Book Review-Change or Die

What if someone put a gun to your head and said that you have to change or die? What if you knew that you were going to die if you didn’t change? Would you? I know that we all believe we would. It seems simple. However, the statistics don’t bear out this reality. These statistics are at the start of Change or Die and should be startling.

Consider those patients with heart disease. Most with heart disease find themselves needing medical help because of poor lifestyle choices. However, if you look at patients with heart bypass surgery two years later only one in ten changed their ways and took a healthier lifestyle that reversed the progression of the disease. The fact of the matter is that 80% of the healthcare costs in the country is consumed by five behavioral issues: Too much smoking, too much drinking, too much eating, too much stress, and not enough exercise. If you fix these behavioral issues you can reduce the healthcare budget by 4/5ths.

Convict recidivism rates (return rates for prison) are around 30% in the first six months and 67.5% in the first three years. So only one in three convicts will change their habits after having been incarcerated.

Only 36% of diagnosed alcoholics are believed to not be active in their addiction after one year. Even with the substantial impact of Alcoholics Anonymous (AA) in improving outcomes, it only works when people work the program and too few are able to stay with the 12 simple steps.

So how about I ask again. If you were told that you needed to change or you would die, would you? Most of us would like to believe the answer is yes, but somewhere between one third and one tenth of us would be able to actually make the change. Change or Die is about what works to change those odds in our favor.

Keys to Change

The key to changing, according to Deutschman, are the three Rs: Relate, Repeat, and Reframe. We’ll look at them each in turn.

Relate

To make a change you have to believe that you can be successful and that’s what relating is about. It’s about connecting at an emotional level to a person or community. That connection, and their success story, can sustain you. Relating to other people including communities of people can create and sustain hope.

Repeat

Repeating is where you practice the new skills that you’ll need in your new life. You repeat them over and over until they become habit. There’s always the race between the rational self-becoming tired and discouraged and the new habit being formed. I’ve talked a few times about the elephant-rider-path analogy from The Happiness Hypothesis and Switch.

Reframe

Reframing is about changing how you think about your life and your world. Carol Dweck, in Mindset, talks about how we can all change and grow and how important the belief that we can change and grow is. Thinking in Systems highlighted the relatively high leverage of changing the paradigm in which you’re operating. By changing paradigms you can radically change an existing system and can therefore break free of the bonds of an addiction or the monotony of doing the same thing and expecting different results.

Discover the Truth

Psychological Concepts

Throughout the course of the book there are 8 psychological concepts explained. They are: Frames, Denial and Other Psychological Self-defenses, Short-term wins, The Power of Community and Culture, Acting as If, Recasting a Life’s Story, Walk the Walk (Don’t Just Talk the Talk), and The Brain is Plastic. Let’s look at each one of these in turn.

Frames

Your reticular activating system (RAS) has a set of simple purposes. It’s designed to regulate your asleep/awake cycle and your arousal (alertness). The system is also responsible for your attention. That is, the RAS, controls what you pay attention to. Many of us have experienced buying a new car and suddenly realizing the other cars on the street of the same make and model as ours. Before we bought our new car we could honestly say that we don’t remember ever seeing the car. This is the impact of our reticular activating system. Once we have purchased the car it’s more interesting to us and thus more worthy of our attention. In terms of Thinking, Fast and Slow this is System 1 handing off information to System 2. We’re suddenly more aware because the information seems more noteworthy to our brains.

Our frame is our perspective, or paradigm, our way of seeing the world. Sometimes that frame is useful and sometimes that frame can create gaps. The frame of car driving we have is clearly incomplete, but we only see how incomplete it is once we’ve changed our frame. Our selective perception and confirmation bias tricks us into believing that our perspective is the right one.

I recently watched A Beautiful Mind, which is about the life of John Nash a brilliant mathematician whose work redefined economics. Nash also suffered from schizophrenia. That is he saw people and voices which weren’t real. What was astounding about this was the distortion between what was real and what he saw. We all do this – just to a lesser degree. We all believe that our perspective – our frame – is right.

The key to change is a frame that insists that we need to change. Change is essential for survival. If we believe that we can cope with the problems we’re faced with through alcohol – or through the use of pharmaceutical drugs in the case of heart disease – we’re not likely to do the hard work to actually make the changes we need to make.

Denial and Other Psychological Self-defenses

Our egos are remarkable things. They’re amazingly resilient even in the face of immense pressure. We believe we’re a good person despite knowing that we cheat on our taxes. We believe we’re giving people, but can’t find a few hours to work at a community kitchen or homeless shelter. We believe that we’re at the top of our profession but fail to find the time to read the monthly magazine of the professional organization that we belong to. I’m talking about myself here – any resemblance to you just means that we’re all alike.

