Behavioral Health Minute

January 2009 - Do something different

The short summary

People doing concrete things differently promotes change and gives energy, optimism and wisdom.

The modestly longer reflection

Cutting across different schools of mental health and approaches to patient education, I see a common theme in people who deal successfully with the psychosocial and coping issues that they come to us with; they do things differently.

A simpleminded idea, perhaps, but I would not underestimate the value of people picking one or two concrete things that they can do differently from what they have been doing.  This pertains to people who have it modestly well together to begin with, and often especially to people who are feeling overwhelmed.

I’m not sure it even always matters what people do differently, so much as that they change something about the patterns in their lives.  Changing how one relates to a partner or child. Changing how one spends time. Making one change in what one eats.

Doing something different

• Gives energy and optimism (when you see something change as a result of your discretionary action, it feels hopeful).
• Gives wisdom and direction (when you start moving, you often get a clearer picture of where you are, where you want to go, and how you’re going to get there).

I will often say to people, to a greater or lesser extent:

I talk with a lot of people and I have noticed an interesting difference between people who come back feeling pretty much the same versus people who come back feeling more encouraged and positive.  People who don’t do so well might have a great conversation with me in the office, but don’t do much of anything to follow up after they leave.  People who do better often focus on one or two specific things that they do differently after they leave.  So…

• [if we have agreed on 1-2 things in the office] I think that the idea of your doing _____________ is great and I want to support you experimenting with this between now and when we next get together.
• [if we have not yet agreed on 1-2 things in the office] I’d like you to sit down in the next day or so and decide for yourself about one or two specific things you want to do to follow up on this conversation.  I’ll look forward to hearing.

A reminder that ideas like this do depend on readiness to change… like any conversation about life change, I would emphasize this more with people who are higher on the readiness to change scale.

Follow-up

Raise the subject with people of doing one or two concrete things differently to follow up on your office visits.

Fred Craigie, PhD