In 2014, my dad’s family doctor told him he was pre-diabetic. That meant he was on the path to diabetes but it wasn’t too late to turn things around. If he ate a bit better and exercised a little more, his higher-than-normal blood sugar would go back into the healthy range.
“Well that’s good,” I thought. He’ll do those things and be just fine.
2015 rolled on by, and my keeping busy with work projects a continent away from my dad, it seemed like 2016 and 17 whisked by in a breeze as well.
I got a call from him in early 2018 — you know, a regular touch-base to see how I was doing, and just as we were wrapping up, he happened to mention in passing, “oh yeah, and I’m injecting insulin now.”
Double take. Um, what?
He explained that it was a relatively low dose and really no big deal, but let me tell you, I was freaking out inside. In my mind, having to inject yourself with anything every day to keep yourself alive seemed like KIND OF A BIG DEAL.
But if I were to really analyze why my internal reaction was so strong, it’s because I know that Type II Diabetes largely results from lifestyle choices — the operative word being “choices.” So when I heard that not only did my dad’s pre-diabetes not get taken care of, it instead had escalated to full blown diabetes due to what I considered to be poor choices, well, I was angry.
I was angry at him. He did this. How could he do this?
Not to mention, when I was a teenager staying out too late the night before a tennis competition, he would lay into me with statements like, “Your body is the most valuable piece of equipment you’ll ever own. You need to take better care of yourself!”
C’mon dad, what gives?
Ok, now in case you’re starting to feel annoyed at me for reacting a bit harshly, let me just say that despite the fact that I’m in the field of psychology and human behavior and that I SHOULD KNOW BETTER, I’m still human. This was just too personal, and I just reacted.
But here’s the thing. I didn’t react out loud. Sure, I was seething inside and really wanted to blurt out things I knew I’d regret later, but I didn’t. At least I knew better than that. Instead, I listened.
He continued to tell me that he understood diabetes to be a natural part of aging and that while he didn’t love being on any kind of medication long term, he felt ok. He could still do the things he loved like travel to Africa, be outdoors with his dog, continue his lifelong pursuit of knowledge, and engage with good friends… so he was happy.
Later that night, I started scheming. I knew there must be a way to reach him differently… a way to motivate him to change. If his diabetes got worse, it could seriously shorten his life. And given that he’d already had a mini-stroke (TIA) which, among other things, temporarily took away his ability to speak, deep down we both knew he was going down a path that could end a lot quicker than either of us wanted.
I thought to myself, I help companies motivate their audiences toward new behaviors all the time. I use narrative persuasion in my job every day. How could I not use it to save, or at least extend, my dad’s life?
Type II Diabetes is often reversible with the right lifestyle changes. It was time to figure out how to inspire those changes.
So I got started.
The first step in telling any impactful story is listening.
As we say in the biz, the best storytellers are the best listeners. Over the next few months, whenever my dad and I spoke on the phone, I made a special effort to listen for very some specific things. To put it coldly, I was effectively doing audience analysis. To put it more warmly, I was being there for my only parent, who had been there for me through thick and thin my whole life.
Understanding your audience in any storytelling context is critical to your strategy. It’s the difference between knowing what you want to say (which can be a challenge in itself) and really appreciating what your audience needs to hear in order to internalize your message.
So I listened for things in his life that could hint at cognitive biases holding him back, or desires that he had yet to attain, or even conflicts that could have taken away a sense of faith in others. Basically, I listened for clues as to the storytelling approach I would have to design in order to truly reach him.
Some of the most informative elements ended up being that…
My dad is a mathematician at heart. While he speaks English, Polish, and several other languages nearly fluently, his mother tongue is logic. I would say that an ability to have a well-reasoned, factual conversation is a bare minimum requirement if you’re going to have any kind of relationship with my dad. You have to make sense.
