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Fear As A Motivator

There is Nothing To Fear But Fear Itself”    This quote has been attributed to President Franklin Roosevelt’s inaugural speech in 1933 when he was referencing the Great Depression and people’s fears about what the future will hold.  Well, tell that to a person about ready to get bitten by a snake or about to go into a very risky surgery!  We have all faced situations when “fear” was/is a natural reaction to a situation, event or circumstance when something bad can happen to ourselves or loved ones.

I had a patient tell me that they had a previous primary care doctor who was on the older side.  When the doctor had a patient that was a smoker present for his/her first visit, the doctor would bring the patient to a special room where there was no exam table, but rather, a funeral casket.  The doctor would tell the patient:  “May as well get in this now and see what is gonna happen to you in the near future if you don’t stop smoking.”  Now, THAT is using “Fear” to motivate someone to change behaviors.

My personal approach to medicine:  Be honest with patients about what their situations are medically and try to provide, in a polite and kind manner, what the “prognosis” may be if situations stay the way they are.  As a doctor, I do not want to “strike fear” into my patients but on the other hand, it is my obligation to inform people as to what the short term and long term medical futures will hold based on the current physical status.

“Fear” can be a very potent “motivator”.   I have seen many patients immediately stop cigarette smoking the day they are on a hospital gurney being transferred to the cardiac care unit while suffering a heart attack.   They do not need nicotine patches, hypnosis, Zyban, Chantix or any other intervention…the fear of dying from the heart problem instantaneously breaks the addiction.

When a person is overweight/obese, how much “fear” is present that something “bad” will happen?  There probably is not much because if there was, the urgency to shed the weight would probably be heightened.

I do understand President Roosevelt’s calming words but I do not exactly buy into them.  In the healthcare arena there are LOTS of things to fear:  Cancer, stroke, heart attacks, metabolic diseases, degenerative orthopedic issues etc.  

We all need motivation to change immediate gratification behaviors to longer-term goals of improved health and happiness.  That motivation can also include a “Fear Factor” of sorts as to what the poor weight control can do to us.  Fear should not be the only motivator for us but it certainly should be part of the picture.  Do not dwell on it but use it!

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