Eat healthy, exercise regularly, and sleep more are healthy goals case managers and nurses reinforce to patients. But case managers often have difficulty living up to their own advice when hectic daily schedules leave little time for healthy pursuits.

These goals are so hard to pursue because the benefits are so long-term. “It’s too abstract, too long a time horizon, which is what makes the task so difficult to pursue,” says Michael Slepian, PhD, assistant professor in the management division at Columbia University Business School.

Slepian is a social scientist whose research typically applies to business management concepts, but he believes there are strong applications to health behaviors as well.

Retirement savings is a long-term pursuit with a long-term goal, similar to health behavior, he explains. However, there is a critical difference. “When you’re saving money, you set aside money from a paycheck, and immediately the account goes up,” says Slepian. “It’s not the same with healthy eating and exercise. You go for a run one day, eat healthy one day, don’t drink alcohol one day, but that doesn’t mean you will feel better the next day. It’s hard to work long-term on something when the benefits are so far away.”

The crux of the problem is that people do not have a solid connection with their future selves, explains Slepian. If they did, people could imagine their healthy future selves — which would be a major source of motivation. “The more connected you feel to your future self, the more you’re willing to put in the work now because you feel connected to that future person,” he says.

To test the theory, Slepian and colleagues conducted two studies, published in the Journal of Experimental Psychology: Applied. In the first study, they assessed how connected 200 participants felt to their future selves. Participants answered survey questions about whether they liked and cared for that future self.

Next, participants reported their health by responding to 10 items assessing physical and mental health, including “In general, would you say your quality of life is…” and “In general, how would you rate your satisfaction with your social activities and relationships?”

Researchers found that those who could visualize and relate to their future selves felt a stronger connection to that person. They also tended to live healthier lifestyles.

But that raised several questions, Slepian explains. Does feeling healthier lead a person to feel more connected to his or her future self? Will this increase optimism and self-esteem? Also, do people with an unhealthy lifestyle feel less connected to future selves? What can be done to improve that outlook?

In the second study, his research group recruited 535 students. Each was asked to write a letter to their future selves. For the longer-term view, they were asked to take five minutes to write a 200- to 300-word letter to their future selves in 20 years. For the near-term view, they were asked to write a letter to themselves three months into the future.

The instructions read: “Think about who you will be 20 years from now [or three months from now] and write about the person you are now, which topics are important and dear to you, and how you see your life.”

After submitting their letters, participants pursued exercise plans. Each recorded the length of time they exercised every day. One group was assigned to exercise for 10 days. another group for just two days.

Researchers found that students with a stronger connection between their present and future selves tended to show healthier behaviors and better health. Those without a strong connection engaged in less healthy behaviors. (The study is available at:

“Healthy behaviors in particular can be hard to commit to, given the very large time spans required to realize their benefits,” the researchers noted.

Slepian recognizes this dilemma in everyday life. “When we attend one exercise class, we don’t see immediate results in weight loss. We don’t see improved fitness today, nor even in the near future,” Slepian says. “Conversely, forgoing a healthy behavior today does not hurt health immediately. By taking just a few minutes to visualize your future self — and see yourself benefiting from those healthy habits — you could go a long way in finding motivation.”

Case managers can use this same technique to prompt patients in viewing their own efforts, he explains. By simply asking patients to visualize their future selves, even write a letter to that person, it is possible to help them find the motivation to make lifestyle changes.

Writing a letter is one way to think deeply about who that future person is, explains Slepian. When people heighten the connection between the current self and the future self, they help to limit the tendency toward short-term thinking and promote an understanding of how each action — especial those that are concrete and feasible in nature — fits into the “bigger picture.”

“Highlight the connection between you today and that person down the road,” he advises. “The more you recognize who that person is, you begin to highlight the connection, and that highlights that it’s worth it. The effort is worth it. It’s no longer just an abstract concept. You feel a real connection to that person.”

It takes just a few minutes to write this type of letter, Slepian says. “Busy professionals as well as patients can take a moment to think about the decisions you make today and how they will affect you down the road.”

Putting in the extra work after a hard day will pay off and it will be more obvious in the future, he adds. “This is a message every healthcare professional can apply to their own lives and take to their patients.”