Improve Your Health Using AMSOR — The Acronym For Change

Amidst the consumption and creation of content that’s designed to promote improvement in areas such as nutrition, overall well-being, and mental health, there exists the problem of ignoring one key reality.

That key reality being that personal change, (and the act of, personally, encouraging others to change) is one of the most painstakingly challenging things to accomplish in life — FULL STOP.

There’s a reason Alan Deutschman published a book called, “Change or Die,” and, I’ll give you a hint, it’s not to talk about how effortless, and easy-peasy-lemon-squeezy the process is.

As it turns out, people (myself inevitably included) will largely do everything within their power to resist change — that is, unless they’re faced with a severe enough of a consequence akin to death. No kidding.

Most notably, perhaps, is that even then, when faced with an untimely demise, research shows that the odds against individual change are 9 to 1 (1).

We see this reflected primarily in our healthcare system, where numbers 1–5 of the biggest factors that contribute to the development of the preventable disease — smoking, drinking, unhealthy eating, stress, and lack of exercise — are all behavioral choices, and not the result of environmental conditions or genetic predispositions, at all.

Of course, this is not to say that there are not other complexities at play here. If you asked me, I would attribute the nation’s crisis of health to a distinct deficit of nutritional education (for both professionals entering into the healthcare system, as well as everyday Americans), in addition to a lack of access to affordable fresh fruits and vegetables. The latter, unfortunately, existing as a result of misplaced government subsidies — think 38 billion dollars of taxpayer money spent, on an annual basis, to subsidize the meat and dairy industries, with less than 1% of all agricultural subsidy money going towards supporting the production of fresh fruits and vegetables (2).

In this sense, I fully accept and understand that there is a vast range of behaviour related factors that lie outside the scope of most people’s control. The issue, however, is that no matter how you want to slice it, the responsibility of the individual to mitigate the effects of these influencing factors remains.

To change or die, therefore, is to commit yourself to the process of change, and to accept personal liability for the outcome, or to fall prey to the consequences of stagnation.

So, whatever the change you currently desire might be — or whatever the changes may be that you are trying to foster within others — there is an acronym that I have found infinitely rewarding in facilitating this process, and uncovering what it takes, not only to initiate change but to, most importantly, maintain it.

Employed predominantly for foundational use in primary care within the fields of behavioral and positive psychology, the acronym AMSOR — which stands for Awareness, Motivation, Skillset, Opportunity, andReinforcement — is a tool that can be used by anyone, for just about anything (3, 4).

First Things First

In order to change, there must be Awareness of the desired change.

I prefer to view this stage as the research phase. There is none of that scary commitment stuff needed just yet, and it’s all about dipping that initial first toe in the water, in order to realistically gauge what this change is going to entail.

When it comes to improving any area of your life, knowing what you want, and where to start, is half the battle — it’s not necessarily the hardest half, but it certainly doesn’t count for nothing.

What’s more, is that we must come to terms with the idea that awareness in and of itself is not enough to accelerate change. While the majority of people understand that smoking causes cancer, that high consumption of cholesterol leads to disease, and that they should be exercising — at the very least — 3 to 4 times per week, this understanding, alone, is often just not enough to sustain a change in behaviour.

While it’s natural to make the assumption that awareness is the end-all-be-all in driving positive change, it’s similarly normal for individuals to do the opposite, and to overlook the relevance of thoughtful preparation, entirely.

True awareness, therefore, involves internalization of both the strengths and, equally, the limitations of said awareness.

What is it that you want, exactly? What is it that you will gain, exactly? And what is it that you are going to struggle with the most, exactly? Answer these questions for yourself before worrying about anything else.

The Ins And Outs Of Motivation

Here’s where things start to get really personal.

Motivation can be divided into two categories: internal and external, and it’s important that you can recognize which one works best for you. It obviously varies from situation to situation, but I find it the easiest to think back to the context of your high-school education days — or something of the like. Ask yourself whether you felt motivated by the intrinsic desire to do good and produce high-quality work, or whether it was an external motivator such as the reward of receiving a high grade, or the anticipation of making your parents proud.

If you’re one of the impressive humans who already possesses the internal willpower to drive positive change in your life, then feel free to proceed to the next step —as you already have your reason d’etre, so to speak.

