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	James L. Holly, M.D.

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Your Life Your Health - Lessons Learned From a Tree: Principles of Change to Improve Your Health

James L. Holly,M.D.

November 15, 2007

Your Life Your Health - The Examiner

Last week, we examined lessons learned from a tree, and concluded that study with the following statement, "Whether you are a healthcare provider, or a healthcare provider who is a patient, the need is the same; it is imperative that we make changes and that we sustain those changes. The former is difficult; the latter is where most of us fail. Next week, we will discuss ways in which to successfully make and sustain changes in our lives whether provider or patient."

When looking for ways of sustaining positive conduct which can change our lives, indeed, which can sustain our health and change our future, we often look first for methods when we actually should be looking for principles. With principles, it is possible to erect on the foundation of sound principles methods which give sustainable power to change your future. While the purpose in this discussion is not sectarian it is impossible for me to think about principles without looking to the "source of principles," which provide instruction for my personal life. That source is the Bible. And, it is not necessary for anyone to believe what I believe about the Bible in order to benefit from the principles found there.

It is in the Bible that I personally find understanding of how we can help one another sustain changes in our behavior which will provide long-term health benefits. In a book of the Bible called First Thessalonians, the writer commends a group of people who have made and sustained changes in their lives over a long period of time. He said, "we never forget that your faith has meant solid achievement, your love has meant hard work, and… (your) hope…means sheer dogged endurance in…life." (Chapter One, Verse three, paraphrased in Letters to Young Churches, J. B. Phillips, McMillan Company, 1955)

"Solid achievement, hard work, sheer dogged endurance," these are the traits required of those who will make and sustain change. In fact, faith, love and hope - in other places these are called "faith, hope and charity" - are the foundational principles upon which we must build if we are to "make a change which makes a difference."

Before we begin let's define our terms.

"Faith" is defined in the Bible as "having full confidence in the things we hope for; it means being certain of things we cannot see." (Hebrews Chapter Eleven, Verse one, IBID) In non-sectarian terms, "faith" defines the goals on the basis of which we will know if we have "achieved" our purposes. Faith really tells us what we are after. Faith tells us where to go.
"Love" is not a feeling but it is the tangible product of faith. Dr. Phillips paraphrased another biblical passage and describes the kind of love which transforms and sustains our actions. He said, "This love of which I speak is slow to lose patience -- it looks for a way of being constructive…Love knows no limit to its endurance, no end to its trust, no fading of its hope: it can outlast anything. It never fails." (First Corinthians Chapter 13 Verses four through eight, IBID) In non-sectarian terms, "love" is the empowerment - it is the energy -- which allows the individual to be relentless, not losing patience; to be goal-directed, not being distracted by competing ideas or interests; to be indefatigable, not wearing out; to be focused, not losing sight of the goal, and to be successful, not failing.

Love is the energy which allows us to daily pursue our goals and to achieve our purposes. "Love" is really a commitment, a person allegiance and resolve, which allows us not to give up on the object of our faith. Seen in its elements - commitment and passion - loves application to sustainable healthcare initiatives is ease to understand.

"Hope" means expectation, but more than that it means the confident expectation and the certainty that the expectation will become a reality.

The relationship of the three concepts in relationship to sustaining healthcare changes can be summarized thusly: "Faith" tells you where you are going. "Love" tells you what is going to get you there. "Hope" is your confidence that you will get there. Hope really is your affirmation that if I make a change; it will make a difference.

Starting: the first requirement for finishing

All three of our principles are required "to start." Without knowing where you are going; without a commitment to go there and without the confidence that you can and will get there indifference will cause you to continue to delay changing.

While there are many things which all of us have started and have not finished, none of us have never finished anything which we did not start. Now before you say, "That's silly," think about it. As humans, we are often so focus on the goal, the product, the endpoint that we forget that every journey, no matter how long, begins with a single step.

To succeed, to achieve our end-point in any initiative, the process must be more in our mind than the product. In health, the process of getting healthy has to become the daily focus of our attention rather than the goal. Here grammar is important. The use of the continuing tense of the verb "to get" is appropriate. The process of "getting" is the focus with its sense of an on-going process. The time required to reach a goal is often too far off for the goal to successfully sustain our attention. Second, the only thing we can do about our health is what we do today. Therefore, if we succeed today, and we succeed tomorrow, and if we succeed the next day; if we continue to focus on daily success, without regard to an endpoint, we will inevitably succeed.

