Measuring Stick

I had an important interaction with a patient a while back.  They were bemoaning their current condition, upset that they had experienced a setback in their health.  They mentioned how they were trying to "eat better" and "take better care of [their] health" but it didn't seem to be doing anything.  

So I asked a simple question:  "How are you measuring that?"

They paused.  Noticeably chewed on the question.  "What do you mean?"

I explained that "better" didn't mean much.  What does better look like?  How could they tell if they were actually making any progress?  And they were quiet again.  

And then I went on to explain a little further:  If I say that I am trying to lose weight, I could get very disheartened by only gauging my success by what I see on the scale.  But if I consider how my clothes are fitting, that my resting heartrate is lowering, measuring certain areas of my body, noting how much less huffing and puffing there is after my cardio warm-up, the amount of weight I can lift, now I suddenly have many ways to gauge how well I am progressing.  These will ultimately be more encouraging to me and validate the progress I have made in the same breath.  In my particular case, I have lost forty pounds in a month before when my Crohn's was sixteen kinds of angry--the best BMI in my adult life I have ever been is when I was unarguably the sickest.  Subsequently, the number on the scale has not meant much to me in terms of measuring health for years.  An indicator, sure, but not the end-all, be-all, particularly compared to how much more stamina I have than I used to.  

Sometimes, we need to check our measuring sticks.  The goal cannot be something as amorphous as "better."  Creating a half-assed goal of "better" sets one up for disappointment.   It is important to set a goal that is measurable, attenable, time-based, and productive.  

Useless goal:  "Eat better."

Useful goal:  "Pack lunch for work three days out of the week;" "rotate in seasonal veggies as sides for X number of meals a week;" "decrease portion sizes by X% for five out of seven meals a week"

Useless goal:  "Smoke/Drink less"

Useful goal:  "Limit smoking to X per day; wine allotment for the week is Y glasses"

Useless goal:  "Get into a better writing schedule"

Useful goal:  "On days off, before noon, have at least a half-hour of writing time"

Another important pitfall to avoid is not starting with the end goal as the ONLY goal.  The ultimate goal for high blood pressure, for example, would be to have blood pressures consistently in a certain range, but it cannot start there, nor can the half-baked goal be all-or-nothing.  No one goes from inactive to marathon runner in one jump:  the baby steps deserve praise.  Not only that, but it can take a lofty aspiration and break it into chewable pieces.  

A diabetic could have a goal of having their blood sugar be under X amount before two out of three meals in a day, Y number of times a week.  Someone with a new blood pressure medication could set a goal of taking their medication every day for a month and another goal of going for a fifteen-minute walk three times a week.  Getting up to the chair for all three meals in a day is a brilliant goal for post-surgery recovery.  For mental health, it could be something like doing a five-minute meditation four of our seven days a week or scheduling the first therapist appointment within the month or starting each day saying three positive things about oneself or practicing a grounding exercise each time Outlook is opened to preempt a normalized panic at seeing the mountain of unreads.  Even something intangible can be translated into something meaningful--e.g. I will rate my mood of higher than three on a rubric made to help scale two days out of the week. 

It takes time and energy to frame goals well, yet the process of individualizing them to one's own ability level keeps drive for the goal in a better place and honors both the speeds and needs of the goal-setter.  Someone else's pace may not match our own needs or abilities, nor should we expect them to, even if the verbiage around New Years' Resolutions seems to oddly push specific examples and ideas as doctrine.  My goals are about being a better version of myself, not being better than someone else; it's a small but important frameshift that allows for greater freedom.  It can be helpful to have a scripted step-by-step; it can also be helpful to recognize that my personal success may not look like someone else's.  

Keep strong on those promises you've made to yourselves, my friends, even if that means finding a new way to approach them.