I have been meaning to write this post for a while, but the post I thought I was going to write isn’t the post that I am now writing. This post was supposed to be a follow up to the post I wrote two months back (two months!) about how Simon Roost Kirkegaard helped me to change my pain by gently challenging some long-held beliefs I’ve had about my hip and my pain and helping me to confront some of my fears surrounding getting back into the gym and lifting weights again.

But life happened. I moved. I started volunteering with an awesome organization. I’ve been researching spinal cord injuries. I’ve being doing a whole lot stuff, just not the stuff I said I was going to do in that post from two months ago.

Even so, I experienced some profound changes after my chats with Simon, changes that I will do my best to parcel out in future posts to give my take on how I think change happened and where I am and where I hope to go.

But for now, a bit of a confession.

Here’s the thing, the thing that has held me back from writing this post and writing in general for quite some time, the thing I’ve been afraid to own up to to you guys: I didn’t do everything Simon asked of me. I didn’t do everything I said I was going to do in that post I wrote way back when.

In fact, I didn’t do most of it. I never got to the heavy lifting phase of my plan. I never video-taped my movement. Those were the two things I was supposed to do. That was the plan. That was what I said I was going to do. I mean, the whole point of our discussion was to help me confront my fears surrounding weight lifting and get my ass back at it.

That was to be my path forward. A path I helped outline. A path I had intended to follow. I was going to lift heavy shit and it was going to be awesome.

But I didn’t do it.

And I felt bad that I didn’t do it. Guilty. I felt like I didn’t hold up my end of the bargain. I felt like I was letting people down: Simon, you, me.

How could I explain that I didn’t do these things, even though I believed (and still do) that they would be really good for me, for my pain, for my life? Where do I start? Do I apologize? More importantly, would Simon, and the other folks who were so stoked about that first post (it was my most popular post to date, by far), be disappointed in me? Frustrated? Mad?

How could I follow that post up with: hey guys, I didn’t do any of the awesome stuff I said I was going to do.

Real life

But that’s how things work. That’s what happens in real life. And it’s a very common thing when it comes to changing pain or changing our health habits or changing any sort of behavior: we’re told or guided or learn about something that we know is ‘good for us’, something we ‘should’ be doing, something we want to do, something we even really really really think we’re going to do, but sometimes that something just doesn’t quite fit in with our goals, needs, wants, priorities…with our life…at that point in time.

So we don’t do it. Or we don’t do it how were supposed to do it. We may do part of it or do something in line with the idea of it, we may tweak it a bit, rearrange it a bit, but we don’t do the whole thing. We don’t follow through the way we intended.

Instead, we do what we can. We do what makes sense for us. We do what we’re willing to do. 

At least that’s what I did. Life happened, so I took the parts I could make work, the parts that I wanted and was willing to make work, and did those parts. But I didn’t do everything I said I was going to do. I kept meaning to. And I kept holding off writing this follow up post until I got it done so I could share the awesomeness that ensued with the world. But meaning to never manifested into actually doing it.

Pretty anti-climatic, eh?

Real learning

But here’s the cool thing. The thing that I think is important to write about and talk about. Even though I didn’t do what I was supposed to, I did what I needed to do. You see, the heavy lifting was really in the changing of my beliefs and expectations, in changing the way I thought about my hip and my pain and my capabilities, in changing the way I approached movement, and life, really.

That’s where change happened. In me. In my very being.

That’s where it was always going to happen, where it was always meant to happen. Change wasn’t going to happen in the gym. The purpose of the lifting weights wasn’t to lift the weights. The purpose all along was to to change my beliefs, my thoughts, my habits.

And those things made a HUGE difference. A monumental difference.

Real Success

A difference that allowed me to drive over 1000 miles by myself a couple weekends ago over the course of two days. Might not seem like much, but that was a major win for me because for the last 5+ years, just the thought of being in a car for a long time could cause my pain to flare up. And sometimes those flares took me weeks, WEEKS!, to recover from.

A difference that allowed me to get back into the gym and feel confident and strong and capable. Again, may not seem like much but this was another major win for me. I hadn’t set foot in a gym in close to 4 years. But suddenly I was able to go and not feel nervous or sad or worried or frustrated. I was able to go to the gym and not compare my current self to my former self or to all the other gym goers. I was able to go the gym and explore movement without expectation, to play, to even move a bit under load. And I enjoyed myself. And I didn’t flare up. I didn’t even flare blip.

