I recently had a fascinating conversation with Dr. Amanda Wurz, PhD, on the science behind successfully changing our behaviour. Achieving our own unique aspirations often requires changing our behaviour, and that’s a big part of what makes it so hard. Amanda breaks down why behaviour change is so freaking hard, and provides a tonne of tips and tricks to make it a little easier.

Amanda has a unique ability to explain nuanced ideas in an easily understandable way, and her enthusiasm is infectious. I first met Amanda when she was completing her PhD at the University of Ottawa. As if completing a doctoral degree were not all-consuming enough, Amanda was also teaching spin classes at a studio where I was a member, as well as completing her yoga teacher training. Amanda's enthusiasm, energy, and exuberance for life were irresistible, even in early morning classes so intense that joy was the last thing on my mind.

Since that time in Ottawa, Amanda has completed her PhD, as well as a postdoctoral research fellowship from the University of Calgary. Amanda now works as an assistant professor at the University of the Fraser Valley in the School of Kinesiology, in British Columbia. Broadly speaking, Amanda's area of expertise is exercise psychology, and her (very active!) research program integrates relevant behaviour change techniques and psychological theories and knowledge to support movement for people with chronic conditions, primarily young people diagnosed with cancer. She also recently developed the university's first physical activity behaviour change support course. 

I learned so much in this conversation, and I’m starting to road test some of the tips and tricks Amanda shared – many of which surprised me. I'll be sharing my road test results in upcoming newsletters. You can sign up here to receive them!

I’ve edited our conversation for clarity and length, but if you’re interested in checking out the entire conversation (including our thoughts on the downsides of optimizer culture and whether it's possible to habit-stack cold showers with air squats), you can watch the video of our chat below.

 

And you can find out more about Amanda’s work and research on her Google Scholar page here and her page on the University of the Fraser Valley website here.

MJ: Thank you so much Amanda, for joining me to chat. I really appreciate you taking the time.

Amanda: Thank you! I'm really excited to be here to talk about behaviour change. I've spent a lot of time trying to figure it out.

MJ: I know you wanted to start with a quick level set on how you're going to talk about science in this conversation, especially given the complexities of the human body and human behaviour, and your own area of expertise. I think that's a great place to start the conversation.

Amanda: I always like to let people know – particularly on this topic – that there is still a lot we don't know. We haven't figured out the magic pill to get people to start or even stick with certain health behaviours. What we see across published research is nuance. This can look like some studies finding effects or patterns when we use certain behavioural approaches, and other studies not finding these effects or patterns. It can look like rapid evolution or slight shifts in understanding when new data is published.

And now more and more researchers are highlighting that we need to individualize and tailor. So if you were hoping for a one-size-fits-all or magic strategy to start or even sustain a new behaviour, I'm very sorry to start us off by telling you that it's hard, it's highly individualized, and it requires patience and acceptance of setbacks and missteps. When I talk about science and this topic of behaviour change, I try to share what we know and provide a range of evidence and informed tips and tricks that you can try on for size. 

I’d also like to share that while I have a background in exercise psychology and behaviour change science in general, my specific area of expertise is with individuals with chronic conditions. Primarily young people with cancer, meaning children, adolescents and young adults. I think that's really important to highlight, because while I feel I'm very well equipped to have this conversation, it's important to be clear about the lens that I look through in my work and that I'll bring into this conversation. 

MJ: As background, I'd be curious to hear how you got interested in supporting getting into exercise and studying its effects on people who are experiencing chronic health conditions. 

Amanda: I've always loved moving my body and am fascinated with how we make sense of and move through the world. And I got pretty lucky. Early in my training, I was exposed to the field of exercise psychology, which focuses broadly on the psychological aspects of physical activity and exercise, including understanding why people do and don't engage in exercise, and how exercise impacts wellbeing and other outcomes. 

I met an incredible professor, who's a mentor to this day, and she shared her work with individuals living with and beyond cancer and the effects that she was finding with exercise. Like many people, I had known people affected by cancer, my life had been touched by cancer, and something clicked. So I knew really early that I wanted to have a career that merged my love of exercise, my love of psychology, and that could hopefully positively affect the lives of people with chronic conditions. And as for working with young people, I've always loved working with children, and so focusing on that population just made sense. 

As I started to focus on young people, I realized there were some glaring gaps in the literature in terms of what exercise could do in supporting recovery and mental health and wellbeing. So I've spent the last 15 years getting to do what I love, mainly with young people with cancer. I do some work in other populations as well – individuals with scleroderma, and more recently, I've started to look at exercise and behaviour change support for postpartum moms, given that I've got a little 16 month old at home. 

MJ: Is that also an under-researched area, or is it getting more attention? 