Within a few minutes any discomfort that you felt as you read the preceding will fade. Your ego will assure you that you are a good person. It will assure you that it’s ok. In fact you can ask most people in prison and be astounded as many will describe themselves as good people who were in bad situations. The reason any pressure you may have felt will fade is because the ego has its defenses. Change or Die refers to a book, The Ego and Its Defenses which I purchased. The Ego and Its Defenses catalogs 22 major and 26 minor defenses as listed in the following:

  • Major Defenses
    • Compensation
    • Conversion
    • Denial
    • Displacement
    • Dissociation
    • Fantasy
    • Idealization
    • Identification
    • Incorporation
    • Internalization
    • Introjection
    • Inversion
    • Projection
    • Rationalization
    • Reaction Formation
    • Rechannelization (Sublimination)
    • Regression
    • Repression
    • Restitution
    • Substitution
    • Symbolization
    • Undoing
  • Minor Defenses
    • Absolution
    • Atonement and Penance
    • Compartmentalization
    • Compromise Formation
    • Condensation
    • Convergence
    • Deferment
    • Devaluation
    • Distortion
    • Diversion
    • Extension
    • Externalization
    • Fainting
    • Fire Drill
    • Generalization
    • Intellectualization
    • Isolation
    • Overdeterminism
    • Personal Invulnerability
    • Replacement
    • Retribution
    • Retrospective (or Retroactive) Devaluation
    • Reversal
    • Splitting
    • Unwitting Ignorance
    • Withdraw

Despite knowledge of the defenses, they’re not neutralized. Even though you can become aware of the psychological defenses employed by the ego doesn’t mean that you’re not still subject to them. However, these defenses aren’t all bad – they’re required for us to live relatively happy lives. If we had to consider that we’re powerless to stop asteroids, earthquakes, tornados, volcanos, hurricanes, etc., we’d all have trouble getting out of bed in the morning. A little bit of ego defense isn’t a bad thing.

Still, it’s important to realize that when it comes to changing, folks’ fear will fade and we’ll return to our own normal state. That is unless you build a close network of personal connections. One of the things from Emotional Intelligence which didn’t make it to my book review – but did make it to my post on Trust => Vulnerability => Intimacy is that isolation – lack of personal connection – was reported to be “as significant to mortality rates as smoking, high blood pressure, high cholesterol, obesity, and lack of physical exercise.”

Overcoming isolation is what AA and other 12 step programs do. They ensure that you’re aware that you’re not the only one struggling with something. They put you in a group where you can share your struggle – and hear about others. This performs the dual purpose of connecting you to others and creating an atmosphere where you’ll be held accountable, as we’ll discuss in a moment.

Short-term wins

Everyone gets discouraged. This is particularly true for people who are facing real struggles in their life for which they need to consider change. Whether it’s in the corporate context or a personal one it’s important to create short term wins. In Leading Change and The Heart of Change, John Kotter speaks about an 8 step process of change which specifically calls out the need for short term wins. However, Change or Die expresses that sometimes the best way to get short term wins is to make a radical change.

The Power of Community and Culture

Kurt Lewin said that behavior was a function of both person and environment. That is that you have to account for both factors when you’re considering the behavior you get. You can put a Bodhisattva monk in a situation where he might kill. (See Emotional Awareness) However, there’s a secondary expression of interrelatedness that doesn’t surface in Kurt’s simple formula. It doesn’t convey how the environment (culture) changes the person and how the person changes the environment (culture.)

We’ve shaped invisibly by the family that we grow up in. We learn habits and create expectations around what we’ve seen. We build expectations around how we treat each other, how much we help, what vacations look like, etc. In this way our familial environment changes us. It changes what we expect out of ourselves and out of others. Similarly, changing dynamics like a new powerful person in the family can shift the expectations of the entire environment. Replace an alcoholic and abusive father with an honorable and respectful step-father who expects that everyone will respect and support each other and the person starts to unwind the existing environment and remake what the environmental expectations are.

Mothers and fathers are concerned about the other children that their children hang around. A network of friends becomes its own environment. Children are shaped by their friends – for better or worse. A culture built around friends with different values can rapidly erode the moral framework that parents had attempted to instill in their children.

