Consultant Physician and Diabetologist at Balaji Hospital Tikrapara
&Diabetic Clinic .
12 मार्च 2013
PART I: THE POWER OF HABITS IN OUR PERSONAL LIVES
PART I: THE POWER OF HABITS IN OUR PERSONAL LIVES
1. The Importance of Habits
While we may agree with the statement that we humans are creatures of habit, it is easy to underestimate how much this is truly the case. Just consider the following list of questions about your daily routine, and how often your answers to these questions reveal deep-seated habits: “when you woke up this morning, what did you do first? Did you hop in the shower, check your email, or grab a doughnut from the kitchen counter? Did you brush your teeth before or after you toweled off? Tie the left or right shoe first? What did you say to your kids on your way out the door? Which route did you drive to work? When you got to your desk, did you deal with email, chat with a colleague, or jump into writing a memo? Salad or hamburger for lunch? When you got home, did you put on your sneakers and go for a run, or pour yourself a drink and eat dinner in front of the TV” (loc. 126). These questions could easily continue on through your evening routine up until the time that you tuck your children in and go to sleep yourself, but you get the picture: for most of us, the answers to these questions betray deeply ingrained daily habits. Given that this is the case, it comes as no surprise that a study in 2006 out of Duke University found that “more than 40 percent of the actions people performed each day weren't actual decisions, but habits (loc. 133).
Of course, there was a time when each of us did make a conscious decision about how we would handle any one of the alternatives mentioned above. However, once these decisions were made, our deliberative minds stepped out of the picture, and our behaviors were reduced to habit. As Duhigg explains it, “at one point, we all consciously decided how much to eat and what to focus on when we got to the office, how often to have a drink or when to go for a jog. Then we stopped making a choice, and the behavior became automatic” (loc. 157).
When it comes to our habits, some of them are extremely simple, such as applying the toothpaste to the toothbrush before sticking it into our mouths (loc. 420). However, other habits are extremely complex, such as backing the car out of the driveway: “it involves opening the garage, unlocking the car door, adjusting the seat, inserting the key in the ignition, turning it clockwise, moving the rearview and side mirrors and checking for obstacles, putting your foot on the brake, moving the gearshift into reverse, removing your foot from the brake, mentally estimating the distance between the garage and the street while keeping the wheels aligned and monitoring for oncoming traffic, calculating how reflected images in the mirrors translate into actual distances between the bumper, the garbage cans, and the hedges, all while applying slight pressure to the gas pedal and brake, and, most likely, telling your passenger to please stop fiddling with the radio” (loc. 429).
There is a very good reason, of course, for our tendency to form habits around out daily activities, simple and complex alike. For any behaviour that can be reduced to a routine is one less behaviour that we must spend time and energy consciously thinking about and deciding upon. This frees up time and energy for other matters. Indeed, as Duhigg points out, “once that habit starts unfolding, our gray matter is free to quiet itself or chase other thoughts, which is why we have enough mental capacity to realize that Jimmy forgot his lunchbox inside” (loc. 432).
Conserving mental energy where possible has enormous adaptive value, of course, and therefore, it is quite likely that the tendency to form habits evolved in our species, as well as in other species, for just this reason. As Duhigg puts it, “this effort-saving instinct is a huge advantage… [for] an efficient brain… allows us to stop thinking constantly about basic behaviours, such as walking and choosing what to eat, so we can devote mental energy to inventing spears, irrigation systems, and, eventually, airplanes and video games” (loc. 438).
2. How Habits Are Formed
So how does it work? How do our brains fall into habits? According to Duhigg, it comes down to a simple, three part loop: cue, routine and reward. In the author’s own words, “first, there is a cue, a trigger that tells your brain to go into automatic mode and which habit to use. Then there is the routine, which can be physical or mental or emotional. Finally, there is a reward, which helps your brain figure out if this particular loop is worth remembering for the future”
If everything lines up, the brain ‘remembers’ the loop, and is predisposed to using the same routine when the same cue comes up again in the future. Essentially this is operant conditioning 101: a certain cue is followed by a particular behaviour, and the subsequent reward for this behaviour reinforces the behaviour itself. The more often the brain uses the loop to good effect the deeper the behaviour becomes ingrained—to the point where the behaviour itself becomes more and more automatic (loc. 457).