(Side note: when I sent my dad a draft of this article for his blessing to publish it, he wrote me a small novel about the difference between math, logic, and how the “philosophers who extended logic into the quantitative domain became mathematicians.” I love my dad but sometimes you really have to go to great lengths to be exact, otherwise you’ll get derailed quickly!) Anyways, back to those elements informing the approach…
If you happen to notice that one of my dad’s beliefs isn’t quite logical and you point it out to him, he WILL listen. This should be unsurprising given how much he values logic, but humans are inherently irrational. As behavioral economist Dan Ariely would put it, people are “predictably irrational.” But if you’ve proven to my dad to be a logical thinker yourself, he’ll listen to what you have to say even if it contrasts something he’s believed for a long time. He’ll change his views if you show him a good reason to. Not everyone is open-minded like that. Most people prefer to have their beliefs confirmed than challenged.
He was mistaken about the inevitability of diabetes in old age. First of all, my dad’s not old. He’s 70. And second, diabetes is often preventable — even reversible in many cases, and is absolutely not an inevitable consequence of aging. But I didn’t tell him that yet. I continued to listen.
He told me he thought he would have to become an olympic level athlete in order to attain the kind of fitness his doctors were recommending. He felt that the amount of training required would be unrealistic and that he didn’t have the time, energy, or desire to work that hard. No kidding! If he thought getting to a healthier weight would take 8 hours of training per day, no wonder he’d failed thus far! Ok… still listening…
He felt people had pushed advice on him the wrong way. Between doctors, nutritionists, and other family members pushing new diets on him without ever bothering to review his motivations as a human being, he felt unheard. People were pushing their own agendas on him without taking the time to understand his wants, his needs, his lifestyle, and what would be sustainable over time. They were making it more about them than about him.
Over the course of about 8 months of listening over the phone and email correspondence, I dropped some gentle hints about paying him a visit, and maybe, if he were willing, letting me have a look at his lifestyle. I asked him, “Dad, if I can find some low-hanging fruit, some small tweaks in your habits that could make a meaningful impact in your overall health, would you be open to exploring them?” “Of course!” he answered, a reaction I realized was probably more related to the excitement of a visit than having me audit his life. But as I continued to occasionally poke him about his take on having me look at his diet and such, it became clear he really was open to that too.
Combine audience analysis results with psychological principles to create a storytelling approach that motivates behavior change.
He’d be the main character in a plot where the challenge was to overcome a variety of conflicts standing in the way of living a long, healthy life. There’d be character development, story structuring, elements of suspense, a journey… and interestingly, he’d simultaneously be the main character AND the audience for this story.
I knew I had to treat the whole endeavor, however long it took, as a story in itself. And I also knew this wasn’t going to happen in a weekend… or a week… or two. This was going to require a bigger time investment. So I emailed my dad telling him to set aside five weeks over the winter holidays. Five weeks was really only the beginning, but I think he was mostly just excited that I was coming home!
Every good story starts with a strong hook — something to pull the audience in and make them pay attention. It can be something unique, surprising, emotionally compelling or all of the above. Either way, it’s meant to get your audience invested just enough for them to stick around for the next part of the story. That’s what I’d hoped to accomplish with that email: to surprise him with the extended length of my visit (this would be the most time we’d spend together since I left for college), and make him feel like he was my highest priority (the emotional appeal), which he absolutely was. He also knows how busy I am with my life here on the West Coast, so to take 5 weeks and devote them entirely to him, well, I think he saw that as a statement of my dedication to our relationship (and his health).
With my hook in place, I packed my bags and set out for my hometown. After landing, my dad and I caught up a bit over dinner (he’s become quite the chef in my absence, holy cow!), and reminisced through some fun memories. It was good to be home.
When the conversation naturally veered to how he was doing health-wise, I took the opportunity to lay out a tentative plan I’d been cooking up. I suggested that for the first week of my visit, I would make precisely zero suggestions about his diet or lifestyle as a whole. Instead, I would simply observe. “What do you think, dad? I’ll just take some notes about how you’re eating, and at the end of the week, we can have a chat about some of the things I noticed?” And with that, I had his buy-in.
From a storytelling perspective, this part doubled as additional audience analysis and a smidge of character development. It was an effort to establish that I wasn’t like the other characters in his life who had pushed their agendas on him, and that I would be respectful and even interested in his life and what makes it special.
