Hidden Doubts

This morning there was a great question on our Aligned and Well Facebook page:

I’m active in a pregnancy group here on Facebook, and it’s so sad to hear all these women having problems with pelvic pain, leaking urine and even prolapse. They think it’s normal and just something they have to live with. I keep posting about your exercises, but can’t seem to get through to them. Does the idea of healing yourself with exercise and alignment perhaps sound too good to be true?

In 1975 two researchers (Becker and Maiman) developed something called the Health Belief Model (HBM). They suggested that the likelihood of someone adopting a behavior that would prevent or correct some disease or physical issue depended on two things. And, don’t worry. I’ll tell you what those are two things are.

And in case you are wondering that I am some sort of information freakazoid, let me introduce you to a little garage sale find called Advances in Exercise Adherence (pictured here, with my baby, and he simultaneously reads and plays in the trash).

This little textbook cost me a whopping three bucks. You never know what treasures are lying around other people’s houses. Which makes me sound a bit like a Klepto. No judgments on my klepto readers. I like shiny things too.

So, applying the HBM to your question, a woman would need two things to be motivated enough to follow your advice on alignment and the pelvic floor. She would need to:

1. believe that she had a personal vulnerability to PFD (or SI or hip pain) and

2. believe that the consequence of these conditions would be severe.

The first isn’t typically an issue because chances are, if they’re reading your posts (or mine) they already have an issue. There’s not a lot of wondering if they’re going to have PFD someday — someday is today.

The severity of the issue is more challenging. I don’t think that women understand that a little PFD now means a whole lot of PFD later.

I write until I’m blue in the, uh, fingers, that if you have a little PF issue now — perhaps a bit of a sneeze-pee — that in the not-to-distant future, your organs will be falling out. Your hips will need replacing. Your knees will need replacing. Your SI joint will wobble around and push on your sciatic nerve. Your toes will go numb. Your lumbar spine will degenerate. Your organs will need to be removed. Your vaginal delivery will likely turn into a cesarean.

When I read the above paragraph, I feel like a bad person because it sounds mean or something, right? I don’t say it because I’m trying to make money. I don’t say it because I’m trying to make you anymore tense than you already are. I say it because somebody has to. Somebody has to start saying that the way you are using your body is making you sick. And it will make you sick in the future. And it is your job — not mine — to hear it, and to take action.

I’ve just decided that the theme of 2012 is Personal Responsibility. Oh, and Upper Body Strength. Which reminds me that I need to go hang from my indoor monkey bars for three minutes before I spend anymore time on this post.

Ok, I’m back. And buff. And definitely in that order.

Now that I’ve explained the Human Belief Model, I need to add some more info. Cuz you see, the HBM is not really that complete. It turns out that many people know that they need to get exercise to avoid dying. They believe that they will die if they don’t do it. Yet they still don’t do it. And, we don’t even have to go to the extreme of dying from something. Most of you, dear readers, have some ailment that I’ve given you an ExRx or info to follow and you still don’t really comply with a regularity that matches your desire to no longer have Issue X. Well, not you, who is shaking your head right now and saying “not me, I follow your advice to a T.” I’m not talking about you.

You used to sit in the front row of the class, didn’t you?

So why is it that we can’t seem to manage to execute the behaviors what we desire to? Enter the Self-Efficacy Theory. This 1977 theory (ha, I was born just before this came out) states that “all behavioral changes are mediated by a cognitive mechanism of perceived efficacy” — which is a lot of fancy words to say that you have to believe that you can perform the recommended behavior.

I like the word believe, because as a science-type (you know, all boring and math and lists and bad at art and no passion and left-brain and black and white and I don’t see in color and I can’t really taste food and my life is very straight and adventureless) I don’t really know what it means. Yet, I’ll bet that you, like me, know what it feels like to be 100% on board with what you believe.

Here are some indicators that might help you identify a lower level of self-efficacy:

“I’m afraid that I’m not doing it right”

“If I can’t do it 100% then I don’t feel good doing it at all”

“I’ve TRIED that healthy thing before and I couldn’t do it”

“My attempts at health have failed in the past”

“I’m not that coordinated”

“I’ve always had this ______”

Sound familiar?

Your belief system, especially your ability to physically do something, is learned from your personal experiences as well as the good and bad experiences of those you model (parents, peer group, etc.).