Amanda: It’s incredibly under-researched, although it's getting more attention recently. But it's surprising when you think of all the women who have babies globally, all the women who are navigating this huge change in their life and their body. Exercise is a great tool, and we don't have a lot of guidance or support for what they should be doing in terms of exercise postpartum. And we have even less in terms of behaviour change supports. So it's been a very exciting and eye-opening experience, paying attention to this field now. 

MJ: I know that the population with chronic health conditions is your deepest area of expertise. What have you learned from working with a population living daily with chronic health conditions?

Amanda: I've learned that people are incredibly resilient, so much more so than they give themselves credit for. And with regard to the young people I work with, I've learned and am reminded often that they aren't their diagnosis. They are children. They dream, they play, they're silly, they find joy, even amidst what for many is a really unimaginable circumstance. I've had the opportunity to witness young people living and dying with acceptance, with generosity – to contribute evidence and change care – and with determination. I truly feel like my work is one of my greatest gifts in this life, and I have been changed in ways I don't even think I can articulate – in the way I go through my day, in the way I look at the world – because I've got to work with these incredible individuals.

MJ: The concept of behaviour change sounds pretty simple. But I'm curious in terms of the context of your work and your research, how do you define behaviour change? 

Amanda: The concept of behaviour change simply captures altering how we think, feel and ultimately act, so our behaviours. There's no crazy definition, it is as simple and straightforward as you just described.

MJ: Perfect, and if it's so simple, we know that it's very easy to do as well! That was actually my next question – why is behaviour change so hard?

Amanda: It is hard for many reasons. First, we see people erroneously assuming that it's just about their own motivation or willpower. But behaviour change is rarely in our control alone. We are influenced by multiple levels, and that can be hard to remember. I'll quickly go through some of these influences, because I think it will help to understand these forces that we're up against. 

First, we have influencing forces from the societal level. This can include things like public policy, cultural values, healthcare structures, or social inequality. 

We also have influence from the community, meaning the areas where we reside, and the organizations and institutions we're a part of, like our schools or our workplaces. These all influence the availability and accessibility of resources and supports. 

Then we have the interpersonal influences, like the relationships we have with other people. These have a powerful sway over what we do and don't do. For example, lack of support from family or friends, the types of people we surround ourselves with, their behaviours, and also social media. All of these can influence us. 

Finally, at the center of these competing influences, is us, the individual. And here we still have a lot of barriers or challenges. Things like our knowledge, attitudes, beliefs, confidence, physical and mental health, skills, abilities, motivations and willpower, which can all help or hinder our behaviour. 

We’ll spend most of our time today talking about the individual and interpersonal factors, mainly because this is where I spend my time with people. But hopefully we won't forget that there's more to it than that. So even if we change our attitudes, we still might be up against barriers at some of these other levels. 

To circle back to your question, it's hard because it's layered. There are forces at multiple levels, and all of those things can make it harder for us. So it's not just about us and our motivation or willpower or lack thereof.

MJ: From my own perspective, I often think as long as I can just control me, there should be no problem. So that is a really great encapsulation of why it's so hard to make changes.

Amanda: It's easy for us to think it's all within our control, because we like to think that we're able to control our own behaviour and our own experience. And to some extent we can, and there are things that we can do to support ourselves and set ourselves up to make lasting behaviour change. But sometimes we put it all on ourselves, and we forget that we exist in this wild world, in these crazy contexts. So let’s start this conversation into behaviour change with that in mind, and maybe some grace for some of the things that we're up against as we go through the slog that behaviour change can be.

MJ: Say we have something we want to change. With this broader perspective in mind, what are some of the first steps we can start to take? 

Amanda: The first step is to get clear on what exactly you want and why you want it. Reflecting on why this thing is so important to you. What will it allow you to do? What will it allow you to experience? Is it tied to your values in some way, or who you want to be? If yes, how? 

In the context of my work, it's physical activity behaviour change, and why changing that thing is important. What is it going to allow you to do beyond lifting a heavier set of weights? How does it tie to who you want to be, who you already are, and maybe other relevant goals or aspirations you have for yourself? 

This clarity on the “why” is really important for both our motivation, and to make lasting change that we can fully integrate into our lives. It needs to be tied to our values, who we are, who we see ourselves striving to become. 

After we get clear on what we want and why we want it, we need to reflect on what we're currently doing. We need to understand what exactly needs changing, and we can't do that if we aren't honest about what our behaviour currently is. 

After that, we set goals, because goals give our actions direction and energy. They can help us with motivation, and there's tools that we can use to help people set goals in ways that are structured to support their behaviour change better. 

Once you've gotten clear on what you want, why you want it, what you're currently doing, and have set a couple of goals, then we need to actually plan for them. Those are the first steps that we can take, before we've even gotten to changing.

MJ: That's a lot of steps that happen before an action is even taken.

