Making change requires effort in the face of resistance and effort requires clear purpose

Why do we seek change? Something inside us suggests there is something better, we seek change essentially to stop suffering, or in the pursuit of happiness (peace, contentment, wellness). So we set out to make a change, start a new habit, stop an old habit, learn more, revise an old idea, plan a different behaviour or schedule, ask for help.

Then, something else happens. It’s painful. It takes effort… we revert to our old habits. The old way seems easier and the new way too hard, beyond us somehow. The change we sought has lost its appeal, its salience. In this state we are more likely to say things to ourselves like, I don’t need that as much as I thought I did, it was probably a silly idea in the first place! When we meet this resistance to change we make a choice, one that might be conscious, but more often is unconscious.

If we make an unconscious choice, not much change is likely, we might not even notice this blip in our thinking or behaviour, we revert back to the status quo. Or we can be aware – conscious and mindful of our internal resistance. Then we must choose – to proceed with effort, or take the easy way out and stick with how it is.

It’s natural to resist, change is threatening and our brains are hard wired to avoid anything that threatens our survival. The outcomes and the experience, the feelings of the change, are different to our normal habitual experiences. The change we thought we desired feels uncomfortable and unfamiliar, unpredictable. Humans as a general rule do not like these feelings, they trigger our amygdala, our mental and physiological warning systems do their jobs and tell us to be careful, go slowly, or even stop.

To really see change through it is useful to understand why you decided in the first place to initiate it. If it is to live true to your values it’s easier, you have an anchor. When you start to feel the pain of the resistance – uncertainty, ambivalence, effort, confusion, you have something to hang on to (that which you value). For example, someone choosing to give up smoking because of an underlying conscious commitment to their health, so they can see their kids grow up, is more likely to stay off the cigarettes than those who are doing it to keep a loved one ‘off their back’. Without this clarity of purpose, the effort and pain is not worth it, it’s too hard and the long term plan is sacrificed for the short term relief.

When we first offered our Immersion Doctor Care Program to doctors we felt confident in our product, the content and the model. We believe strongly in our intent to help doctors care more effectively for themselves for the long term, in a system that does not do this well, so that they can care more effectively for their patients. However recruiting doctors to our program is counter culture. It asks doctors to commit for several months, it is not just a tick the box exercise. It asks doctors to focus on skills they do not necessarily have and it asks the doctor to give this learning of new skills a priority, and to continue this prioritising over several months. Doctors who join the program describe feeling keen and curious to learn and grow their emotional and social intelligence and they also say they feel vulnerable because they have never done anything quite like this before. Those who do join are hungry for something better, yet the invitations to stop or retreat (resist) are many.

In this instance Better is described as I want to get more balance in my life, I want to give and receive feedback more effectively, I want to reach a goal like being accepted into a training program and it’s so competitive, I want to communicate with my peers more effectively, I want to build better relationships as I am interested to develop my leadership qualities, I don’t want to burn out.

Resistance on the surface sounds like this, I don’t have time, my roster doesn’t allow for it, I’m not that important – it’s the patient care that I need to focus on, it’s harder than I thought it would be, I’m not willing to share my experience in a group, I’m uncomfortable talking about myself or my needs. Internally it can sound like this – I’m not good enough, I’m showing my weakness/vulnerability and now I wont be accepted/ promoted / trusted, they think I can’t cope with the pressure / complexity, I will disappoint my family, I am an imposter who should never have been here in the first place, who do I think I am?

We meet overwhelming enthusiasm for our work with doctors from individuals and organisations alike. All say medicine needs this kind of program, where ‘soft skills’ are learnt. Over the past 18 months, 21 brave doctors have overcome their personal resistance to being vulnerable and joined us on this journey of discovery. Their courage is important to recognise because they are engaged in sharing their experiences, experimenting with their interpersonal skills and reflecting openly on ways to enhance their careers, care for their patients and share in fellowship with their colleagues. They are fully engaged in effortful skill building that requires risk, vulnerability and growing their self awareness. We provide the support structures that keep them safe while they do.

The discomfort I experience in the recruiting process is my own personal experience of resistance. It is easier to just carry on providing one-to-one coaching. The feelings of uncertainty during the waiting time of the registration period is utterly worth it, the work these doctors do when they come together in service of each other can not be achieved in one-to-one coaching by itself. I care deeply about doctor well being and patient well being and how both of these can be achieved, this sustains me when I am waiting in the unknown space of the registration period.

Our participant doctors are holding on to their values too, the reason they signed up in the first place is critical to their ability to meet their own resistance when they are in the room together and they inevitably meet something they were unaware of, for instance an unconscious bias. In these moments of feeling uncomfortable, growth happens, real change can be achieved. Any change that has been worthwhile has come from effort, not magical or wishful thinking.

If you want a different experience, you need to meet your resistance, your unconscious fight/flight, when things get tough emotionally. Big transformative change happens when we become aware, when we notice something not seen, heard or felt before and now that we know, we must take action. Awareness plus effort (action). Awareness on it’s own is not enough. Awareness on it’s own can make things worse sometimes. Taking the next step, action, makes the effort of awareness worthwhile. We are more likely to sustain a change with support from others.

Empathy is about being aware of what it’s like for another person. Our empathic response also lights up our brain’s pain network. Compassion on the other hand is empathy plus action and this it seems, lights up our neurological reward centres. The key difference between empath and compassion is that when we feel compassion we are driven to act, to offer our assistance. Working together in our Immersion Program allows doctors to show compassion and help each other as they meet their various resistances, as they explore new ways to understand themselves and their roles, their emotions and their unconscious biases, their communication and their relationships with patients, colleagues and internally with themselves.

This reflection about resistance is offered because our doctor clients have asked me to share it. They have felt their own resistance and stayed with it, as a result they have celebrated the outcomes of real personal growth and development (change). If you are invested and curious in doing the work of personal change please do get in touch. We do deep work that includes emotions and emotional intelligence, for the purpose of more effective human connection and better health outcomes. As Keegan and Lahey say in their book Immunity to Change “any exploration of our immunity to change brings us deeply into the world of feelings… an immunity to change, as the name implies, is a system of self protection”. More on this next time.

Reference: Keegan, R and Lahey, LL (2009) Immunity to Change

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This post was written by Sharee Johnson