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For now, ignore any automatic thoughts from your feed that pop up to derail you and convince you that you can't achieve or have these things (remember, you now have the tools to zap those). Take one small step. Come up with just one five-minute activity you can do to move that forward. If it's a home you're dreaming of, perhaps you can call a real estate agent to schedule an appointment to see what's out there. These responses tend to reinforce the permissiveness of the classroom climate, since it is obviously safe to differ. Encouraged by this acceptance, Miss C explores her milder objection, and something of her puzzlement. This response is attitudinally accepting. In terms of content it seems somewhat overgeneralized. A more specific response might have been preferable. You thought they were supposed to be `middle-of-the-road' and yet you feel that actually they are more nondirective. This perplexity is an attitude to which the instructor might well have responded, but perhaps he was not given the opportunity. Mr R: Well, that's true, but I didn't mean that they drew conclusions, they just summarized what the client had said, picking out the high spots and more or less emphasized them. Mr B: It seems like we could use both nondirective and directive therapy successively on the same client if we did it carefully enough, and get better results than if we used one or the other. That way I'd feel better because I wouldn't be tied down to one set of criteria; Is that really so? On the next article is the actual data, drawn from their report. I suppose the word modest regarding weight loss was well chosen. The change in body mass index (BMI)* was less than 1 unit after ten years! This is well below the 5 to 7 percent weight loss goal they deem desirable. In other words, they demonstrated that they were not able to achieve the recommended goals.

And truth be told, would you have rather endured the ten years of dieting, or been part of the placebo group that did nothing but had similar results? You can see that those who took a diet drug didn't fare any better either. The weight loss was minimal, and there were multiple interventions that could have caused the outcome (changes in diet and exercise, for example), so it's a stretch, too, to attribute the health improvements to that tiny weight change as opposed to changes in lifestyle. Calling it a stretch is overly generous; If you want to feel more connected to your extended family, choose one family member to reach out to today. Commit to doing this one activity today and see what happens. Use the positive momentum to keep going. Take note of how you feel after you take this step. Accomplished? If so, commit to a day and time that you will do another five-minute step, either toward this goal or another one on your list. The more of these small steps you take, the more momentum you'll gain--and the more you will align what you do with what you want in life. Here's how meQuilibrium member Lauren, forty-eight, put this into action: In twenty years, I want to have established enough success in my job to be able to leave the corporate world and work on my own as a consultant. I want to be able to set my own hours and travel often with my husband, who, by that time, will be retired. I'd be more comfortable in the situation that way. Then I'd never get the feeling that I'd be pinned against the wall and have no counseling ammunition left. Inst: If you could use the best methods of both viewpoints you'd feel a lot safer all around, is that what you mean? 10 through 13. Here is the type of interchange of which there is a great deal in any student-centered class. To the reader it may not seem too outstanding, unless he notes these characteristics.

Differences of opinion exist, but they do not tend to be pure argument for argument's sake (this in fact rarely seems to occur in a group once an acceptant atmosphere is established). These differences are expressed as each individual is trying to formulate his own evaluation of the subject under consideration. There is no appeal to the authority of the instructor or any other authority, but each is trying to define more sharply his own current judgment. These comments would apply not only to this interchange but to most of the quoted material. A better argument can be made that the interventions they studied are damaging, given the known deleterious health effects of the weight cycling and stigma induced by this study and others of its ilk. Many other investigations do demonstrate very compelling evidence that behavior changes benefits health, with or without weight loss, my own government-funded study included. Data from the also government-sponsored Look AHEAD (Action for Health in Diabetes) trial was significant because it was the largest and longest randomized trial evaluating whether weight loss and lifestyle modification could reduce deaths from cardiovascular disease in people with diabetes. Again, less than 1 BMI unit. When we actually pay attention to data, even a quick glance at the research shows that despite decades of trying, there is no evidence that efforts to prevent or reverse obesity are successful. The scientists are failing, not the people following their recommendations. Much evidence suggests that the prescription for weight loss is more likely to result in harm, promoting weight stigma and, ironically, worsened health behaviors, health, and well-being. It is true that most people with type 2 diabetes fall into the BMI categories of overweight or obese. It's also true that insulin resistance, one of the main underlying problems in type 2 diabetes, encourages weight gain. Even if high weight contributes to diabetes, what is clear is that its role is exaggerated and, more importantly, the focus on weight is not just unhelpful, but damaging. The one thing I will do, starting today, is to begin to strengthen my connections in my industry so that I have independent relationships with clients. I will also reach out to a consultant I know to ask if I can take her to lunch and interview her about how she built her client base. My Life in 20 Years What do I want my work life to look like? What do I want to have accomplished, and what do I want to be doing? What do I want to have in my romantic life?

