Dealing with a Rebel Patient or Health Client
The Rebel Tendency can contribute to real health issues.
Because Rebels will resist if told to do something, many strategies that work well on Upholders, Questioners, or Obligers may be counterproductive for a Rebel. This pattern can be very frustrating for people trying to help Rebels with health issues; well-intentioned advice, encouragement, reminders, and admonitions may push Rebels into doing the opposite of what would be good for them. Even the medical condition itself can seem like something to resist. For instance, one Rebel explained:
I’m a type 1 diabetic, and I have a hard time dealing with how this health problem controls how I feel and what I do. I know that I should view looking after myself as “taking control over my diabetes” instead of vice versa, but I can’t seem to grasp that. I hardly ever check my blood sugar, I take fast-acting insulin sporadically—I don’t like to schedule meals!—and I haven’t seen my endocrinologist in years, so I actually don’t even know what my A1C is.
Rebels can’t stand the idea of “following doctor’s orders.” In fact, if a doctor praises a Rebel by saying, “You’re doing great, you’re following my directions exactly,” the Rebel might immediately stop, in order to demonstrate freedom.
Rebels do better when they’re reminded that any action is their choice. Instead of telling a Rebel, “You must do X,” a doctor might suggest, “It’s up to you, of course, but X is often effective.” “Have you considered trying X?” “What would you think about X?” “Some people have found that X works for them,” or “Some ideas for you to consider include X, Y, and Z.”
Rebels resist even the rules that they try to impose on themselves. One Rebel college student explained, “I’m struggling with extra weight, but the minute I make a rule about eating at night, I start eating more at night. Or I say I’ll give up bread and then I go buy a beautiful loaf of sourdough.” Another Rebel figured out a clever way to work around this kind of self-resistance: “If I want to eat healthy, I’ll eat the chocolate or the ‘bad’ thing first thing. I show myself, ‘I won the war, I do what I want!’ And the rest of the day, I feel free from rebelling against me telling me what to do.”
To help a Rebel, as always, it’s most effective to provide information, consequences, and choice. As one Upholder doctor reported:
I’m a family physician, and I had a patient who was very resistant to my recommendations to help with weight loss and to treat pre-diabetes/insulin resistance. As I talked to her, “Rebel” popped into my head. I switched gears and made a list of suggestions she could try “if she wanted to,” rather than using the more directive style that I find works best with most people. This patient did come back for a later visit, and she’d taken one of my suggestions. Her weight was down, and she was feeling much better. I don’t think the result would have been the same had I been directive. That approach works with the Upholders and Obligers, and also Questioners, because I always give a detailed explanation of my recommendations. But for the Rebel, that strategy just doesn’t work.
Rebels may benefit from information like knowing their daily weight or the number of steps they’re taking—and it’s more helpful to frame monitoring efforts as “You might find it interesting and useful to know how much exercise you’re getting,” rather than “You need to take 10,000 steps every day, so you should wear this activity tracker.”
An appeal to choice, freedom, and pleasure works with Rebels: This drug/diet/exercise routine/daily habit will make you feel better, give you more energy, take away pain, prove interesting, improve performance, enhance your sex life, give you the life you want. A nutritionist could say, “One client found that when he gave up sugar, he had more stamina, and his tennis game improved.” Instead of telling a Rebel what to do, the nutritionist is giving information to help the Rebel decide what to do. One Rebel recalled:
My favorite personal trainer always told me, “Maybe you just want to try it for a week, and if you don’t like it, don’t do it anymore.” No pressure, no guilt, no real rules, just discover yourself—and always, always against the mainstream. I don’t stick to programs very well. All those 30-day things feel so restricted. If I do choose to do these programs, I need to break one of the rules.
It’s also possible to offer help: “Would it make your life easier if I organized the weekly pills?” “Would you enjoy walking more if I came with you?”
I got an email from someone desperate to push her Rebel husband to quit smoking. No surprise, her constant admonishments weren’t working, even though he said he did want to quit. She asked if I had any suggestions. I wrote:
Maybe your Rebel husband can change his way of thinking about quitting.
—Rebels hate to be trapped, constrained. So view smoking as a trap: “I’m chained by addiction; I’m helpless without my cigarettes.”
—Rebels hate to be exploited: “I’m pouring money right into the pockets of the big tobacco companies.”
—Rebels want to express their identity. “I’m a nonsmoker. That’s the person I choose to be. That’s what I want.”
—Rebels value pleasure. “It will be so great to wake up without a hacking cough and bad breath, to feel more energetic, and not to huff and puff when I walk up the stairs.”
—Rebels value freedom. “In places like office buildings or airports, they order me around, telling me where I have to go if I want to smoke.”
—Rebels like to do things in their own way: instead of following a standard cessation program, he could come up with his own way to quit.
—NOTE: For Rebels, there’s always the “I’ll show you” gambit. “Honey, I think quitting smoking may just be too tough to do. Those cigarettes have really got their hooks into you. I don’t think you’ll ever be able to quit. Maybe you should give up trying.”
