Winning Acromegaly Battles With Behavior Modification Using Successive Approximation

Living with a chronic disease like acromegaly isn’t always easy and some days can seem darker than others. But if you’re feeling especially hopeless or defeated, there are a variety of ways you can try to pick yourself up.

One of these is a technique called successive approximation, or shaping, which sounds fancy but really isn’t at all. In fact, you’ve likely heard of this approach before but just didn’t know its scientific name. So just call it “baby steps” if that works better for you. The idea is the same, and you may be surprised how effective it can be.

“Ten baby steps equals one, big, giant Mother-May-I step.”
Linda Rio, MA, LMFT

What is Successive Approximation?

The method of successive approximations is a behavior-shaping technique identified in psychology. Instead of reinforcing a single desired response, shaping reinforces a series of responses that are progressively closer to the end goal.1

We use this technique when learning to walk or write, or when tackling more complex skills like learning to play a song on the piano.1 You don’t play it perfectly the first time. You learn some notes correctly in row, then passages, then gradually the entire song. The key is acknowledging accomplishments at steps along the way to the end goal.

You’re still on the path, even with small steps

As anyone with acromegaly can attest, living with a rare disease can present a lot of opportunities for depression, anxiety, isolation, and other negative emotions to creep in and drag you down. But as Linda Rio, MA, LMFT, editor of The Hormone Factor in Mental Health and co-editor of Pituitary Disorders: Diagnosis and Management notes, “For a lot of patients, when I have talked to them, it does feel hopeless. But the steps we make are not about perfection. Sometimes it starts with just going online and searching about their illness and that’s a beginning. The important thing is that you’re on the road. It doesn’t matter how slowly you get there, but it does matter to have some hope.”

Every success builds on success. 
Shawn Atchley, MA, LICW, LISW 

Acromegaly patient and therapist Shawn Atchley, MSW has a similar perspective: “Short meditations or breathing exercises can help chop up large issues into smaller ones. Compartmentalization and particularization as well, so patients can handle small problems over time.” He often talks with patients about moving away from passivity to become more active. “If I’m depressed, I don’t want to get out of bed, but I might be able to get up and take a shower. I might be able to get up and fix breakfast. Once I get up and fix breakfast, then I might be able to go outside and sit on the porch. Then I might be able to take my dog for a walk. The more success we have, the more proactive we become, the more able we are to manage our symptoms.”

Successive approximation can be applied in all sorts of ways, to a variety of circumstances and goals that can help you face the challenges of living with acromegaly or other rare endocrine disease. For additional insights and supportive ideas, read our full interview with Shawn and Linda.

Additional Resources


1. Shaping in Psychology: Behavior Modification Through the Method of Successive Approximations, Howard Allen,, March, 2021.