By Steve Simmons, MD
What do New Year’s Resolutions tell us about ourselves? Will they cast light on our hopes for the coming years or embody regrets best left in the year past? Resolutions tell us about our hopes, about who we want to be, and if made for the right reasons can lead us to the person we wish to be tomorrow. A positive approach utilizing the support of family, friends, and caregivers will help us follow through with our resolutions and improve our chances for success.
For the last two years, resolutions to stop smoking, drinking, or overeating, have ranked only ninth on the New Year’s Resolutions list, while getting out of debt, losing weight, or developing a healthy habit are the top three. If you find this surprising, you are in the company of many physicians. Yet this demonstrates the positive approach preferred by a majority making a New Year’s resolution. For each person making a resolution to stop or decrease a bad behavior, five choose to increase or start a good behavior, instead. We can learn from this and maintain a positive focus when considering and following through on a resolution. Keep in mind that only 40% find success on the first try and 17% of us need six tries to ultimately keep a resolution.
Avoid making hasty New Year’s resolutions based on absolute statements, which all too often meet with failure at the outset. We recommend an approach based on The Stages-of-Change-Model, developed from studying successful ex-smokers. For 30 years, primary care doctors have used this model to help their patients successfully rid themselves of a variety of bad habits. The Model’s foundation is the understanding that real change comes from within an individual.
Below, I’ve outlined the five typical stages a person progresses through in changing a behavior, using the example of a smoker:
1. Stage One/Pre-contemplative: This is before a smoker has thought about stopping.
2. Stage Two/Contemplative: A smoker considers stopping smoking.
3. Stage Three/Preparation: The smoker seeks help, buys nicotine gum, etc.
4. Stage Four/Action: The smoker stops smoking.
5. Stage Five/Maintenance and Relapse Prevention: Still not smoking, but if our smoker smokes again, keeps trying to stop, learning from mistakes.
The family and friends of a resolution maker are an intrinsic part of success and should avoid a negative approach. Instead, help them move through the stages, advancing when ready at their own pace. The following exchange is typical of an office visit where a spouse’s frustration spills over, finding release:
“Dr. Simmons, Tell John to stop smoking!” John’s wife demands of me.
“Mr. Smith, you really should stop smoking,” I request of John.
“Well Doc, I don’t want to and that’s not why I’m here,” John says, pushing his Marlboros deeper into his shirt-pocket, clearly agitated with his wife and me.
“I’m sorry Mrs. Smith, John doesn’t want to stop, perhaps I could hit him over his head, knock some sense into him?”
Once negative energy has been interjected between me and my patient, I struggle to find an appropriate response. Should I use humor to redirect? I have rarely seen someone stop a bad habit after being berated. I would prefer a chance to help him think about smoking and how it’s affecting his health. Does he know that smoking is making his cough worse? Has he been thinking about stopping lately? Nagging seems to be more about our own frustration than a desire to help and should be avoided since the effect is usually the opposite intended.
A resolution can show the path to a happier and healthier life. If you or someone close to you is planning to make a New Year’s resolution, just start slow, stay positive, have a strong support network….and one more thing: Resolve to stay Resolved.