It was awesome. Just not the awesome I thought I’d be sharing with you guys. I didn’t lift heavy shit, but I moved and felt strong and I felt good about what I was doing.

That’s change. Meaningful change.

It’s not just about the how, it’s more about the WHY

Those are two huge wins for me. Huge changes. Powerful changes. So even though I didn’t do what I was supposed to, there have still been profound changes in my beliefs, my expectations, and my pain. Profound changes in my life. I did what I needed to do.

I came to a new understanding of my pain and myself. And that understanding is what matters most.

This is important, folks, because the reason I learned so much from our exchange, the reason I was able to make huge changes without doing what I was ‘supposed’ to, was because wasn’t just told what to do. I was guided along a path and we decided together where that path should go.

And even though I took a detour, even though I didn’t go the route we planned, because of the way I was guided, because of the way I was helped to understand WHY the path we chose was a good one,  I was able to find a route that worked for me right now that is still getting me to where I want to go. A path that fits in with my life, my goals, my desires, right now.

MY path.

A path that I can navigate, with confidence, on my own. Because I understand things differently. I expect differently. I believe differently. I behave differently. I feel differently.

How did I get here?

As I outlined in that first post, Simon had me provide my own contradictory evidence to some of my unfounded fears and beliefs surrounding my hip and my pain, which led me to a different way of thinking. And he reinforced and added to my existing knowledge of pain science, of strength training, of movement in general (granted, other folks may not have my same background so a bit more groundwork may need to be laid rather than just reinforced). Through gentle questions, gentle challenges to my beliefs and thought patterns, he led me to a decision of how best to move forward.

Through that guidance I’m the one who came up with the idea of lifting heavy shit. Granted, it was where he wanted me to go (he’s skillful!) but it wasn’t forced on me. I came to the idea because I understood why that path was a good one.

So I told myself I was supposed to do it. That I had to do it. It was an onus I put on myself. And when I didn’t follow through, when I didn’t lift heavy, when I didn’t video tape my movement, I felt like I failed him. And if I failed him, I felt like I failed myself. And all of you. More unfounded fears! I’m good at them!)

I didn’t fail.

It’s true that I didn’t follow the plan. The plan I had announced publicly. But I’m human, and human things have happened over the past two months.

But despite not following the plan we came up with, I still succeeded. I was still able to powerfully change my pain, thanks to my new understanding of my pain, my hip, my capabilities, myself. And I was able to put that new understanding into action, just not how I thought I was going to.

And that’s more than not failing, that’s a HUGE success. It was the understanding that got me here, to this new, better place. Not the assignment, not the “here’s what you should do”. I took that understanding and shaped it in a way that fits in with my life, that suits me right now. A way that will still take me to where I want to go.

This is why I think it so incredibly important to start changing our definitions of success, especially when it comes to the patient-practitioner relationship. I ‘failed’ if you look at this situation one way, I didn’t follow through on a set of specific actions. But I succeeded beyond measure if you look at it another way, a more meaningful way: my understanding and my beliefs fundamentally changed and that changed everything.

Closing the gap between what we “should do” and what we actually do

We all know what we “should do” or what we’ve been told to do by our healthcare practitioner, yet we don’t always do it. We might do it, or we might only do part of it, or we might do none of it at all. There is often a disconnect or a distance between what a practitioner wants a patient to do and what the patient wants to do (or what the patient understands they should be doing) or there’s a gap between what the practitioner’s goals for the patient are and what the patient’s goals are.

Even if there aren’t actual differences, there sure as hell are perceived differences, which is really all that matters, isn’t it? Yet we don’t always recognize these disconnects, sometimes that’s because we don’t even know they’re there but other times it’s because they make us uncomfortable, so we just skirt around them or avoid talking about them.

I think there’s got to be a better way to narrow the gap between should do and actually do, there’s got to be a way to go about this more effectively and that it probably lies in what the end goal is (the mutually understood and agreed upon end goal) and not the specific actions we think we should take to get there. There are a lot of paths in life, this changing pain business is about finding the right one for each individual.

It starts with talking about this stuff open and honestly.

It ain’t easy, at least not for me. It’s incredibly hard for me because I never want to let anyone down. I never want to seem difficult. I don’t want to fail, I don’t want to not follow through. I want to be a good patient. I want to do what I should do, what’s good for me. I want to succeed.

