Feature Article:

Resistance: Diagnosing and Managing Your Immunity to Change

By Shelley Simon, RN, DC, MPH, EdD
Founder, Beyond Practice Management

It?s February. Do your New Year?s resolutions already feel like distant memories? Are the goals you set just a few short weeks ago untouched by action? Has your enthusiasm gone south for the winter? If you?re nodding your head knowingly or experiencing a touch of guilt, anxiety, or frustration, you may be in the midst of your own unique pattern of resistance. If so, pay attention. This is a good thing. Resistance can be a positive force for successful change — if you engage it instead of pushing it away, if you let it work for you instead of against you.

We began this three-part series dedicated to advancing successful, sustainable change in your practice and personal life with Resolution: Why Developing Personal Competence Enhances Resolve in January. In that feature article, we covered how to make resolutions become realities by paying careful attention to intentions, targeting personal development efforts, and by creating measurable, actionable steps toward your goals. If you missed that issue, click here to read it now.

In this issue of Practice Your Way, we explore resistance and how you can work with and learn from this all-too-predictable component of change. Let?s begin by considering some common scenarios:

• You want a stable staff and you know all the actions that are required of you to have such a staff. Why then, do you find it so hard to listen, empathize, hold your staff accountable, and lead in a way that will bring about the outcomes you desire?
• Nothing is more important to you than building your practice and enhancing word-of-mouth about your services. So why do marketing activities always fall to the bottom of your ?to do? list?
• You?ve just returned from yet another motivational seminar where you and your staff created a vision and action plan for moving toward a cash practice. But now you?re back at the office and find that neither you nor your team is doing anything toward implementing the plan.

I have worked with clients in all of these situations. They have good intentions, they?re motivated, they make plans, and they have the resources they need to achieve their goals. And yet, many don?t follow through and quickly become frustrated and disappointed. They again resolve to take action, and again hold back. They finally get started on something and then stop midway through, daunted by some obstacle or fearful of the outcome, consequences, or risks involved. It sometimes seems that these individuals have acquired a powerful immunity to change. In cases such as these, I?ve found that there are four primary elements missing from the success equation: (1) inability to see resistance for what it is; (2) failure to recognize patterns of internal resistance; (3) not seeing the value of resistance and learning from it; and (4) not addressing ?dueling? intentions and competing commitments.

Dictionaries typically begin by defining resistance as any force that slows or stops movement, an act of resisting. The definition may then be expanded specifically for the application or field in which it is a driving factor — electrical, mechanical, psychological, biological, or medical. Remember the basic physics principle: ?For every force, there is an equal and opposing force.? Resistance is a force, it?s energy, and it can be a protective factor in human experience. It may be internal or external. It is invisible, yet palpable. It can be a repelling force that is distracting and insidious. Still, resistance is not in itself negative or positive. It just is. How we interpret resistance is personal. Push resistance away and you may unintentionally increase the strength and power of the ?equal and opposing force.? Look upon resistance as something to be explored — with curiosity, not judgment — and you can put it to good use.

To understand resistance and use it to fuel your intentions and change efforts, you first have to become acquainted with your own patterns. I sometimes (okay, often) resist sitting down to write this newsletter. Right now, I have a deadline to keep, but I?m tired. It?s Saturday and I worked hard all week. I need a day off. I could be running errands or taking a nap. I tell myself I?ve just got to get started. But, wait, maybe if I wait until tomorrow my deadline will really be on top of me and then I?ll work faster and better. If only I could get beyond the first couple of paragraphs, then I?m sure the rest would flow. My mind is foggy and I?m not in a creative mood. Maybe the newsletter should be quarterly instead of monthly. And so the stories go. I procrastinate. I do administrative tasks, shuffle papers, and check e-mail. I?m tempted to clean my office but remember that I don?t clean. Perhaps if I go for a walk I?ll find the inspiration I need. Yes, a walk . . . what a great idea! Sound familiar? Your brand of resistance may be similar to mine or completely different. But now you know you?re most definitely not alone.

Resistance can make itself known in any number of ways. Some people experience a sense of confusion about what to do next. They deny or rationalize the need to take action. They criticize themselves for previous false starts or past unsuccessful efforts and, in doing so, sabotage their future success. Others slip into a state of perfectionism, unable to move forward until they are certain they know everything and can execute their plan perfectly. Many of us demand immediate results or adopt an all-or-nothing attitude. Some people become dramatic, placing blame or becoming envious of others who are seemingly doing ?better? or who are more successful than they are. Still others take on so many projects (and have so few practical strategies for managing multiple priorities) that they hit the wall before they even start running. And then there is good old procrastination: I?ll get started on that marketing project just as soon as I read all the journals sitting on my floor, check on my stock portfolio, or rearrange my pencil drawer.

Resistance may surface at the exact moment a person is making a commitment. I?ve had clients poised to sign up for my services — actually reading off their credit card information to me so that we can get started — and then stop mid-number. Maybe I should talk to my spouse first? Should I try again to put my practice in order by myself? Is this really a good investment? This kind of resistance is known as cold feet.

The word resistance has a certain pejorative quality to it, as if we are refusing to do what is best for us. It hints that we are being intentionally stubborn or lazy. More often than not, resistance is seen as something we need to eliminate, overcome, neutralize, or conquer. We try to meet resistance with more force and use our willpower to bring about the desired change in ourselves or others. Our difficulty with change is often attributed to insufficient motivation or lack of commitment to the change process. ?Just do it,? your coach may tell you. Then, when you are not successful, you may judge yourself as weak, not trying hard enough, or somehow faulty. Given this level of negativity about resistance, it?s easy to see why we tend to want to push it away. The idea of embracing and studying our own resistance is a foreign concept.