Amanda: There's a lot of pre-work that goes into it. So when you talk about why it's hard, there's layers. There's the pre-work that goes into it, and then there's the actual effortful changing of behaviour. It's a process.

MJ: Once someone has actually identified a goal that's personally meaningful to them, is there a generally acceptable method for achieving it? 

Amanda: I’ll back this up and focus us on the goal part first. When setting goals, we often recommend setting SMART goals, which is just an acronym for setting goals that are specific, measurable, attainable or achievable, relevant and timely. And in my work, specifically in health behaviour change, we recommend setting SMARTT (with two T’s) goals. The last “T” stands for together.

Once you've identified something you want to change, set some good goals for yourself. This is one of those early steps that's going to set you up for success in the longer term. Your goal should be specific. You should be able to very easily answer, “what do I want”, “why do I want it” and “why is this important to me”. 

We want to be able to measure our goals. We need to be able to track progress. We can do this by answering things like, “how much” and “how often”. How will you know when you've actually accomplished this goal? 

We want our goals to be attainable or achievable. Our goals need to be realistic to be successful, which doesn't mean they're easy. I actually see this a lot – people starting to set goals that they could achieve in their sleep. A great goal should stretch your ability but remain possible. We want something that feels just out of reach, but within the realm of possibility. And we can make sure our goal is achievable or attainable by answering the question. “how can I accomplish this goal based on my history and other current constraints?” 

Our goals need to be relevant. We spoke about this when we talked about specificity. Your goal needs to align with other relevant goals. It needs to matter to you in order for it to hold weight. 

Then we want to set goals that have some sort of timeframe, some sort of deadline that we can be working towards. 

Then the final T in our SMARTT with two T's goals is together. Who is supporting you in achieving your goals? What does the support look like? Who can you do it with? 

I want to highlight that when you're setting your goals, think big. Have big, lofty goals, and then the intention with these SMARTT goals is to scale back and set multiple smaller goals that we can achieve. This is because of a little trick – our confidence is increased when we experience success. If I experience success somewhere, I'm going to feel more confident I can do it again or take that next step. When we break big goals down into these small goals, we get these little confidence hits. And confidence is one of the biggest predictors of future behaviour. If we can find ways to increase our confidence as we're working towards big ambitious goals by breaking it down into bite sized pieces, we're going to be more likely to stick with these little steps that can get us to our big goal. 

One more thing – once you set goals, make sure you revisit and update them. Oftentimes I'll see people setting amazing goals – they're specific, they're measurable, they're perfect, and then they just set them to the side. So we want to revisit and update. If you're meeting your goals, set new goals. It means now your capacity is greater, so you can set goals that push you to strive a little bit further. Or sometimes our circumstances change. We talked about all those levels of influence – sometimes things happen that are out of our control. If we have goals we've set and we don't revisit or revise them to reflect our current circumstances, we can get discouraged and table that goal altogether when really slight adjustments to the goal mean that we can stay on track. We might just change the timeline, or scale back a little bit more than we initially had planned to. 

So set goals that get specific, are measurable, achievable, are relevant, time bound, and include other people. And then come back to them often to make sure that they still are relevant to you. If you've met them, great. That's a huge win. Set another goal. 

MJ: For the measurement part of the acronym, I was going to ask if it's just one measurement at the very end, or milestone measurements. But it sounds like the sequence of smaller goals creates that measurement of progress as you go.

Amanda: Yes, this is another tool that we recommend. For the measurement of progress, we can use something called self-monitoring. Most of us already do it without realizing. It's basically a way that we can track and record our behaviour so that we can get insight into patterns, identify areas for improvement, and hold ourselves accountable. This can also help us stay on track with our goals. If we have little measurement touch points, and we're self-monitoring on a daily or weekly basis, we're able to see if and when we veer off course a little bit. 

Exercise is an easy example. We can self-monitor in high tech ways, like our Oura rings or smart watches. Or we can do it in low tech ways, with pen and paper, a journal, a calendar. If we set a three month deadline in our goal, we don't want to get to the three month mark and realize that in week one, we actually stopped doing what we planned to do. 

MJ: For me, self-monitoring often comes holding hands with self-judgment and self-criticism. Is there anything that you have noticed can help people keep the helpful accountability part of self-monitoring, but get a little bit of distance from the self-criticism/self-judgment piece?

Amanda: I love that question. One of the things that I've been spending a lot more time researching and am embedding more in our behaviour change and support interventions is the idea of self-compassion. Dr. Kristin Neff has done some amazing work in the area of self-compassion [Note: you can find out more about Dr. Neff’s work at https://self-compassion.org/]. 

Essentially, self-compassion is giving ourselves the same kindness that we give to other people. It's hard and it’s a practice. We can do it by looking at how we speak to ourselves and noticing when that inner critic comes out, and then flipping the script and asking, "If my friend were saying this to themselves, what would I say to them?" Let’s use the voice that we give so readily and easily to the important people in our lives, on ourselves. 