On the other hand, if you appreciate that the majority of positive change in your life occurs as a result of an imposing outside force (whether good or bad), providing you with the incentive to act on your ambitions, then you need to take the necessary steps in pin-pointing your motivation, moving forward.

You can create a monetary incentive to encourage this personal change, or, alternatively, you can seek out family and friends to hold you accountable. You could reward your successful efforts with a vacation, or a new pair of shoes, or you could even harness the fear of failure and any coinciding consequences to make sure that you’re committed to your own success.

The point here is: find your motivation and set up camp.

Ready, Skillset, Go!

Once you have awareness and motivation under your belt, the next course of action is to develop the Skillset that’s required to support your desired change. Skill can be thought of as applied knowledge — knowledge that you’ve gained already via awareness.

If your goals include establishing better eating habits, then the skillset needed here might be knowing how to cook and prepare different types of vegetables in a way that’s appealing to your tastebuds! If you’re interested in signing up for Couch-to-5k in the near future, then the skillset you require could include comprehension of proper stretching technique, correct running posture, and learning to productively schedule your day around your training. So on and so forth; you get the idea.

There are 4 steps to developing any skill, and they are as follows: unconscious incompetence, conscious incompetence, conscious competence, and unconscious competence.

Unconscious incompetence is the very initial stage of learning anything new. That is to say, that you’re not even going to know what it is you don’t know.

Next comes conscious incompetence, which also happens to be the stage where most people are inclined to give up. Suddenly, you will have ventured just far enough into the journey of learning a new skill, that you are able to recognize exactly how much farther you have to go. You will likely feel overwhelmed and, well, incompetent — but this is no time to give up.

Thankfully, the stage referred to as conscious competence is quickly to follow. This stage of developing your skillset is where you know what you’re doing, and, although it does require a concerted effort, you are making due progress and already beginning to benefit from the implementation of the aforementioned skillset.

Last, but not least, is unconscious competence. Your newfound skills will become second nature to you, and you will no longer require cognitive labour in the form of focus and paid attention in order to be successful.

Organizing Opportunity

Hint: if you put a fire under someone’s ass — so to speak — and you’re finding that they’re still unable to make any significant changes to the betterment of their life, what they likely have is a Skillset or an Opportunity issue, not a motivation one. This mistake is all too common made within sectors of healthcare, and can often mean the difference between failure and success.

I’ve always been a big fan of the, “there’s no time like the present,” sentiment, however, when it comes to realistically evaluating the likelihood of enacting successful change in your life, it’s crucial not to underestimate the importance of good timing and opportune circumstance.

Opportunity, in this sense, represents the extent to which you are currently going to be supported and propelled forward by the situation at hand.

Luckily for us, opportunities can be found anywhere and everywhere, be that professional, environmental, experience-based, or as a result of interactions with others. Depending on the type of changes you’re making, an opportunity might also resemble more closely a subtraction, versus an addition. For example, someone who smokes mostly in social settings, but also occasionally at home, might use social-distancing — and the explicit lack of social life — as the perfect opportunity to completely wean themselves off cigarettes.

Paramount to bear in mind, is that humans also have a high propensity to postpone difficult tasks, often unconsciously assigning the hard work to be completed at a later date. Here, it becomes necessary to act as an objective observer of your own circumstance and to rationally assess the opportunities that remain at your disposal. Once secured, you can move onto the final stage.

Reinforcement, Reinforcement, Reinforcement

Congratulations — because to reach this stage, means to have beaten all the odds and to be well on your way to a happier, more positive, and hopefully, healthier lifestyle!

Following your progress from entering the initial stages of Awareness, and successfully pin-pointing your Motivation, to building your Skillset step by step, and seizing the opportunity to make a shift in behaviour, you have arrived at Reinforcement.

This stage in the methodology of change refers to the maintenance of on-going incentive and feelings of reward; it’s about recognizing the mechanisms that allowed the change to occur, in the first place, and creating a system that allows you to revisit these mechanisms as frequently as necessary.

Find ways to remind yourself of your primary motivations, and set yourself up for success by streamlining this process to fit your lifestyle, and specific needs, best.

If that means changing your phone background to a particular photograph or meaningful quote, then do it. If that means meeting on a weekly basis with like-minded friends to discuss your mutual progress, then do it. And if that means re-reading this article — from the top — from time-to-time, then you bet, I’m going to encourage you to do it!

Alexandra Walker-Jones — January 2021

Text References: