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Cognitive Behavioural Therapy for Workout/Diet Adherence – Stick to Your Training Like Glue!

By Adam Sinicki on December 17, 2014

Cognitive Behavioural Therapy is a school of psychology or a ‘therapeutic approach’ used by psychologists in the treatment of a number of anxiety disorders and other mental health issues. For the most part it has been shown to be effective (1) above and beyond other psychotherapeutic interventions such as psychotherapy or behavioural therapy on its own.

I have long believed though that cognitive behavioural therapy has use outside of clinical settings and could be used instead as a tool for us to increase our happiness, productivity and even health above and beyond what is considered the ‘norm’ (here’s an article I wrote on that recently in fact). In other words, it could be useful not only to help us feel better when we are psychologically unhealthy but also to feel better when we are psychologically average. To stop being ‘well’ and to start being ‘optimal’.

Studies have already shown that CBT can be used to improve productivity (indirectly at least (2)). But what about improving your health behavior? As it can help to teach a more disciplined way of thinking, could it possibly help make us more disciplined when it comes to sticking to a diet or an exercise routine?

How CBT Works

CBT works essentially by getting patients to identify negative thought patterns and then to try and replace them for positive ones. These thought patterns include ruminations that can cause them more stress for instance in the face of a phobia, as well as thoughts and behaviors that can ‘enforce’ maladaptive beliefs.

This will usually involve the use of something called ‘mindfulness’ – which is a type of meditation where the patient ‘observes’ their own thoughts (and possibly writes them down via journaling) – followed by ‘cognitive restructuring’ which is the process of swapping those beliefs for positive ones. This latter step can be achieved through the use of positive affirmations as well as ‘hypothesis testing’ and ‘thought challenging’ where you test how realistic your views really are.

Someone with a phobia of speaking in public for instance might worry that people will boo them and that this would be terrible. Thought challenging would involve asking yourself ‘how likely is that really?’ and ‘would it even really matter?’. Hypothesis testing meanwhile might mean speaking in public and then purposefully ‘choking’ to see what happens. Nothing will happen and you’ll quickly realize there’s nothing to be afraid of.

Finally, CBT might involve the use of reassociation and desensitization. These are ideas from behavioural therapy that try to address negative associations. You can do this by gradually increasing your exposure to that thing, or by using techniques like breathing techniques to calm yourself down. Likewise, you can create new associations by being exposed to the thing that makes you anxious and then getting a ‘reward’ so that you associate the negative stimulus with the positive reward.

Using CBT to Stick to a Training Program

So what does all this have to do with exercise and diet? How can you apply these principles here?

The obvious place to start would be by looking at the negative thoughts and emotions that you might experience when you start thinking about working out. Imagine you have to work out now and right away your mind and body will probably start protesting. Listen to these protestations to see what it is you’re actually using to convince yourself not to train.

Perhaps you find yourself imagining how tired and sweaty you’re going to be. Or maybe you are stressing about how long it’s going to take you to set up. Maybe you’re telling yourself you’ll do it tomorrow or you’ll do it later. That you deserve to rest right now because you’ve had a long day.

Make a note of every thought you have as well as all the emotions and feelings. Now we’re going to focus on each of them and change them.

Tiredness and Stress

After a long, tiring day at work it can be very difficult to convince yourself to train as the very thought of exerting yourself that much is likely to make your whole body ache and feel drained. Then you think about sitting on the couch and how comfy that will be… it’s a no-brainer right?

Every time you think this though, you are strengthening the association between working out and feeling exhausted/not working out and feeling comfortable and relaxed. You need to combat this association and form new ones, so how do you go about doing this?

One way is to focus on something different. Focus on how good you feel once you’ve done your workout, how much more guilt free your relaxation will feel after you’ve trained and how much it will boost your mood.

Likewise, try to focus on how lousy you can often feel when you waste an evening. Are you going to spend a whole night lying on the couch watching the TV? How do you think your back will feel as a result of that? Won’t you feel all hot and ‘cabin-fever-esque’? Focus on these emotional and physical responses and over time you’ll be able to create new associations.

The same strategy can also be used when trying to make yourself eat less desert. Instead of focusing on the anticipation of eating that delicious chocolate cake, instead try to focus on the last time you overindulged. What did that feel like? You were probably wracked with guilt, you probably felt sick and you probably found it wasn’t worth it. Focus on this sensation the next time you’re considering ordering a huge pudding in a restaurant and you might find you’re better able to resist temptation. How much better would it feel to have a tea or a coffee?

Reasons You Don’t Workout

One of the common reasons that people fail to motivate themselves to begin training is that they have ‘so much else to do’ or because they literally can’t fit it in.

Now is the time to use a bit of ‘thought challenging’ and to ask yourself whether this really is accurate. What are your plans for this evening? How much do you really have to do?