We can also remember that we are human. When we check our watch and we didn't get the step goal that we'd set for ourselves, we can remember that we're human beings. And being human means making mistakes. There's no way to disentangle that. When we make a mistake or when we don't do things as perfectly as we think we should, we forget that everybody else is making mistakes and isn't doing things perfectly. We get so caught up in ourselves that we forget that there's this whole rich tapestry of people making their own mistakes and fumbling their way through their lives.

Then the third element of self-compassion is the idea of mindfulness. Just sitting with, paying attention to, being aware of. 

All of these things sound lovely but they're really hard to do. I’m hoping a theme from our conversation today is going to be one foot in front of the other, progress over perfection. It's all a process. We get into this idea that we have to have a goal done by a certain timeline. But we've got our lives ahead of us to slowly make these steps and improve in areas that are important for us.

MJ: I can already see that change is complicated and hard! Is there a pathway to creating lasting change that the research bears out?

Amanda: We do have a pathway or a process. It's a staged process that we typically see people go through when attempting to change behaviour. I should highlight that it's not linear, it's not a one time event. It's a messy pathway. It's gradual. We see stops and starts and relapses, where we might move from one stage to the next and then revert back to earlier stages. And that's all expected with behaviour change.

First, we have what we call the precontemplation stage. This is when we aren't even considering changing anything. 

Then we move into the contemplation stage. Now we're starting to think about changing our behaviour. 

From there, folks will typically enter the preparation stage. Now we're thinking about changing our behaviour. We're getting ready to take action. Maybe we're making small steps. 

And then we get into it. This is the action stage. This is the hard stage. It's volatile, it's effortful, it's uncomfortable. If you are changing a behaviour or have just started to do a new behaviour, you're probably in this stage. Success here depends on staying consistent, overcoming setbacks, reinforcing the new behaviours through self-monitoring, accountability, positive feedback from others, and starting to change or notice our own self-talk. It's the messy middle phase. 

Once we've been in the action stage for six months, then we move into maintenance. It's feeling a little bit easier. We might have built some habits. We might have some routines, maybe some momentum. It's not feeling as brand new as it was in the action stage. People might hang out in maintenance for a year or many years, and they might, at times, revert back to those earlier stages. 

After maintenance, we have some people moving on to a stage that we call termination. This is where we have fully integrated the behaviour into our lifestyle. Once we reach termination, we're no longer at risk of reverting back. It's just part of who we are. It's become automatic. There are probably things in your life where you've reached termination that you don't even think about anymore because it doesn't require resources or effort to do it. 

The pathway from precontemplation to termination is long, variable and non-linear. For some people, it's longer than others. We can move towards it by setting and revisiting goals, planning for setbacks, integrating self-monitoring, and getting crystal clear on our “why”. 

I'll highlight the “why” piece. We talked about it at the beginning, and it's really important here too. If we want to fully integrate something and have it become automatic, part of our identity and who we see ourselves as, we can only get there if that goal is already valuable to us. We want to set personally meaningful goals so that as we're slogging and pushing through and having setbacks and missteps, we're all the while working towards something that eventually we can fully integrate within our lives and just view as part of our identity and who we are. We get clear on our what and our why, because that link is so important. 

We also want to get clear on our own personal what and why, because as humans we have an innate need or desire to have autonomy or choice. It's actually considered one of our basic psychological needs. So while choosing our own goals, we are fulfilling one of our basic psychological needs and hopefully setting ourselves up to move towards integrating this behaviour within our lives.

MJ: An example of the change pathway that comes to my mind is weightlifting. It took me years to get to the termination (or integration) phase. Now my current change pathway is probably cold showers, but that's another topic.

Amanda: It’s interesting when you can look back and reflect on the hard things you've already done. We don't give ourselves credit where credit is due. You just mentioned cold showers, so that's the next health behaviour that you know you want and why you want it. You've done this before. You know it's not going to be easy, but you've done this process. 

And there are probably things that you could take from your years-long journey with weightlifting and apply. I imagine maybe you had a trainer. Maybe you were at a gym where there were other people. You probably had something that we call action plans, which is where you lay out what you're going to do, when you're going to do it and who you're going to do it with. You take some of the thinking out, because we know that motivation drops, it ebbs and flows. 

And I'm imagining you also had something we call contingency plans – if something comes up, here's what I'm going to do. If I travel, I'll find a gym, and I'll still engage in my weightlifting. If I get sick, I will take rest so that I can come back prepared to start again. If → then, if → then. 

So if you're finding that you're having a hard time with a new health behaviour, you can look back and see, what did I do when I successfully integrated a behaviour change in the past? What are some of the structures I had set up so that I could get into the slog, stay in the slog, and then stick with it for multiple years before having it become something that is just part of my day? 

