Saturday, January 1, 2011

New Year's Resolutions

This is the time of year when many people decide to make changes in their lives. We frequently resolve to do something differently, whether it is eating better or giving up a habit in which we would prefer not to engage. However, this is also a time of year in which people become frustrated with failing to make the changes in their lives that they want to make. In fact, sustaining the change is so difficult that how quickly a New Year’s resolution is broken has become a source of jokes.

Many people do not know how to make real changes in their behavior. This is not something that we are ever taught. I have frequently had clients tell me that it takes 28 days to form a habit, but none of them have been able to explain the science or reasoning behind that claim. In fact, I have never found that there is good science or reasoning behind the claim. But it suggests a belief that if one can simply change a behavior effortfully for 28 days, then he or she can develop a new habit. Ask an ex-smoker if after 28 days of not smoking they experience a behavioral inclination to smoke when they go to a bar (beyond the actual chemical craving), and see if 28 days is adequate for developing new habits. The truth is that there is no standard for when a behavioral change becomes permanent.

What does exist are well accepted theories of change that can be helpful in planning for and following through in changing behavior. Within in psychology, James Prochaska’s Transtheoretical Model for Change is the most widely used model for behavioral change. His model consists of stages: pre-contemplation, contemplation, planning, action, maintenance, and relapse. People in the pre-contemplation stage are not yet thinking about making a change. The people around them may think they should, but they do not feel that way themselves. People in the contemplation stage are thinking about making a change, but are still undecided if they want to follow through with it. Once someone decides he or she wants to make a behavioral change he or she moves into the planning stage. During this stage the person considers what actions will most likely facilitate a successful change. Once a plan is in place, a person begins making the behavioral change and therefore moves into the action stage.

People often choose the symbolic date of New Year’s Day to transition from the planning stage to the action stage. Unfortunately, many of them fail to actually complete the planning stage before moving into the action stage, and consequently move directly into the relapse stage, rather than move into the stage of maintenance. The maintenance stage is the marked by going through the deliberate actions that will form the new behavior as a habit. Relapse is when one engages in the old behavior after having entered the action stage. The maintenance stage is frequently punctuated by intermittent relapse stages. If a relapse stage lasts long enough, the whole cycle may need to be repeated.

Forming a new habit (which includes shedding an old habit) involves a change in brain anatomy and physiology. Biologically, habits can be thought of as well-established patterns of brain activity. The more one engages in a habit, the more easily the pattern is triggered. The establishment of an alternative habit is the process of establishing and strengthening a competitive pattern of brain activity. In Prochaskan terms, the maintenance stage is the deliberate effort of establishing the competitive pattern and relapse is reverting to the old pattern. The more deliberate practice in which someone engages, the stronger the new pattern gets and the weaker the old pattern becomes.

Both planning and patience are important in forming a new habit. To extinguish an old habit or acquire a new habit more successfully, think about specifically what you want the new habit to be. If trying to get rid of an old habit, think it terms of “instead of X, I will do Y” (not just “I do not want to do X”). Setting step-wise, specific, and measurable goals can help one feel a sense of accomplishment and therefore encouraged and reinforced. Addiction recovery is often thought of in terms of “one day at a time.” Adopting the perspective that your goal is to have the new habit today, instead of “from here on out,” can make the change feel less daunting. And appreciate the number of instances in which you are able to engage in the new habit. Recognize that relapse is a natural part of any behavioral change and allow yourself that. Do not give up when the old neurological pattern wins, instead just keep building the new pattern with deliberate effort.

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