One friend of mine talks about being “refamilied” into a group of friends that love and support him despite his weaknesses. His new “family” is his new environment which supports the behavior he wants to have and is helping to make it easier for the person to get the behaviors he wants consistently.

Acting As If

We believe that the relationship between what we think and what we do is directly causal. That is we believe that what we believe we will do. However, the relationship isn’t directly causal (as I’ve discussed here.) However, there’s something more. Sometimes what you do changes what you think. It’s possible to “go through the motions” or “act the part” or “fake it until you make it.” The sayings are wise. They know that sometimes you won’t FEEL like doing something but if you do it anyway, you’ll start to feel it.

Changing – and sustaining change – is about creating new habits. It’s about new paths for the elephant of emotion (see Switch and The Happiness Hypothesis for the Rider-Elephant-Path model) to follow without the rider needing to intervene.

Recasting a Life’s Story

I’ve spoken about victimhood a few times. (See Beyond Boundaries, Boundaries, and Daring Greatly) One of the revelations from Change or Die is that victimhood is a trap. It’s a trap because if you admit that you’re not the victim you have to face the fact that you’ve been doing the wrong thing for a very long time. It forces you to accept that you’re the one responsible for your life’s condition – not someone else’s fault. This can be a hard thing to swallow. In Anatomy of Peace there were four kinds of “boxes” – one of which was the “I Deserve” box. This is the box of entitlement – and perhaps entitlement is why people believe they’re victims. Boxes prevent people from perceiving reality clearly and cause them to lash out. Perhaps this lies at the heart of why a cycle of victimhood is so hard to break.

The good news is that we can change – as we learned in Mindset. We can learn to see ourselves not as a victim but as a savior. Instead of the one victimized we can recast our perspectives to someone who helps others be saved. In that transition there is a great deal of power to help ourselves. That’s one of the things that was learned at Delancey Street, one of the book’s case studies of change. Here convicts learned to recast their story into one of hope.

Walk the Walk (Don’t Just Talk the Talk)

One of the reasons that many of us struggle with politicians today is that they talk about family values and protecting the American dream while being unfaithful to their wives and accepting campaign contributions from large lobbyists who have their own interests at heart. We don’t need to look far to see leaders failing to live up to their own ideal words. Of course in truth everyone lives somewhat differently than the ideals that they espouse. However, alignment between what you believe and what you do is greatly respected because we have an innate understanding of how difficult this is to live out.

There are two kinds of misalignment that happen. The first kind of misalignment is unknown misalignment. This happens when we’re truly not aware of the fact that we’re saying one thing and doing another. Those misalignments are best addressed by our family, friends, colleagues, and coworkers holding us accountable to what we say we believe.

The other kind of misalignment is where we’re aware that there’s a difference between what we say and what we do. These misalignments will create a stress that the ego will attempt to protect itself from leading back to the state of being unaware of the misalignment. Being held accountable minimizes the ego’s ability to keep the misalignments hidden.

The more you can bring into alignment what people believe with what they do, the less psychic stress they’ll have and the happier they’ll be. I’ve mentioned several times that our happiness has fallen over the past few decades despite books like Flow, Redirect, Stumbling on Happiness and The Happiness Hypothesis trying to tell us what makes us happy.

The Brain is Plastic

Plastic in this sense doesn’t mean cheap or breakable. In this sense plastic means that your brains are malleable. That is the more that you do with them the more they can do. This isn’t a new concept per-se. Culturally we talk about what we’re putting into our kid’s brains in the form of cartoons, video games, and the news. We speak about how seniors live longer the more active and engaged they stay. However, it’s more than that. In Outliers Gladwell discussed how 10,000 hours of purposeful practice could make you into a master. Howard Gardner in Extraordinary Minds came to the same conclusion. Gary Klein in Sources of Power talked about how experience worked its way into your thinking to the point where you couldn’t distinguish where it came from.

Our brains are more malleable than any other part of our physiology. We can quite literally enlarge different processing areas of our brain over time the more we use it. Flute players can get enlarged areas for fine motor control. The upshot of all of this is that we have the ability to change. It’s inherent in our physiology. It’s in our DNA to change. We simply resist it at times.

Change or Improvement

Recently I heard that we should be speaking of improvement instead of speaking of change. While not directly related to Change or Die, I felt like the topic was one good to close with. Inherent and assumed in the language of change is that we’re seeking improvement. We’re seeking an improved match for our abilities and the environment which we’re in. The idea is that we should change to improve our chances of not dying.

If you’re looking for some compelling stories of situations where change is important – where it is truly life or death, you may want to pick up Change or Die.