75% of chronic illnesses can be improved or cured with four lifestyle changes: reducing exposure to tobacco smoke, improving nutrition, getting more physical activity, and reducing stress. Obviously, many people recognize that implementing these changes is worthwhile. Still, many of us are falling short in these endeavours. As part of the theory of self concept, Carl Rogers identified three components: self-image, self-esteem, and ideal self. When our self-image does not match our vision of our ideal self, there is incongruence. Everyone lives in a state of incongruence to some degree, and we become motivated and set goals in an effort to minimize it. Goals are mental representations of desired outcomes to which people are committed. Setting and achieving goals helps us to make major changes in our lives and progress toward our healthy, ideal self.
As part of the MD program at the University of Toronto, we’re given lessons on motivational interviewing and the transtheoretical model of change (Prochaska 1995). The transtheoretical model of change involves moving through five levels towards change: precontemplation, contemplation, preparation, action, and maintenance. Medical professionals are encouraged to help patients move through precontemplation and contemplation by informing them about the benefits of healthy changes and encouraging them to explore their current reasons for resisting change. However, when people reach the preparation and action stages, it becomes difficult for health professionals to help people to achieve their goals because the health professional cannot reasonably follow their patients every day and keep them motivated. With that said, an important part of motivational interviewing is promoting autonomy and self-efficacy. That’s part of the reason that I wanted to write this brief blog post to give interested individuals a place to start when they have decided to pursue a new major life change. Here, we’ll discuss some successful goal-setting strategies.
When people are feeling particular motivated, we are inclined to set new goals. BJ Fogg refers to this as a motivational wave. Unfortunately, this motivation doesn’t last forever. Eventually, regular life stressors return in full swing and we’re distracted from our newly established goals. Research about goal-directed behaviour suggests that goals with particular characteristics are more likely to be achieved than those missing these key ingredients. If we can set these type of goals while we are experiencing a motivational wave, we’ll be more likely to have success. We should set goals that are well-planned, aligned with our values, SMART, approach-oriented, automated and rewarding, and also intrinsically motivated.
Goals are more likely to be achieved if they are aligned with our values (Fishbein, Triandis, Kanfer, Becker, Middlestadt, & Eichler, 2001) . In other words, we should set goals that will directly allow us to become more like our ideal self. For example, if your ideal self is healthy and in touch with nature, you might consider setting a goal of going for a run through a nature trail at least once a week. With this in mind, it’s also important not to take on too many new goals at once or to set goals that are difficult to achieve. Research shows that we only have a finite amount of cognitive energy and willpower, and that we must use it wisely (Baumeister et al. 1998). If we set too many goals, or set goals that require a lot of energy, they might become overly burdensome and may drain our cognitive resources. If this occurs, we will be less likely to have the energy and willpower to continue goal-striving. But as we achieve our goals they will become a part of our self image and become routine, so they won’t require so much cognitive energy. This will free up conscious capacity and will allow us to take on more goals.
It is incredibly important to write down our goals and express them explicitly. It is a great idea to communicate our goals to our loved ones and social circles, because feeling socially accountable and expressing our values and goals aloud can help to solidify them within our own minds. For formulating an explicit goal, an acronym that many people are probably familiar with is SMART; this acronym is often used to remind people to set goals that are specific, measurable, attainable, relevant, and time-bound. There is a lot of literature on this subject, so I would encourage you to look it up if you’re interested in learning more (a good place to start might be Doran’s article in Management Review 1981). But, I want to point out that the aforementioned points have been about setting goals that are attainable and relevant (i.e., goals should not be too large or unrealistic, and they should fit within our personal set of values). I also want to mention that setting time-bound goals can be very difficult, but is one of the most effective methods for sticking to our goals. Research has shown that setting a quit-date is one of the most effective strategies for people who hope to quit smoking. To maximize the probability of success, we should try to set a “quit-date” for all of our goals.
