  Share this information (every single detail) with your family and friends, and ask them to tell you how they will be affected over time by your choosing medical compliance, or on the other hand, your choosing continued unhealthy behavior.  Give this article to them, so they know what you can do, and what they can do.  Another article is coming next week or soon, to guide them in how to help you.

4.  Make a written analysis of why this is so hard for you. Start by listing and then rank-ordering the situations that tempt you to unhealthy behavior.  Consider the following :

A.  Mental triggers:  dread, boredom, lack of hopes or goals, or unhealthy or unrealistic beliefs about God, your family, friends, work, health, control, revenge, entitlement, unconditional love, euphoria, nirvana, etc.  (You might need a friend or counselor to draw your thoughts out, and help you identify the sick ones.)

B.  Physical triggers:  being hungry, tired, on a caffeine or junk food high or low, etc.

C.  Emotional triggers:  feeling unattractive, scared, insecure, angry, hurt, shameful, discouraged, elated, embarrassed, jealous, craving something or someone, dreading or craving sex, etc.

D.  Situational triggers: the setting is too lonely, boring, structured, chaotic, stimulating, tempting, or you have failure, money in hand (or none), a tempting friend or group, etc.

E.  Relational triggers: being rejected, ignored, refused, criticized, patronized, suckered, ordered around, etc.

A and B arise within you, and D and E are external situations you run up against, but you also seek and provoke. C comes from both inside and outside of you, but everyone is fully responsible for coping with their own emotions.

Healthier Behaviors

5.  List constructive alternative responses that will reduce your frustration and temptation in these situations.  For example, some people benefit from buying time (“I’ll think about this and get back to you”), prayer (the Lord's prayer, the serenity prayer, Google St. Francis’ “make me an instrument” prayer, write out your favorites), inspiring thoughts(Google AA slogans, list your favorite sayings and Bible passages, see the tab here for “New Proverbs”), calming behaviors (cardio or yoga exercises, deep breathing, muscle relaxation, visual imagery, visual and auditory relaxations and distractions), reviewing consequences(next section below).  Keep a list of these coping strategies on your person at all times.

Backside Motivations

6.  Plan and imagine rewards and punishments.  Set up short, medium, and long-term goals for your behavior (the number of pounds lost, miles walked, weeks clean and sober, etc.).  Plan to reward yourself at each of these points in time, and plan with others how they can best reward these accomplishments.  (You may want to do this all by yourself, but this would be as foolish as a physician who tries to treat himself:  both of you would have a fool for a patient.)  So agree with two or three people on how they can react to you in ways that will help you stay on the right track, and report to them at regular intervals.  (You might want to ask if there is anything in their lives that they want to be accountable to you about in return.) When you have had a bad day or time, remember that self-administered punishments (e.g., giving up TV shows, or doing household chores without being asked) work way better for stopping your unhealthy behavior than other people criticizing or punishing it.

7.  Ask your loved ones to follow your lead.  Tell them as much of this as you can: “When I've treated myself well, you treat me good too.  When I've been bad, just leave me alone, and don't help me with anything. Wait till I have shown a change of heart by admitting my mistake, punishing myself in some way, and asking you to help me start over. Meanwhile, just walk off-- no lecture, no further interaction, no hanging out in the same room together, and especially, NO EMOTION FROM YOU.  Let me feel all the emotional pain.  Seeing yours just gives me a temptation and excuse to mess up some more, and distracts me from my own painful emotions. I need my painful emotions to motivate my healthier behavior, not yours. Whatever you need me for, find someone else for now.”

8.  Ask your loved ones to speak your love language strategically.  You might have a different one, but the five most common love languages are:  words of affirmation, quality time, physical touch, receiving gifts, and acts of service.   Know what your favorite love languages are, and ask your significant other to speak them to you only when you have been taking good care of your health.  Otherwise, those parts of your loved ones go on strike.

            For the public good, an evolving copy of this article has been posted on my website given above, under the homepage tab of “Doctor’s Orders”.  I invite readers to send any suggested improvements for this piece to my email ([email protected]), because any help you can give may add years to someone’s life, and peace to someone’s home.  The same will go for my next column written for the friends and family members of people who are defying doctor’s orders for their health.

One last question for you:  if you think you can still enjoy and manage your life successfully without following these suggestions, how would you ever know if you were wrong—what would it take to convince you?


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Dr. Paul F. Schmidt