This week’s Healthy Minds “Therapeutic Thoughts of the Week” pertains to the concept of “goal setting.” During this time of year, many individuals think about setting New Year’s resolutions with the earnest intent on making new and positive changes in the upcoming New Year as well as intend on potentially accomplishing or fulfilling a longtime dream. The thought for some of attaining a specific goal or fulfilling a longtime dream may be anxiety provoking from the start and can on-set certain mental barriers that cause a sense of “pause, doubt, or anxiety” in the individual. This hesitation, doubt, and anxiety can become the barrier that prevents the individual from taking the first step forward in initiating their plan to make change or to accomplish their goal or dream. Hopefully, this week’s Healthy Minds “Therapeutic Thoughts of the Week” will provide a working framework for individuals on how to overcome their internal doubt or fear and have the courage to take the first step forward in making behavioral changes.
The names and information used in this case presentation is fictional and is used as an example to provide a conceptual framework around goal setting and overcoming your fears to achieve long-term behavioral goals.
Martha is a 31 year old single mother of two who works part-time at a local fast food chain and volunteers part-time at her children’s schools. Martha is 40 pounds overweight per her doctor and has been diagnosed with Type 2 Diabetes. For the past two years, Martha has made a New Year’s resolution to herself to lose the 40 pounds; however has been unsuccessful in losing the weight. Martha has decided that she is committed this year to lose the 40 pounds; however she is already embarking on this goal knowing that she has failed twice already. In the past when Martha has not seen observable weight loss she would become depressed and call herself derogatory names such as “fat cow,” resulting in binge eating. Martha admits that she possesses low self-esteem since her marriage ended two years ago and oftentimes wonders if she is capable of loving again. Martha indicates that she use to view herself as a moderately attractive person and reports that she is deeply connected to her two children. Martha reported that she is happiest when she is spending time with her children.
Martha’s long-term goal: Lose 40 pounds
Martha did not indicate how she attempted to achieve her long-term goal of losing 40 pounds; however Martha did share with us some key factors to take into consideration when brainstorming short-term goals with Martha; which ultimately will hopefully support Martha in achieving her desired goal.
Short-term goals: Martha indicated that when she did not observe visible weight loss that she would become depressed; resulting in Martha to take part in binge eating.
Depression, anxiety, and other mental health impairments may be on-set and/or exacerbated by medical conditions. Martha has been diagnosed with Type 2 Diabetes; however Martha should partner with her Primary Care Physician to rule out any medical comorbidity that may be contributing to Martha’s weight gain and difficulty toward weight loss. Martha indicated that she works part-time at a local fast food chain which may or may not contribute to Martha’s weight gain? Martha may consider partnering with her Primary Care Physician to discuss food programs for patients diagnosed with Type 2 Diabetes and may want to consult with a nutritionist prior to identifying healthy ways to lose weight.
Martha indicated that she has carried an additional 40 pounds for approximately two years which correlates with the time when Martha may have separated and/or divorced from her husband. This correlation is very important as Martha may use food as a way to manage her feelings of sadness, depression, and/or anxiety. Martha may need assistance with identifying other coping skills that will help her manage differently her feelings of depression, sadness, or anxiety that does not result in her binge eating.
Martha reported that there was a time when she viewed herself as a “moderately attractive person.” I am curious to explore and identify with Martha what were some of the things that she viewed as being “attractive” about herself and to identify other areas about Martha that promotes positive self-esteem within Martha? There may be unidentified areas in Martha’s life in which she associates positive attributes to herself which may combat her feelings of depression and anxiety pertaining to her weight gain.
Martha reported that she loved her children very much and that she is most happy when she is spending time with her children. Martha’s children are a good source of motivation to assist Martha in maintaining commitment toward achieving her goal. Martha’s children may be able to get involved in activities with Martha that promotes healthy living and weight loss and also promotes more family time together.
Establishing a long-term goal is commendable; but for some may be extremely overwhelming and potentially debilitating. Keep in mind to reality check yourself on a regular basis and to create short-term goals to assist you in taking the steps needed to move forward in making long-term positive behavioral changes. Surround yourself with positive influences and remember to take one day at a time.
David P. Sanchez, Psy.D, LMFT
Licensed Therapist, Healthy Minds