Health problems and symptoms, with the possible exception of pure genetic disorders, carry a signal to change our lives. Even the flu tells us to rest and take Vitamin C. The message can be as obvious as, “get better shoes,” if our feet hurt, or it may be hard to decipher. It can relate to an internal issue, like fatigue that means, “Stop trying to be the perfect mother, already!” Or it could be telling us about an external change, like asthma that means, “Get the mold out of this apartment or move away!” Changing such harmful situations makes it possible to achieve higher states of wellness.

We usually think of health changes in terms of diet, exercise, rest, and a few other areas, but a whole range of life factors come into play. These modifications can be huge decisions, like leaving a miserable relationship, or simple choices, like a better mattress to sleep on, or cutting down on coffee. Even small changes can have large payoffs. By giving us a sense of control, they set the stage for further growth. It doesn’t always matter much what change we decide to make. Just doing something, anything, for ourselves, for our bodies, makes a huge difference.

Several recent studies have confirmed the power of “self-efficacy,” the feeling that we can do what we set out to do. Self-efficacy has been positively linked with lower rates of hospitalization, higher self-reported health, greater longevity and quality of life. Most of us don’t really believe in our efficacy, though, until we actually change something about our lives, until we see some results. The sooner we establish those feelings, the better off we are. It doesn’t matter where we start.

Say you are an out of shape, depressed person. You could think of five or six changes that could help move your life to a better track, and they would all work (except dieting; that rarely works.) It wouldn’t matter if you started psychotherapy, exercise, meditation, healthier eating, bird watching, college, or playing the flugelhorn. Some people might choose exercise; others might pick something else, maybe something not on the list. But we have to do something!

How change works
To help us survive when life was much more dangerous than now, our brains learned to like things they’ve gotten used to, even if they’re awful. “What do you mean we’re going to change caves? This is good enough for me. There are tigers out there!”

So it’s normal to fear change to some degree, but the actual process of change is pretty straightforward. Behavior change experts say we need only three things to make change: motivation, a method, and practice. Here are some guidelines:

1. The best changes are things you want to do, not things someone else tells you to do. In the Stanford University Arthritis Self-Management Program, each participant has to make a weekly action plan. One woman, Martha, planned three weeks in a row to do more walking, and never did it. Finally, the truth came out. She said, “I don’t really like to walk; I just thought I should.” Substituting another form of exercise got her going.

2. You need to believe that whatever change you plan to make will actually help. If you need convincing, talking with others who share your issues, reading books and articles, or listening to your doctor can provide evidence of effectiveness.

3. Changes should be realistically attainable. People tend to want things to go too far, too fast. They turn self-care into a form of self-abuse. “I will run on the treadmill an hour a day.” “I want to lose 100 pounds in three months, like that person on the TV ad.” Good luck! We have much better chances if we make changes that feel good as we go along, and set realistic timetables.

4. Start small, breaking large goals into achievable chunks. It is far better to start with a less ambitious goal and achieve it, then to shoot for some gigantic transformation and fall short. The first pattern leaves you feeling good about yourself and ready for more; the second makes you want to forget the whole thing.

5. There will be ups and downs. The great leap to fitness, the steadily improving ability to speak up for ourselves, or the sudden, permanent adoption of a healthy, natural diet, these things do not happen often. In real life, there are good and bad days, good and bad weeks, even months. Coming back from the bad patches is part of the process.

6. Change happens when we’re not looking. We work and work toward getting in shape, say, or being more disciplined about finishing what we start. Nothing seems to happen for the longest time. Then one day, we notice that we are not getting tired nearly as fast. We’re breathing easier, feeling better. When did it happen? Probably, it happened when we stopped watching. When we give up the need for miracles is when miracles happen. And in self-motivated behavior change, miracles happen every day. If you follow these guidelines, they can happen for you, too.

Adapted from the book The Art of Getting Well: A Five Step Plan For Maximizing Health When You Have a Chronic Illness, copyright 2002 Hunter House Publishers. Order from on-line bookstores or from David at, where you can also learn about David Spero’s books, classes and seminars.

Author's Bio: 

David has been a nurse for 35 years and has lived with multiple sclerosis for 30 years. He is author of two books, The Art of Getting Well, and Diabetes:Sugar-coated Crisis, along with dozens of articles and web pieces for health magazines and websites like He is an inspiring speaker on self-care and social change. He also leads couples workshops on sex and intimacy with his wife Aisha.