6 Ways to Set Realistic Goals When You’re Chronically Ill

When it comes to making New Year’s resolutions, building healthy habits or going after your wildest dreams, every expert will give you the same advice: set SMART goals.

Instead of a vague idea, making your plans specific, measurable, achievable, relevant and time-bound will help you to actually achieve your goals. Although that’s definitely a helpful and effective strategy for most people, SMART goal setting can be easier said than done when you live with chronic illness.

When your symptoms flare-up without a warning, leaving you bed bound, immobile or in need of rest, you can throw even the best laid plans out of the window. I used to struggle especially with being specific and time-bound. For years, I made the most detailed study plans, only to feel like a failure when I started my schedule an hour late because burning pain kept me up all night. Not to mention the pressure that self-imposed deadlines can put on you.

So a few years ago, I decided to try something different. I still choose a clear direction of where I wanted to go, but didn’t get into the nitty gritty of how to get there, and exactly when. Instead, I adjusted my plans to my ever-changing situation, without set time lines. And that made all the difference. Creating a doable daily rhythm around my ‘theme’ for the year helped me achieve more dreams than a strict schedule focused on SMART goals ever did.

“Plans are nothing; planning is everything.” – Dwight D. Eisenhower

When chronic illness makes your daily life unpredictable, how can you set goals you can actually achieve? Everybody’s health, character and circumstances are different, here are some out-of-the-box ideas.

6 Ways to Set Realistic Goals When You're Chronically Ill | The Health Sessions

This blog post contains affiliate links to resources I thought you might find helpful, at no extra cost to you. All opinions are my own. 

Realistic Goal Setting with Chronic Illness

1. Pick a theme word for your year

It’s frustrating and discouraging to set goals and not be able to meet them, time and time again. You may feel like a failure for not reaching the finish line, when in fact, you have come a long way. So what if you didn’t focus on a specific end result but on how you want everything to feel?

Let’s say you want to improve your health. Aiming for 10,000 steps a day, eating veggies with every meal and meditating each morning are all smart – and SMART – sub goals to boost your wellbeing. But you probably won’t be able to stick to these healthy habits on days when you’re stuck in a dark room with an immobilizing migraine.

What if you shift your goal to a theme of ‘feeling comfortable in your own skin’? By focusing on sensations, mindset and emotions instead of numbers, you won’t feel like failure when you really can’t stick to your plans. Because you may not be able to work on your fitness on sick days, but you could still manage to work on your body acceptance, do a relaxing body scan or make yourself a health-boosting hot drink – whatever fits your ‘theme’.

Even better, you’ll notice the immediate rewards of your self-care activities, which turns out to be a way better motivation to stick to healthy habits than the long-term goal of health and happiness.

So take a moment and vividly imagine how would you like the next year or a new season to feel. Do you wish to feel energetic or long for adventures? Are you looking for more serenity, balance or peace of mind? Would you love to experience more joy every day? When you pick a theme word, your destination is still clear, but the exact path you’ll take will depend on your fluctuating health.

2. Have a game plan and a back up plan

Ditching SMART goals does not necessarily mean that you don’t make plans. It means your plans are fluent and can be adjusted to better suit your changing situation.

Personally, I love making lists and plans. Nothing beats sitting down with a pen and beautiful notebook to clear my mind and help me achieve my goals. But as I’m planning, I’m well aware that actually sticking to them is not a matter of willpower alone.

From sleepless nights and sick kids to flared-up symptoms and doctors visits, unexpected events can tax your already limited energy when you’re chronically ill. That’s why supplementing your game plan with a backup plan for bad days (or weeks) can help you to stay on track with your goals.

It’s like the boy scout motto says: Hope for the best, prepare for the worst.

So map out how you’ll overcome potential obstacles. You can leave buffer time in your calendar to rest up or catch up on work. Divide your to-do list in high-energy and low-energy tasks, so you can still make some progress during times when your activity level or attention span are low. Think of how you can make things easy on yourself on sick days, like stocking your freezer with healthy meals and easy activities to keep your kids entertained.

Sometimes giving in to your need for rest is the most productive thing you can do. And that becomes easier to do when you know a bad day doesn’t mess up your overall plans.

6 Ways to Set Realistic Goals When You're Chronically Ill | The Health Sessions

3. Think small

Will Durant wrote: “We are what we repeatedly do.” Habits shape our lives because we perform them regularly. That’s why most of us have such a hard time building new healthy routines: we don’t stick to them on a daily or weekly basis. Life gets in the way, or we just don’t feel like exercising/having a salad/meditating today.

What could you do to stick to the healthy habit that helps you achieve your goals, even on your worst days? 

Come up with the smallest possible habit, something you can perform even when you’re sick, busy and overwhelmed. For example, maybe you still manage to walk one block, have veggies with lunch or get outside every day on bad days. That could be your baseline, the tiny habit you promise yourself to do no matter what.

When you determine the smallest possible habit, you don’t need motivation and willpower to make consistent changes.

You can learn more about the power of small acts in James Clear’s bestselling book Atomic Habits.

4. Never miss more than one day

No matter how badly we want to achieve our goals, we all have days when we don’t stick to our habits and plans. And that’s ok. But when pain, fatigue and brain fog mess up your game plan too often, the ‘Seinfeld Strategy’ might come in handy: never miss more than one day.

Throughout his long career, comedian Jerry Seinfeld has consistently provided high-quality work. His secret? For each day that he wrote comedy, he marked a big red X on his wall calendar. After a few days, those red X’s formed a chain. And his strategy was to not break the chain.

Now, one missed red X will not affect your long-term results… but letting your habit slowly slip away will. So when you’ve skipped your habit once, get back on track the next day. This can be hard when you’re severely ill, but try to stick to your smallest habit or rely on your back-up plan. Strive to not miss two days in a row.

6 Ways to Set Realistic Goals When You're Chronically Ill | The Health Sessions

5. Focus on rhythms, not schedules

Sticking to strict schedule is often not a successful strategy for spoonies. And the worst part is how lousy you may feel about not getting things done, again.

If you struggle with sticking to inflexible plans too, try creating a daily rhythm that works for you.

For example, going for a gentle walk or bike ride in the morning has a really positive impact on my mood, energy level and mental focus, but I don’t specify exactly when. Some days I bring my kids to school and daycare and get my cycling in before 9am, other days I need more time to get my body up and going, so I head outside for a walk mid-morning. And ideally, I do high-focus work and physically-demanding jobs during my most energetic hours, but I no longer plan hour by hour or give myself hard deadlines.

By listening closely to what my body and mind need, I get much more done than I did all those years I tried to stick to a more time-based schedule.

6. Let go of the end result

Goals are by nature future-oriented, often with a specific outcome in mind. But if chronic illness has taught me one thing, it’s that it’s not just about reaching your destination. The journey matters too.

Let’s say you dream of being able to dance again. Your goal may be to show off your moves on the dance floor on your birthday or next New Year’s Eve. But what if you’re ill or injured that day? Does that undo all the progress you’ve made, going from no dancing at all to regular living room dance parties?

Over the years, I’ve learned to put in the work without getting too hung up about the end result. When I’ve done all I can, even if that’s little compared to what other people or my healthy self could do, I take pride in that. The rest is out of my hands. To me, the striving has always been almost equally as important as the outcome.

As William Penn wisely put it:

“To have striven, to have made the effort, to have been true to certain ideals – this alone is worth the struggle.”

What helps you with realistic goal setting when you’re chronically ill? How do you manage to stick to your plans and avoid disappointment or feelings of failure when life gets in the way?

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