Knowing and Nudging Terroir Part 4

Fake It ‘Til You Make It

At the end of Charmaz’s paper from which I continue to heavily quote in this series, she touches on treatment teams working in these spaces with patients. She has many astute observations, but this is likely my favourite:

Flickr.com: L. Filipe dos Santos

Patients and practitioners may hold very different frames of interpretation about the patient’s condition and what it implies. A practitioner can look over the present on into the future and make predictions and estimations of potential gains and conceivable losses. The patient also looks over the present, but not to the future. More likely instead, he or she goes back to the past for a frame of reference. This patient may have no other ready set of comparisons. When the past forms the frame of reference, compliance to stave off an ambiguous, perhaps unarticulated future seems unlikely.

Having the background in eating disorders that I do, it was a common refrain that I saw of people wanting to get back to the way things were before the eating disorder was activated— that there was a recovery process, a cure and then a return to normalcy. In fact, I wrote about it: When Will I Be Done? What I did not know then is that this common refrain was just folks going back to their past for a frame of reference when they were facing an ambiguous and unarticulated future that has uprooted both self as concept and self as habit.

The trouble with the onset or diagnosis of any chronic illness is that it is not a time conducive to self-directed experimentation and adventure. When Lefie speaks of change training in the video shown in Part 1 of this series, she speaks of it being accomplished during times of relative ease and lowered stress. Fun change. Mini-change. Change that can be walked back. Switching up habits as experiments is one thing; but habits that have to be adopted whether you are ready for them or not, is quite another thing.

If you are now living with a diagnosis – then the time to play at habit switching has passed. The good news is that you are undertaking something a bit more transformative— you are reconstructing the self.

The key to this process lies in Charmaz’s point: 

Habits can become a bridge between self as process and self-concept as a stable object. Developing new habits contributes to the self as process and the reconstruction of identity after loss or change. 

For most with a chronic illness, the new habits that have to be adopted are either relayed to you by your treatment team; or else the body/mind itself demands that the old habits stop as they damage you in pretty noticeable ways.

You will fail and you keep trying. You will fake it until you make it. The critical difference in habit switching that is needed vs. habit switching that is change training, is to recognize that returning to previous habits is not respite; it is relapse.

If Lefie goes without coffee for 30 days; she can return to coffee after that point— challenge then respite. However, if Lefie has been told by her doctor that she needs to stop drinking coffee because she has developed a life-threatening allergy to the coffee bean in all its forms, then drinking coffee is never going to be respite from this point on.

I loathe “safe foods”— the phrase, the concept, the use. I particularly take issue with using “safe foods” in eating disorder treatment as a reward for embarking on successful fear-food challenges.

It is important not to confuse failure with respite. It is very, very okay to fail when having to take on new habits that are being foisted on you in order to survive or have better health outcomes. But falling back to an old habit in these circumstances is damaging and not rewarding.

It is even more important to be self-compassionate. Even a big failure that results in objectively really serious damage and perhaps a very bad outcome, is just you being human like everyone else. It is equally important to be honest and to own the behaviour and the outcome. Then learn. 

Where would you experience any respite if you are having to adopt new habits whether you want it or not and you cannot just “take a break” from the new habit because it is not a change experiment but your real life? You experience respite in the integration of those habits. “And life subsequently feels natural, as people’s changed habits fit their current situations.”

Prepare for the Plan

I want to take a moment to revisit the few first-person experiences that were posted here on this site over the years. I recognize of course that these few examples are not exhaustive and are not in any way representative of the whole, but there are some interesting similarities across the experiences described by Kerrie (one and two), Melissa, Nicola, and Natalie.

The adoption of new habits triggered self-concept reconstruction for each of them in very different ways. Although the details are starkly different for each, I would say the common ground is that it was necessary to emphasize areas of softness in their self-concepts so that new habits could be applied and subsequently give rise to a new self-concept. 

I believe there are also techniques we can use to prime ourselves for loosening our grip on hard self-concept borders. And in Part 5 we will look at how to prime ourselves as further preparation for adopting new behaviours and change.