Fixation and Long Term Care

Most of you have heard the old joke: The definition of insanity is trying the same behavior, over and over, expecting different results.  That’s fixation.
We all have met people who are unsatisfied with certain aspects of their lives.  Attempts to lose weight are good examples.  Most people will make temporary changes (New Year's resolutions!), but they soon lapse back into the same old eating habits that caused the weight gains.  These people are fixated on certain eating routines, which are very difficult to change.  It’s the mental/emotional processes that support and cause the repetition of the physical eating routines that we can call fixation.

I like to play golf.  My wife calls it my positive addiction.  Actually there is such a thing as positive addition, but that’s for a later article.  All golfers will voice a desire to get better at the game and will often make short term changes to their swings, but when the changes don’t give them the rapid improvement they desire, they revert back to their old habits which have been ingrained over the years.  Some researchers of sports activities have shown that it takes ten to twenty thousand correct repetitions to change from one style of physical activity to a new one, until it becomes enough of an ingrained habit that you no longer have to consciously think about it.

Imagine, twenty thousand repetitions of a correct, new swing before you can swing like Tiger Woods—if you have the physical capacity for it, or you don’t quit out of sheer boredom!  But the big danger for a devout practice is to think that he is practicing the correct new swing or behavior, but he really isn’t. I can’t tell you how many times I’ve had golfing friends say, “Look, Joe, I’ve changed my swing.  I’m trying to hit the ball inside out instead of cutting across it and slicing.”  Yet, when I watch them closely, it’s clear they only think they’re changing, because the swings almost always are the same old fixated ones.  Yes, fixation is hard to overcome.

Another good example is learning to type while looking at the keys.  If you do this you’ll probably never be able to learn to type without looking at the keys.
Fixation is basically the inability to change one’s responses to meet changing situations.  They can be physical activities as described above or social/mental/emotional responses.  And stress compounds the process; the higher the stress levels the more difficult it is to make the desired changes.
Obsessive/compulsive behavior can be classified as fixation.  The question becomes: Why does the person repeat the same behavior over and over, expecting different results?  One obvious answer might be that he’s given up on expecting different results and has become comfortable and “locked in” on the same old behavior.  In this case the old dysfunctional behavior is so ingrained, and has been reinforced in a negative sort of way over time, so that his anxiety would go up if he had to actually change!  Thus, not changing reduces anxiety!  Crazy, huh?

So how would one change fixated behavior?  First, the anxiety that arises needs to be dealt with; if the anxiety is not overcome, nothing new is going to happen.  Counseling and/or anti-anxiety medications might help, and many folks choose this route.  But I prefer dealing with the anxiety and change in a direct manner.  If one desires to change badly enough then go ahead and map out the corrective, new behavior, set up a practice schedule repeating the correct behavior, all the while knowing that it’s going to take some time to extinguish the old behavior by not repeating it.  Then go ahead and begin practicing the new behavior as much as possible—and leave the old behind.  One thing that helps is to get others involved in your program of change, whether it is Weight Watchers, Alcoholics Anonymous, or scheduling regular lessons and practice sessions with your sports professional.  Keep your mind focused on the new behavior, and after ten to twenty thousand repetitions you’re on your way!  If all this fails, and you still do want to change—do seek professional help.  My professional experience has taught me that the best thing you can spend your money on—especially as we get older-- is your health.

The question that remains is what does fixation have to do with long term care?  One thing I’ve seen a lot over the years is that people who are healthy and capable of managing their lives effectively, have trouble changing their behavior when they become very ill or disabled.  Also, as we age, change is more difficult.  But you already knew that.  A very good friend of mine, who was a heavy smoker, was recently diagnosed with lung cancer and received extensive chemotherapy.  Did he quit smoking?  No.  He smoked up until his death.  Though many people will need long term care, whether in a nursing facility or some type of medical care at home, there is often resistance, even though the care may be helping them.

There are many chronic diseases such as obesity, diabetes that lead to needing long term care but most people will reuse to change their habits until it's too late.  Once they need long term care say in a nursing home they have to begin to pay the $50,000+ per year out of their savings and before too long the well runs dry and they are broke.  Long term care insurance will pay those expenses as well as home health care but you have to buy it before one needs care 

Alcoholics and drug addicts who get clean and sober are usually the ones who faithfully participate in Alcoholics or Narcotics Anonymous, following those programs to sobriety—with help from a lot of similar, dedicated people.  They leave failure behind and follow a new path.

When a person needs long term care, change of some sort is always indicated. He must adapt to the new reality and leave some old behaviors behind.  This is not easy, because fixated behavior can kill good rehabilitative efforts.