Low motivation…

In my last post I talked about how many of us have a low tolerance to things that are hard, difficult, or painful. In this piece, I want to talk about how we all have low motivation to do things that are hard, difficult, or painful, and I don’t care how motivated you think you are to things that are hard, difficult, or painful I know every one of you is a lazy fucker.

Now before you go and get mad or offended and start ranting in the comments section let me explain why I think you are all lazy fuckers. I know each and every one of you is lazy because all humans are inherently lazy, even the most devoted, eager, and ardent human is a lazy git given the opportunity because evolution has taught us that being lazy is really advantageous and conserving energy whenever possible is really smart.

And this is the same for all species on our planet, for example, you don’t see a lion going for a jog in-between meals of antelope, or a gorilla doing some press ups to keep buff, or an elephant doing a HIT workout when it’s got some free time. In nature, you will not see anything do something if it doesn’t have to. It’s no different for us humans.

To get a human or anything else to do something that requires a significant expenditure of energy they need a strong stimulus to act. Something like fleeing from a predator, or hunger to catch something to eat, or a sexual urge to reproduce. It’s these basic instincts that motivate us and everything else to move.

To get a human to expend energy without these basic instincts is really hard, really, really hard. For example, many humans know that regular exercise is beneficial for them for many reasons, yet despite knowing this many humans are sedentary and do not do any exercise, and it’s getting worse.

A recent depressing and distressing report found that most humans in the UK now sit on the toilet longer than they exercise per week. Our species appears to be devolving away from exercise as our past evolution is fighting against us. Simply put the motivation to conserve energy these days is much stronger than the motivation to expend it.

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To change this then surely all we need to do is increase our motivations to expend energy? However, barring the zombie apocalypse we don’t have many things trying to eat us, nor do we or have to chase things to avoid starvation or mate with. Most of us live in secure safe environments, with easy access to plenty of food and members of the opposite sex. Basically, our modern world has lost most of the strong motivators for us to expend energy.

The other reason why trying to increase motivation to exercise is not the answer, is that motivation is actually a really weak stimulus to get anything done consistently. Motivation is also very limited and finite, in fact, barring some extreme circumstances motivation tends to runs out extremely quickly for most of us.

Yet motivation is often hailed as and believed to be the answer to getting us moving more and exercising regularly. You only have to go on Insta-google-face-tweet-book to find a gazillion personal trainers, doctors, physios, and other exercise gurus giving their motivation tips, pictures, and videos to encourage humans to move and exercise more. But they don’t work! If they do it’s only for a very short time.

Personally, I think motivation is about as useful and effective as a chocolate teapot to get people to exercise more often and more consistently throughout their lives. Personally, I think its time we move the focus away from increasing motivation and start focusing more on increasing discipline.

Many think motivation and discipline are the same thing, they are not. Motivation operates on the assumption that a particular mental or emotional state is necessary to complete a task. Discipline, by contrast, is independent of and separate from the moods or feelings of a task.

Motivation is about trying to like doing stuff. Discipline is doing it even if you don’t like it.

More need to recognise and realise that discipline is a key skill to master in life. If you master discipline you can master anything, even exercise. Once discipline is mastered you don’t need motivation to exercise regularly. Of course, if you have motivation to exercise as well that’s great, but you shouldn’t rely on it as it will run out, even if you really like doing exercise, and I know this only too well.

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I love to exercise in lots of different ways, mainly running and lifting heavy things and I’ve done these for as long as I can remember. I love the culture, the feeling, the rewards, and even the smells of exercise. Yet despite this, there are many, many times when my motivation to exercise just isn’t there due to a tough day at work, feeling tired, an ache, or a busy schedule. These things often reduce or completely steal my motivation to exercise.

However, despite no motivation most of the time I still go and lift, or run, not because I want to, but because I know I need to. This is the difference between motivation and discipline, and this is what I think needs to be educated, promoted and focused on more in the general population and our patients. More just need to understand that it is still possible to do things even when you don’t want to.

I know many of you will think I am yet again being too simplistic, too harsh or too uncaring towards those who don’t exercise regularly. I’m not, I’m just trying to highlight that trying to increase someones motivation to exercise is ineffective and insufficient and something else needs to be done. This is explaining and encouraging discipline in others.

Now I am well aware that is by no means an easy task and there are huge barriers to negotiate and overcome, but there are lots of ways to improve discipline to exercise regularly. Things like setting targets, routines, rewards, back up plans and having a good support network if possible. But without a doubt, the best way to start having the discipline to exercise consistently is to start with small steps.

Any change is hard to tolerate but small change is less hard. There is an old tale that if you put a frog in boiling water it will jump out immediately as the change in temperature was too much. However, if you put a frog in warm water and slowly heat it up it won’t jump out as you bring it up to the boil. As nasty as this sounds the moral is sound, don’t try to do too much all at once. Small changes done consistently lead to big changes done consistently.

Some research has looked at exercise compliance within physiotherapy and the general population and found it to be low, very low, due to many multifactorial reasons (ref, ref, ref). I also know some research has also come up with suggestions of how to address these (ref, ref, ref) and I think these recommendations should be implemented as much as possible. However, they tend to overlook or ignore the effect of an individuals discipline when it comes to exercising consistently.