She wrote back with a progress report: “The most effective strategy was an adaptation of the last point. I told him that his eighteen-year-old son thinks that an old guy like him can’t quit (true), and there was a definite ‘I’ll show him’ response.”
Rebels also enjoy flouting convention and proving that they’re too smart for the tricks that fool most people. One Rebel quit drinking in a very Rebel way:
The revelation came to me that I like drinking but I don’t like gaining weight, I don’t like spending so much money, I don’t like embarrassing myself at parties, and I don’t like being hung over. Once I realized the lie the world tells us about drinking and indulgence—that skinny, beautiful people on TV drink and eat out constantly and never get sick or poor or fat—it was much easier to let go.
Rebels want to express their values through their actions, so tying a habit to an important identity can help a Rebel to change.
Choosing a Career as a Rebel
I’ll say it again: Rebels can do anything they want to do. Recognizing this, Rebels often seek out careers that give them the flexibility to choose their work, set their own schedules, and avoid having to answer to other people. I’ve heard from many Rebels about how they strive to create situations where every day is different, with no set expectations from others. “I have a superflexible job schedule. I used to work in an office and really hated that. Now, as a project manager and H.R. director for a restaurant, I work from home and occasionally go into the restaurant. I make my own schedule every day, and every day is different.” “I’m an IT contractor. I get bored and change jobs a lot, and fortunately, there haven’t been too many periods of being out of work.” “I’m a certified public accountant in a tax practice. Deadlines, and nonsensical, arbitrary rules are all I deal with! However, I do this as a self-employed person, controlling my own work life and client base.”
Rebels often start their own businesses because they don’t want to answer to anyone but themselves—but, of course, Rebels don’t like to answer to themselves, either. I met a Rebel at a technology conference. He said, “I have to work for myself because I want to wake up every day and do only what I want.�
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“But,” I pressed, “you’ve got your own business. There must be tasks you have to do, even if you don’t want to.”
“Well, that’s a terrible problem,” he admitted, deflated. “I can’t make myself do that stuff until it absolutely has to be done. It’s crippling my business.”
One successful Rebel entrepreneur told me, “Rebels on our own aren’t very effective. We don’t like all the little management details, deadlines, that stuff. So I’ve started three companies with my wife. She’s an Upholder, and she balances my Rebel side, and together we’re a fantastic team.”
Rebels often thrive in a situation where they’re given a challenge and allowed to meet it in their own way. Perhaps that’s why many Rebels gravitate toward sales—because in sales, actual results tend to be the thing that matters the most. One wife of a Rebel observed, “My husband clashes with his boss a lot, but he’s also the most successful salesperson. Not ‘despite’ but ‘because’ he ignores the rules that his boss sets that would make him lose the sale.”
Similarly, in creative industries, results count for the most. My sister, Elizabeth, who’s a TV writer and producer, observed, “In Hollywood, Rebels can get away with flouting the rules, as long as they produce something good. Also, especially among director types, they want to do things their own way, and they don’t care what other people think, and creatively, that can lead to a great outcome, even if the process is unpleasant for everybody around them.”
I talked to a Rebel corporate lawyer—a job that doesn’t necessarily sound like a good fit for a Rebel. “How do you do it?” I asked.
“I love it,” she said. “I’m brought in during a crisis, when people are willing to take risks. If things aren’t working, I break them apart, I fix whatever’s wrong, then I move on. Once things are stable and rules are imposed, I find it suffocating.”
At the same time, as noted earlier, Rebels may be drawn to areas of high regulation, like the police, the military, and the clergy.
SUMMARY: DEALING WITH A REBEL
They resist both outer and inner expectations
They put a high value on freedom, choice, identity, and self-expression
If someone asks or tells them to do something, they’re likely to resist.
They may respond to a challenge: “I’ll show you,” “Watch me,” “You can’t make me,” “You’re not the boss of me”
They may choose to act out of love, a sense of mission, belief in a cause
They have trouble telling themselves what to do—even when it’s something they want to do
They meet a challenge, in their own way, in their own time
They don’t respond well to supervision, advice, or directions
They tend to be good at delegating
If they’re in a long-term relationship, their partner is probably an Obliger
APPLYING THE FOUR TENDENCIES
11
When the Four Tendencies Pair Up
No relationship is doomed, or assured, based on the Tendencies. Nevertheless, when people from different Tendencies pair up—as romantic partners, as parent and child, as colleagues, or any other kind of pairing—certain patterns tend to emerge.
When we first meet someone, we’re often attracted to the very qualities that, over time, will drive us nuts. An Upholder might initially be intrigued by a Rebel’s refusal to play by the rules, and the Rebel may be drawn to the Upholder’s ability to get things done—but five years into the marriage, those qualities look much less attractive.
It’s not the only thing that matters, of course, but understanding the Four Tendencies can give us a useful insight into our relationships.
Upholder-Upholder
I’ve talked to very few romantic pairs of Upholders, which may mean that Upholders don’t pair up well or may simply reflect the fact that Upholders are fairly rare.