My dad and I are both characters in this story, but I was also very careful never to make myself the main character. This was about him. And knowing that it’s easy to talk some big talk, I made sure to walk the walk as well — even with things as seemingly small as asking him whether a week of observation was something he’d get behind. Even though I was pretty certain he’d say yes, by framing it as a question instead of a statement, I kept the control in his hands. He could say yes, or no, or even suggest a different way forward.
Self-Determination Theory states that people must have three general psychological needs met in order to feel fulfilled: autonomy, competence, and relatedness. By asking questions instead of delivering statements, I was addressing the autonomy part. The more agency people have over a situation, the more likely they are to feel secure and on board. The relatedness part came from my being his daughter, loving him, but also showing him that I’ve struggled with some of the same battles he was. And the competence part… well, we’ll come back to that in a bit.
Ok, so remember how I said I would simply be observing for that first week? It wasn’t exactly simple. Well, it was for my dad because he didn’t have to do anything differently; he simply went about his days as normal. But I went into data mode. I tracked his fasting glucose, food eaten (calories in), exercise (calories out), what types of foods he ate, how they broke down by macronutrient… it was a lot.
And as the data came in, I started running correlations. Call me nerdy, but I wanted to see what the trends were from an objective, mathematical perspective. I guess the apple doesn’t fall far from the tree, huh? This statistical approach was actually another great symbol of our relatedness.
Glucose & drinks correlation wasn’t yet statistically significant in the first week, so we kept collecting data.
Glucose & drinks correlation wasn’t yet statistically significant in the first week, so we kept collecting data.
The data was starting to suggest that of all the things that could affect my dad’s fasting blood glucose levels, sugary drinks may have been the biggest offenders. He didn’t really indulge in desserts much, and the rest of his diet was pretty responsible. But about 20% of his daily calories were coming from a combination of fruit juices throughout the day, a beer at dinner, and the occasional glass of wine to cap the evening. He figured, he never consumed sugary sodas, so everything else was cool, right? Not really, dad. But I held off with saying anything because, after all, I’d promised to stay quiet for that first week.
It’s not easy for me to keep my big trap shut… about anything. So that was the hardest part about this whole thing. But story structure is incredibly important, and the order in which things are communicated can make or break a story. I can’t tell you how many times I’ve seen companies with a great story absolutely butcher the order of information presented, and completely ruin their chance of making an impact. Unfortunately, this is the norm, not the exception.
As the week went on, I would occasionally ooh and ahh at my spreadsheets. I mean, it was really cool to be able to see emerging trends so clearly, and I was getting very excited to share these initial findings with my dad. Every so often he’d peek over my shoulder, not knowing exactly what he was looking at, and I’d tell him how much I’m looking forward to showing him all the details. A little suspense, while showing personal investment can go a very long way.
But the next question was how to share the information most effectively. I knew this was going to need to be treated as a story within a story. The presentation itself had to have its own story structure, while also representing just a single plot point in the story arc of the 5 weeks (and arguably lifelong) journey we were on.
I thought back to my audience research points and based my presentation approach on them.
I had the math part down — check.
The logic part? Well, the math helped with that, but I went a step further by building scientific studies into my presentation to further support my facts about diet, exercise, body weight, and diabetes.
The lifelong learning part? I made a lot of the presentation about information I knew he’d find interesting that he didn’t already know.
The misconceptions he had about his condition? I addressed those by showing him evidence that diabetes is not an inevitable part of aging, and that a person can achieve big results if they focus on making the right kinds of changes. I also made it clear that those changes don’t have to be huge. It goes back to the Pareto Principle, also known as the 80/20 Rule: Find the 20% that’ll make 80% of your impact, and you’ll make meaningful headway with relatively little effort.
And the part about him feeling like people were imposing their agendas on him? Well, it was already clear to him by that point that I was making him the priority. He also saw that I realized that his health included his emotional well-being, and that being the master of his domain was a big part of that.
When it came to actually putting the presentation together, I decided to make it a Keynote with slides and everything. My dad’s a retired professor, I thought the format would have a warm familiarity to it. Plus, it meant I could use his living room tech, which he takes a lot of pride in. He’s got a pretty sweet setup.
