New Year’s resolutions have the potential to make our lives new and different and better than ever. But they also can do more harm than good. That’s because we put all our energy into setting the goal and don’t do the homework necessary to meet that goal. By the time February arrives, we’ve relapsed to our old habits and, what’s worse, we’ve given up hope of ever losing that weight or running that 5K. We’re left feeling incompetent, depressed, and ashamed.

New Year’s resolutions can be particularly problematic for physicians. Physicians are high achievers, perfectionists, and conscientious to a fault. Grab your DSM-V and take a look at the symptoms of obsessive-compulsive personality disorder. You’ll see a description of the ideal physician.

It’s one thing to be compulsive about your patient’s care. It’s another to be such a perfectionist about your own self-care that you have unrealistic expectations of what you can accomplish in the New Year.

Physicians generally understand that it’s difficult for their patients to quit smoking or lose weight. There are psychological issues, family issues, addiction issues, and all kinds of challenges to be overcome.

But when they themselves are trying to make a change, many physicians I know forget that it’s hard for them as well. They are such high achievers, and they hold themselves to such high standards that they think they can just will themselves to make a major life change. They forget that they, too, are human beings with needs, bad habits, and frailties. Not to mention sixty-hour work weeks, which leaves precious little time for addressing personal needs and goals

Whether you’re a patient or a doctor, it takes a lot more than a “resolution” to change. It takes preparation and planning, motivation and self-efficacy. It takes self-understanding, skills, strategies, and social support.

So, if you’re thinking about learning Spanish, ask yourself not only why you want to study a new language, but also why you might be ambivalent about it. Be honest with yourself. Do you have the time? The energy? The motivation? What are you willing to give up to gain this new skill? Make lists. Journal. Discuss with friends. Don’t commit unless you know the price and are prepared to pay it.

Here’s another example. Let’s say you’re thinking about making a resolution to stop watching so much TV. The first thing I recommend is to make a list of all the benefits of watching TV. You have personal needs that are met by watching TV, and you’ve got to identify those needs and find other, healthier ways to meet them. Or not! Maybe you’ll conclude you actually need that time vegging out evenings and weekends.

And even if you do decide to make a change, you’ll have a better chance of success if you plan and prepare first.

Let’s say you want to lose weight. Here are the tools you’ll need in your toolbox before you make that resolution.

Skills. How will you respond when your clinic serves bagels at Monday morning staff meetings? Or cake at the monthly birthday celebrations? How will you say “no” to your relatives when they serve you high-carb feasts over the holidays? You don’t want to appear rude, but you don’t want to eat all that food, either. If you’re having trouble figuring out your “script,” you might actually consider asking someone to coach you in handling difficult conversations. Your ability to lose weight could hinge not on your willpower but on your ability to articulate your goals to family, friends, and coworkers.

Strategies. What will you do about your proximity triggers: the candy in your pantry and the ice cream in your freezer? What will you do about your physiological triggers: eating when you’re tired or sleepy? What will you do about your emotional triggers: eating when you’re stressed, depressed, or bored? For each of these, you’ve got to have a strategy or your New Year’s resolution is doomed to fail.

Social support. Who will hold you accountable to these changes and help you get back on track if and when you relapse? Will you give them permission to call you out? Will you listen to their input while taking full responsibility for doing the hard work yourself? Are you going to join a formal accountability group, such as Weight Watchers? Or will you form your own personal support group of friends and family? Or both?

If your Achilles heel is eating junk food while you watch football with your buddies, what are you going to do to keep that from sabotaging your success? Have a conversation with your buddies, find new buddies, or watch alone? Eat apples and drink Lite beer? Walk on the treadmill while you watch the game? Go out and actually play football rather than watching other people do it? These are huge changes, and they don’t come easily.

The bottom line is this: Don’t make a New Year’s resolution until you’re ready. Keep thinking and strategizing until you come up with a solid plan.

Perhaps you’ll decide you’re not ready to make a change. That’s fine! Giving up a life-long habit requires honest reflection, careful analysis, and comprehensive planning. Premature resolutions are doomed not only to fail, but also may erode your confidence in making other changes in the future. It’s better to take all the time you need to prepare before you commit to a goal or resolution.

Summing up

I wish I could boil this down to “three easy steps,” but there’s nothing easy about it.  So instead, here are the “three hard steps” needed for a successful New Year’s resolution.

1. Think through the pros and cons of change. You’ll need to ponder this for weeks and months, not hours and days. Be completely honest with yourself. You’ll probably discover reasons for your bad habits that you didn’t know existed. This may turn out to be less of a behavior modification project and more of a journey toward self-understanding.

2. Make lists, make schedules, journal, discuss with friends, consult with experts. Imagine you’re the CEO of a large organization, and you’re plotting a major restructuring. You wouldn’t do that impulsively on December 31 with a notion to implement on January 1. Would you?

3. Marshal the skills, strategies, and social support you’ll need to turn your resolution into a reality. You might need to take a course, read a book, or hire a coach to develop a key skill. You will definitely need to identify sabotaging situations and develop strategies for dealing with them. And you will need to share your plan with key friends who can encourage you toward success.

Given all the preparatory work that’s needed, it might make more sense not to make a New Year’s resolution. At least, not this year. Instead, you might “simply” resolve to accomplish the three steps above. If you get that done in the coming months, or even if it takes you the whole year, you’d have achieved a major accomplishment. And you’d have built the foundation for a truly sustainable lifestyle change.

Warren Holleman runs a wellness program for physicians and is on the editorial staff, Pulse — voices from the heart of medicine. He blogs at Work Well.  Be Well. 

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