To put this as simply and as tactfully as I can many patients need to recognise that the exercises given to them by physios just need to get done, even if they are hard, difficult, or painful. As a physio, I give exercises to patients because they address their problems and issues, such as a lack of strength, capacity, or confidence and are simple and easy to do. I don’t give patients exercises just because they enjoy them, or are exciting, or fit with their preferences.

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Don’t get me wrong if I can find an exercise that covers all of these factors then that would be perfect, but we don’t live in a perfect world, and to be honest not many of my patients get over excited about the squats, deadlifts, or overhead presses I have asked them to do. I know the online functional therapeutic movement gurus think this is abhorrent, lazy, and ineffective and that I should find an exercise that the patient likes to do, but this is just not always possible or practical for an average jobing physiotherapist to do this.

Most physios simply don’t have the time or resources to explore all the potential barriers and issues of why a patient may not do an exercise. Nor is it possible or practical for most physios to play around for an hour experimenting with different exercise or movement ideas to find one that best suits a patients preferences the best.

Instead, a physio needs to find an exercise that will do the job quickly and efficiently and that a patient can do effectively. This often means the exercise is a simple well known and trusted exercise such as a squat, deadlift, or overhead press, not a sexy, novel, exciting, experimental, but often bull shit exercise, nor should it have to be.

In summary more patients and the general population need to realise that if they want to improve their current situation, their health, or have a better quality of life then they have to do things they don’t like or want to do, such as eating healthily, sacrificing some comforts and treats occasionally, and exercise consistently. This doesn’t mean it has to be a complete ball ache all the time but it needs to be recognised that it needs to be hard, difficult and occasionally painful at times.

Often its a case of just doing the fucking work. 

As always thanks for reading

Adam

 

 

 

17 thoughts on “Low motivation…

  1. Hitting the mark spot on as always Adam! Love your honest, straightforward work. Keep it coming. Hope this comment will motivate you 😉

  2. I found myself re-reading this blog entry several times, somewhat unsure of exactly what was intended, or alternatively, unintended, when writing it. To me, it looks like a bare admission that some folks in PT feel they are in a place to judge others, using words such as “motivation” and “discipline” to label clients for not doing what they are told. Are you aware of how paternalistic this sounds? Goodness me, who do you think you are to proffer such utter nonsense? One of the biggest impediments to the PT profession is its attachment to the medical model. Included in this apparently unexplored set of attitudes is the notion that knowledge is power, and so, the professional who possesses such knowledge must therefore know better than the client. From that condescending position, many traditional health professions try to convince the public that it is only by seeing them that such knowledge will be made available to the client.. The public is rejecting such a relationship, yet PT seems entirely oblivious to its own irrelevance going forward. The profession needs to evolve, yet it cannot or will not, perhaps out of fear of what admitting the truth might mean.

    While I enjoy many of your posts, this one not only missed the intended mark, but demonstrated the assumptions related to agency that PT remains blind to.

      • When you write a blog entry beginning as you do here, the reader may not easily understand if you are offering a parody of sorts, as if someone’s belligerent, drunk uncle at Christmas dinner just arrived to spout off with an ignorant opinion. If you are trying to be funny and get a rise, fair enough. But if you really do care about this or any topic, then maybe rein in the SNL skit writing and provide a theory-based argument for why PT program curricula should blend in psychosocial health, incl foundational training in social psychology topics like “motivation”.

        If you expect people to take your courses, your credibility matters, so maybe you might want to raise the bar so it doesn’t look like this is a Trump rally. Clear enough?

        • Darla, just in case you missed this, this is a BLOG. Blogs are for people to express their views and opinions. If you want impartial theory based arguments go read some research and peer-reviewed journals. If you want to hear my thoughts, views, opinions, and a bit of piss taking read my BLOG… or don’t… I dont care… no one is forcing you or anyone else to read this!

          As for expecting or wanting people to take my course… this is not my focus and has nothing to do with anything. As for comparing me to Trump… this is a tiring and boring tactic that you and many others do in an effort to detract the focus away from my points and onto my tone or attitude. Its pathetic.

          This conversation is over… don’t like it… tough… as this is my blog… my rules!

          • You mean to say that there are others who point out to you that you sound like Trump? Maybe that should give you some pause?

            I have appreciated reading well-supported criticisms. However, my concern is that this blog is more about you looking for attention by being obnoxious and noisy, rather than an authentic desire to reform the PT profession using best evidence and rational argument. If you cannot tolerate dissent here, then this is a fishing expedition in search of sycophants.

  3. Wow, superb observations. So, so true. As a physically fit 61 year old – in spite of various permanent issues (snapped – hence missing bicep for example). The true key is discipline. Motivation is a valid factor, I often use it while at the gym if slightly tired, however it is the discipline that has got me there in the first place. I am not a health professional, but really enjoy your honest takes. Keep it going.

  4. Maybe the larger issue here is what are society’s expectations of health care providers (physicians, nurses, physiotherapists, social workers etc..). Are we expected to motivate and convince patients/clients to take an active role in their health OR are we expected to educate patients/clients on the importance/benefits of taking an active role in their health and ultimately leaving it up to them to decide whether to do so or not. These are actually two completely different things in my opinion. The former actually being more paternalistic while the latter being more mutualistic and patient centered.

    I would argue that persuading patients to CARE about taking an active role in their health should not be our responsibility. But, we can educate them and let them decide for themselves what is important to them.

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