As noted, in our view there is no single approach to helping patients become regular exercisers that will work for everyone. Therefore, in this book, we present you with two different approaches to doing so. There are others, to be sure, but these are the two with which we have had experience and for which we have evidence of success, at least in practice. In this chapter we cover “The Wellness Motivational Pathway (WMP)” approach. In the next chapter we cover the approach that is known as “Climbing Mount Lasting Change.” Each will be helpful for different clinicians helping different patients with the practicalities of becoming regular exercisers, once they have mobilized their motivation through one pathway or the other. These are covered in Chapters 7, 8, 9, and 10.

As noted in Chapter 4, we talk about mobilizing motivation, not “developing” it or “acquiring” it. Your patient will not “get” motivation from the outside, or “find” it upon looking under the pillow, opening a bottle of pills, (even the so-called exercise pill) or even talking with you. It happens that most otherwise healthy people are inherently motivated to be, become, and remain healthy, because, as Thomas Jefferson said (see Introduction, p. 12) being healthy is a central part of living. As we have also noted, motivation is a process, not a thing or an endpoint. It is a process that links a thought, feeling, or emotion to an action. When people are “unmotivated,” it does not mean that they lack the “right stuff.” It simply means that the motivational process for the desired change has not been mobilized.

The most important commonality of the two approaches to mobilizing motivation that we present in this book is that each recognizes that the complexity of the motivational process can be broken down into a series of modifiable steps, at any of which you may intervene. Each has a series of steps for your patients to follow, fewer in the WMP, a larger number with smaller intervals between them in the behavior change pyramid. Different strokes for different folks, the comprehension of which principle by both you and your patients is key to helping people change their behaviors in positive ways.

Each approach to mobilizing motivation should be seen as the framework for establishing a continuous mental feedback loop to be engaged in by your patients over time. The mental tasks are connected with one another and with the ongoing process of behavior change in a continuous, self-reinforcing, feedback loop. Each should also be seen as prescribing a pattern of thinking that will likely work for just about any health-promoting behavior change that a patient might undertake. While neither approach should be regarded as establishing a lock-step progression for a patient to follow, each does set up a pathway that is logical in its progression and which most people who use one or the other do follow, at least the first time through.

Recalling the Stages of Change discussed in Chapter 4 (1,2,3), the WMP provides your patient with the details of the bridge they need to cross in order to advance from the Planning Stage (III) to the Action Stage (IV). The WMP has been developed over time from observation, anecdotal interviews, and experience. While it has not been tested experimentally, as the behavior change pyramid has been, it appears to be a logical approach to how to cross the bridge from Stage III to Stage IV, and also appears to have no potential negative side-effects. It is the application of the classical program-planning model (4) to getting on to and staying on the wellness pathway, for life. The WMP is summarized in Three-Minute Drill 5-1.

The WMP has five steps: