Well-being Investment: An Expanded Approach to Lasting Change

(NEW) TL;DR at the bottom*

We continue to take a deeper dive into our physical health as one facet for our well-being. 

Background:

It's a new year and a new day! Many of us aspire to make meaningful lifestyle changes, such as incorporating regular exercise or improving self-care. Yet, despite our best intentions, we often encounter obstacles that feel insurmountable. These obstacles can often be hidden and stem from competing priorities, hidden fears, or assumptions we haven’t fully explored.

Thankfully, there’s a framework to help untangle these barriers and create a clear path forward. Based on the work of Dr. Lisa Lahey and Dr. Richard Kegan in Immunity to Change, this method helps align your actions with your goals through small, manageable steps.

Grab a pen and paper, paper turned horizontally, drawing 5 columns, and let’s dive in!

Framework for Change

Step 1: What Do You Want to Improve? (Column 1)

Write down something that aligns with your well-being goals, that, if improved (e.g., exercise, nutrition, etc), would make you proud. Then, reflect on why it matters to you.

Example:

• Goal: Meet the 150 minutes of weekly aerobic exercise and 2 days of strength training.
• Why: Long-term health, more energy, keeping up with family and friends, staying active with future grandkids. “Be able to carry my own groceries when I’m 90,” Ali Novitsky.

Step 2: What’s Getting in the Way? (Column 2)

Identify behaviors or choices YOU are doing or making that conflict with this goal.

Example:

• Not waking up early.
• Staying up late watching Netflix with my partner.
• Not fitting in that walk during lunch.

Step 3: Reframe Your Fears as Goals (Column 3)

List the fears tied to the opposite of your current actions. Then, reframe these fears as goals.

Example:

• Fears: 
• Missing sleep,
• losing quality time with my partner,
• lack of fun/entertainment,
• neglecting work or work relationships.

• Reframed Goals:
• Obtain 8 hours of restorative sleep.
• Maintain quality time with my spouse.
• Have fun and entertainment.
• Complete work tasks.
• Maintain healthy relationships with colleagues.

Step 4: Identify & Challenge Underlying Assumptions (Column 4)

Identify and challenge assumptions that make you believe these goals are mutually exclusive.

Example Assumption: If I get enough sleep, connect with my spouse, have fun, and meet work expectations, I can’t fit in exercise.

Step 5: Brainstorm Solutions (Column 5)

Think creatively about how you can achieve all your goals.

Ideas:

• Shorten Netflix time but still enjoy it with my spouse.
• Replace some Netflix nights with shared physical activities (e.g., walking, pickleball).
• Alternate nights for Netflix and an earlier bedtime.
• Use meal prep services to save time and prioritize evening exercise.
• Ask colleagues to join me on a walk at lunch.

Action Step: Test one small change for one week—e.g., replacing two Netflix nights with outdoor walks or games.

Then, review and tweak until you find what works best for you in your current situation.

A Way Forward

This framework is a powerful tool for tackling lifestyle changes with self-compassion and curiosity. It’s not about fixing yourself but experimenting with small steps to align your values and actions.

Closing Reflection:

We often fail to make change because we miss the hidden assumptions and competing priorities that, without exposure, set us up to fail and be hard on ourselves. Making meaningful changes in your life can feel daunting, but the Immunity to Change framework helps us identify those invisible hurdles and reminds us that we don’t need to solve everything at once. You can create momentum toward the life you envision by identifying what truly matters to you, challenging hidden assumptions, and taking small, actionable steps. Remember, progress is a journey, not a destination. Celebrate the small wins and learn from the setbacks—both are invaluable parts of growth. Let this process be a source of empowerment, helping you live more intentionally and joyfully.

Try it out and let me know how it works for you! Next week: Focus on Movement & Exercise

Have a joy-filled week!! Tonya

*TL;DR:

Many physicians, like most people, struggle with incorporating exercise or other well-being habits into their lives due to competing priorities and hidden assumptions. Using Dr. Lisa Lahey’s and Dr. Richard Kegan’s Immunity to Change framework, you can explore your goals, identify hidden obstacles such as fears and assumptions, and brainstorm creative solutions to trial. The framework involves 5 steps:

1. Identify what you want to improve and why it matters.
2. List what you’re doing (or not doing) that’s getting in the way.
3. Identify and Reframe fears behind those actions as goals to uncover hidden competing priorities.
4. Examine assumptions about the mutual exclusiveness of those priorities.
5. Brainstorm experiments to meet all goals and test one small change out.
    

Next week: Focus on Movement & Exercise