Making Exercise a Habit with Cancer.
Rehab tools to make exercise habits happen.
We all know what we need to do. Eat better, sleep more, move more, spend less and so on. But why is it that research shows that despite being aware of what we need to do, we often make choices that consistently undermine our well-being. (Duckworth and Milkman)
If a patient knows that exercise is medicine, they will go to the gym and if the rehab plan is shared the patient will commit, right? We often think that we just need to kick ourselves into gear and be more disciplined but in all actuality, habits are hard. The act of implanting a new behaviour, even on a small scale is actually very difficult, environmentally dependent and is even trickier when there are barriers.
Take the barrier of a cancer diagnosis as an example, the many appointments and the stress associated with it. Eating well, sleeping more, and exercising are hard commitments for a regular person, so we can imagine that it’s even harder when cancer treatment is in the mix. Fatigue, dizziness, neuropathies, weakness, pain or lack of motivation are a few common barriers cancer patients report. Additional barriers may be present, such as a lack of understanding of what might be considered safe exercise.
The well-respected psychologist Dr. Daniel Kahneman started researching decision making 50 years ago; eventually earning a Nobel prize. Many social programs and public policies are founded on the concept that if you just educate the public on the recommended behaviour, then the correct behaviour will follow. If everyone could just muster up a bit more self-motivation and discipline, society and the planet would be better off.
But as Dr. Kahneman’s research has shown, If behaviour was merely a rational response; we would see people eating better, exercising daily, spending within their means and conserving our natural environment. Unfortunately, this just isn’t so, and what is observed is that habits are hard.
Daniel Kahneman’s concept of behaviour is that of an equilibrium, a balance between 2 forces: restraining and driving
We have started to learn that incentives, threats, negative self-talk and in other words, ‘pushing the driving forces’ is not effective. Instead, focusing on the restraining forces and how they could be lessened has shown to be more impactful.
In other words, behaviours and habits can best be made easier by making them easier, here are some examples of valuable questions you could ask yourself in hopes to make change easier and lessen barriers to form a new habit:
1) Why hasn’t the behaviour been adopted?
2) How can we change the environment to better support the habit?
3) How can we make it easier to adopt this behaviour?
4) How can we add more meaning to how this change may better for society at large? Can you think bigger than yourself?
Here at the cancer physio, we try to meet patients where they are at, offering personalized medicine. Personalized rehab doesn’t just mean planning specific to a diagnosis and stage, it also means that we take the time to understand what habits can be made easy. If we start with a personal and strategic approach, small habits can become permanent behaviours, and behaviours can change lives for the better.
Charles Duhhig in “The Power of Habit” speaks to habits as ‘habit loops’. A habit loop is a breakdown of a habit including a cue, a behaviour, and a reward. To create long term change, these short-term habit loops need to simply add up daily. A side from the above strategies on making habits easier, there are strategies to help build habit loops.
We have come to learn that we are visual beings and environments matter, we have also come to understand that humans are also social beings, there for support matters; building on that here are some habit forming tips:
Cues matter: set up your environment and/or schedule to trigger an action that can become a habit. Routines work.
i.e. exercise clothes are laid out ahead of time, appointments are organized, family members are informed on the exercise taking place a day ahead.
Rewards matter: always finish with a reward, the brain remembers the last part of experiences therefor causing us to crave the habit loop again.
i.e. always finish exercise with a very ‘feel good’ experience such as a hot shower, a relaxing stretch or a tasty snack
Beliefs matter: you have to believe the habit is valuable and understand it intrinsically.
i.e. stay informed on how to exercise safely and understand how exercise is medicine; in this way you have no confusion or concerns about it
Small habits matter: small change can lead to behaviours that snowball into big changes.
i.e. understand your phase of treatment to be realistic with yourself. Set small goals and large goals, some can be as simple as a 10 min walk, some can involve strength, this allows you to meet your body where it is at each day building it for tomorrow.
Willpower can be learned: be strategic, learn your energy cycles and optimize your day for the most important things
i.e. understand your phase of treatment and what to expect, removing the shame from yourself. Use strategies to form habits, social supports and your cancer physio to increase your chance of sticking to an exercise habit.
With some reflection on how to make the behaviour easier, and tips on habit loops, we can all improve our ability to make small changes. Although habits are hard and exercise is even harder, we all know that when something is hard it’s probably because it’s working!
Here’s to small actions that make exercise as medicine over the long run.
Thank you for your interest in science and rehab.
Kindly, The Cancer Physio