Eventually, the cue ends up being so bound up with the reward that the cue itself will trigger a craving for the reward: “the cue and reward become intertwined until a powerful sense of anticipation and craving emerges” (loc. 457). In fact, it is only when a particular cue triggers a craving directly that the associated behaviour truly becomes a habit: “countless studies have shown that a cue and a reward, on their own, aren’t enough for a new habit to last. Only when your brain starts expecting the reward… will [the behaviour] become automatic” (loc. 964). Ultimately, the sense of anticipation that the cue triggers becomes so powerful that the absence of the anticipated reward can cause deep disappointment and frustration (loc. 901-23); hence why habits are so powerful (loc. 912).
The sub-conscious brain is constantly looking out for opportunities to form new habits (by identifying rewards that follow particular routines that are performed after certain cues), and therefore, habit formation itself is very much an unconscious process (loc. 912). Given that this is the case, many of the habits that we develop are not necessarily ones that we want. As Duhigg explains, “habits emerge without our permission”; for example, “studies indicate that families usually don’t intend to eat fast food on a regular basis. What happens is that a once a month pattern slowly becomes once a week, and then twice a week—as the cues and rewards create a habit—until the kids are consuming an unhealthy amount of hamburgers and fries” (loc. 575).
3. Changing Your Habits
Once habits set in they can, of course, be very difficult to change. In fact, studies indicate that once habits are formed in the brain, they become encoded in the structures therein, and can never truly be eradicated (loc. 469). This is particularly problematic given that at least some of the habits that we develop (if not most of them) are ones that we would prefer not to have. Thankfully though, it turns out that we can take control of the habit loop and develop new habits that come to overpower and override the old ones; and, as the author points out, “once someone creates a new pattern, studies have demonstrated, going for a jog or ignoring the doughnuts becomes as automatic as any other habit” (loc. 475).
The ability that we have to change our habits (and with it the underlying neurology of our brains) is seen nowhere more dramatically than in cases such as Lisa Allen: “Lisa Allen, according to her file, was thirty-four years old, had started smoking and drinking when she was sixteen, and had struggled with obesity for most of her life. At one point, in her mid-twenties, collection agencies were hounding her to recover $10,000 in debts. An old resume listed her longest job as lasting less than a year” (loc. 55). Within a span of 5 years, though, Lisa had transformed herself into a person that bore almost no resemblance to her former self: “the woman in front of researchers today… was lean and vibrant, with the toned legs of a runner. She looked a decade younger than the photos in her chart and like she could out-exercise anyone in the room. According to the most recent report in her file, Lisa had no outstanding debts, didn’t drink, and was in her thirty-ninth month at a graphic design firm” (loc. 58). Lisa had also quit smoking, lost 60 pounds, run a marathon, completed a master’s degree, and bought her own home (loc. 61). Not too shabby.
How did Lisa change her life? Simple: she changed her habits. Well, actually, this is a bit misleading, for Lisa didn’t so much change her habits as create new habits that came to override her old ones. And all of this was reflected in her brain wiring. Indeed, as the neurologists who study Lisa explained, “one set of neurological patterns—her old habits—has been overridden by new patterns. They could still see the neural activity of her old behaviours, but those impulses were crowded out by new urges. As Lisa’s habits changed, so had her brain” (loc. 106).
So, how did Lisa manage to create new habits that came to override her old ones? According to Duhigg, the most effective way to modify your habits is to attack the habit loop directly, and to replace an old routine that is associated with a particular cue and reward, with a new routine. This is a known as the golden rule of habit change: “you can never truly extinguish bad habits. Rather, to change a habit, you must keep the old cue, and deliver the old reward, but insert a new routine” (loc. 1138).
As an example, Duhigg brings up the instance of how he changed his habit of going to the cafeteria everyday at around 3:00 pm to buy a cookie, to a new habit, where, instead of going to the cafeteria to buy a cookie, he would go and seek out 10 minutes of social time with a friend.
So there you have it. If you want to change a habit, first identify the cue that is triggering the routine (this may be anything from a location, a time of day, an emotional state, the presence of certain other people, or an immediately preceding action [loc. 4680]). Second, identify the reward that the habit is bringing you. This can be tricky, as the reward is sometimes masked among other things. For instance, in Duhigg’s case, one would have thought that the reward for his going to the cafeteria and ordering a cookie would be a burst of sugary goodness. However, this was not actually the case. As it turned out, the reward that Duhigg was really after was the companionship of the colleagues that he would invariably meet when he went down to the caf. Given the sometimes obscure nature of the rewards that drive our habits, you may need to experiment with your routine a little in order to identify precisely what the reward is that is behind your behaviour (as Duhigg did in the clip).