So resistance has gotten a bad rap, but before you resist the idea of embracing resistance, consider your own immune system and the natural biological function that is activated when a foreign substance or challenge to the body is introduced. Our physical response is to expel or neutralize what is unknown or harmful. In a similar way, we can mentally and emotionally become triggered by the unknown and develop an immunity to change — sometimes for good reasons. Even when we are genuinely committed to a different experience, the prospect of change threatens our current thinking and habitual behavior. Even when it?s inevitable, we very often resist change. A different future may seem riskier than the status quo, even when the status quo isn?t what we want. At least it?s familiar.

By paying close attention to our inclination to resist change, we can understand our behavior in a deeper way. Sometimes, our behavior actually makes sense when we understand how dueling intentions and competing commitments come into play. When you find yourself acting in a way that is contrary to your commitment or intention, there may be another force at work. Your immunity to change may be triggered by an unconscious (though active) commitment to keeping certain things from happening — experiencing conflict or confrontation, having to say no, being unliked by patients or staff, or making a mistake. For example, you are committed to transitioning to a cash practice and have a good, solid plan in place. Still, you?ve always been known as amiable, flexible, and generous. Taking a stand for transitioning your payment method feels risky, counter to your natural tendencies, and even challenging to your identity. Is it surprising, then, that you would hesitate and resist implementing your plan?

You may have a sincere commitment to change and yet unknowingly apply your energy to hidden or competing intentions. This dynamic pattern is a form of self-protection and is frequently the cause of stalled change efforts. Understanding your underlying reasons for resistance can help you accept, work around, learn from, or manage the resistance you face. Here are some steps to support you in determining whether your resistance is the result of dueling commitments:

• First, review your resolution, commitment, or goal.
• Ask yourself what you are doing that is working against your success. Are you procrastinating, trying to ?look good,? avoiding conflict?
• Ask yourself what you stand to lose or what the risk might be in changing some of the behaviors that are working against you. Imagine the worst and best case scenarios.
• Now, try to identify any competing commitments or dueling intentions that are in play.
• We often generalize and hold underlying beliefs that keep us from living the way we would prefer. What assumption do you hold that keep these competing or dueling commitments in place?

Keep in mind that when you are resisting change, you may not even see the resistance in yourself. Or if you do recognize that you are resisting, you may consider it self-protective or necessary.

Begin to identify your own patterns of resistance by practicing self-observation and reflection. Honestly inquire into your own unique (and often wily) brand of resistance. Because each individual manifests and manages resistance in his or her own way, it?s important to take a personal approach to dealing with it, instead of simply adopting mind-over-matter and positive affirmation approaches. Your patterns of resistance are just that — your patterns.

Here is a series of questions you can use anytime you find yourself in resistance mode. These are designed to help you engage, learn from, and manage resistance.

1. What change am I resisting? What am I avoiding or trying to keep intact?
2. What triggered this resistance?
3. When I realized I was resisting, what were my thoughts, judgments, feelings, and physiology?
4. What can I learn from this particular experience of resistance?
5. What are my external reactions or behaviors? (Ignore something, make a deal, shoot the messenger, give in too soon, use control or manipulation.)
6. What are the short or long-term consequences to continued resistance in this area?
7. What, if anything, do I need to do about this resistance?

Resistance is normal, predictable, and inevitable. It?s a natural part of the cycle of change. The fact that you resist does not mean that you aren?t resolute or that there is something wrong with you. Resistance is not a character defect. At times, we all resist working on a complex project, confronting a sticky situation, trying something new, taking advice, or asking for help. The trick is to understand your own patterns of resistance and use them to your advantage. In the process of doing so, you can develop the resilience needed to support sustainable change in your practice. Tune in next month when we?ll cover resilience, the final ?R? in our three-part series.

Client's Corner:

Beyond Resistance

Having read the feature article in this issue of Practice Your Way, you probably know far more than you ever imagined you?d need to know about resistance. Okay . . . so resistance is normal and you?ll try to embrace it, or at least not shove it out the door. But you still want to achieve your goals and keep your resolutions. Here?s how.

1. Go back to your plans or goals and decide on next steps. Persevere.
2. Assess your personal competencies and skills to determine if you need to learn something new — leadership, technique, finesse, or management.
3. Visualize your desired outcomes. Try them on; wear them around for a while.
4. Maintain a clear focus by keeping one eye on the prize and the other eye on what you?re doing on a daily basis to achieve your goals.
5. Assess your progress on a regular basis. Evaluate where you are in terms of accomplishment and take a curious look at any resistance that crops up along the way.
6. Arrange for a support system so that you will stay accountable and on track.
7. If burnout is an issue, address it head on with appropriate support and self-care.

What's New:

Shelley Simon features in Today's Chiropractic Lifestyle

Look for the February issue of Today?s Chiropractic Lifestyle where Shelley Simon is interviewed in a feature article ?Converting to a Cash Practice.?

Introductory Consultation:

Make 2007 Your Year for Success

Are you committed to taking yourself and your goals seriously this year? Focusing on developing and enhancing personal competence may be the most important thing you do in 2007. If you?re ready to move beyond short-term tactics and learn self-management skills that will to help you achieve your most important goals, then don?t wait — act now, while it?s on your mind. Click here to request a free consultation with Shelley Simon and get the support you need to have a truly great year.

Upcoming Issues:

March: Resilience (part three in the three-part series Three R?s for Successful, Sustainable Change