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Meaningful Change: A Workshop Blog

Last week, I wrote how physical exercise was the top area faculty and residents alike identified that, if changed, could make the most improvement in their well-being and joy. And so this week, I wanted to walk you through a framework that can be easily applied to lifestyle changes of many kinds, including exercise - workshop style! As a review – there are some key concepts I’ve written about previously regarding movement and exercise, so if this is important to you right now – review those.


Now, let’s delve into my take on Dr. Lisa Lahey’s and Dr. Richard Keagan’s, two Harvard Graduate School of Education professors, framework, which they outline in Immunity to Change that can be applied to change very broadly.


They really delve into the mindset to help us bring more natural momentum to behavioral change. They unpack how our mindset is often like an auto-immune disease in which the vital immune system turns on the host and harms us by keeping us from change. Their method allows you to move forward from a place of self-compassion rather than beating yourself up for “failing.” Grab something to write on and let’s begin.


Make 5 columns.

In Column 1 write:

What, if you improved about your (exercise, self-care, etc) would make you proud? 

Why and how is that important to you?


In Column 2 write:

What are you doing and not doing that gets in the way of that goal?


In Column 3:

         Imagine the opposite of what you wrote in Column 2.

What fears come up?

List them all.

         Restate each fear as a goal. (What a reframe, right?!)


In Column 4, write:

What underlying assumptions exist to make you believe they are mutually exclusive – i.e, what happens to the Column 1 goal if you meet the Column 3 goals?


In Column 5:

         Challenge the assumptions.

How could they all be met?



Action: Run small experiments.


Example (mostly hypothetical 😉)

Column 1 Goal and Why:

Meet the 150 minutes of weekly aerobic exercise and 2 days of strength training

Long-term health, have more energy and feel healthier, keep up with my active family and friends, be able to be active with my grandkids when they’re older


Column 2 Obstacles that I control that keeps me from meeting goal:

                   Not getting up earlier

                   Not going to bed earlier/staying up watching Netflix with my husband

                   Not re-arranging workday/prioritizing exercise


Column 3 Opposite Actions of Column 2:

                   Not getting enough sleep

                   Not spending quality time and maintaining connection with my husband

                   Not having fun or entertainment

                   Not getting all the work done


         Rewrite as goals:

                   To obtain 8 hours of restorative sleep

                   To spend quality time and maintain connection with my husband

                   To have some fun and entertainment

                   To get my work done


Column 4 Assumptions

If I meet Column 3 goals, I won’t meet my exercise goals. In other words, if I achieve restorative sleep, meet my own job expectations, enjoy time with my husband and have fun, I can’t exercise.


Column 5 Challenge and Brainstorm:

         How can I obtain quality sleep, spend and maintain connection with my husband, have fun and entertainment, and still get my work done?



  • Maybe I can shorten the duration of Netflix and still maintain the fun and quality time
  • Maybe we can go out for run/walk/ski/bike together in place of Netflix
  • Maybe we can join an intramural team together
  • Maybe 3 days a week, I watch Netflix and 4 days a week I go to bed earlier to fit in exercise the next day
  • Maybe I start with one day of skipping Netflix, and slowly overtime add more early to bed, early to rise, and work out
  • Maybe I order food prep service to cut out time in the kitchen and exercise after work and still have time for Netflix




Action: Small test

         Next week, I will try replacing 2 of the usual Netflix nights with an outdoor walk or game of pickleball.


Then we have ourselves a PDSA cycle. A way forward.


Try it out and let me know what you think. I found it very powerful in several areas.

Next week, I'm reposting the popular series featuring self-care in the form of movement. In 2 weeks, I will highlight a physician coach known for exercise as she shares her tips. 
Until then, have a joy-filled day!   Tonya

If you're interested in talking with me about a coaching partnership for yourself, your residents or faculty, schedule a call.



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