When it came to designing the look and feel of the slides, I chose a medium contrast, warm color palette, with an easy to read type face, and an overall aesthetic that fit his style. My dad and I have very different stylistic preferences, so I’ll tell you straight, I didn’t really like the design of the slides myself. But again, this wasn’t about me. Even if all it contributed to was his subconscious, I wanted my dad to feel comfortable in the moment, in a familiar setting, with a warm and inviting approach, that would foster feelings of ease.
Why ease? Because according to behavioral economist Daniel Kahneman, situations that promote cognitive ease tend to make people feel like they’re experiencing something true and good. And what’s better than making my dad feel like what I’m sharing with him is both true and good? Especially if it may save his life? Thinking about the environment, the medium, and even something as subtle the font color helped set a foundation for a positive experience together. It seems like such a no brainer as I write it out, but how often do we put into practice what we preach? In contrast, how often do we just walk into whatever conference room is available, plug in our laptop, and hit go?
My Keynote had 37 slides, which you might think is overkill for a “let’s get dad to eat better” intervention. Normal people just tell their parent a bunch of stuff and hope for the best. Well, I did that back in 2014 when he was pre-diabetic and we all know how that turned out.
Here’s a table of contents of my presentation:
The general math of calories in, calories out, and weight loss (which I explained was an oversimplification but a good framework to start with).
A review of my dad’s calories in, out, and what his body actually needs.
Examples of specific days where he was over his caloric budget and what contributed to the overage.
Correlations and evidence of the biggest offenders: sugary drinks.
Misconceptions about diabetes and aging, and how mindset is everything.
Three options for moving forward.
And a question about why this matters to him in the first place.
The first 5 sections of the keynote spoke to the items I found in my audience analysis. But the ones that ended up being most important to our overarching 5-week story structure were sections 6 and 7.
Section 6 was basically a multiple choice question. Effectively, what I was asking was, “now that you have this information, what do you want to do with it?” Notice again, I’m asking a question not making a suggestion.
Option one is to do nothing. Maybe my dad doesn’t want to compromise quality of life for quantity. Maybe he enjoys his life as it is and doesn’t want to trade the food he loves for a longer life that doesn’t contain the things that make it enjoyable.
Option two: Reduce sugary drinks only. This will make the biggest difference with the smallest amount of effort. Not only do sugary drinks elevate blood glucose, they may contribute to weight gain. If we reduce them, we’ll likely have a double effect — weight loss and lower blood sugar.
Option three: Try different combinations of things. We tweak different foods and drinks, while tracking glucose levels and body weight over the next few weeks, and we see what sticks.
Which would you choose?
I honestly think that any one of these choices would be fair to make. And I told my dad that, because even if he chose the first option and didn’t change anything about his lifestyle, I’d at least come away knowing he’d made an informed decision and that I’d helped him choose the life he truly wanted to live. I just wanted to know I’d done my best for him. What I couldn’t live with was the idea that he could choose a harmful lifestyle based on a bunch of misconceptions in his head that I hadn’t tried to dispel.
This moment, the decision to either move forward or maintain the status quo, is sometimes referred to as “the acceptance” in a story arc. You’ll find this kind of plot point in most Hollywood movies, were the main character makes a commitment to start a journey toward overcoming some hurdle to reach a goal. In my dad’s case, he had a few hurdles, but together, we’d already squashed some of them — like believing he’d have to train 8 hours a day to get to a healthier weight. Nah, he’d just have to cut down on juice. Piece of cake.
So what did my dad ultimately choose? “Option two: reduce sugary drinks only, because it will make the biggest difference with the smallest amount of effort.” In truth, there’s a bit of psychology in presenting three options to people, to make the middle one more attractive. Dan Ariely writes about that too.
Now’s the moment we come back to the idea of competence in Self-Determination Theory. Up to this point, I’d addressed autonomy by giving my dad all kinds of choices so he’d feel he was in full control of his path. And the relatedness part, that was only getting stronger the more time we spent together. But it was this part that really addressed the competence issue.
Human beings have an innate need to feel like they can achieve mastery in the things they engage in. I’d gotten the impression in our conversations months ago that my dad didn’t believe he really could do this. By showing him precisely how he could conquer this challenge, and how the challenge was actually quite smaller than he initially thought, it gave him the confidence to say, yes, let’s try this. Going in with open eyes, knowing the trajectory wouldn’t be linear, and that some days would be easier than others, he decided to reduce sugary drinks… not tomorrow, but right now. And he went and got himself a glass of club soda from the fridge.