Once you have identified the cue that triggers your habit, and the reward that it brings, it is time to come up with a plan to replace your current habit with a new one. In Duhigg’s case, he found that the reward for going down to the cafeteria at 3 o’clock was social companionship, so he replaced the act of buying the cookie with simply searching out a friend in the office to gossip with for a spell. The cue and reward stayed the same, but Duhigg changed his routine. As simple as this technique sounds, it has actually been used to successfully treat such conditions as “verbal and physical tics, depression, smoking, gambling problems, anxiety, bedwetting, procrastination, obsessive-compulsive disorders, and other behavioural problems” (loc. 1371).
4. The Importance of Keystone Habits
Now, if you are like Lisa Allen, and you have a whole lot of habits you would like to change, the aforementioned approach—which seems to require tackling one habit at a time—may sound like a somewhat long, drawn out, and tedious process. Thankfully, though, there is a shortcut, and it involves what are called keystone habits. Keystone habits are habits that, when changed, set off a chain reaction that extends to all aspects of a person’s life: “some habits, in other words, matter more than others in remaking… lives. These are ‘keystone habits,’ and they can influence how people work, eat, play, live, spend and communicate. Keystone habits start a process that, over time, transforms everything” (loc. 1729).
For Lisa, one of her keystone habits was smoking; when she quit smoking, other habits started to follow suit: “that one small shift in Lisa’s perception… the conviction that she had to give up smoking… had touched off a series of changes that would ultimately radiate out to every part of her life. Over the next six months, she would replace smoking with jogging, and that, in turn, changed how she ate, worked, slept, saved money, scheduled her workdays, planned for the future, and so on” (loc. 102).
Identifying keystone habits is not always easy, but there are tricks for it. For instance, research has revealed that keystone habits seem to operate on the principle of ‘small wins’, which are just what they sound like: tiny victories that give you an indication that you are progressing, and that you can in fact succeed. As one Cornell professor puts it: “once a small win has been accomplished, forces are set in motion that favor another small win” (loc. 1919). Duhigg adds that “small wins fuel transformative changes by leveraging tiny advantages into patterns that convince people that bigger achievements are within reach” (loc. 1919). Though keystone habits may exist in a myriad of forms, and may be different for different people, certain habits tend to act as keystone habits across the board. Exercising is certainly one of these (loc. 1858-64). And eating as a family (loc. 1864), and doing things like making your bed every morning (loc. 1864) have also been shown to be highly correlated with other good habits.
5. The Importance of Belief and Communities of Support
As mentioned above, when you are trying to change your habits, small wins can provide an important sense of belief that this change is in fact possible. And the power of belief should not be underestimated, for it has been shown to be a particularly effective tool when it comes to making change—and specifically when the habits you are trying to change are especially stubborn, such as alcoholism. In the case of alcoholism (and those like it), times of deep stress can easily derail any progress that an individual may have made in replacing their old habit with a new one, and send them right back to their old ways. If, however, the individual has developed a strong sense of belief that they will be able to cope with their stress without the use of alcohol, then this seems to make all the difference (loc. 1497). As the researcher Scott Tonigan of the University of New Mexico explains, “belief seems critical. You don’t have to believe in God, but you do need the capacity to believe that things will get better. Even if you give people better habits, it doesn’t repair why they started drinking in the first place. Eventually they’ll have a bad day, and no new routine is going to make everything seem okay. What can make a difference is believing that they can cope with that stress without alcohol” (loc. 1500-04).
The program Alcoholics Anonymous has always made excellent use of this fact. AA was once considered to be somewhat of a cult organization among scientists, due to its heavy reliance on spirituality in its approach. Recently, however, scientists have begun to take AA more seriously. Part of the reason why Alcoholics Anonymous has been so successful, it seems, is because the program makes the belief that things can change an important part of their meetings. Tonigan argues that “by putting alcoholics in meetings where belief is a given—where, in fact, belief is an integral part of the twelve steps—AA trains people in how to believe in something until they believe in the program and themselves. It lets people practice believing that things will get better, until things actually do” (loc. 1507).
And a big part of why AA seems to be so effective in engendering belief among its members, is because the program takes place in a social setting, where the matter of belief becomes a group experience. “There’s something really powerful about groups and shared experiences,” claims Lee Ann Kaskutas of the Alcohol Research Group, “people might be skeptical about their ability to change if they’re by themselves, but a group will convince them to suspend disbelief. A community creates belief” (loc. 1510).
So, putting it all together, then, Duhigg sums things up this way: “we know that a habit cannot be eradicated—it must, instead, be replaced. And we know that habits are most malleable when the Golden Rule of habit change is applied: If we keep the same cue and the same reward, a new routine can be inserted. But that’s not enough. For a habit to stay changed, people must believe change is possible. And most often, that belief only emerges with the help of a group” (loc. 1627).