Motivation

This blog was transcribed from our 6th episode of our Spine & Rehab Specialists podcast series featuring Harry Koster, PT, Cert. MDT and Lukas Gilmore, PT, DPT. Scan this QR code or click the button on the right side of this page if you are interested in listening to this, or any of our other episodes!


Let’s talk about motivation! I am sure we all have some sort of idea of what motivation is, but we are going to go more in detail for this blog today.
 
Motivation is the process that initiates, guides, and maintains goal-oriented behaviors. It is what causes you to act, whether it is getting a glass of water to reduce thirst or reading a book to gain knowledge. Motivation involves several key points; the biological, emotional, social, and cognitive forces that activate behavior, among may others. In layman’s terms, “motivation” is frequently used to describe why a person does something – the driving force behind human actions. Motivation does not just refer to the factors that activate behaviors; it also involves the factors that direct and maintain these goal directed actions (though such motives are rarely directly observable). We must often infer the reasons why people do the things that they do based on observable behaviors, which isn’t always 100% accurate, but it’s the best we have to work with. We can break this down into three parts with an Activation phase, Persistence, and Intensity.
 
Motivation can be split up into two different kinds: Extrinsic Motivation and Intrinsic Motivation.
 
Let’s start with Extrinsic Motivation. Extrinsic Motivations are those that arise from outside of the individual and often involve rewards such as trophies, money, work bonuses, social recognition such as likes on an Instagram post, or praise in general. Even those things can be extremely powerful forces to “drive” someone, they’re often short lived in the grand scheme of things when considering areas such as Physical Therapy, health, and wellness. With that said, they can be effective at redundant/ boring tasks to get things done quickly. Jobs that give a piece rate pay grade is a good example. Another example is a parent forcing their child to remain I their bedroom to study longer. If the homework the child is doing is boring, with a reward by doing it, the child may be likely to get it done quickly.
 
To summarize, Extrinsic Motivation is outside motivators that are normally incentivized with rewards. Now, let’s get into Intrinsic Motivation!
 
Intrinsic motivations are those that arise from within the individual. An example would be doing a complicated crossword puzzle purely for the personal gratification of solving a problem. Intrinsic motivations usually have longer-lasting effects and boosted creativity and fulfillment. To show the opposite of our earlier homework example; a parent educating their child on why they should want to do the homework, for achieving greater potential and enjoying the learning process, will likely increase the probability that their child will be creative on his/ her approach to the subject. I.e. internalization of views yields greater autonomy.
 
So how do we benefit from motivation? Why is motivation so important in our everyday lives?
 
Motivation is important because it shapes everything that we do to change our lives for the better, or for the worst. Motivation helps improve the efficiency of people as they work towards goals. It helps people act and encourages people to engage in health-oriented behaviors and avoid unhealthy or maladaptive behaviors such as risk taking and addiction. Motivation helps people feel more in control of their lives and improve their overall well-being and happiness, which I would say is all pretty important.
 
Let’s also take a look at the science behind motivation. Your brain runs on dopamine. We normally associate dopamine with pleasure, but it also has been found to fire before a reward (external or internal) is given. Researchers at Vanderbilt have demonstrated that dopamine has a strong impact on willingness to work. They used brain mapping to define “go-getters” and “slackers.” The “go-getters” had higher dopamine in the areas for motivation and reward, whereas the “slackers” had more dopamine in the area for emotion and risk.
 
Remember when we talked about creativity being most commonly seen in intrinsically motivated people earlier? A spin-off experiment of the Candle Problem, which was originally created by professor Dunker in 1945, was conducted in 1962. For those unfamiliar, the Candle Problem is one where a few items were made available; a box of tacs, a candle stick, and some matches, all of which were on a table in the corner of a room. The idea was that the participants needed to find a way to get the candle lit above the table without dripping was on the table. Some unsuccessful attempts were made one being melting the wax a little and trying to stick it to the wall, and another being trying to tac the candle to the wall; neither worked.
 
In the experiment, participants were told to solve the problem as quickly as possible. All the participants were grouped into 2 different groups. One group was offered a money reward for winning and the other group was not, while both groups had the goal to solve it as quickly as possible. They found that the group without the reward did so significantly faster, since the solution required them to “think outside the box”, they used the tacs to tac the tac box to the wall and use it to hold the candle.  A similar experiment was conducted where all components were laid out and the money reward group dominated the other. It was hypothesized that this was because this mow simple solution didn’t require creativity.
 
If your goal is a creative product, then the threat of being late will make that much harder for you to innovate.
 
Now that we know more about motivation, how does it relate to health, wellness, and of course, Physical Therapy?
 
Motivation is extremely applicable to Physical Therapy and other aspects of our health. For one, as we create advanced/ creative ways to optimize our care as Physical Therapists for various treatments and exercises. More importantly, helping patients tap into this creative/ intrinsic motivation to live an active lifestyle that they can take with them long after they finish their plan of care. A patient I have recently reminded me of something the wise JT killings once said, Physical Therapy never stops, it’s something that always continues.
 
One way we try to optimize motivation with our patients in the clinic is by conducting a motivational interview. These interviews are beneficial to physical therapists because it taps into change talk, which shifts patient’s perceptions from being receivers of care, to autonomous individuals in charge of their lives. For those that don’t know much about motivational interviews, change talk is essentially getting patients to talk their way into realizing what matters most to them. The more we as PTs can let our patients ramble on about the positive benefits of health, wellness, and fitness, you are doing it right.
 
Going off of that, gaining customized/ individual needs is extremely important, as knowing what matters most will help intrinsically motivate them to participate. As mentioned in this past Sunday Stroll, examples like grandkids, 5ks, vacations, and more are all goals to address. Goal setting, which is done in our initial evaluations, is addressed throughout care and allows the patients to meet milestones along the way. These help shape perceived positive change in patient’s care.
 
Motivation can be hard because it’s all in your head, or at least most of it is. We need to shift our perception of things in a way that puts you in control of yourself, to maximize autonomy and accountability. If you struggle with motivating yourself resist saying “I must/ have to do this” and “I can’t do this” instead choose to realign your tasks and realize that effort creates excellence over longer periods of time.

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