Thursday, August 23, 2012

Creating a meaningful emphasis on dose

I've spent the last couple days in a Medical Exercise Therapy class designed for physical therapist and my brain is FULL of fabulous new ideas for helping my clients! 

The single thing that I thought was most helpful (and everything built off this) was that exercise is all about dosing.

Too little and it will do something (it always does something) but it may not have the effect you want it to have.  Too much and the body tissue you're working on will breakdown -- then the exercise is doing more harm that good.

Here's the thing -- many people I work with feel they are in too much pain to exercise.  Now I'm not talking about overloading a stress fracture in the foot with a high intensity spin class -- that would be above the ability of those healing tissues to withstand.  I'm talking about the chronic fatigue or fibromyalgia pain that can flare up when people exercise.

The instructor of this course contends, if dosed right, exercise will actually help that person manage their pain, increase blood flow to the muscles and nerves, provide other stimuli so a person's sense of pain is reduced, and a myriad of other benefits.

But all of those benefits hinge on finding the proper dose of exercise.  And many of us think we need the horse pill equivalent of exercise before it does any good.  I'm here to tell you that is not the case.

Sometimes, taking 3 steps more than you did yesterday or making it half way out to your mailbox is just the right dose of exercise to help and not hurt you.

After a few days of doing that, you may be able to make it 3/4 of the way down your driveway and back.

Over time, you may end up doing things you never thought possible (there are a few of you reading this that should recognize your situation right here!)

But the point is -- we get so caught up in what we can't do (can't hop up off the couch and walk a 5k), that we don't see any point in trying to walk half way down the driveway.  But everyone who walks  has to be able to accomplish the 1/2 of a driveway before they can move on to greater distances.

So, what does this have to do with mindful eating?  Well, here's the thing -- if you are one of those "can't make it to the end of the driveway so I might as well not try to walk half way" kind of people, chances are you are going to struggle and get frustrated with mindful eating because you're not going to lose weight as fast as you would like. 

So you may not try to journal your food intake.  You may not try to reduce your soda intake by one soda a day.  You may not think it is worth investing the effort to make one small change in your behaviors because you think one small change isn't enough to make any kind of difference in the 100 pounds you have to lose.

You're wrong.

It's all about the dose of change.  Maybe you only have enough stamina for a small dose of change right now.  But -- if we get you working on that change, your mindfulness muscles will get stronger. 
As they strengthen, we can get you doing more complex behavior changes.  But much like physical therapy or exercise in general, if we do too much at once and overload your mindfulness muscles, we'll do more damage than good -- and you'll end up at home on the couch feeling bad.

It's all about dosing the change to maximize the positives and minimize the risk of negative outcomes.  You can make a change -- it just might be much smaller than you'd really like.

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