MJ: It had not occurred to me that we could use the things we've already accomplished in that way, but it's so helpful.

Amanda: I think we're pretty hard on ourselves, and I see people getting really hard on themselves when changing their behaviour. We're doing this thing we've never done before, or we've never done before successfully. And for some reason, we expect it to be easy and go perfectly, and then we're surprised or we beat ourselves up when it doesn't. 

But if a good friend was telling you that they were starting something new that was uncomfortable but this thing was really important to them, you'd say, “Oh, keep trying, keep going! You've got this. It's going to be hard. Look at you pushing through this hard thing!” Again, that comes back to the self-compassionate view, or how we speak to ourselves.

MJ: That's a great lead-in to a question I've been wanting to ask you. Are there mindsets that you've noticed are particularly helpful to start and then also stick with behaviour changes?

Amanda: We see pretty consistently in the literature, and anecdotally in practice with the patients I work with, that people who are mentally tough, resilient, self-compassionate and who are accepting of mistakes seem to have higher levels of physical activity and engage in other supportive health behaviours. Those are the mindsets that we see most commonly linked to starting and then actually sticking with lasting behaviour change.

MJ: Do you see a lot of people who have both mental toughness and self-compassion? Because I've got to be totally honest with you, I haven't seen that combination a lot.

Amanda: Maybe I'll talk about how we define or describe mental toughness, and bring back self-compassion, because there’s a lot of overlap. 

When people who are mentally tough encounter a negative experience, a challenge, a big goal or a setback within a goal, they look at the situation as a challenge to overcome and an opportunity for personal growth. They believe they have control over their experiences and their ability to achieve. There's the sense of agency we talked about earlier. They have confidence to overcome the challenge and they're committed to it. 

There are sometimes characteristics that are linked to mental toughness, like competitiveness, determination and desire, but really this idea of mental toughness is about encountering a challenge and viewing it as an opportunity for growth, self-development, or something that can be overcome.

MJ: So it's not that I can control what happens to me, but I can control my reaction to it.

Amanda: Yes, and I can see this challenge as an opportunity for me to try a new skill, to use one of the tips or tricks I’ve learned. I feel confident that I have the resources needed to overcome this. It's just a way of looking at challenges and instead of saying “Oh, a misstep, I'm done”, saying, “Okay, I've got this. Let's try. Let's do some hard things today”. Maybe it's big hard things, small hard things. It's similar in a lot of ways to resilience, which is our ability to bounce back from setbacks and keep going despite difficulties. 

Then self-compassion, which is what we're comparing here, is the idea of self-kindness. Oftentimes we mistake self-kindness as being “easy” on ourselves, but practicing self-compassion is about the three things we talked about: self-kindness, humanity– everybody makes mistakes – and mindfulness. 

Self-kindness doesn't mean I'm going easy on myself. It means I'm holding myself accountable. What is the next right step? What is the next thing I need to do? I'm also going to recognize that this setback is normal, and then I'm going to view it as an opportunity for me to practice and hone the skill of mental toughness. I'm going to overcome this – not sure how yet, but I'm going to keep going. 

So mental toughness and self-compassion aren't the same construct, but there's overlap. And people who have one often also have the other. 

MJ: The way you define mental toughness, I can see how it would align very nicely with self-compassion. And thank you for calling me on my own personal definition of mental toughness, because I think it is based on being very hard on myself to keep going. 

Amanda: Mental toughness doesn't mean that you never take rest or take breaks. For a lot of people, this is not a skill that's innate or natural– athletes work with mental skills consultants to hone the skill of mental toughness. Sometimes we see popular culture depictions of mental toughness as never resting, never stopping, constant striving. But when we go to the definition of what mental toughness is, and when we research it, it is people who view a challenge as something to overcome. It very much encompasses this idea of a growth mindset and being process oriented.

MJ: You had talked about the extra T in the SMARTT goals your field uses – togetherness. I was wondering if you could talk a bit about how important community and social support are to achieving sustainable change.

Amanda: From a behaviour change lens, our community – the social support around us – isn't just helpful, it is absolutely crucial to making any sort of sustainable change. We actually see social support to be among one of the strongest predictors of long term success when trying to adopt or maintain new behaviours, especially in the context of physical activity and other health related behaviours like nutrition changes. 

There are different types of social support. First, other people can provide us with companionship. Having people around you who are aware of your goal, who you can do it with. 

Social support can also provide us with encouragement. We know that motivation is going to dip. It's normal. Having people to cheer you on and remind you of your “why” can help you get back on track. We also know that positive reinforcement or encouragement from other people is related to confidence. If we have other people boosting our confidence, we're going to be more likely to stick with it. And if we've had a misstep, they’re going to remind us it’s normal and then tell us to keep going, because we've already put in so much time and effort.

