THE HEALTH CONVERSATION, Chapter 4: Key Tools To Tame Your Health

Key Tools for the Book

Like any plan of action in life we need a combination of luck, skill and preparation. Thankfully you are just reading a book and so I would hope that the first two are not needed in too much abundance. The final one, preparation, is what this next part of the book is about. In the next few pages I want to tell you about three key tools that I want you to try and apply to yourself as you go about reading this book. These tools are (1) The Knowing-Doing Gap (2) The Cycle of Change and (3) Self-Motivational Interviewing. Now yes, I would like you to digest these three tools applying them to your own life as your browse this book but I also want you to remember that you can apply these to any part of your life – not just your health. Consider how they may be useful in work or with your family and friends. As promised there is no whale music featuring in The Health Conversation so you can blow out the joss sticks and turn off the meditation CD for now.


Tool One: The Knowing-Doing Gap

The “Knowing-Doing” gap is one of my favourite principles. It makes me smile just to think about it and its simplicity actually. Remember, simple is good. Now, I want to share it with you, not just because I clearly have a literary crush on it but because it frames the very ethos of The Health Conversation. In doing so, it help make sense to you as to why some of this book is just so bloody simple and straightforward.

Now I first read about the “Knowing-Doing” gap in a business book. Much to my disappointment and frustration I still cannot remember what the book was called. But anyway, let me still share with you the story within it. Picture a packed, high-profile glossy, no-expense spared conference centre in North America. The conference centre is packed full of high-flying executives, most of whom were at the top of their respective companies – CEOs, CFOs, CMOs, and the ‘Who-knows’. They were all there waiting to receive the invitational key-note speaker of the conference – the executive of executives who conveys an almost God-like presence. Forty-five minutes later this executive deity finished his speech.  Unfortunately for the paying delegates however, he had just spent that 45 minutes telling the packed conference centre of experienced executives exactly what they already knew about running a company and how to behave in business. Naturally the delegates sat there feeling slightly short-changed. It’s like asking for a Sunday Roast Dinner – and getting a corned beef sandwich instead. Disappointing to say the least. Of course being a room of alpha-male and female personalities, someone put their hand up and brazenly asked the question that everyone was thinking: “Thank you, Sir, for a wonderful talk. However with respect, don’t you think we knew all of that?” The key-note speaker just smiled his deity-like smile and replied, “Now, be honest and show me the evidence that you actually DO what you KNOW you should do in your business.” The penny had dropped. This was no message from a higher-being; this was just someone saying how it is:

We know what to do – but more often than not, we don’t do it.

What a wonderfully powerful, yet simple message.

The reason I wanted to share this with you is because it translates as readily to your health as it does to the above business example. What you will read in this book you may already know a lot of – which is brilliant. All I am trying to do is highlight that fact. In doing so, I want to prompt you to actively think “I know this – but maybe I just don’t do this”. In essence I want to make you aware of your own “Knowing-Doing” gaps. This is the first step to realising that change can and is possible.


Tool Two: The Cycle of Change

This leads us nicely onto the Cycle of Change. Now I wanted to introduce this principle to you because we are all, whether we like it or not, in it. You may knowingly be trying to change or perhaps stuck stagnating on the Cycle of Change because you have not even considered changing a habit or lifestyle choice. That’s the beauty of it, it covers all bases.

To explain further, I want you to think of the Cycle of Change as a journey. It starts with a thought (or actually even before the thought) and proceeds along a journey over days, weeks, months or years to an action. It is this action that elicits a change in some part of your life. Even then your journey is not over, for we sometimes either needs to make efforts to maintain that change or sometimes we simply relapse and need to begin again at a point further back down the Cycle of Change. The points along your journey to change have specific sign-posts. What we’re going to do now is briefly touch on each of the sign-posted stages so that you can go away and consider where you are on the cycle for various things you may wish to change in your life.

First in the Cycle of Change comes pre-contemplation (Stage 1). Here you have not even considered changing something. For many of us there may be elements of our life which we should consider altering to improve our health but we simply haven’t reached a point in our lives where we need to or can even think about doing so. When we do however, we enter the second sign-post on the journey – contemplation (stage 2). Here you are considering a change but you have not yet planned or acted upon it. As this contemplation and resolve to enact upon your new desire grows, you are led nicely to the third stage – preparation (stage 3). This stage is all about preparing for your change to happen. It may be that you seek out who will support you on your decision to change or you are planning what elements of your life may need to change for it to be successful. You can only advance to the next stage successfully (unlike Monopoly, you don’t collect £200 when you pass GO) when all of the preparation stage is complete. If it is, then you can happily proceed to the fourth stage –action (stage 4). This is the stage where the change takes place. It is often the most high risk stage as it calls upon those two elements I asked you to have earlier – patience and hope. From this stage two eventualities usually happen – maintenance or relapse (stages 5). Both are equally important to the process of change and you can definitely learn from either. In a maintenance stage you reinforce your change and thereby further concrete it for life. In a relapse stage you will have experienced a hiccup and broken that change. That’s ok though – we are human after all! Besides, we learn the most when we are failing. If this does happen, all you need do is get up and dust yourself off, and move back to the preparation stage of the Cycle of Change again. From there its simple – you proceed forward again, this time with some added wisdom!



Tool Three: (Self) Motivational Interviewing

The final tool I want to share with you is what those in the medical profession sometimes refer to as motivational interviewing. Now if Lord Alan Sugar springs into your head with his sturdy finger pointing at you as he grumbles “You’re fired!” then you can relax. It actually has very little to do with interviewing. In fact, come to think of it, I have no idea why they even bother calling it that – though I’m sure somebody with a bigger brain will correct me after this is published. Instead I want you to think of Motivational Interviewing as a conversation. Now this may often be a conversation between you and somebody in the healthcare profession such your GP, a specialty doctor, or you and your personal trainer, for example. That is all great, don’t get me wrong. However what I want to say to you is that perhaps, for those of you who are maybe a little bit shy, don’t want to speak to a health professional right now, that Motivational Interviewing can be just as much about having a conversation with yourself. Hence, Self-Motivational Interviewing. I love it and do it all the time.

So what’s the conversation about? Well since it’s your conversation, it can be anything you want it to be about. As a guide for you, I like to think of mine incredibly simply and ask myself questions like:

  1. What is my health goal?
  2. Why is this health goal? (After all this is what is fuelling it, right!)
  3. What is stopping me from achieving my goal?
  4. How can I overcome these barriers to my goal?
  5. How can I break the actual goal (not the barriers) down into bite-size achievable chunks?

The final point is really important as some goals can just feel utterly insurmountable. And you know it is of course a very personal issue. For example, for one person, losing 5 pounds of body weight may seem like a terrifying and unachievable proposition. For someone else however this may be easy and yet they have instead blinded themselves with the enormity of setting a self-imposed 5 stone loss target. The trick with any goal is to agree bite-sized goals. They will after-all add up to that final goal; the one that you’ll finally turn to, your head at slight angle and a Wild-West Clint Eastwood squint in your eye, and growl  “Huh, you ain’t so scary after-all”.

So there you go, three tools to have in the back of your mind as you read this book: The Knowing-Doing Gap, The Cycle of Change and (Self) Motivational Interviewing. As we now amble onto the twenty one health conversations for twenty first modern living please don’t be afraid to flick back to these to refresh your memory. Alternatively you may find it useful as you go through the book to take a time out with a piece of paper and a pen when something really grabs your attention or sparks an idea.

Remember, like that friend we talked about earlier, this book is not on your Christmas card list!

Chapter 5 will be out next week! Follow me if you like at @drnickknight on Twitter!


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