Who am I with, and what is our relationship like? What do I want my relationship with my children to be like? How do I want my children to be in the world? What qualities do I hope to have instilled in them? Mr B continues the discussion but turns it in the direction of his own very personal feelings. This is a good example of the way in which the type of thinking in a student-centered class tends to differ from that in the more conventional course. In a situation in which there was more of an element of threat, Mr B would in all likelihood have stood for the same point of view -- the same abstractions. But it is quite unlikely that he would have seen the basis of these ideas as residing in his own need for security. Such personal feelings tend not to be seen or to be expressed in the ordinary class. The leader wisely endeavors to understand the attitude Mr B has expressed. Mr B: That's right. I guess a lot of my intellectualization is based on attitudes of my own that I really don't want to recognize. At this point the subject of discussion changes, and the group explores other issues. Since it is not feasible to give the content of the whole hour, we shall select another portion of the interchange which occurred somewhat later. Dropping the weight focus allows other (evidence-based! For example, a study published in the New England Journal of Medicine29 examined health outcomes over the course of ten to fifteen years for women initially living in stressful, low-income housing projects. They randomized them into three groups: one got a voucher for better housing and help moving, one a voucher for moving to any area without help, and the control group got neither. Both groups who got housing assistance had lower prevalence of diabetes compared to the control group, with the group that got the most housing assistance having the lowest prevalence. None of the participants got a drug prescription or advice on lifestyle changes. This is one of many studies providing evidence that diabetes prevalence can be reduced through social policy, without weight loss or behavior change prescriptions.

The new paradigm starts from affirming the individual's worth, value, and cultural traditions, and recognizes the physiology of oppression: that one's environment (economic, political, and social factors) and individual stress response trigger biological reactions within the body, like diabetes, and affect lifestyle behaviors. It acknowledges that while behavior change is valuable, it can't remove the stressors one faces, and supports systemic solutions in tandem with individual change. This approach moves away from the stigmatization of weight and avoids the metabolic dysregulation and other fallout of dieting. It also enables us to integrate clinically meaningful data about social determinants, stigma, and stress as we consider strategies for individual change. What do I want for my health? Where do I want to be living? Who do I want to be surrounded by? What creative, physical, or other endeavors do I want to have become accomplished in? What do I want to be known for in my community? What contribution do I want to have made to the world at large? And here's the game plan that Todd, thirty-four, laid out: In twenty years, I want to be married with a few kids, living in a house that's close to my brother and his family. I want to be in good health and in good shape so that I can enjoy a weekly squash game with my buddies and be an active, engaged dad. But right now, I'm spending all my time at work and not socializing, which will make it hard to meet the life partner that will make this plan work. Discussion had ceased on one topic, and a pause of one full minute ensued. Then Miss E spoke up. Miss E: If understanding the client is the important thing then what does a counselor do with a really dependent client who wants to lean on him -- not for understanding, but because he can't seem to function efficiently by himself. He's indecisive, fearful, and needs support. In fact he oftentimes comes to the counseling situation just for support. We get a lot of them in our agency and I think we have to give them more than acceptance and a good atmosphere.