Other people can also provide us with important information and link us to resources. Maybe a friend sends you a podcast, maybe somebody sends you a list of gyms in your area. 

Then the final type of support that we particularly study in my area is tangible support. These are the material things. For example, if I didn't have a partner willing to do the wake up with my daughter at 6am, I wouldn't be getting my workout in. Or it might look like somebody driving you to a class in the dead of winter, if you don't like driving on winter roads. Or it could look like somebody buying you a month membership somewhere, or making sure there is money within your budget so that you can allocate it to your goal. When I talk about social support, I often get people to think of a behaviour they are trying to change, and if they have these supports. Because if not, there's a good chance some of these things are going to get in the way. 

MJ: Is there an accountability piece with community as well? I don't want to put undue pressure on people, but I personally find it quite motivating and I've heard from others that they also find it motivating. Is there a line between encouragement and social accountability, and too much pressure?

Amanda: I love that question. Yes, at first I will say you are 100% right. We see accountability often in the literature. Especially when we do qualitative interviews – when we talk to people to find out what their group experience was like – participants often say, “It was great. I knew that people were expecting me to show up and having that accountability got me out the door.” 

When you talk about a negative or dark side to social support, I will speak to my area, and that's with young people. And we do see a double-edged sword, where sometimes too much pushing can be unhelpful. However, that's within a context of children, adolescent-parent relationships, and developmental psychology, which is a whole other area. 

In terms of when you're in the community with other adults, I would say offering encouragement and accountability is more likely to be helpful than harmful, though there’s always nuance and individualization all across the board. Some people might be in a phase where that accountability won’t be as helpful or just personally isn’t the best way to support. I’d say a rule of thumb for most people is that accountability is going to be helpful. I wish I could give you a clear cut answer – each of us, based on our own personality, our lives and our context will find those supports more or less important. 

MJ: If someone has identified a lack of social support, whether it's the community aspect, resourcing or support at home, are there some good ways to build that up? 

Amanda: Join a group or a class, or recruit someone to join you. Let the important people in your life know your goals and what they are. I often see people keeping their goals to themselves. You need to let people know and maybe bring somebody else on board. Have someone else do it with you and check in afterwards. Join communities online, that's a beautiful place for people to start to get that social support. If you can't find a group that resonates with you, create your own and find other like-minded people. 

If you have the means, depending on the behaviour you're trying to change, find a coach, a trainer or a mentor. Then the final thing – and this is probably going to be the hardest thing – practice asking for support and help. In general, we aren't good at asking for support. We can practice it, and I think we'll be surprised by the people who will show up and the support that we already have. Let's start practicing asking for it and getting the support we need to achieve our goals. 

MJ: You have covered a few so far, but could you summarize a few booby traps that can arise when we're trying to make these sustainable types of change?

Amanda: A major trap is that we don't plan for the setbacks. We adopt this infallible mindset when starting a new behaviour that we've either never done before or we've struggled with in the past, and then expect it to be perfect and go without a hitch. We can get around this by making our goals, revisiting them often, and making plans. 

Make contingency plans, thinking through all of the things that are going to stand in your way. These can be things outside of our control, like crazy weather or a sick kid, or it can be things in our control, like having a low motivation day, a lot of negative self-talk, or feeling really doubtful. So we make a list of those things, and then we plan for them. That way we don't need to be relying on our motivation or our creativity to overcome a barrier, we just automatically do what we planned. 

We can also practice some of these things we've talked about, like self-compassion, building our mental toughness, resilience and getting people around us. 

I mentioned this already but it's really important – explicitly tell your network what your goals are, what you need and how they can support you. 

We often see people rely on motivation or willpower alone, and then when their motivation dips, their behaviour stops. So here we can practice little habits or routines. Remember, the goal is to get to termination or integration. 

We can start to habit stack, or build these things into our day and be more likely over time to automate them. I love this idea of habit stacking, and we talk about it a lot with people who are starting quite low in terms of movement and physical activity. When you’re brushing your teeth, that's where you can do calf raises and balance. You're making coffee, that's when you're doing your air squats. 

We can get even more granular with our goals. If your goal is simply to move more in your day, what are you already doing? Stack your movement on there. What other habits do you already have? How can you add or build on them? 

As a final one, I do often see people stopping because of boredom or burnout from doing the same thing. It can be exhausting. If we set too big of a goal, it can be really draining, because we're caught up in the tedium. We don't see the progress we're making. 

Try centering variety, adding fun, trying different exercise classes, different formats and different settings. My bias is likely coming in here too, because I work with kids and they love to play. They love change. As we get older, we forget to center fun. There's a lot of ways that we can make the things we want to do more exciting, fun and playful. We get this set idea of what things need to look like for it to be successful behaviour change and we forget that we can make it a fun time along the way. So if you find yourself in these periods of boredom or burnout, step back. How can we make this a funner time? How can we make this a little more playful? 