The Self Efficacy Theory has been researched and is believed to be the most successful in explaining habitual exercise behavior. Which is a lot of fancy words that says even if your organs are falling out and your hips hurt so badly that you can no longer walk, and even if you thought that them falling out would kill you (good news: it won’t) you STILL wouldn’t spend a couple hours a day doing your exercises and make a standing work station and give up your heeled shoes and value your health enough to really invest in it because you don’t believe that you can change.

And therein lies the problem. It doesn’t matter how many solutions you post, or how many blog posts I write and emails I answer. The steps toward repairing (anything) need to be taken by them, your readers. They have to value the repair more than you do. And that’s tough, because you’re excited and following it and posting about it because you’ve chosen to help others. They’re reading your FB posts as something to fill extra time and aren’t necessarily looking for answers — just interaction, which are two fundamentally different things. Interaction is often mistaken for taking action.

Then, original poster, there could be the other issue too — that they totally believe in themselves and just don’t believe what you are posting. The prevailing notion that our body injuries are a result of a single incident, and not the slow accumulation of micro-damage, makes it very difficult to even begin understanding our ailments.

In other words:

If asked, by a health practitioner, to explain how your back went out, you are much more likely to explain: “I was moving a 40-pound bag of cement up 27 flights of stairs,” than you are to say: “I’ve sat in a chair for 10 hours a day for, oh, I don’t know, 17 years, and then I’ve been under a lot of emotional stress too, when I used my body for a huge athletic feat with no training program whatsoever.”

In other other words:

We have an inexcusable lack of knowledge regarding our own function, and the inability to see that What We’ve Been Doing is what has led, directly, to the ailment you have now.

So, maybe they think you are spending your valuable and precious time posting nonsense. Although I believe (with the other half of my brain that’s more interesting and has a personality and passion and loves poetry and sewing and rainbows and fairies and stuff) that, if you have come here to read, or they have come to your site to read, that the material is resonating them on a cellular level. The fact that they don’t trust the info has more to do with trusting their own ability to do something with it — their efficacy.

P.S. I couldn’t post the problem without posting a solution, can I? If you feel that you might have an issue with self-efficacy, then do a little mental investigation.

1. Do you regularly interact with people who were in your household when you were growing up?

2. Do they (not you!! Do they — never you — this is about them) regularly make excuses to avoid learning or doing something new (doesn’t have to be body-related either)?

3. Even if you REALLY WANT to change something, do you have reasons that you’re not doing EVERYTHING THAT IT TAKES to make that change?

4. Even if they are *valid* reasons, write down every reason you can’t do something or didn’t do something today.

5. Do you TRULY believe that you can make something better, or are you skeptical? Give your skepticism a percentage, i.e I think that it’s PROBABLY true that I can make something better, but I’m 40% doubtful.

6. If you could only make yourself 25% better, does improving your health 25% have value to you, or if you can’t be 100% better, are you tempted to do nothing?

Once you start doing this type of research you might become aware of a more hidden efficacy issue. It’s really fun.

Not really. It’s pretty scary, actually, to see what’s in the old upstair closet, if you know what I mean. Do you know what I mean, “Or, am I being obtuse?” {Name that movie, and you can be my new BFF.}

Are you still interested in learning more on this?

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43 thoughts on “Hidden Doubts

  1. Awesome post, and awesome reference to an awesome movie. “I think I just miss my friend”. I bawl every time I see that part, and it’s numbering in the dozens by now…

    PS – Am going to ask my husband to build me monkey bars for my Christmas loot this year. I am such a copy cat. Forgive me.

  2. KATY: Awesome and bossy – I LOVE IT!

    PLEASE, PLEASE, PLEASE come visit us at practiceyogadayton.com face to face. Kathi Kirzirnis is our yoga teacher and WE NEED U!

  3. Hey – you really are a mind reader aren’t you? I have been thinking about this for ages (I have the tools to help me but keep ‘forgetting’ to do them.

    Am on a big journey of finding out why I tick – and more am amazed that my knee and back issues aren’t due to ‘extra long’ ligaments as a doctor once told me – but of poor posture and movement learnt from mum.

