🗒 If you want to see change, make it a habit

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The ancient Roman poet Ovid said “Nothing is stronger than a habit” and two thousand years later these words are as potent a truth as ever.

Helping people establish healthy behaviours is a practice with which GPs are familiar. Habits are incredibly powerful, but can be challenging for individuals to establish – how often do you see good intentions fall down by a lack of consistent action? Whether you consider your own health behaviours or your patients’, you’ll find the same rings true: motivation will get you started, but habit is what will keep you going. As the primary point of contact for health and wellbeing for your patients, establishing your own healthy habits may help you be the best doctor that you can be.

Doctors are busy and time poor. Days can be relentless, and the workload can feel insurmountable. Often, you are tired and the prospect of cooking or exercising becomes challenging. More likely, you want to relax on the couch, stare at the TV, or see what others are up to on social media. You want time to really “unwind” in your own way. Maybe you go to bed late, only to repeat the same cycle the next day.

Your job as a GP is not likely to change in its intensity or requirements anytime soon. So what do you do to avoid repeating a cycle that is detrimental to your health in the long-term? Prominent neurologist and psychiatrist Viktor Frankl tells us “when we are no longer able to change a situation…we are challenged to change ourselves.” So what habits of your own can you challenge?

Is it what you eat?

There are foods that you keep coming back for more. By far and large, this is food that is a perfect combination of sweet, salty and fatty ingredients. These options are often cheap and convenient – in other words – difficult to resist. In a study published by Cornell University, people were asked how many food decisions they think they make in a day. On average, people estimated about 15 food decisions. When measured however, the study found that people are actually making around 200+ decisions around food each day. If you don’t make healthy choices habitual so that it can become a part of autopilot, what chance do you have? Choose your challenge and take a step toward long-term health: 

  • Set up a supermarket delivery to your door if you can’t make the time to go shopping. These can be set up once and saved for next time. Options include: Coles, Safeway/Woolworths, Farmers Direct, Hello Fresh, just to name a few.
  • Live by these rules for your supermarket delivery: eat ‘real’ food, mostly plants, not too much. Refer to Michael Pollan’s series of books on eating in today’s food environment if you need more guidance (and an interesting read).
  • Do not add 'junk' food to your supermarket delivery. Make these occasional foods the items you have to go out and buy separately – in other words – make them harder to get.
  • Spend an hour on a Sunday getting snack and/or lunch items as ready as possible for your coming week. Cut the carrots, slice the cheese, prepare the salad. Whatever it is, prep pays off. Prepare your next day’s lunch as fully as possible the night before. Rather than sitting down when you first get home, make preparing the following day’s lunch the first thing you do. If you have children and you’re preparing their school lunches – do yours at the same time!
  • Even on days where you have nothing prepared, think: fruit and most vegetables require little preparation. Throw an apple, banana, carrot and some celery into your bag everyday as snacks. Nuts could not be easier! A handful of almonds or cashews in your bag can help keep you going. 
  • Invest in a pressure cooker, slow cooker, or both! These items assist you to control your cooking a little better depending on your schedule (for example, you can throw a casserole on the night before and it will be cooked by morning in the slow cooker, or you can cook that casserole in half an hour using a pressure cooker at the end of the day). 
  • Get rid of the sweet biscuits and cakes in the staff room. Plan with your colleagues to create an environment that supports healthy daily habits. 

Is it how you exercise?

One thing that every health professional can agree on is that exercise is a good thing – in many ways. Not only does exercise provide you with physical health benefits, it also protects and promotes your mental health. Exercise is energising, which seems counterintuitive, but it’s true. The Australian Government’s Department of Health Physical Activity Guidelines are encouraging – any physical activity is better than nothing! Given that adults should accumulate at least 150 minutes of moderate intensity, or 75 minutes of vigorous intensity activity each week it is worth finding a way to enjoy exercise habitually. Think about what helps you maintain exercise (you may need to experiment to find out if you’ve never been an active person).

For example:

  • Do you need to be accountable to someone? Get a personal trainer or join a small group gym where you will get to know the people and trainers (try personal training studios, HIIT studios, yoga and Pilates studios, or CrossFit gyms). Most gyms offer a trial – try a few and find the one that suits. 
  • Do you need to be having fun? Plan exercise with a friend or colleague, or join a sports club. Try different forms of exercise to find what you enjoy.
  • Are you restricted on time due to family commitments? Offer to referee your child’s sports match and do some running around, join a club where you can take your children with you, or do physical activities with your children (but beware, there’s nothing like a little running race against your seven year old to make you feel  ‘slow’)
  • Do you need a goal? Join a run club – for example, Park Run – or get a run coach and set a goal, for example, running 10km
  • Do you need the exercise to be integrated as ‘incidental’ activity? Park further away from work, or get to work a little earlier and go for a power walk around the block, ride to work, or walk to get some of your food or groceries.
  • Do you need a reward? Define a treat however you like, and give yourself a reward to look forward to if you’re struggling to make it through a session. 

Is it how you sleep?

In her book, The Sleep Revolution, Arianna Huffington, writes: “Much of our society is still operating under the collective delusion that sleep is simply time lost to other pursuits…” But here are the facts: just two hours less sleep a night can have a major impact on work performance and make you irritable, clumsy, unmotivated, distracted, indecisive and forgetful. According to the Australian Unity Wellbeing of Australians report, getting six or less hours sleep a night leads to lower wellbeing, both physical and mental. Aiming for at least seven hours can make all the difference. Sleep loves routine:

  • Try to go to bed at the same time every night and wake at the same time every morning. Establish a thinking / relaxing pattern when you’re in bed (for example, listening to or thinking about something soothing) that let’s your brain and body know it’s time to sleep.  
  • Avoid all stimulants like caffeine and alcohol for at least an hour before bed and finish eating at least two hours before bed. 
  • Have a buffer zone well before bedtime to reflect or plan as needed. Do not use time immediately before sleeping to search online or go down the rabbit hole of social media.
  • Turn off your mobile phone, iPad, or at least put it on silent and out of arms reach. Turn off bright lights and lamps at least an hour before bed. 
  • Keep your bedroom quiet and dark with comfortable bedding suitable for the season.  
  • Staring at the clock when you can't sleep actually raises cortisol levels, making it more difficult to fall asleep. Try turning your clock away from you.

A final say on healthy habits 

Plan for failure. In her book ‘Rethinking positive thinking’ Gabriele Oettingen explains that conventional positive thinking approaches to motivate miss a crucial element of success – focussing on the obstacles that stand in our way. The very thing that most of us are taught to ignore or diminish, are your way forward. 

So, regardless of which area of your health you would like to improve, do not wait for a breakthrough in your own ability or attitude to undertake change. It’s not coming. Instead, focus on the daily discipline of improving your routine habits. Plan your habit formation through following these three steps (and for each step be specific, be measurable and be mostly realistic):

  1. Decide on your outcome
  2. Plan for your obstacles
  3. Stick to that plan

When you fail, review the failure, plan and try again. This will be a cycle you continuously live with as you break and make new habits. Be consistent and be prepared. It is consistency and repetition that matters.
You will find that once you’ve repeated a behaviour often enough, your feelings and attitude will follow. Going to gym will begin to feel like an “unwind” activity in the evening rather than a chore, eating healthy will feel the norm, and buying ‘junk’ food will hold less reward. Hard to believe, but it’s true: nothing is stronger than a habit.

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