When it comes to taking care of our health, my job is often less about delivering new information and more about helping people problem-solve, reframe their assumptions, and remember what they already know. Most of us don’t need to be told that exercise matters, vegetables are good, or sleep is essential. And yet, many of us struggle to exercise enough, eat well, or get to bed on time. We know what we need to do, but we don’t do it. The gap is not an information gap—it’s something else.
We often assume that the way to make better decisions is to get more information. But no one has ever looked at me with confusion and said, “You mean I should exercise? But I thought lying on the couch all day was good for me!” The barriers we face are usually not about knowledge. They’re about competing priorities, difficulty implementing what we value, or internal conflict about what matters most. Maybe we’re overwhelmed. Maybe we’re falling back on old habits. Maybe we’re not fully clear on what we want.
The space between what we intend and what we actually do is awkward and frustrating. We often try to close that gap by doing more of what we’re already doing—trying harder, pushing ourselves further, doubling down on effort. But when we do that, we usually stay stuck. What actually closes the gap is not more intensity, but a different approach—one that often requires us to grow in unfamiliar ways.
In the office, I’ll see this when someone has made multiple plans to change a habit, and none have stuck. I’ll reflect on the gap between our plans and the actual progress, and the patient will nod and say, “You’re right. I just have to be more disciplined about bedtime.” But we’ve already made that plan five times. We’re not failing because we’re not trying hard enough. The plan isn’t working because something else is getting in the way. So the real question becomes: If we’re already trying hard, already know what needs to change, and still can’t get there—why?
This is the point where people often get written off—in healthcare, in recovery, and in life. “I guess they’re not serious,” we might say. “They just don’t want it badly enough.” But what if that’s not true? What if we *do* want it, and it *is* important, and we’re actively trying to make the change—and it still isn’t happening? Most of us have been in that place: stuck between a reality we don’t like and a change that seems perpetually out of reach. We get frustrated, discouraged, and disappointed in ourselves.
In that space, we often turn harsh. We berate ourselves, yell inside our heads, repeat the mantra: “I have to do better.” But it doesn’t work. The gap becomes a source of shame—a mirror that reflects back all the ways we believe we’re failing. But what if, instead of judgment, we met that gap with curiosity? What if we asked: *Why is this so hard for me? Why don’t I make these changes I say I want to make?*
That tone—curious rather than critical—makes a real difference. When we’re harsh and unforgiving, we don’t get good answers. That critical voice is built on the idea that if we punish ourselves enough, we’ll eventually change. But shame rarely leads to growth; it leads to hiding. It narrows our perspective and keeps us stuck. Compassion, on the other hand, creates the safety we need to be honest with ourselves. And honesty opens the door to real change.
Fear shuts down reflection. If we want to understand what’s really going on beneath our repeated struggles, we need to shift from judgment to discovery. That shift allows for better questions—and with them, better answers.
Where that process leads isn’t always predictable. It might mean giving ourselves permission to lower the bar and focus on consistency instead of perfection. It might mean asking for help. We might discover that what we thought was a top priority… actually isn’t. Maybe we thought the problem was snacking on Oreos every afternoon, and we’ve been blaming ourselves for a lack of willpower. But perhaps the Oreos are just a symptom, not the cause. Maybe we’re using them as a way to cope with stress—or maybe the real issue is that we haven’t eaten a proper lunch in three days. In either case, the solution isn’t “just stop eating Oreos.” It’s understanding *why* we’re reaching for them in the first place.
Change isn’t usually about forcing ourselves through the gap. It’s about understanding what’s in the way—and doing so with kindness instead of contempt. That’s how we start to move forward in ways that feel more sustainable, more meaningful, and perhaps even more joyful.
Though I write here in the context of health, this applies broadly. The same kind of gap shows up in our relationships, in our finances, at work, and in how we care for our families. We often respond the same way—try harder, beat ourselves up, push forward with gritted teeth. But what if the answer isn’t more force, but more insight? Let’s stop punishing ourselves for not having already changed. Instead, let’s get curious. Let’s be kind.
Cheers,
Doc
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