When I get the chance, I love working with other Upholders: I can rely on them to complete tasks without any chivvying, and they tell me frankly if I’m being too demanding.
I’m not sure I would want to be married to an Upholder, however. All that expectation-keeping might get too intense, and even if two Upholders get along well, they might make a tough environment for others. One Upholder wrote:
My husband and I are Upholders, and as my 13-year-old daughter says, “Mom, I don’t know any parents like you and Dad.” I take that as a compliment. We both highly value character and discipline. I’m a health coach, and my husband is a coach and tennis director. With our clients and students, we are nothing but compassionate and caring, but “behind the scenes” we can be judgmental. We both get frustrated when others don’t do what they say they’re going to do.
Two Upholders are likely to get a lot done, but they’ll find drawbacks, too. On a trip that my family took with another family, the Upholder husband/father of that family and I decided to take our children on a boat ride through Berlin. Along the river we could see many places to catch a tour boat, and a guide pointed to one and said, “The next boat leaves from that stand.” A little later, we two Upholders stood next to this empty stand and watched as passengers boarded a boat at another stand just a few yards away.
“He told us that this was where the next boat would be,” my friend said, as the boat departed.
“I know!” I answered. “Right?” We had to poke fun at ourselves—even though we could see that one boat stand was empty and the other was active, we’d stuck to what the “expert” had told us. I thought to myself that if Jamie had been there with us, we’d have left this stand and gone to the other one. There are advantages to having a Questioner around.
Upholder-Questioner
Upholders often pair with Questioners. That describes my marriage, and I think it’s a very helpful combination, for both spouses. Upholders sometimes meet expectations too readily, so the presence of a Questioner helps them to question or reject some demands that they might otherwise thoughtlessly meet. From the Questioner perspective, Upholders are generally easy spouses, because they so readily meet expectations.
My sister pointed out that as an Upholder, I have a Questioner in two of the most influential places in my life: my husband and my literary agent, Christy Fletcher. Their questioning helps save me from doing things I don’t need to do, at home and at work.
For instance, around the time of the publication of the paperback edition of Better Than Before, I was asked to write a magazine piece. My proposed assignment: Write a first-person story on the Four Tendencies, with a brief introduction explaining each Tendency, along with advice for each Tendency for mastering habits, in about 1,000 words. For free.
This would be a terribly demanding piece to write, and my heart sank as I read and reread the description. Then I thought of an escape. I emailed Christy to say, “Should I do this?” “No way,” she wrote back instantly.
As an Upholder, being married to Questioner Jamie has helped me learn to question more myself. (In fact, perhaps Jamie wishes I’d picked up fewer of his Questioner ways; it’s quite nice to have a spouse who generally does whatever’s asked, without any questions.) At the same time, as an Upholder, I can get impatient with his Questioner refusal to act until all questions have been answered—not to mention the Questioner reluctance to answer questions.
Nevertheless, it’s a relief for both Upholders and Questioners that their partner can readily meet their own inner expectations.
Upholder parents can get annoyed with the questions of Questioner children, because they expect their children to just do it. One Upholder father wrote,
Sometimes I get frustrated parenting my Questioner child; it’s hard to understand why my child just won’t do what has to be done. Of course all little kids can be frustrating. But to my mind, things like putting on shoes, getting spelling done, having a shower, are just things that have to be done, so the child should just get on with it. But for a Questioner child, everything is a negotiation.
Upholder-Obliger
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p; Like all the Tendencies, Upholders pair well with Obligers. Obligers and Upholders both share a desire to meet outer expectations (unlike Questioners and Rebels) and so will cooperate and respect that desire in each other.
Upholders are gratified by the Obligers’ (mostly) reliable meeting of outer expectations, but they can become frustrated by Obligers’ inability to meet their own inner expectations.
Also, they may be very unsympathetic to Obligers who feel pressured by expectations. For instance, an Obliger might tell an Upholder boss, “I’m exhausted, because I’ve stayed up until 3:00 a.m. for the past five nights to get the report ready for you.” Instead of answering with the appreciation that the Obliger expects, the Upholder might well say, “You need to learn to manage your workflow so you don’t have to work these intense hours. To be at the top of your game, you need sleep.”
For their part, Obligers appreciate the Upholders’ meeting of outer expectations. However, they can get overwhelmed by what Upholders expect, and they may feel judged by Upholders, who may have little understanding of why Obligers might struggle to meet inner expectations.
Obligers sometimes find Upholders cold or selfish, because Upholders may choose to meet an inner expectation even when it conflicts with an outer expectation. One Obliger (who sounds primed for a major spell of Obliger-rebellion) wrote:
During our nine-year marriage, my Upholder husband has completed medical school, residency, and is now working. He was a very intense student, and I was excited when his exams were done. I thought I’d finally have my whole husband. To my disappointment, I’ve realized that he will always have a major goal or project that he’s working on. And because I’m an Obliger, I feel like I internalize his goals, which means that I’ve often “picked up the slack” for him in areas that traditionally are a man’s domain so he could focus on school, etc.
The Four Tendencies Page 17