    Am loving working through your posts and putting them into practice (and going to the playground with my little boy is great fun now I can play too ‘because Katy says..’ lol)

  4. Every morning when I am tempted to either not do my stretching/walking/dancing routine or cut it short so I can get to editing, I tell myself this is my investment for, hopefully, a longer life, but certainly a healthier and pain free old age still working at what I love to do!

    This often makes the morning the best time of the day, especially doing restorative to music!

  5. Yet another awesome article!

    Anytime I hear someone use the word Obtuse I think of Warden Samuel Norton saying something very vulgar about a train and the body. My efficacy at changing that thought has failed repeatedly!

    Thank you very much for sending my mind off on a tangent and reading more into Self-efficacy, which also led me to the Transtheoretical model which I think the two go well together.

    1. Love your comment. I can never even THINK of this actor as anyone else. Nor the word obtuse about anything else. Weird how that works!!!!

          1. Wow I am going to have to dust off some neurons here and access a part of the brain in long disuse.. I have been so caught up reading things related to yoga, anatomy, movement, massage, psychology (mostly trauma based stuff, Peter Levine & Robert Scaer), that I have neglected the good old entertainment of movies. So here is to crossing my fingers that I actually take a lazy entertainment time.

            Welcome to Shawshank. At least I know one! But you also helped stimulate that portion of my brain.

  6. GREAT post!! I mean, they’re all great, but this one was especially spectacular, also a nice follow up for Lectio Divina.

    I tend to be a more self-aware person than most people around me, kind of always been introspective, so this stuff is right up my alley. I’m going to write through your steps up above and see what I come up with. In the meantime, what role does fear play in self-efficacy? On the one hand, it’s somewhat opposite of belief, but I think the two can coexist even as the one errodes the other. In my own case, I spent the first 26 years of my life ignoring pain and then the following two listening to it too much- after a major back injury, fear and misinformation kept me from moving enough. I’m now in the process of trying to find some kind of middle ground. It’s been a barrier in implementing the things I’ve learned here (not the only barrier, I’m sure).

    I’ll stop there, as I feel this is the beginnings of my own blog post….Thanks, again!!

    1. Taking the steps is key. There are a lot of people who will read and nod, but it’s the ones who WRITE IT DOWN that will see the most change. The resistance to change is powerful stuff — enough to prevent you from picking up a pencil~ Can’t wait to see your blog post.

  7. So, if I read your post correctly, I’m a bad person, right? :o) Very good info and helps explain why people (not I said the little red hen) interact but don’t act. I will read up on this Self-Efficacy Theory.

    Who could forget Tim Robbins asking the warden if he were obtuse in “The Shawshank Redemption? Robbins’ character had a lot of self-efficacy.

    I didn’t sit in the front, uh-uh. I stood in the back doing single and double lateral hip muscle contractions like an obsessive over achiever

    Finn looks awesome!


    1. Yes, that’s EXACTLY what this post said. You are a bad person. Glad you got that message out of it (can someone say check your filter??????)
      DON’T GIVE THE ANSWER GEEEEEEEEZ. I bet you DID sit in front before you realized you weren’t supposed to. Because sitting makes you bad.

      You’re such the best student (and teacher) EVER T.H.!

  8. I love your blog – and this post was very good.

    I just wish – such a big wish – that someone as obviously commited and intelligent as you seem to be would tak an interest in ME, and tell me how to exercise. Fatigue, mad worse by excersise, is one og the diagnostic criteria. Exercise too much, too often, and you get flu-like symptoms, low-grade fever, chills, brain fog, cramps – and fatigue. Stand too long, and your blood pressure drops. No fun at all.

    So I want to exercise – I always did before I got ill, a lot, and it was FUN – but now my body has a very ambivalent attitude to activity – too little is bad, too much is worse.

    I just wish I really knew what my muscles were doing, how to pace myself to get maximum benefit from what I do, how to keep reasonably fit even if I have to spend a fair amount of time sitting or lying down (tall order, that!). I do my stretches, and I ride my horse when I am able to (more sitting, but at least it is active sitting!)

    To cut a long story short – there are times when even belief is not enough 🙁

    1. Trudy, do you have our DVD for chronic pain? Because I take a huge interest in autoimmune disorders. And, if you have taken any of our online courses, you will have a great insight to pacing, correct prescription, etc. Which of our programs are you following?