But before we got ahead of ourselves with a new “drinks regime,” I wanted to make sure he and I covered section 7, the part about why becoming healthier mattered to him in the first place. Why should his “why” make a difference? According to Simon Sinek, the question “why” is arguably the most important one a person can ask. “Why” roots efforts in a greater purpose. “Why” elicits clarity, especially when the road gets rough. “Why” reminds us that no matter what happens, there’s something bigger at stake.
So I asked my dad which potential results mattered to him most, which is a way of indirectly getting to why something matters. In an effort to make the question easier to answer, I proposed some options for him to consider.
Which results matter to you most, dad?
No longer needing to inject insulin?
Reducing the daily medications you take (and their side effects)?
Surprising your doctor with significant improvements?
Climbing Mount Kilimanjaro?
Prolonging the quality of your life?
He gave me two answers. First, he didn’t want his body to limit the things he wanted to do in life — fishing in the Niagara Gorge, visiting remote areas of Africa, skiing in the Rockies (hopefully with me!). And second, he told me he was a bit scared of the possible side effects of his medications. The idea of being on any kind of drug long-term was uncomfortable for him, and if he could reduce his dosage and maybe even come off the meds entirely one day, well, that was motivating.
Ok! That’s TOTALLY realistic!
I was excited. With this deeper “why,” I could see he was starting to believe these things were attainable, and that we’d be invested in his progress together.
The presentation was a success. I went to bed in celebratory spirits, feeling like I’d really accomplished something big. And then I woke up the next morning remembering that yesterday evening’s events were just a single plot point in a much bigger journey. Getting someone to say yes is just the beginning. Follow-through… that’s the hard part. But I knew my best chance of getting his motivation to stick for the duration of my 5 week stay and beyond my departure was to continue with the overarching story approach.
In that regard, we’d gotten through the hook. We’d identified a conflict to overcome (the challenges associated with lowering glucose levels and losing weight), and he even expressed an acceptance of those challenges. But in a three-act-structure plot, the acceptance typically comes in about a third of the way into a story, so I knew there was a long journey ahead.
Now, I can sense some of you shifting at your standing desks in protest. And I hear ya. It seems as though I’ve outright contradicted myself. Front and center of my Sway Storytelling website live the words, “Facts don’t sell.” I even follow this statement with, “As behavioral economics shows, people mostly make decisions with their subconscious minds—the emotional parts of their brains.” And yet, here I am claiming that I sold my dad on these ideas by presenting facts. And that’s true.
When tailoring a storytelling approach, whether it’s for an audience of one or an audience of a million, we need to understand what’ll move them emotionally. And my dad, who’s a very special kind of human, is emotionally moved by numbers. He also takes so much pride in being a lifelong learner and logical thinker, that reasoned arguments have a very special place in his heart — more so than for most. And that means my approach had to be very specific to the way he works, which entailed teaching him something that would make a lot of sense. That said, there was a whole whack of what you’d consider “traditionally emotional” elements in the mix, like his only child visiting him for an extended stay, him appreciating my commitment to devote this much time and effort to his health, there was our reminiscing together about old times, thinking about the future and all the things he’ll do in his retirement, and reconnecting not just as father and daughter, but as friends.
As my dad was making breakfast, we talked about my week of meal tracking and how we only had seven full days of data. The original plan was to stop tracking after a week and just see what happened to his glucose with some small dietary adjustments. But my dad, enjoying the insights the numbers were providing, asked if I could keep tracking his food and exercise until the end of the 5 weeks. That was a pretty awesome development. I would’ve expected that my logging every calorie, every gram of protein, every budgetary slip up would eventually start to feel like an intrusion to him, but here he was going out of his way to request it! Without hesitation, I responded, “so what’s in your breakfast?”
