Changing Health Behaviors? How to Deal with Doubt

Learn how to deal with doubt, negative self-talk, and pesky feelings.

Posted Nov 10, 2020

I was filled with doubt the year before I applied to my doctoral. Doubt as to what was next, doubt as to whether going back to school for another four years would lead to anything worthwhile.

I found myself taking long car rides and exercising excessively because I wasn’t comfortable with my thoughts. I’d drive to neighboring cities and talk to nurses, physicians’ assistants, physical therapists, and dieticians to grasp at careers I imagined had certainty and security.

Despite having my mind at ease (for a bit), with a sense of momentary direction, none of it felt right. None of those paths fit me. I was running away from doubt and that was causing me more distress.

All of this sounds rather dramatic and I realize good career uncertainty is a problem most people would prefer to have. But this experience was valuable. It taught me something I have carried over to health coaching. I had to ask myself:

“Am I okay feeling like this, if it means I get what I truly want?”

I ask this question with two assumptions. The first is that you want to be healthier and make changes. The second is that you have some pesky thoughts and feelings that demotivate you and make it hard to act on your good intentions.

When it comes to addressing and changing health behavior, answering the initial question involves clarity on two other points:

  1. What do you care about?
  2. If you accepted your thoughts as truth, and that guided your behavior, would that behavior work for your goals and values?

Define Values and Top-Level Goals

Values determine how we experience the world; they are motivational and guide action. When we know what is important to us, we have a sense of purpose that guides behavior. Values help us determine what matters and what doesn’t.

Goals exist in a hierarchy. Low-level goals (i.e. a daily to-do list) act in service of medium-level goals, and medium-level goals are achieved in service of high-level goals. High-level goals, or top priorities, are what psychologist Angela Duckworth calls “Ultimate Concerns." Your Ultimate Concern helps to keep your priorities in order.

My Ultimate Concern is on promoting physical activity and health behavior change. My medium level goals involved getting my PhD and my low-level goals include smaller things such as writing this blog post.

I often ask clients what they care most about because being healthier has a positive influence on all areas of life.

Think about what you care the most about. Then ask yourself, how can having better health, more energy, and more confidence have a positive influence on your Ultimate Concern? How do your health behaviors or lack thereof, fit into your Ultimate Concern?

Thought Workability

Once your Ultimate Concern and values have been defined, think about the negative internal dialogue or feelings you have experienced in the past. How have they held you back?

Maybe you think:

“I can’t stay consistent with exercise because I’ve never been successful before.”

“I can’t eat healthy, because what’s the point? It will take ages to lose 50 pounds!”

“I know people are judging me in the gym. It makes me feel uncomfortable.”

You filtered these thoughts through your experiences and beliefs which guided your behavior. If you accepted these thoughts as true, would it help you achieve your Ultimate Concern? Would it help you act on your good intentions?

Dr. Stephen Hayes writes that “workability” functions as a truth criterion, and “chosen values act as the necessary precursor to the assessment of workability because values specify the criteria for the application of workability.”

If your negative thoughts are guiding your behaviors, are those behaviors workable? In his excellent book ACT Made Simple, Russ Harris writes:

“Is what you’re doing working to make your life rich, full, and meaningful? If the answer is yes, then we say it’s 'workable,' so there’s no need to change it. And if the answer is no, then we say it’s 'unworkable,' in which case we can consider alternatives that work better.”

Experiential Acceptance

Experiential avoidance describes the struggle to avoid or get rid of unwanted thoughts and feelings. When it comes to health behavior, the easiest way to get rid of unwanted thoughts and feelings is to disengage from the change effort, to convince yourself that the goal wasn’t that important. Acceptance happens when you drop the struggle with unwanted thoughts or feelings.

When we fight with feelings, they tend to occupy our attention. We miss everything else going on around us. We’re ready to ask our first question once again.

“Am I okay feeling like this, if it means I get what I truly want?"

If workable behavior (i.e. exercising, eating healthy, trying new health behaviors) leads to a valued outcome and unwanted thoughts and feelings, are you okay having those thoughts and feelings if the behavior gets you what you truly want?

If you are able to achieve clarity on what you want, identify whether behaviors are working for you or against you, and accept unpleasant internal experiences if it means you get what you want. You will build resilience and be more likely to progress to a healthier version of yourself.

References

Harris, R. (2009). ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.

Hayes et al. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Psychology Faculty Publications. 1010.