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Pete is 60 lbs overweight. He was told by his doctor that he has pre-diabetes and then referred to me for weight loss counseling. While Pete says he is eager to get back to his old athletic physique and improve his diet, our work together has a one-step-forward-two-steps-back feel to it. He sticks to his diet and exercise goals for a week or two, but then ends up overturning his progress whenever he gets busy and stressed at work. During times of stress he indulges in frequent dining out, lets his exercise slide, and increases his alcohol consumption. These phases inevitably result in his regaining the few pounds he just managed to lose and sometimes even more. He defends his pattern by saying that after a stressful day he loves to unwind with indulgent restaurant meals and a few drinks, which he does 4-5 times per week. We set small goals around reducing the amount he's drinking, reducing the frequency of eating out, and making healthy choices when eating out, but he rarely follows through. He says that as a lawyer, this is just his life. His position involves a high pace and has certain demands, and people just don't understand all the pressure he is under. I ask him how he deals with all the stress, he says, "I don't know, I just have to power through. I work hard, I deserve to relax and indulge once in a while, God knows I've earned it!"
Pete routinely sabotages his progress and seems to also defend his tendency to do so. But why?
Pete is certainly living in a pressure cooker but that is not the problem. The problem is that he uses unhealthy means to cope with his stress. Even worse, his unhealthy coping via indulgence in food and alcohol seem like an entitlement to him. When I try to chip away at those habits he responds by defending them. This is the push-and-pull of our work together.
The first challenge for Pete will be to realize that the way he copes with his work stress undermines his goals in other areas of his life. He is living lopsided. Are you living lopsided?
Getting upright
Acknowledging the lop-sidedness might be tough for Pete because once acknowledged, the next step is change. At some level, Pete probably realizes that his habits are contributing to his health problems, but he is resistant to change because he doesn’t know what else to do. Asking him to stop his unhealthy habits means asking him to stop coping with stress. That is an unreasonable request. Preaching to him the dangers of his habits will just make him pull away in frustration. The goal of our work together will no longer be to tweak his diet plan or help him figure out the best time to exercise, it will be to focus our attention on building a more robust arsenal of stress reduction strategies, ones that won’t undermine his ability to be the person he wants to be. This may seem like a simple solution, but people rarely explore new stress management strategies, especially when they have ones that work, regardless of how counterproductive they are to other areas of life.
Trying new ways to manage stress is hard because they may not work, and then what are we left with? In my work with Pete, we are focusing on new things he might try to take the edge off the pressure he is under. In this step it is important to be permissive with Pete about his current stress reduction strategies, even though they are unhealthy. I don’t want to take away his supports before bringing in new ones. Instead I want Pete to try a range of new healthy coping strategies in the hopes that one sticks and displaces his desire to engage in the unhealthy stuff.
In my research laboratory we are currently conducting a series of studies based on this approach. We are recruiting people with various unhealthy habits and intentionally not encouraging them to change or lecturing them about the dangers of their habits. Instead, we give them free stuff. What stuff? We give them unbridled access to a wide range of stress reduction activities, from the typical to the bizarre, to allow them to sample various options in the hopes that new habits spring up and displace the old bad habits. We will be looking specifically at the characteristics of successful stress reducers to find out why they work and the duration necessary for the new habit to stick and successfully displace the old bad habits. Our hope is to shed light on an approach that could be applied to a wide variety of problems that are driven by stress, ranging from overeating to addictions.
If you feel like you might be trapped in a cycle of self-sabotage rooted in unhealthy stress reducing habits, I encourage you to go on a "stress reduction binge." Open your mind to a wide array of new activities and see if you can create a new self-soothing passion. Ideas might include exercise, yoga, meditation, dance, massage, an artistic pursuit, a talent or interest, but these are just a small few. The key is to really get out of the box and try things you have never tried.
The tendency to “medicate” our stress with unhealthy actions is the real epidemic of our time. The key to a healthy life lies in the ability to cope with the demands of life without having to compromise your ability to be the person you truly want to be.
Pete is not a real patient but rather an amalgam of many patients used to demonstrate the concept.