Over the next few weeks, there were some other interesting developments. First of all, my dad didn’t stop at just reducing sugary drinks like we’d agreed. He started being more conscious of how much fruit he was eating, he bought low fat mayo the next time we went shopping, and even started pre-portioning his hazelnuts so he wouldn’t absent-mindedly eat too many in one sitting. Thinking back on it now, I realize that while he’d chosen option two (reduce sugary drinks only), he was really living out option three (tweaking a combination of things while tracking glucose levels and body weight to see what works).
On one hand, I was thrilled. Not only had I gotten him on board to adjust one habit, he was now going over and above, making multiple changes to his diet. On the other hand, I was afraid he might be biting off more than he could chew, so to speak. There was a risk that with too big a modification, he’d burn out, and it would all be for naught. But when I brought it up, he assured me that he felt like whatever sacrifices he was making were minimal compared to the potential rewards.
Just one week after starting the dietary tweaks, we had some meaningful results. To give you some context, his doctors had instructed him months prior to try to keep his fasting blood glucose under 7 mmol/L (126 in American mg/dl units). In the first week of my visit, before making any changes to his diet, his average was at 8.4 (151.2). But as we continued to measure his levels every morning during that first week of adjustments, we were amazed to see a nearly instant improvement. He was averaging 7.1 (127.8)! He went down more than a whole point in a week, with some of his readings even landing below his doctor’s recommended number! If that isn’t proof of competence, I don’t know what is!
Now, as we expected, it wasn’t a linear process — especially around the holidays. Drinking a little extra champagne when the clock struck midnight and celebrating with good food and good friends meant some caloric, shall we say, excess. All the while, I did everything I could not to be the bad guy. I never wanted my dad to feel policed, partly because that would reduce our relatedness, partly because it could strip away his feelings of autonomy, and lastly, because I just didn’t want to be the bad guy. It was the holidays, my dad was doing awesome with his changes overall, and I wanted to celebrate that with him!
He didn’t sleep very well New Year’s night though. In fact, as a result of a few overindulgent days that month, he learned that he sleeps better when he eats well. So that was motivation enough to get himself back on track. I didn’t have to say a thing.
By the fourth week of our time together, not only had his glucose levels remained down, he’d lost enough weight that he couldn’t use his belt anymore and had to switch to suspenders to keep his pants up.
As the end of my visit neared, we talked about making sure this was a sustainable trend beyond my departure. Five weeks is great and all, but this has to be a lasting practice to have a meaningful impact on his health. He reassured me that my approach had set him up for long-term success. If I had been micromanaging him along the way, policing his every move, he might have grown to rely on me to make decisions for him. But because he felt empowered with the knowledge to make better decisions himself, he wasn’t concerned about continuing after I’d gone. I was still a bit worried that with the absence of subtle social pressure, he might revert back, but I realize now, I’d underestimated him.
Wouldn’t you know, a few days after I got back to Portland, I got an email update from him saying, “And worry not, I keep to the diet regime. My fasting glucose reading as of today was 6.2.” (mmol/L or 111.6 mg/dl) He also informed me that he’d made his own spreadsheet to track his glucose and weight, the results of which he would be sending me monthly. Wow, I thought. Here he is, taking initiative, going over and above again, imposing an extra bit of social pressure on himself to stay accountable. That’s impressive.
In the first few months following my departure, my dad’s weight continued to drop and his glucose levels even occasionally dipped to levels that were borderline too low. Wow.
And a few weeks ago, something kind of incredible happened: he stepped it up even further. Without any prompting from me whatsoever, he started an intermittent fasting program, with an 8 hour window every day where he’s able to eat, and a 16 hour window (including sleep) where he doesn’t.
Since then, he’s stopped having to inject insulin.
And that’s where this exercise becomes really meaningful, and where we come to our plot’s “answer.” My suggestion for him to reduce fruit juice consumption was never meant to be “the” solution. It was meant to be a foot in the door — a small action that could produce measurable changes, to inspire him to take things into his own hands and find the most effective solution for himself and his life. And he did.
I realize it’s impossible to know how many years this undertaking may have added to my dad’s life. What I do know is that aside from him becoming healthier overall, our bond has grown stronger than it ever has been. And considering that “people who are more socially connected to family, friends, and community are happier, healthier, and live longer (source),” maybe I’ll live a little longer too.