Non-inspirational advice for heart patients

by Carolyn Thomas  ♥ @HeartSisters

I know I’m not the only one who wonders why famous inspirational speakers and writers are so often NOT inspiring.  Call me cynical, but maybe I’ve heard once too often:

• Follow-your-dreams!
• Reach-for-the-stars!
• Eat-more-kale!

These pep talks are typically delivered with varying degrees of cheerleading conviction by speakers who invariably spend considerable time boasting about their own amazing dream-following, star-reaching and kale-eating accomplishments. 

For this reason alone, I agree completely with Shawn Callahan, the Australian who helped to launch anecdote.com, and whose expertise lies in the unique field of business storytelling. His beef with motivational speakers is this:

“There is too much of a gap between the sender and the listener.

“Winning Olympic gold, being a world-class dancer, or climbing Mount Blanc while blind are just too far from the understanding and realities of most of the people they will share their stories with.

“It is too easy for the audience to sit back and say: ‘That’s great, fantastic, but I’m not like them, and they don’t know what it’s like for me!’

“In some ways, it almost does the opposite because it doesn’t build a key element of personal behaviour change – self efficacy.

“Self efficacy is a term coined by renowned psychologist Albert Bandura. It relates to a person’s belief in their own competence and ability to undertake a task.

“But hearing one of these speakers does not build self-efficacy and belief that you can achieve something more. It may, in fact, do the opposite.”

That is how I too sometimes feel when listening to big-time inspirational speakers.

If anything, I find them de-motivating, particularly on a day when I’m worn down by the chest pain, shortness of breath or crushing fatigue associated with my diagnosis of coronary microvascular disease. On those days, although I can admire people who are able to reach their goals in the same way I can admire Mother Teresa’s impressive lifetime record of sacrificial service to Calcutta’s poor, or the way I can admire the tenacity of a triathlete based on the volume and velocity of all that the vomiting at the finish line, these “inspirational” role models can also leave me feeling exhausted and inadequate.

Not inspired.

I’m guessing that inspirational speakers start off sincerely trying to help their audience members by sharing what they genuinely believe will work for listeners in order to ______ (insert lofty goal).  

So here’s the trouble with those dreams-stars-kale inspirational talks.  As social scientists often point out, “inspirational” messages are simply about the intention to inspire, while truly “inspiring” messages show the effect of becoming inspired based on a person’s internal reactions.

Thus, inspirational happens to you, while inspiring happens within you.

Here’s a little example.  A few years ago, I happened to read about Mike and Edward Wimmer, the father-son duo who founded the medical I.D. company called Road ID. Mike had frequently urged his son to wear an identification wrist band or dog tags with him during his solo marathon training runs, but Edward dismissed his Dad’s concerns with a casual “What could possibly happen to me while I’m out running?”  One day, however, Edward (as usual, carrying no personal identification) was out running when he was nearly struck by a frightening “King Kong-sized pickup truck” that left him sliding into a roadside ditch.  Luckily, he was not seriously injured – but was left very shaken.

“What if that truck had hit me? I would have been rushed to the local hospital as ‘John Doe’. Without proper I.D, family members and friends could NOT be contacted. Likewise, my medical records could NOT be accessed at the hospital. How long would I lay there unidentified? This freaked me out!” 

For 19 years, I too had been a distance runner. Like Edward and most other runners I knew, I frequently left the house for training runs with only the front door key tucked into a little pocket in my shorts.  I could relate instantly to his ‘what if’ story. As a heart patient, why on earth wasn’t I wearing my own medical identification?

Something clicked inside me, and I went online that very day to order my own I.D. bracelet (a purchase I’d been meaning to make for a few years). The glossy medical I.D. brochures I saw at my local pharmacy were intended to be inspirational, but Edward’s reminder of the mistake so many runners commonly make was what actually inspired me to act.*

The reality is that people usually change behaviour not because they hear a celebrity on a stage saying “Get motivated!”, but because something clicks in their life – big or small – that actually does motivate them.

Before my heart attack, I gave virtually no thought whatsoever to my heart (except maybe while struggling up the killer Quadra Street hill with my running group).

