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How People with Lupus Can Build and Maintain Motivation for Healthy Habits

Adapted from a presentation at the SLE Workshop at Hospital for Special Surgery

Developing and maintaining healthy habits is challenging for everyone. When you have lupus, it can be even more so, because of the complexities and unpredictability of the condition. In her presentation, Ms. Seehaus shared how motivation is developed, cultivated and maintained, and she offered strategies for building healthy habits and staying motivated to maintain them.

Her objectives for the program were for workshop members to:

  • understand the components of their own motivations
  • ponder the use of behavior change theory to increase their motivation
  • learn cutting edge, research-based tools to quickly boost motivation for healthy habits

Defining and understanding motivation

“Motivation” is a word we often hear in relation to discussions on healthy habits such as:

  • eating healthier
  • exercising
  • working to improve particular areas of one’s personal life

Motivation has been described as the directive of one's behaviors, or that which drives someone to repeat certain behaviors. Cultivating the motivation to improve health is an idea that can be difficult put into action. Change is hard! But people change every day.

Motivational factors may be:

  • internal (from within ourselves)
  • external (life experiences, events or encouragement from others)

Internal and external motivational factors

What motivates someone to create and maintain healthy habits? For patients with lupus, the most sustainable motivational factors to maintain healthy habits are internal. These include the desire to:

  • reduce stress levels
  • increase energy and strength
  • improve self-care and overall health

Common external factors, however, may include managing relationships with family and loved ones, since illness can put stress on those relationships.

Components of motivation

The various components of motivation were summarized in terms of:

  • beliefs people have about their own capabilities
  • intentions, priorities and incentives that initiate the goals of and later maintain accomplishments of change

Beliefs about your own capabilities

These include:

  • self confidence
  • self esteem
  • self-efficacy – how you feel about your own abilities to perform or complete a task
  • control over environment – how much you adjust or control the setting you’re (work or living situations, etc.) in to accomplish your goals

Intentions, priorities and incentives

In order to accomplish and maintain your goals, consider your:

  • Intentions – What are your intentions when setting, working towards and accomplishing your goal? 
  • Priorities – How important is this goal? How willing are you to prioritize this goal to achieve it? 
  • Incentives – What will serve as your “reward” for change?

Finding Your “Why”

An element that is critical to building and maintaining motivation that translates into change is to identify your “why” – that is, a conscious reasoning, rationale or purpose that underlies your motivation. As described by a group member, “your 'why' helps push you when you want to give up, because you understand why you are doing what you do and why not to quit."

Goal setting: “SMART”

            Ms. Seehaus stated that, when considering new goals or revisiting goals that may not have been accomplished, you should aim to be clear and intentional about what you want to achieve. To describe this intentionality, she used the acronym SMART:

  • S – specific
  • M – measurable
  • A – achievable
  • R – realistic
  • T – time-measured

Defining healthy habits

In collaboration with Ms. Seehaus, support group members identified the following healthy habits for people living with lupus:

  • eating nutritious foods
  • exercising regularly
  • refraining from smoking
  • drinking moderately or not at all
  • getting adequate sleep
  • reducing stress
  • support from others
  • following medical treatment plans agreed upon between you and your healthcare team
  • setting boundaries – understanding what may or may not be doable and refraining from overexerting or overextending yourself

The stages of change

Ms. Seehaus explained the stages of change as a cyclical process that begins with “precontemplation.” She displayed the cycle of stages through the use of the diagram shown here.

Graphical representation of the stages of change cycle, with a circle made of arrows pointing in succession to the following label words: Enter, Precontemplation, Contemplation, Determination, Action, Relapse, Maintenance (back to) Precontemplation, with supplemental label reading "Exit & re-enter at any stage."

Group members shared personal experiences of being at different stages within the change model in regard to their own health habits and how that affected their journey living with lupus. The complete stages of changes are listed below, along with the steps you can take at each stage to move along to the next:

  • Precontemplation:
    • Learn the facts.
    • Identify pros and cons of changing your behavior.
  • Contemplation:
    • Find your why.
    • Develop realistic expectations.
  • Determination:
    • Identify options for moving forward.
    • Make a plan.
    • Strategize for roadblocks: "If 'X' happens, then what?"
    • Get social support.
  • Action:
    • Start changes with small steps.
    • Identify ways to cope with barriers.
    • Chart progress.
  • Relapse:
    • Accept that sometimes you may diverge from your planned habits, but don’t let it discourage you.
  • Maintenance:
    • Return to your why or find a new why.
    • Set new short- and long-term goals.
  • Recurrence (back to precontemplation).

Members noted that maintaining a healthy diet was the most challenging. One member shared that “eating healthy used to be a struggle, and I stayed in the stage of contemplation regarding healthy eating but, finally, when I put my thoughts to action, I can say now I am in the stage of maintenance.” Ms. Seehaus reemphasized the fact that the stages of change are not always followed in sequential order and that people may – and often do – enter or exit at different stages of change.

The four tendencies

When attempting to build and maintain healthy habits, it is helpful to be in tune with yourself and understand the tendencies you may fall into. Ms. Seehaus discussed the work of Gretchen Rubin on the four categories of “tendencies” people may have in their relationship to change. She shared strategies for each persona – methods each type of person can use to help accomplish their goals:

  • The Obliger meets outer expectations and questions inner expectations.
    • Strategy: Ask someone to hold you accountable.
  • The Questioner questions all expectations.
    • Strategy: Find a mentor or trusted authority.
  • The Upholder meets outer and inner expectations.
    • Strategy: Expect stumbling blocks, but stay flexible and forgive yourself.
  • The Rebel resists both inner and outer expectations.
    • Strategy: Find a why you truly and passionately believe in.

Radical acceptance

Ms. Seehaus introduced the concept of “radical acceptance” – accepting life on life’s terms and not fighting against that which you cannot or choose not to change. She described radical acceptance as “saying yes to life, just as it is.” For patients with lupus, this can be understood as:

  • learning to accept your physical abilities and limitations
  • focusing on your personal strengths
  • using those strengths to have to cultivate gratefulness and progress in a manner that is unique to your personal journey

Lastly, it is important to understand that change is not easy, but it is achievable.

Additional resources

For more information on how to build and maintain motivation for healthy habits, please visit:


Headshot of Mavis Seehaus, MS, LCSW

Mavis Seehaus MS, LCSW
Director of Ambulatory Care Social Work Services
Department of Social Work Programs at Hospital for Special Surgery

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Headshot of Asia Tayor, MSW

Asia Taylor, MSW
Masters of Social Work Intern
SLE Workshop Coordinator, 2018-2019

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