Change, now. You need it, the world needs it.

August 19th, 2007

One of the scariest things you can read is this Alan Deutschman article:

Change or Die

I’ve referred before to this article, which appeared in the May 2005 issue of Fast Company magazine and led to Deutschman’s book of the same name, which debuted at the beginning of this year. The short opening section of the article tips you off to its impact:

Change or Die.

What if you were given that choice? For real. What if it weren’t just the hyperbolic rhetoric that conflates corporate performance with life and death? Not the overblown exhortations of a rabid boss, or a slick motivational speaker, or a self-dramatizing CEO. We’re talking actual life or death now. Your own life or death. What if a well-informed, trusted authority figure said you had to make difficult and enduring changes in the way you think and act? If you didn’t, your time would end soon — a lot sooner than it had to. Could you change when change really mattered? When it mattered most?

Yes, you say?

Try again.


You’re probably deluding yourself.

You wouldn’t change.

Don’t believe it? You want odds? Here are the odds, the scientifically studied odds: nine to one. That’s nine to one against you. How do you like those odds?

Deutschman got my attention – and a lot of other readers’ – with that challenge. The article goes on to talk about how Dr. Dean Ornish and others have worked to crack this nut when it comes to people’s health. Most of the worst problems that the United States faces in terms of health care are behavioral – not genetic, not related to freak accidents, and not even related to infectious disease. Just think: When Americans die younger than they should, what do they die of? No-fault cancer, some of them, or car accidents, or infections. But by and large, they die from causes tied to their own excess: heart disease, emphysema, late-onset diabetes, hypertension, stroke, and so on – all caused by behaviors of eating or drinking or smoking or failing to exercise or marinating in stress that (a) are obvious and (b) are eminently and easily subject to treatment. We’re not talking about explaining superstring theory to people, right? We’re talking about (say it with me) a high-fiber, low-fat diet that includes plenty of fresh fruits and vegetables and lots of water; quitting smoking or never taking it up in the first place; drinking in moderation; half an hour of aerobic exercise three times a week; and learning to manage the stressors in your life. Simple, huh?

Except we don’t want to change. We want to keep doing what we do. As Deutschman’s article documents, even after the crisis of coronary bypass surgery, 90 percent of patients “don’t sustain changes in their unhealthy lifestyles”. The fear of death isn’t enough for most people to get past the denial of the obvious – that they eat poorly, that they need to get some exercise, that they should quit smoking, and so on. All the facts in the world about lung cancer, increased stroke risk from obesity, the connection of junk-food diets to diabetes and heart disease – none of these facts change behavior by themselves, because all your goody-two-shoes data won’t change my “It’s my life, leave me alone” narrative. When we do change, we nip and tuck at the edges instead of making necessary, sweeping changes, and doing it pronto. And we’ll swear, all the way to our early graves, that we can’t change because we’re set in our ways, our old habits are too hard to break, we’re just wired like this. And similar bullshit.

In his own successful work with heart patients, Ornish stresses “the psychological, emotional, and spiritual dimensions that are so often ignored” in treating heart disease. Ornish’s patients learn relaxation techniques, practice meditation and yoga, get instruction in aerobic training, and attend support groups. Because this course of treatment gets at the feelings of the patients and helps to change their narratives for how they explain their lives and habits, more than three-quarters of Ornish’s patients adhere to better lifestyle habits, even three years post-op.

The breakthrough of Ornish’s approach – and the breakthrough that can apply to any of us as we try to change for the better – comes in reframing. Politicos are familiar with this concept, especially through the seminal work of the linguist George Lakoff, an expert in cognition who has written books about frames, i.e. the “mental structures that shape the way we see the world.”* In the case of heart patients, reframing could mean, for instance, taking the stress off dietary deprivation or the “fear of dying”, and empasizing instead the “joy of living”. Ornish gets his heart patients to focus on the pleasures available to them when they can take a long walk or make love without chest pain. Having access to these pleasures implies following healthy habits; the promise of pleasure can drive good habits much better than tsk-tsking at a patient for wanting a doughnut.

One of the most surprising points of Deutschman’s article is that “radical, sweeping, comprehensive changes are often easier for people than small, incremental ones”. Whether or not this invalidates my prior thinking on this issue, it certainly cuts agains the grain of it. I’ve always figured – and have often “preached” to my friends – that baby steps all the way was the right approach. But now that I think about it, I don’t think that the two approaches are at odds, not at all. If you’re going to make comprehensive changes to eat right, you still have to make baby-step choices about what you eat for breakfast, what you eat for lunch, what you eat for dinner, and what you eat at all the times in-between. You have more baby-step choices in terms of portion sizes and which dressing to use on your salad, whether to have your sandwich with bacon, cheese, both, or neither. Are you going to drink a sugared soda, or diet soda, or no soda? If you have a soda, will you stop at one, or have a refill? How many beers will you drink when you get home? And so on. Even as you’re making sweeping changes, you’ll have many baby-step decisions to make along the way – and these will be easier to make when you’ve adopted the proper frame for making fruitful choices across the board.

Since Fast Company is a business magazine, Deutschman talks about how radical change applies to the world of commerce:

Of course, radical change often isn’t possible in business situations. Still, it’s always important to identify, achieve, and celebrate some quick, positive results for the vital emotional lifts that they provide. Harvard [Business School]’s [Prof. John] Kotter believes in the importance of “short-term wins” for companies, meaning “victories that nourish faith in the change effort, emotionally reward the hard workers, keep the critics at bay, and build momentum. Without sufficient wins that are visible, timely, unambiguous, and meaningful to others, change efforts invariably run into serious problems.”

The big point I take from this, as I try to think about framing my own life for the better, is that you can – you must – make meaningful changes today, right now. If you’re trying to alter the course of something big like a company, a social practice, an industry, or a government, it’s not going to turn on a dime. But you can engender a sense of urgency and an openness to possibility in yourself and those around you – starting now. You can take steps in the right direction – starting now. You can start making a difference – starting now. All of which is code for this: You should get off your ass – starting now.

Last year I wrote an entry here about getting rid of the “pending” category in your plans. This doesn’t mean you can only engage in projects that can be finished in one day or one sitting. But it does mean that you should reframe yourself to have a strong bias toward immediate action on what’s most important to you. Be willing to take a radical step in the right direction that requires only five minutes to complete. If you’re of two minds about which project or task to tackle next, be willing to take radical action within your own mind to figure out which one comes first and then engage with it. When I do this, I’m often amazed at how little effort it takes for me to decide on what’s most important, what’s most vital, or what’s most helpful for all the things I want to accomplish. And if you’ll discard the notion that anything fruitful is going to come from putting something in the “pending” file indefinitely, it’s amazing the radical good you can do now, in this moment. Don’t be of two minds: decide where you’re headed for now, even if some element of the decision has to be a little arbitrary. Being a little bit arbitrary is fine, because we seldom have the luxury of being 100 percent certain about any course of action. So just make a choice, reframe your thoughts and habits if you need to, and forge ahead. Don’t let your dreams and plans die because you couldn’t change your way of acting on them.

I’m preaching this sermon for myself, of course. I’m revisiting “Change or Die” because I recognize that I’ll never have the impact I want to have if I keep doing things – or keep framing things – the same way I have been. (Let’s just say that my “pending” file has stayed pretty fat through the course of my life to date . . .) And as I see it, we have some pretty big challenging facing us – most notably the atmospheric overheating† that is throwing the world’s climate into turmoil, with devastating impacts on human populations and ecosystems alike. I’m more optimistic than to say that the stark choice is “change or die” when it comes to climate change. But “change or suffer drastic consequences” is compelling enough for me. So I’m changing the ways that I frame my world, my tasks, my projects. I invite you to join me.


* Lakoff volunteered extensive advice on reframing to the Democratic Party in his book, Don’t Think Of An Elephant! How Democrats And Progressives Can Win: Know Your Values And Frame The Debate: The Essential Guide For Progressives.

† As Seth Godin and others have pointed out, “global warming” sounds neutral, or even potentially good. (Warm cocoa, warm blueberry muffins, a nice warm bath . . .) We need terms that better convey the reality of the threat.

4 Responses to “Change, now. You need it, the world needs it.”

  1. Chris H. Says:

    I just grabbed the your intro and the main excerpt and skimmed through the rest, but I look forward to coming back to read this more thoughtfully.

    Just wanted to quickly comment that I’m actually surprised that the odds (nine to one) are that good! They feel a lot worse. “That’s science for ya.” – Karl Pilkington.

  2. Tim Walker Says:

    What’s so fascinating to me is that a person’s indivdiual odds are so easy to set based on their own CHOICES. I mean, it’s not like you’ve decided to bet a particular number at roulette, where the odds are fixed. We can change them — stack them in our favor — at any moment. But usually we don’t.

  3. What I’ve Learned So Far » Blog Archive » Commonplace: DeLillo.* Says:

    […] I’ve heard this saying any number of times, and in fact I’ve used it myself with smart friends who might change their own narratives if they can be persuaded that they’re acting ignorant instead of intelligent. It is so painful to see anyone — myself very much included — know what’s better to do, but then eschew it for reasons of pride or self-delusion. I believe that this apothegm can be a great astringent for self-delusion: taken seriously, it forces us to consider what we do know, and how well or ill our actions comport with our knowledge. […]

  4. What I’ve Learned So Far » Blog Archive » Poverty and personal narrative. Says:

    […] It’s late and I’m tired, so this is just a placeholder for now. But I wonder whether the poor don’t face both threshold effects and the kind of narrative problems that Dean Ornish finds in his cardiac patients: all the facts in the world won’t make an intelligent recipient of a triple-bypass operation stop eating triple cheeseburgers . . . if he doesn’t change the narrative about what he eats. Could the same be true for poor people, beholden to the culture of poverty in which they live? […]

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