In summary I'd say not setting up for the inevitable setbacks, not recruiting social support, overly-relying on motivation, and then getting bored or burnt out are the main places we see people fall off and then not get back on their behaviour. 

MJ: The only one I was wondering about that you didn't already hit on is moments of frustration. Is there anything you've noticed is helpful when people feel frustrated? 

Amanda: I like to share the reminder that you're not alone. If you're feeling frustrated, it means you've probably been doing it right and sticking to it for long enough that you're now frustrated. So remembering that that's part of the process. I think we have this tendency as humans when we experience negative emotions to feel like we want to get rid of it right away. Whereas oftentimes, it's a signal that you're doing the right thing. 

Keep going with your accountability, or take some more accountability. Maybe reach out to your network, maybe plan for some purposeful rest. 

If you keep feeling like you're banging your head against a wall, maybe this is a beautiful time to sit down and revisit and reflect on that goal. Is it still important to you? Is it still tied to your values? Have your circumstances changed? If it's still really important to you, circumstances haven't really changed and it's just a really hard goal, then remember everybody feels this. It's not fun feeling frustrated, but that's also going to pass – you've got all your plans in place and you're just going to keep going.

MJ: Switching gears a little bit, you're probably well aware that there is a tonne of content out there on fitness, wellness, optimizing ourselves and healthy lifestyles. A lot of it is created and promoted by people with medical and scientific backgrounds. Is there anything about this kind of content that frustrates you?

Amanda: Yes there is. It’s an interesting dynamic we find ourselves in. It is such a gift that we have access to information the way we do. And I think most of the time it is well intentioned, well meaning and the goal is to share. But there are things that I sometimes get on my little soapbox about. 

The first is oversimplifying complex topics without acknowledging variations in evidence. I sometimes see people describing a single study that actually doesn't capture the nuance or what we're seeing across the literature. And most science – at least in my area of behaviour change – is not very sensational. But sensational is what sells and what gets people to come to the podcast or the YouTube page. 

I also see a tonne of one-size-fits-all messaging. Just because something worked for that expert doesn't mean it's going to work for everyone. Just because one single study found that something worked in a very specific population, in a specific context, in a specific moment in time, doesn't mean it's going to work across the board. Our bodies, our goals, our motivations, the context we find ourselves in, vary widely. Individualized approaches are often the most effective, particularly in behaviour change, and what more and more researchers are turning towards. 

With health messaging it bothers me to see – particularly with the population I work with – moralizing health behaviours. Sometimes there’s an underlying message that being fit, or drinking this green smoothie, is going to make you better-than. That can fuel really maladaptive emotions like perfectionism and comparison, which are both linked with poorer mental health. It can actually stop people from engaging in health behaviours altogether. And when we moralize health behaviours, we overlook all of those layers that we talked about earlier and focus on the individual only. When I see this messaging, it feels insensitive to people navigating different or more complex circumstances. 

I've also seen health narrowed down to a single dimension of the physical. But there are many more dimensions to health than that. We have emotional, social, financial, spiritual, vocational and environmental dimensions of health, and when those are left out of every conversation, it feels like the advice isn't complete.

I get frustrated when science is misrepresented. That can happen when a single study is oversimplified, but science can also be misrepresented by talking about studies in certain populations and then explaining it in a way that is generalizable when maybe it's not, or if we're extrapolating from animal models to humans. We're different than mice. 

I also see the over-utilization of jargon that muddies the message and makes it so that people can't fully understand what is being shared, and that feels like a missed opportunity. 

MJ: I personally think that even some of the most problematic content creators and promoters who do fall into the sort of behaviours you've described still often have some great little nuggets. What would you suggest people keep in mind when they're listening to a so-called expert talk about these kinds of topics – because there are some little pieces in there that can be really helpful. 

Amanda: I love that, because I think you're right. I touched on things that frustrate me, but I often will still listen to podcasts in their entirety and be like, “I disliked when this was said, but that other part was fantastic”. 

Beware of absolutes. If it's “this is going to work for everyone, or even most”, think twice. Maybe take something and try it on for size, and if it doesn't work, you tried it on for size and it didn't work. It's not because you're wrong. It's because that's one strategy that works for some people, not all people. Just being mindful when trying things that if it doesn't fit perfectly, it doesn't mean that it’s you. It means that all of this is likely individualized. More and more in medicine in general, we're going to individualized, precision care. 

Also, check out the credentials of the person speaking. This is one of the first things I do when somebody sends me a podcast. Where did they train? What is their background? Are they open about the limits of their knowledge or scope? Are they open about the lens that they're looking through? I think we can have expertise and still talk about other topics, but we want to be mindful of how we're representing ourselves and our knowledge. 

Then it's important to look at whether they are actively practicing or conducting research on this topic. If yes, that can give us a bit more confidence in some of the things that are being shared. If not, it doesn't mean throw it out and disregard it. It means let's be mindful of what we can learn from somebody who doesn't have that expertise, but they're educated, and maybe they can give some insights into this area or topic, or give one practical skill or strategy that we can try and see if it works. 

MJ: Could I put you on the hot seat and take it out of the research-based realm and into more personal, lived experience? I'd love to hear about your own relationship to change and pursuing ambitious goals. When setbacks do arise, how does your expertise in behaviour change come into play?

Amanda: I love and I hate – in the truest sense of the word – behaviour change. I love growth, I get excited about big and ambitious goals. I crave that momentum and the striving, sometimes to an unhealthy extent. And I truly believe as humans, we have this capacity to grow and evolve. It excites me to think that we're always in progress. How beautiful. I resonate with that. 

But then the actual process of change, the uncomfortable stuff, the messy middle. It's disruptive. I love a routine, and change of any kind messes with my routine. I hate that. I find it stirs up a lot of my negative self talk, especially when I'm in the midst of changing behaviour and self-monitoring. That judgment, the criticism, it gets loud, and that's hard. Even knowing what I do in those moments, I find I want to give up. I feel the resistance. I hope things are going to magically fall into place, and then they don't, and that's frustrating. I feel frustrated a lot of the time. 

What I've learned, what I practice, what I teach, is really the skills to cope with all of that messy stuff that I dislike. I set goals that are meaningful because they're harder for me to abandon and walk away from if it's a goal that really matters to me. I review my goals pretty regularly and update them. I make plans. People think I'm so self-disciplined but the reason I plan is because I'm not self disciplined. It's a hack. If I don't plan it, it’s not gonna happen. So one of the ways I build my habits is by doing this planning so that I don't need to rely on motivation or my own self-discipline. 

I'm really working right now on practicing self-compassion. I've learned that beating myself up never helps. Yet I find myself often beating myself up. So in the last two to three years, I've started studying self-compassion, integrating it within our behaviour change support interventions, assessing it in trials. I am trying to lean hard on this idea that everybody makes mistakes. I can be kind to myself. It doesn't mean I'm going easy on myself. And practicing being more mindful, which is not a comfortable place for me. I'd say that's my big learning. That's my big sticky spot right now. Practicing self-compassion, which is then linked to the behaviour change I want to see. 

So to answer your question, I love what change can give us. I get excited when somebody talks about changing things, and I love and feel grateful for what this field has taught me. But I don't love how demanding behaviour change is, because it's hard, it's tough.

MJ: I really appreciate your candour in saying that. I think it's so helpful for people to hear, especially from somebody as accomplished as you. And I love that not only are you practicing self-compassion, you're actually bringing it into your research so that there will be more evidence-based research around this.

Amanda: I feel like as somebody who works a lot with folks who are in that messy middle, it would feel wrong to say, “Oh yeah, it's fine, I love behaviour change, and I'm great at it.” 

MJ: I wanted to ask as many questions as I could think of to cover the gamut of behaviour change. Before we wrap up, are there any other concepts you wanted to cover? 

Amanda: I'm hoping it's really come through in this conversation– give yourself grace, behaviour change is hard. 

I think a lot of times we set these goals without taking the time to reflect on the “why”, and without that “why”, we're going to see behaviour change fail, which is going to decrease our confidence. If we can just pause and look at the goal and figure out our “why”. Sometimes the goal stays the same, but we've just identified the “why”. Sometimes the goal shifts a little. Sometimes the goal is thrown out the window. And sometimes it changes a lot. The “why” is so important, and there's evidence to support figuring out that “why” for our motivation, to direct our energy, to keep us coming back. 

Then there's a lot of things we can do when we see those drops of motivation to bolster ourselves. It really is going to be a personalized process and journey for everyone to make lasting behaviour change. And you've already done it. There are so many behaviours in your life that at one point weren't integrated. You've experienced success. So remind yourself of that, and what can you learn about yourself and what went well with that behaviour that maybe you can borrow for these future goals that you're setting for yourself.

MJ: I feel like I could have added five or six letters to the SMARTT goal acronym. An extra “S” at the beginning, for “sequential”. An extra “R” at the end, for “re-assessing” our goals all the time. [Note: this would make it SMARTT-R!] 

Just now I was thinking in addition to self-monitoring, let's add self-inventory because as you said, we’ve already accomplished so many goals and integrated so many changes. If we could just do an inventory, how powerful would that be? 

I think that's the perfect note to end on. Amanda, I really appreciate you taking the time, and I hope that we can have another conversation, because you have a lot to share! 

Amanda: Thank you so much for having me!