The purpose of this short blog is to discuss the issue of compliance as it relates to understanding what motivates an individual and how values precede action.
Health care is a tricky business because it depends heavily on the willingness of the patient population to adopt the recommendations set forth from the practitioner. I could have the greatest health revelation since curcumin and it would go nowhere if my clientele could not yet appreciate it. I feel that part of it is consumer fatigue from every fad and cure-all that now even practitioner recommendations are seen as just another whisper in the wind. Functional medicine practices are popping up all over to capitalize on the holistic trends as well as to avoid the conventional physician burnout, but many still fall under a new patch and band-aid system with herbs, supplements, hormones, etc. instead of only pharmaceuticals. Don’t get me wrong – it is a spectacular shift, but there is still something lacking.
People are different, point blank, and understanding what makes the person sitting in my office different from everyone else is important to me as someone who will be expecting them to hear and appreciate my assessment. For simplification, each person can be thought of as a map – but a map that has different levels of resolution, like Google Maps. Depending on what you want to see, the resolution can be set globally, continentally, by country, by state, by city, by town, and right down to the exact street. I believe that unique care plans start with examining each person at the level of analysis with the most global, i.e. lowest, resolution - personality.
Personality is a large contributor to the lens through which people perceive and then behave in the world. It highlights certain aspects and ignores others because it is intrinsically motivated by some value, which by definition places some things in the ‘relevant’ category and everything else in the ‘irrelevant’ category. Why does this matter to me as a practitioner? What happens if a client only thinks that they want to be healthy? Is thinking up a desire motivating enough to carry through with it? If you really want an ‘A’ on an exam does that mean you will get one? No, simply no.
Actions are the manifestation of true belief – there are reasons that there are intelligent students who do well and intelligent students who do poorly, just as there are reasons that well- meaning individuals who could lead healthy lives, do not. If an individual does not act in accordance with their goal or desire then suffice it to say that the goal is not representative of any real value. If it were, then they would act in such a way that the goal could be foreseeably accomplished. As harsh as that may sound, these are not judgmental statements, but rather statements of an outsiders’ observation. It is the point at which many can then say, “well why don’t I act in a way that will see me accomplish the goal? Is it me? Is it something in my environment?”. They can also choose to justify their lack of commitment with excuses and play victim to forces outside of their control. In the end, both conclusions are therapeutic and bring me as a practitioner closer to how that individual perceives the world. Again, the goal here is to understand what the patient values and how those values can enhance or prevent the pursuit of well-Being.
Setting patients up for success is paramount to a successful practice. Non-compliance is an ever-present phenomenon that, in spite of wanting to reach a certain degree of health or performance, actively working against the individual. Does the value of workplace success overshadow the need for down-time and stress reduction? Does the value of social interaction or the value of social success overshadow the need for eating clean and moderation of alcohol consumption? On the flip-side, is there a proclivity to value health at the expense of other
important values that it becomes paradoxically unhealthy? The challenge then, is how to elevate the value of health to the top and prioritize actions to reflect that without compromising sub-strata in their hierarchy of values. Like I said at the beginning – it’s tricky.
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