Lee Ramsey: A solutions-focused approach to health — find what works and do more of it


A few years ago, I was in graduate school for psychotherapy. While in my second year, I came across two names: Steve de Shazer and Insoo Kim Berg. These two founded a model of therapeutic interaction called: Solutions Focused.

The foundational axiom of the model is that the therapists and clients focus should be on solutions, not problems. By focusing on solutions, more solutions are discovered thereby diminishing the impact of the problems. (It’s not saying “ I am avoiding thinking about my problems.” It’s saying, “I am going to put my energy into fixing the issues and not ruminating and dwelling in a place of frustration about the things going wrong in my life.” )

Lee Ramsey (Photo provided)

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Sandra walks into the gym for personal training. She has just had a conversation with herself in the car about how she needs to workout, eat better, stop sleeping in so much, and would love to have no back pain. She sits down with a trainer and begins going over everything she feels is wrong with her health.

The trainer asks her, “What do you need help with? What is the biggest reason you are here today?”

She grins sardonically, “Over the past five years I have put on 50lbs, I hate looking at myself in the mirror. I have semi- chronic back pain and am unsure why. I want to feel young again, I want to be strong and energetic. I don’t want to feel like an old person.” The trainer sits back in his seat, pauses for a moment then says, “When do you not feel like an old person?”

Learning to ask yourself solutions-focused questions

Over the past three years, I have learned that these kinds of questions are far more compelling than simply asking, “why do you struggle with the things you struggle with?”

The question of, “When do you not feel like an old person?” is reframing the conversation to shine a light on when you feel like the person you want to become. When we orient so much of our dialogue around problems, it can create an illusion that we only struggle and never do anything good (often shame-motivated). That is undeniably not true, we simply have to begin to notice it. We have to do perception work, and this is precisely what asking solutions-focused questions does. Questions open the door to new perception, noticing something we have not previously noticed, thinking in a novel way, and hopefully leading you to live differently as a result of the answer.

If you were to answer the question, “When do I not feel like an old person,” you would likely discover behaviors that you would need to do more of. As opposed to identifying what you need to do less of, a more compelling method of lifestyle change is pursuing behaviors that you want to add to your life.

Oftentimes when we first notice our need to change we become consumed with everything we wish we didn’t do. “I wish I didn’t stay up this late, I wish I could get in a better routine, I wish I didn’t eat out as much, I wish, ect.” The issue with this line of thought is that it is utterly directionless. It tells you nothing about where to go, or what to start doing. A mantra of mine is, “Try to expand what is already working, and by consequence what is not working will shrink.” Find things that are already working for your health and do more of it.

Lee Ramsey has a passion for fitness as a way to help people grow and change into more adaptable, capable and resilient versions of themselves. He is owner of Sanctify Fitness in Covington and a regular fitness columnist for the NKyTribune.