“It always seems impossible until it’s done”- Nelson Mandela

I’ve been thinking about change. Every January countless numbers of people resolve to make changes in their lives. And every February, countless numbers of people reintroduce alcohol into their diet, cancel their gym memberships and go to Five Guys for a burger. That’s because change can be difficult. Whether it’s leaving the EU, getting to grips with a new electronic health records system or coming to terms with the fact that Starbucks have removed their salted caramel brownie hot chocolate from their menu, change often makes us feel the kind of discomfort that you get when you accidentally make eye contact with someone on the tube.

So far, so obvious. Then, why is it that change makes us feel so uneasy? Well, one explanation comes from the University of Groningen in the Netherlands. Bennick et al (2013) used a prospective cohort design to examine the correlation between life changes and depressive symptoms. Essentially, they followed a group of adolescents over time, periodically asking them to disclose any significant life changes they had undergone and to self rate any depressive symptoms to see if there was a correlation. Interestingly, not only did the team find that negatively perceived life changes correlated with depressive symptoms, but so did large numbers of positive life changes when they were introduced all in one go.

But before you throw your homemade flaxseed and quinoa energy ball in the bin, there is a reasonable and helpful explanation.The researchers suggest that our brains are unable to distinguish the difference between “change” and “threat”. That means that when a change is introduced, our brains tell our body to release cortisol, the stress hormone, which puts us on edge and makes us feel that discomfort that we know so well. This has an evolutionary advantage if you still hunt for your food, or want to take part in Bear Grylls, but it’s not especially useful for 2019 city life. Bennick et al (2013) make the suggestion that positive changes should be introduced one at a time in order reap the benefits that they can bring and to minimise the chance of them being perceived as threats.

But, what does this have to do with research? Well, everything. Research, at its core, aims to improve or change our practice for the better by making it easier, safer and more efficient. However, anyone that has conducted clinical research, or been tempted to, might be put off due to the challenge of implementing the findings. Through understanding how change is perceived, we can better equip ourselves and smooth the process. We can all be Change Makers who embrace, rather than fear, change and ensure that our patients receive the very best care we can offer. Now, if you’ll excuse me, my wheatgerm and spinach smoothie is waiting.


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