    2. Trude, have you had your cortisol levels checked? What you’re describing sounds so much like what I was dealing with when I had severe adrenal insufficiency. I’ve been working on repairing my adrenal function for the last 4 years and exercise no longer makes me sicker. (Ten minutes of walking used to make me throw up.) Worth checking into, at least.

  9. I am thinking about minds, alignment, strength and movement for toddlers.

    Doesn’t it seem that if we start them off well they would be less likely to develop the pf issues, pressure disorders etc? Aligned and well for early childhood educators Katy? Please!

  10. believing that you can change is huge, and it’s a starting place – a starting place that many people don’t even get to. But I think the rest of the journey depends mostly on sheer effort and self discipline. I’m not trying to be harshly critical when I say this, but I believe that our convenient, and relatively easy life here in North America, has made us lazy and weak willed. Not just a little, but a HUGE lot. Nobody likes to be told they are weak willed and lazy, our cognitive disonance kicks in and we say, “no I’m not, I’m a good person”. Sure, you’re (I’m) a great person, but you’re (I’m) still weak willed and lazy – 10%, 20%, 50%, 80% of the time. And that’s OK – but it just might be the reason why I didn’t get off the couch today after supper and go for a walk. So, I’m going to start a social support group similar to AA, called WW & LA. Sounds like a great way to spend a Wednesday evening. I know I’ll be the only one there. Or maybe I’ll just stay home and vedge on the couch some more.

  11. I qualified to be your BFF (as well as your stalker) before reading the replies!! Great and inspiring post btw!

    With my life-coaches hat on., the reason for change has to be big enough. Desire is about the “Why” not the “How” The “Why” has to be 90% and the “How” 10% before it acts as the driver/motivator.

    Also, I love this quote by Guy Finley :

    “The best time – in fact, the only time – to make a real change in your life is in the moment of seeing the need for it. He who hesitates always gets lost in the hundred reasons why tomorrow is a better day to get started!”

    Keep up the good work and the passion


  12. Here’s a little extra tidbit: What we humans tend to do is base our beliefs on our experience. In other words, if I have personal evidence that XYZ works, I’ll believe in it. Well, for healing, or changing anything, if we use that model, we’ll tend to fall into the trap of noticing what doesn’t (or didn’t) work and remind ourselves that we can’t change or heal because we haven’t yet. It’s circular logic that keeps us trapped in our “problems.” Maybe “faith” is a better word than “belief” because it tends to imply what we haven’t yet experienced. Okay, part 2: in order to really heal (or change) what helps tremendously and speeds up the process is to visualize and feel like we’ve already succeeded. We have to consciously create the feelings beforehand, not based on what has already happened. It’s like creating a movie in your mind. And then what really helps is to create a ritual or a practice, where you visualize and feel your desired outcome every day. Then that will begin to change the neural pathways in the brain, etc., etc… My favorite book on the subject is “Excuse Me, Your Life is Waiting,” by Lynn Grabhorn. There’s lots of awesome info out there – Bruce Lipton is a great one, too. The movie, “What the Bleep” is amazing. I’ve watched it at least 20 times because it really sinks in a little deeper each time. Anyway, I could go on about this forever… It’s one of my favorite subjects. 🙂

  13. Hitting home, as usual!!! The best blog yet, Ms. Katy. I’ve read it over a few times and will print it out for a few of my “lack-of-computer-skilled” people.

    Mind over matter…………..



  14. I have to agree with Andy. I have not always been a believer that I even possessed the “how” to properly do many of Katy’s exercises, particularly the squat. However, “why” I needed to be able to do this exercise has motivated me far beyond my perceived limitations of two C sections and broken tail bone. Well it took a few years, but now I actually possess the “how” to fully squat with feet on the ground and shanks vertical, and sure enough it was only “why” that kept me going for the last 5 years….now on to working on that figure 4 to free up my lateral hip musculature…the next big “why” on my hip health list. Thanks for keeping us inspired Katy, I’m now looking forward to traveling to a county with pit toilets so I can void like a native.

  15. Love this post. I kept thinking what would be the soundtrack for this post. I went with eye of the tiger.

    Love SSRedemption too. I’ve seen it more than any other movie including CUTTING EDGE which I love.

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