Health’s Neglected Immunity
The latest National Health Survey found that 11.4 million Australians, almost 50 per cent, live with a chronic disease. A diagnosis of this nature is hard to receive, yet living with chronic illness is even harder.
Living with IBD (Inflammatory Bowel Disease) has shown me the sheer amount of persistence, resilience and motivation it requires to manage an ongoing health condition. Cordon et al. (2018) contend that motivation within the disease is a key point to achieving proper therapeutic management of IBD.
Despite feeling motivated to actively improve my disease, I often fail to act in my best interest. Research shows I’m not alone, with studies highlighting poor adherence to lifestyle recommendations in patients with coronary heart disease.
Robert Kegan & Lisa Laskow’s 2009 Self-help book foregrounds how individual beliefs and mindsets can generate a natural yet strong “immunity to change.” This is perhaps, health’s most neglected immunity.
Kegan & Laskow outline a process to diagnose the underpinnings of our immunity to change. By partaking in this process with the aim of improving my diligence toward health-related behaviours, I’ve had a number of useful insights.
The process required me to highlight the behaviours I was doing or not doing. Following this, I identified my ‘hidden competing commitments’; conscious or unconscious commitments that held me captive, limiting my progress. I had to dig deep, as this was an unfamiliar way of thinking. After lengthy contemplation, I found I was committed to:
- Doing what I want in the moment
- Not feeling like an old sick man
- Devoting time to study, relationships and leisure
- Not letting my illness define me or dominate my relationships.
I often become frustrated with myself when falling victim to my symptoms, subjecting myself to damaging self-hatred. I tell myself things like, “if only I was more motivated and committed to getting better, I wouldn’t feel like this.” On the surface this seems reasonable… but maybe it isn’t that simple.
Through undertaking the immunity to change process, I realise I’ve been treating my health as a technical challenge rather than an adaptive one. I am committed to my health, but I also have competing commitments working against me. It's not necessarily motivation that I need, but rather, a different approach and mindset.
The immunity to change process then had me determine the underlying assumption making my competing commitments seem absolutely necessary. Again, this was not immediately apparent, however, such assumptions became clear through deep introspection.
My biggest assumption was that if I’m always prioritising health improvement behaviours, my life will be controlled by my illness. This assumption convinces my subconscious that in order to maintain my identity, I can’t always be prioritising health-related behaviour. Having a strong and constant sense of identity is desirable; it brings both comfort and security. Thus, my sense of identity is, in itself, immune to change.
Moreover, this assumption persuades my subconscious that consistently prioritising health-related behaviour will limit my autonomy — my freedom. Of course, to me, my freedom is indispensable.
As my assumption leads me to believe that my sense of identity and freedom are in jeopardy when I prioritise health-related behaviours, then of course I will avoid doing so. Albeit, this belief is predicated entirely on an assumption and thus, a potentially false premise.
As a science student, experimentation seems like the appropriate course of action for determining the veracity of my assumption. A possible experiment would be to make health improvement behaviours my top priority for a finite period of time, reflecting on the way I feel by journaling regularly. Specifically, these journals would focus on my feelings toward my personal identity and freedom. After the timeframe elapses, I would analyse each journal entry relative to others to identify changes in my mental state over time.
I could also speak with other individuals who believe they are able to manage chronic disease effectively. I would ask them if they feel their life is controlled by their illness or if their freedom or identity feels infringed upon.
Alternatively, to better understand the practicality of my assumption I could simply invest more time pondering my assumption through a critical thinking lens. Since partaking in the immunity to change process, I have begun to recognise faults within my assumption. For example, if I truly desire to prioritise health-related behaviour, through doing so, would my disease be controlling my life or would I be taking control of my disease?
I have found this process tremendously helpful. I implore others managing chronic disease to use this process to gain insight into their own immunity to change.
