Dear Therapist:

My husband has been diagnosed with type 2 diabetes. He is also overweight and has slightly high blood pressure. He is on medication to help with these issues but his doctors keep emphasizing that he needs to eat healthily and exercise in order to really control these problems and prevent dangerous complications. I have been a dutiful wife and been preparing healthy meals for him. He eats those but will sneak unhealthy food at other times. He stills eats out a lot and basically doesn't have things under control to the consternation of his doctors (and me!).  I am encouraging him to exercise as well. However, although he has 2 gym memberships and bought a treadmill he really doesn't do much exercising. I don't want to become his health "mashgiach" but I also don't want him to have a stroke at age 50. I am stuck and I am really worried about his disregard for his health and, by extension, his family. Any suggestions or is this just out of my control?

Response:

Although we all have unconscious needs, triggers, and motivations, I will assume that your husband’s are not out of the ordinary. I will assume that he has no deep-seated, unconscious aversion to remaining healthy or to exercising.

Changing lifelong habits can be extremely difficult. I understand your consternation and concern over your husband’s apparent lack of interest in his own—and by extension his family’s—wellbeing. This is not an uncommon problem. Some of us are better than others at self-motivation. Even those who are generally able to set goals and achieve success can have trouble when faced with certain particular objectives. This can be especially true when the task involves a long-term change of longstanding habits. Additionally, when we feel that a task is thrust upon us by others, it can be difficult to accept.

When faced with our own goals (whether self-imposed or otherwise), we may make excuses for our lack of follow-through or minimize the importance of the goals in order to justify our behavior. When viewing someone else’s behavior, however, we are much more likely to see things from an objective, unemotional perspective. It’s easy to make decisions for others, and hard to understand when they seem to self-sabotage. We tend not to fully acknowledge when we do the same ourselves.

Your husband may be balking at taking on so difficult-seeming a task, especially if he feels that doing so was not his decision. Certainly, he can use your concrete help in keeping to a diet and exercise regimen. However, what he probably most needs is self-motivation. Without this, your efforts will likely be largely in vain. Rather than urging him to do the right thing, perhaps having a frank discussion with your husband about his fears, concerns, and what he wants can help him to build his own motivation with regard to his health.

When you discuss your own fears and concerns, try to do exactly that—speak about how his diagnosis affects you…and what it is that scares you. Your husband may not respond to conversations centering around him (and what he should be doing for himself), but a completely separate conversation referring only to your feelings may help motivate him to begin changing things on his own terms.

Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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