The disconnect between what I feel like I should do or what I’ve been told to do and what I’m actually doing can lead to a great deal of anxiety for me. I’m probably not the only one, eh? There are probably other folks in the same boat. So that’s why I’m talking about it now.

We need to talk about it without awkwardness or judgment or exasperation or frustration or embarrassment. This is real life, these are real lives being lived, not idealized versions of those lives. These are not the lives we *wish* we were living, the lives we wills start living tomorrow, or Monday, or New Years Day. They’re the lives we’re actually living right now.

It’s the life being lived that matters. That’s where we need to meet. That’s where we need to figure out the path that can be realistically taken by the real person traveling it and the real person guiding it.

Not what is ideal, but what is real.

I didn’t do what I said I was going to do. I didn’t lift heavy. And if I didn’t know better, I may have thought that because I didn’t, I failed. But the point of lifting heavy wasn’t to lift heavy, it was to make those all-important changes in how I perceived myself, my capabilities, my pain.  And it was to take that new understanding and make it work for me, on my own, without being dependent on someone else to figure it out for me. To allow that new understanding to change my beliefs, my habits, my expectations.  My pain. My life.

So I may not have tested myself in the way I thought I was going to, but test myself I did, in a way that was much more meaningful.

And I aced the damn test.

I’m forever grateful.

I did listen, I did learn, I did gain from it. I did succeed.

One last point that I want to make for my practitioner friends is that my enthusiasm for lifting heavy and getting back to strength training wasn’t false. I was genuinely enthusiastic and on board and downright excited about it. I really wanted to do it, and I really thought that I would. (And I still think I will at some point.). But life happens. That’s not where I am right now. 

I like where I am right now, it’s a pretty awesome place to be.

Life happens to all of us, sometimes we have to change course. If we’re empowered with knowledge and understanding, if we’re allowed in on developing the path forward because we understand the why behind the method, we’ll be able to adapt when life happens and still get to where we want to go. Then it’s not just a list of “should dos” that we may or may not do, rather it’s a fundamental change in our constitution that leads to actual change in our pain, our health, our very being.

It will allow us to change our lives. That’s the true measure of success.

What do you think?

As always, I’d love to hear your thoughts, particularly on how to open up these lines of communication to come to a more realistic set of expectations and actions. Patients want to get better. Practitioners want to help them get better. How do we do that better? How do we redefine success? How do we narrow the gap? I feel like this was a success (and for the record, so does Simon!), even though it didn’t look like what I thought it was going to look like, but I also think others may not think so; how do we more closely align those two sides?

Thanks for listening, folks. I’ll leave you with a photo from my new hometown.

I didn't follow through, though I meant to. Sometimes we need to change course to get to where we're going.

I may not have done what I was supposed to do, though I meant to, but sometimes we need to change course to get to where we’re going.

Share

13 Responses to "I didn’t follow through, does that mean I failed?"

    • I loved reading those three words this morning, John! Thank you so very much, you have no idea how much I appreciate you reading my words and giving me such wonderful encouragement.

      Cheers!

  1. What JQ said. And again. And tattoo it on the insides of the eyelids of as many people as you can! Especially clinicians. It’s absolutely OK to not do what you said you’d do when life intervenes, as it does. What matters is the general direction you’re going in – and then using flexible persistence to keep going. Love you to bits Jo!

    • Thank you so much, Bronnie! You know that means a great deal to me, your support and encouragement have been invaluable to me. I can’t wait to meet you in person at the Pain Summit. Love you to bits, too!

    • Thank you for taking the time to leave such a lovely comment, Lise, it’s very much appreciated! I am thrilled that you enjoyed reading the post and it means a great deal to me that you took the time to leave me a message, thank you!

  2. I also wonder how often this gets people to totally give up because they feel they let down their providers or are going to “get in trouble” They dont want to go back and admit that they didnt follow the plan for whatever reasons and either fear they will be dissapproved of or just are embarrassed or feel bad about it.

    And as providers in our current system “compliance” is such a big deal. Either an insurance company, case manager, or work comp doc is ready to cut people off because they arent following the plan or as providers we can write people off because we think they are not committed or whatever.

    Because of your current understanding you are able to look back and rationally reflect on it, but many people are unable to do this. So, they give up on rehab or exercise or work or themselves.

    As a therapist it is difficult to peel through these layers sometimes, and of course sometimes you know part of the issue is that understanding of why they need to do things is not yet there and understanding on our part of the many different parts of their experience that may influence doing things.