But after I survived a heart attack that had been misdiagnosed as acid reflux, I was suddenly intensely focused on All Things Cardiac while trying to make sense of a senseless chronic and progressive condition. I’ve spoken to thousands of women since then about heart health – not to inspire them, but as a cautionary example: don’t end up like me!

Instead of being called “inspirational”, I like the way Vancouver Coastal Health Research Institute described me after a recent public panel discussion (with three cardiologists) as more of a “knowledge translator”.  For example:

“In Thomas, the audience could see themselves, their mother, or another loved one; her story made the day’s information more relatable, understandable, and impactful.”

Inspiration is a relevant topic for those of us living with heart disease, because our health care providers are always thinking up new ways to inspire the freshly-diagnosed patient:

Take these pills, eat this food, follow this daily exercise plan, avoid that stress, keep those medical appointments, stop doing that, start doing this (and order that medical I.D.)!

Yet the sad reality is that (as I’ve written about here and here) no matter how sound the advice or how slick the informational brochure, most have been remarkably unsuccessful in inspiring heart patients to be more compliant (a distasteful and patronizing word that sounds like it has punishment at the end of it).

In other words, I could listen politely to an inspirational speaker onstage talking about dreams and stars and kale, words intended to motivate me into doing or feeling something I’m not currently doing/feeling. I might even take a stab at adopting the inspirational content, at least for a short while. But unless something within me suddenly clicks, the speaker onstage might end up being just another entertaining after-dinner speech on the Rotary club circuit.

And we never know from one minute to the next when we will encounter something or somebody who inspires us to take action. We may not go looking for inspiration, but we will know it when it strikes.

In her book Mindset: The New Psychology of Success,  human motivation researcher Carol Dweck writes:

“We often see books with titles like The Ten Secrets of the World’s Most Successful People crowding the shelves of bookstores, and these books may give many useful tips. But they’re usually a list of unconnected pointers, like “Take more risks !” or “Believe in yourself!”

“While you’re left admiring people who can do that, it’s never clear how these things fit together or how YOU could ever become that way. So you’re inspired for a few days, but basically the world’s most successful people still have their secrets.”

Behavioural scientists generally consider that, to be truly inspired, the inspiration is not willed – it just happens. In fact, the most inspiring messages involve three  related qualities, as described by the University of Pennsylvania’s Dr. Scott Barry Kaufman:

1.  Inspiring happens spontaneously and without intention. This could be an idea that comes from within, an inspiring role model, or a divine revelation.

2.  Inspiring transcends any self-serving concerns and limitations, often involving a moment of clarity and awareness of new possibilities. This moment of clarity is often vivid, and can take the form of “seeing” something one has not seen before (but was probably always there).

3.  Finally, inspiring involves approach motivation, in which a person strives to experience a new idea or vision. (Read more about approach goals vs. avoidance goals).

Here’s another example – in contrast to all that inspirational dream-stars-kale out there:  the late U.S. tennis legend Arthur Ashe once had this simple piece of advice that I found utterly inspiring. Best of all, it’s focused on other people, not on his own stellar accomplishments or those of other elite athletes.  And it makes sense for chronically ill patients seeking to enhance their own self-efficacy, one small step at a time, and applicable to almost any life challenge:

“Start where you are. Use what you have. Do what you can.”

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Q: What has helped to inspire you as a patient?

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NOTE FROM CAROLYN:   I wrote more about what works (and what doesn’t work) to inspire patients in Chapter 7 of my book, A Woman’s Guide to Living with Heart Disease  (Johns Hopkins University Press, November 2017).  Yes, this was the infamous chapter that the anonymous Johns Hopkins cardiologist who reviewed my manuscript before publication called “irrelevant to female heart patients”,  recommending that it should be deleted. (Happily, it wasn’t!)   You can ask for this book at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).

See also:

Please! No more bragging about mountain climbing!

“I’m just not a pill person” – and other annoying excuses

No, really – patient education that’s actually useful!

Confessions of a non-compliant patient

“To just be a person, and not a patient anymore”

Why don’t patients take their meds as prescribed?

Why patients hate the c-word

* Mentioning Road ID does not imply endorsement of the company or products.