The greatest opportunity for impacting one's health is presented by the calendar and the clock. Concepts such as the new year, today, this morning, etc., all present beginning points at which we may make a decision about changing our health. This is illustrated by a group of ladies whom I observed in a water aerobics class. In October, 2002, my column was entitled, "Exercise for Life, Something is better than nothing." (The full text of that article can be found below) That article stated:

"It is my habit to walk five miles five days a week. Saturday morning as I walked, I noticed a group of ladies in a water-aerobics class. They were older and overweight. As I continued my walk, I realized that exercise for health is not a competitive sport. In order to benefit -- indeed, in order to win -- you don't have to beat someone else, or be better than someone else; you simply have to improve your own performance gradually and continue the process over a long time. This is not unlike Mikhail Baryshnikov's declaration, "I do not try to dance better than anyone else. I only try to dance better than myself."

As I continued to walk and as I continued to think about these ladies, I realized how smart they are. They want to live well, while they live, and they are doing something about it. That's smart! They don't have to do a great deal; they don't have to be competitors with others; they simply have to take responsibility for their own well being and determine to start and to continue exercise for the rest of their lives.

Starting and starting over is the process of success

Implicit in the first concept about beginnings is another that is equally simplistic: It is better to fail a thousand times than to succeed once doing nothing. While the calendar and the clock relentlessly move forward, they both also provide us with the opportunity to start over. No matter how often we have started and stopped; no matter how often we have failed, however, we may measure or judge failure, we can begin again.

In reality, with any initiative for our health, success is always marked by starting and stopping. The difference between those who achieve their goals, or who at least move toward their goal, and those who do not, is the time between the realization that you have failed and the determination to begin again. If the failure is indiscretion at a meal with overeating, it is possible to acknowledge that failure and to begin again at the next meal. Weight gain is not measured in months but in meals. Success in moving toward a goal in weigh reduction is not measured in pounds but in decisions about the next meal, snack, or exercise opportunity.

In 1910, Teddy Roosevelt gave a speech at the Sorbonne in Paris. In that speech, he said:

"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, and comes short again and again, because there is no effort without error and shortcoming; but who does actually try to do the deeds; who knows the great enthusiasms, the great devotions, who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who know neither victory nor defeat."

Faith, love and hope give us the courage to start. And, they give us the ability to start over when we have failed. Inherent in these three principles is a fourth and that is "forgiveness." Forgiving others is often the easy part of this decision; forgiving ourselves is what is most often difficult. When we fail, the goal has not changed; when we fail, the possibility of success has not changed. The only thing which has changed is our passion and our commitment. Often constructive self-love has turned to destruction self-loathing. The act of forgiving ourselves allows us to renew our commitment and to regain our passion and begin the process anew.

Inertia: An element of success or failure in health initiatives

It is a psychological fact that success and failure in health initiatives have inertia of their own. This simply means that success tends to breed success and failure tends to give birth to failure. But, rather than being defeated by this reality, it is possible to turn it to one's good. Building on prior success in the case of a positive result, or being released from the pessimism resulting from prior failures are both mechanisms in the process of change which lasts.

Get Going

How can we capture the potential of a faith, love and hope in order to improve our health? First, recognize that where you are is not as important as where you are going. And, for your health, it is not the destination which is as important as the journey. It is the continuing tense of the verb "to go" which is important. Sometimes, we are not inclined to start because we think the journey is too long, but when we re-direct our focus from the destination and focus on the first step, we realize that we are capable of taking that step and then another and then another.

Success is founded upon not focusing upon success; success is founded upon focusing on getting started. And, if in one year, you discover that you have failed and restarted a thousand times, you will have restarted three times a day, which means that you will have made more progress than someone who never started.

Get Going for yourself

Second, don't focus on others. Comparing yourself with others will only defeat you. For all of us; there is someone, somewhere who is faster, leaner, smarter, etc., than we are. Your bench mark is not someone else; it is you. If you can run safely do so. If you can't run, walk. If you can't walk, swim. If you can't swim, pedal. If you can't pedal, row. The reality is that exercise is critical to any improvement in anyone's health, no matter what the goal. And, there are extremely few people who can do no form of exercise. So, get started. Start where you are, not where you want to be.

Get going with something you can do

Third, start something which you have a high degree of probability of sustaining. Make sure the equipment needed is readily available. Make sure the time required fits your schedule. Make sure that the energy expenditure is possible within your age and condition.

Get going with others

Four, your probability of success will increase if you become accountable for your program. That may mean having a personal trainer with whom you meet. That may mean having a friend with whom you exercise. That may simply mean having someone to whom you report your progress. Whatever it means, remember you, like all people, operate best when others are encouraging you and when you are reporting to others.

Start Over, but start over quickly

Five, if you fail, admit it and start over. Here, it is possible to gain perspective from President Theodore Roosevelt's comment above. Roosevelt's words challenge, yet comfort, all of us who have started, stopped, started, failed, started over and in the long-run, kept going. "Have faith, hope and charity (love), that's the way to live successfully. How do I know? The Bible tells me so."

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	Exercise: Something Is Better Than Nothing

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