    And from my experience, not as a therapist, but just as a living breathing human, changing anything can be hard.

    Thanks for another great post

    • Keith,

      I would suspect you are correct in that people give up because they feel like they can’t follow through. I think part of that giving up is because they aren’t told there are any other options. And they’re rarely a part of the process, they’re usually just told what to do, they’re assigned ‘homework’, but they have no role in determining what that homework is. If people are afforded the opportunity to develop their plan, I think compliance rates would be much higher because the plan would be more meaningful to them, rather than just being told ‘this is what you need to do to get better’. And if they’re a part of developing the plan, they likely have a greater understanding of what will be beneficial and why so that if life happens, they can adapt the plan while still getting to where they want to go.

      I was a model patient. I am a former athlete. I’m a former firefighter. I’m really good at following directions, I’m really motivated, and I’m enthusiastic. But if I’m just given a set of 5 exercises to do so many times a day, exercises that I don’t see how they translate to my goals, need, life, I’m not going to be likely to do them. If I’m like that, I can’t imagine what others are like that don’t have those same characteristics.

      If the goal is to get certain muscles moving without fear and with more ease, finding a way that the patient wants to move is crucial, in my opinion. Specific exercises may be ideal (but I don’t even know that that is true), but that may not be reality. We all need to get better at working with our realities.

      I know that compliance is necessary for work comp/insurance reasons but I hope there is some room to change the plan the patient is to be compliant with. If the patient has a say in their plan with the practitioner, even if it’s not ‘traditional’ sets of specific exercises and is more along the lines of dance for 10 minutes with your daughter tonight or play on the ground with your dog a few times (or whatever is meaningful to that person and is getting them to move in functional ways without fear or pain that will improve their lives – if the goal is to be able to go to the ground and get back up, having a more fun way of doing that is beneficial, if the goal is to improve movement variability and moving with ease and less fear, dancing can be a great way to do that), the report back to the insurance company/case manager can be that the patient is compliant with their movement plan.

      And you are right about my ability to reflect now and that many folks in a great deal of pain can’t. I was that person for years myself, that’s why I’m sharing my experiences now, to try and help others recognize these things early on along their own path and maybe give them some insights (and the people who treat them) so that we can improve their rehabilitation and ability to get on with a life that they love living. The more we all talk about it, the better.

      Change is very hard. That’s the biggest reason people need a say in their rehabilitation plan, they need to be the locus of control. If they’re not, change won’t happen.

      It’s not easy. I don’t have solutions. I just want to keep talking about it so that we can all figure out the solutions that work best for each individual person traveling this path.

      As always, I greatly appreciate your insights, perspective, and comments, they’re invaluable to me when trying to see this pain management thing from many different angles. I am grateful for our discussions! And I know you may not hear it enough from your patients, but you are helping folks to change their lives. Some of it might not sink in until later, sometimes years later, but you planted those seeds.

      Keep on keeping on, my friend!

      • Yes, I have always tried to get people involved in the plan and the things I have been learning from Bronnie have assisted greatly in this for the people who dont have a clear answer especially.

        And asking do you think you can do this? or how do you think you can do this? when we agree on a plan really seems to increase “compliance” as well as making things activities rather than exercises when the goal is more movement in their life.

        • Yes, Bronnie is wonderful at coming up with those leading questions that can help with people who don’t have a clear goal or direction they want to go in. For folks in pain, just getting out of pain is the primary goal and it’s hard to think beyond that! I love how she guides folks, though, through non-threatening language and suggestions, like ‘some people have said…’, I think that not only helps to provide options but also tells the individual that they’re not alone while also giving hope that there’s a way forward. It’s nuanced. And hard!

          Asking about the being able to do it is key, too. That’s a part of motivational interviewing and is also something that I learned through Precision Nutrition through their certification. It’s all about coming up with a next step that the person feels confident they can do. PN has you ask the client/patient on a 1-10 scale how likely they are to follow through with the next step, if it’s not an 8 or above, and usually they want a 9 or above, the ‘next step’ or the new habit is changed until it is an 8, 9, or 10 out of 10. Sometimes you have to regress that step pretty far before it gets up that high, but that’s ok.

          We have many of the same influencers. The more we all get together to share this stuff, the better! I hope more folks will join the conversation, too, from all disciplines and from patients, too.

  3. Pingback: Labels, narratives, identity, and chronic pain - MyCuppaJo.com

Leave a Reply

Your email address will not be published. Required fields are marked *