What change are you resisting? What should you deliberately practice?

My 13-year-old daughter inspired this article. If you parent a middle school volleyball player, you know that overhand serving is the holy grail of the game at that level. My daughter has a solid underhand serve that works well for her, but a consistent overhand serve would give her a big boost. To my consternation, she prefers to practice passing, i.e., bumping the ball back and forth. Why would she work on the skill she already has? Well, that’s why: she’s already has it.

Adults do this all the time. In my musculoskeletal practice, my most inflexible patients tell me that yoga is not for them. My most frenetic patients tell me that holding still and meditating is not for them. My over-exercising patients tell me they can’t rest, and my sedentary patients tell me they can’t move. A coaching client who was mired in negativity recently told me that gratitude journaling was “not for him.” Why do we resist that which would potentially make us better?

Resistance, defined

Freud suggested that resistance might represent the client’s innate protection against emotional pain, while also signaling that the client is close to the work that needs to be done. Other psychoanalytic traditions define resistance differently. For example, the existential approach to psychotherapy views resistance as an obstacle to full awareness and openness. The relational approach describes how resistance emerges between client and therapist in the interaction between their subjective views. So resistance might be a guide toward what we should do, or it might result from someone else giving us advice.

In my mind, there is likely truth in all theories around resistance. Even the electrical definition is useful here: Electrical resistance is opposition to the flow of electric current. Recall R=V/I, so that as voltage increases, so does resistance. That describes us too. Our resistance increases with increasing differences in potentials (voltage). Our biggest changes in potential are met with the most resistance. Darn it!

How to persist despite resistance

Doing what’s hard for us is usually not fun, nor that desirable flow state in which we lose ourselves. But we do call this career a medical practice, as opposed to medical comfort zone. Our medical forefathers and foremothers knew we would always be practicing, i.e., preparing with the goal of improvement. If it’s not uncomfortable, the practitioner will likely plateau.

The alternative to mindless repetition of what we’ve already mastered is deliberate practice, in which one looks for errors or areas of weakness and establishes a plan for improving it. Deliberate practice was coined by performance psychologist Karl Anders Ericcson. According to this fabulous article on the subject, if we want to improve, “we need to know what exactly has to change and what might get us there.”

Deliberate practice techniques

Breaking down the skill into the smallest possible parts
Make a plan to work through them in a logical order
Modify the plan when weaknesses or complications emerge
When practicing, aim to make the skill 10 percent harder than the level at which you are comfortable
Deliberate practice requires rest and recovery time
Deliberate practice is most effective when done with the help of a coach or teacher

For an inspiring and very publicized example of someone taking on their weakness head-on, consider our very own Giannis Antetokoumpo and his free throw evolution, accomplished while not taking himself too seriously.

To persist despite resistance, but also to exist

While I’m arguing that we must persist though we resist, most of the time we simply exist. Constant deliberate practice would be miserable and frustrating. To keep deliberate practice tolerable, one could try employing the Pomodoro technique, in which work is done intensely and without interruption for 25 minutes followed by a break, up to three cycles.

We should enjoy our well-deserved comfort zones — we earned it! My daughter confidently delivers the ball over the net most of the time with her solid underhand serve; her mastery of this skill keeps the game fun for her (an important reminder for Mom).

What about the client who resisted gratitude journaling? A significant health issue gave him an opportunity to step away from work and experience sincere gratitude for his career and team. He hopes to maintain this as he returns to work. His example demonstrates that rest and recovery are necessary components of any improvement strategy.