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How to help a client who resists exercising


help clients who resist exercising

You want your patients and clients to exercise. You know the unique and powerful health benefits it could give them. Your clients also want those benefits too. They may even leave your office with great enthusiasm to get started, but the next visit they report "life" got in the way.  What is the root of excuses and barriers to exercising?  Exercise resistance can be cured, but it takes rethinking our approach to talking about it and doing exercise for health benefits. 


Why exercise habits fall apart

Habits are the result of the fascinating brain-body-spirit connection. Habit form based on what the body tells the brain when it encounters a stimulus. That stimulus could be a thought, a smell, a place, an emotion, or a sense from intuition or values. Signals are then sent to the brain to either repeat or avoid that action. 


As health professionals, we want our clients to practice The Big Three health habits: eating healthily, managing stress, and exercising regularly.  The evidence around these three habits makes them powerful medicines for preventing and helping to treat nearly every medical condition. However, most people struggle with one or all of these. 

Your clients might do well for a while, but then things seem to fall apart, especially when life gets stressful. Those stressors could be positive like preparing for a wedding or becoming a grandparent. They can be a challenge like an injury or caring for an elderly parent. Stress will derail habits unless those habits help to calm the stress state. Unfortunately, our culture makes exercising stress-producing so your clients resist exercising. 


Our cultural messages about exercise say it has to be hard and intense to be worth your time. They incorrectly promote the benefits of soreness at the start as a sign that exercise is working. The message is: work hard at the start, so you see results, and then you will be motivated. Even if you try to counter these messages and tell clients something is better than nothing, they are getting more powerful messages in the media that exercising means pushing their bodies to the limit. 

This study by Silvio Maltagliati, et.al “Why people should run after positive affective experiences instead of health benefits” found 

Positive affective experiences toward physical activity can reduce the perception of effort, provide more immediate consequences, and strengthen beliefs about health benefits. Because affective experiences have the potential to tip the balance in favor of physical activity over sedentary alternatives, they should be at the core of physical activity promotion.”

What are positive affective experiences and how do we create them with exercise? 


Positive affectivity is when someone experiences emotions such as happiness, pride, enthusiasm, energy, and joy. Negative affectivity is when someone experiences emotions such as sadness, disgust, fatigue, boredom, fear, guilt and shame. 

The key point here is that affective experiences are felt. Your client's prefrontal cortex may have all kinds of ideas and thoughts about exercise, and know what to do and why it's important, but how their body feels through emotions and physical sensations is what will determine if exercise becomes a habit. 

Often, though, the benefits of exercising for health, such as weight loss, cause positive emotions for us but negative emotions for clients. We feel encouraged by the research, they feel discouraged by the challenges of putting exercise into practice! 

To create positive affective experiences with exercise for our clients, we need to tune into the ways exercise may be a negative affective experience for them. This is not always clearly expressed in conversations. It’s often mixed with their exercise history and the messages from their social network. They want to be healthy and know exercise is important. They may have plenty of ways to exercise, and people around them enforcing the benefits of exercise, but are still resistant to doing it. 


How to get to the root of exercise resistance

For example, I spoke yesterday to a man who keeps a gym bag in his car, and thinks about going to the gym every day after work, but doesn't go. 

After digging a bit, it became clear he was mentally and physically tired after work and his mindset was that exercise had to be done for an hour to be worth it.  Add to that the experiences of being sore and having back pain the last time he started until his body “got used to it” and his limbic system was overriding his frontal lobe each time he thought about exercising. 

Our conversation about misinformation about muscle soreness, how to reduce back strain with exercise, and how much is enough exercise for health and weight loss opened him to the possibility that exercise could feel good from the moment he started. 

Addressing the fatigue after work, we discussed how stress takes energy from the body because of the held tension—like a balloon filling up with air with every stressor of his workday. By the end of the day, he was full of tension that drained his energy. Like holding a 50-pound backpack all day long, his body was truly tired. The solution was to do some mindful stretching breaks to let some air out of the balloon during the day and see if this helped him feel more energy at the end of the day. 

The next solution was to go to the gym and listen to his body so he was doing enough to have more energy now and no pain. I reminded him that soreness is not normal or needed. There is no research showing soreness speeds up progress. There is plenty of evidence as seen in the article mentioned above that soreness and negative affective experience create resistance to starting to exercise. 

His whole person lightened as exercise became less of a second job and more of a chance to recharge after work. 


Bottom line for reducing exericse resistance

The bottom line is that exercise resistance is often caused by conflicting messages from the logical brain and survival brain. Use your exercise conversation time well by skipping the logical reasons they should exercise and get curious about the root cause of the resistance. Listen for information about how they think exercise will feel or should feel when they start. This gives you a shortcut to the cause of their resistance. Then you can address those negative affective reasons for resistance with evidence about how exercise can be a habit for self-care. 


 

If you are a healthcare professional who recommends exercise and wants your clients to learn the skills that prevent stress from derailing exericse habits check out the Professional Membership and the Start Well Package @Exercisingwell.com Both options restore exericse self-efficacy and make your job easier! Message me for more information. 


Sources


  • Nikos Ntoumanis, et.al (2021) A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health, Health Psychology Review, 15:2, 214-244,

  • Dasso NA. How is exercise different from physical activity? A concept analysis. Nurs Forum. 2019 Jan;54(1):45-52. doi: 10.1111/nuf.12296. Epub 2018 Oct 17. PMID: 30332516.

  • Morris LS, Grehl MM, Rutter SB, Mehta M, Westwater ML. On what motivates us: a detailed review of intrinsic v. extrinsic motivation. Psychol Med. 2022 Jul;52(10):1801-1816.

  • Silvio Maltagliati, Philippe Sarrazin, Layan Fessler, Maël Lebreton, Boris Cheval, Why people should run after positive affective experiences instead of health benefits, Journal of Sport and Health Science, 2022,

  • Lee W, Reeve J, Xue Y, Xiong J. Neural differences between intrinsic reasons for doing versus extrinsic reasons for doing: an fMRI study. Neurosci Res. 2012 May;73(1):68-7

  • Schuman-Olivier Z, et.al Mindfulness and Behavior Change. Harv Rev Psychiatry. 2020 Nov/Dec;28(6):371-394.

  • Moore, Margaret A. et al. “Coaching Psychology Manual.” (2015).

  • Ludwig, V. U et. al. (2020). Self-Regulation Without Force: Can Awareness Leverage Reward to Drive Behavior Change? Perspectives on Psychological Science, 15(6), 1382–1399.

  • Król M, Kupnicka P, Bosiacki M, Chlubek D. Mechanisms Underlying Anti-Inflammatory and Anti-Cancer Properties of Stretching-A Review. Int J Mol Sci. 2022 Sep 4;23(17):10127. doi: 10.3390/ijms231710127. PMID: 36077525; PMCID: PMC9456560.


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