The first thing you’re likely to find is that you can easily fit your evening’s activities into a few hours if you’re quick with it. Maybe you want to watch something good on TV. Can’t you do that at the same time as working out? And do you really need to watch hours of TV now? Couldn’t you maybe catch up on that program another night?

We all think we’re rushed for time but the vast majority of us tend to spend at least a few hours a night vegetating in front of the television and often watching things we don’t even really want to watch. Maybe you spend a long time procrastinating by browsing YouTube or playing pointless games on your smartphone. Wouldn’t you rather forego these distractions and thus be better able to do your workout?

Here’s another thing to consider: you only really need to work out for ten minutes to have benefit from it. If you can exercise for just ten minutes you’ll find it has benefits and everyone has ten minutes. Thus the argument ‘I don’t have time’ really doesn’t hold water.

I’ll do it Later/I’ll Only be a Minute

The problem with procrastination is that it begets procrastination. Once you pick up that mobile game, there’s a very slim chance you’re genuinely going to be able to put it down after just five minutes – and you need to be self-aware enough to realize this.

Next time you find yourself indulging in a five minute distraction then, ask yourself what happened the last time. Was it really only five minutes? The answer is probably a resounding no!

Likewise, one of the worst things you can catch yourself thinking in terms of working out is: ‘I’ll do it later’ or ‘I’ll do it tomorrow’. Again, the question is: ‘really?’, because if you think about the last time you thought this then you’ll likely find that you actually just put it off indefinitely and never got around to actually doing it. And what’s going to have changed in a couple of hours? Or tomorrow? Chances are you’ll be just as tired and just as busy. Life has a way of filling up our schedule so even if tomorrow is looking less busy, it probably isn’t. Do it now, or you probably won’t do it at all – that’s the simple reality of the matter.

Priming

Priming isn’t so much a technique from cognitive behavioural therapy so much as it is just a ‘general’ technique. That’s why it gets its own heading (lucky priming).

Priming essentially means putting yourself in a particular state of mind for whatever you’re about to do. To get yourself pumped in other words. This shouldn’t be under-estimated as it’s hugely helpful. Stuck for motivation to workout? All you have to do is watch a Rocky training montage or an episode of Dragon Ball Z perhaps. When I need to write this blog but I’m not in the mood I’ll often read an Iron Man comic first or play Deus Ex. Maybe I’ll listen to a podcast by Tim Ferriss. Similarly, when you’re about to go on a night out, watch a comedy that will put you in the mood to chill and socialize. It’s funny how much watching a film or listening to some tunes can change your state of mind.

For your convenience:

Still not in the mood to workout?

Note: When you’re feeling low on energy or in mood, you often don’t want to listen to up-tempo music. When we’re sad we often can’t bear happy music and want to ‘wallow’ instead.

The solution is to start slow tempo and then build up gradually to bring yourself slowly around. Playlists that gradually increase in tempo have actually also been shown to be more effective for CV workouts than those with constant high tempos. Now you know.

The Other Approach

This above tips help make it easier to be strict with a workout routine by showing you how to ‘reprogram’ the thoughts and feelings you have regarding your workouts and your diet. By changing the focus and the emotional impact you associate with training and by challenging the thought processes you go through, you can encourage yourself to act more realistically and to actually stick to your training program.

But there’s another angle to this as well, which is to treat the process almost like ‘customer feedback’ in a focus group. Yes you should change what you’re thinking but you can also change your approach to working out such that it becomes easier to stick to.

For instance, if a complaint you have is that it’s going to take a long time, then making your workouts shorter is often a good solution. Likewise, you should make sure that your gym kit and any other equipment you need is ready to go: packing a gym bag the night before is often a very good strategy. If you hate the idea of getting in the car and driving to the gym, then start working out from home. If you think working out is going to hurt your knees, then work on improving your knee health.

The same goes for dieting: listen to yourself and to the complaints you’re making with regards to your diet. Maybe you don’t like being unable to eat the things that you really enjoy. If that’s the case – and if it’s preventing you from sticking to your diet – then you should reconsider the type of diet you’re sticking to. At the end of the day, it’s better to stick to a ‘quite good diet’ than it is to completely ignore a ‘really good diet’. Once again, it simply comes down to being honest with yourself and knowing yourself.

What kinds of excuses are you making to stop yourself working out or dieting? How can you make those excuses less valid? And can you then change the way you’re thinking such that you stop making them?

All of this takes time and practice, but over time as you learn the way you think and you practice being mentally strict with yourself, you will find that you become better and better at ignoring your own excuses and training no matter what. Burning building or no…

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About Adam Sinicki

Adam Sinicki, AKA The Bioneer, is a writer, personal trainer, author, entrepreneur, and web developer. I've been writing about health, psychology, and fitness for the past 10+ years and have a fascination with the limits of human performance. When I'm not running my online businesses or training, I love sandwiches, computer games, comics, and hanging out with my family.