Having approach-oriented goals instead of avoidance goals can make it easier to set SMART goals. An example of an approach oriented goal is “I will run three miles a day” whereas an avoidance goal is “I will not eat chocolate”. It is easier to set a SMART goal if you are using an approach-oriented formulation because it allows us to complete a task and mark the completion of that task (i.e. measure it) every time that it is completed within a given time period. Another advantage to approach-oriented goals is that when we think about our goal we activate neural pathways that lead us to engage in behaviours related to that goal. For avoidance-oriented goals, on the other hand, reminding ourselves about the goal makes the object or action we are trying to avoid salient in our minds and thus more difficult to avoid. For example, if you remind yourself everyday that you do not want to eat foods with trans fats, you are continuously activating neural pathways in your brain that bring temptations of trans-fatty foods to the forefront of your mind; this will create cravings and make the foods even more difficult to avoid.
It is important to consider the power of habits when we are implementing strategies to complete our goals. According to dual-process and dual-systems theories (e.g., Strack and Deutsch, 2004) habits are separate from effortful goal-directed behaviour, and in some cases these processes oppose one another. Temptations involve impulsive and reflexive processes that operate quickly and automatically, without requiring conscious effort. This is separate from the slow, deliberate processes involved in participating in goal-directed behaviour. (A classic book that goes into much more detail about this and other mental processes is Thinking, Fast and Slow by Daniel Kahneman). In his book, The Power of Habit, Charles Duhigg discusses habits as composed of three things: a cue, a routine or behaviour, and a reward. When we are experiencing a motivational wave, it is important to change our environments as soon as possible to remove cues that might lead to bad habitual behaviours. For example, smokers might be cued to smoke when they smell cigarette smoke or when they see ashtrays or lighters. So, if you are experiencing a motivational wave and decide to quit smoking, it is important to remove all ashtrays and lighters from your home, and it might also be a good idea to wash all of your clothes to remove the smell of cigarette smoke. Fortunately, the power of making new, good habits can also be used to our advantage when we are trying to achieve a new life change.
We can change our environments to automate behaviours that are relevant to achieving our goals. This involves creating deliberate cues around our homes or work environments. For example, if a person is trying to run three miles in a nature trail every week, they might consider leaving their running shoes on the passenger-side floor of their car so that they see them every day after work. Also, they could change their route home from work so that they drive by the entrance of the nature trail every morning before work and every evening after work. These will act as daily reminders about their goals, and these will also be visual cues that lead to habitual behaviours that help them to achieve their goals. But, in order to make our goal-directed behaviours more habitual, we also need to have rewards that will immediately follow the behaviour.
Ideally, we should attach several rewards to our goal-directed behaviours. Many of the goals related to health will have intrinsic motivators – in and of themselves, they can be enjoyable activities. It is a good idea to think about intrinsic rewards early on, so that we can appreciate the activities/behaviours as we perform them. Even if someone does not enjoy the activities at first, if they actively look for or invent intrinsic motivators they will be more likely to enjoy the activities. For example, even if a person does not enjoy working out at first, if they tell themselves that the activity is rewarding, eventually the effect of positive thought-patterns and the release of endorphins will make that true. This is akin to the “fake it until you make it” aphorism that relates to Beck’s cognitive triad and cognitive behavioural therapy (CBT). It is also beneficial to attach extrinsic rewards to our goal-directed behaviours. For example, someone with a sweet-tooth might want to have some candy or a sweet, high carb post-workout shake after a hard workout. Having extrinsic rewards immediately following our goal-directed behaviours will give us something to look forward to when the workout gets tough or when we are having a particularly tough day. Furthermore, these extrinsic rewards can reinforce our behaviours and make them more habitual/automated.
In conclusion, setting goals and striving to achieve our goals is not easy. But, it can be fun and certainly will be rewarding. Setting goals can help us to become healthier, become better, and align our self image with that of our ideal self. Some strategies for effective goal-setting and goal-striving might include setting goals that are well-planned, aligned with our values, SMART, approach-oriented, automated and intrinsically rewarding. Importantly, we have to recognize that we might fail a few times before we achieve our goals. Never give up; we should adjust our plans, adjust our expectations, and/or adjust our goals. Becoming more healthy is an iterative process, and we should approach it as one. Even if we can only take small steps toward a better self, at least we’ll be moving in the right direction.