Estimated reading time: 8 minutes
Just before midnight at the NYE dinner party I was hosting the guests started to ask around the table “what are your New Year’s resolutions?”. Many people disclosed that they had similar resolutions each year- exercise more, reduce alcohol intake, meditate, generally ‘be healthier’. At the time people are discussing these new year’s resolutions they appear very motivated. So, what happens that makes so many of us fail?
Paradoxically, motivation is not a great marker for success. Especially when it comes to diet, exercise, sleep patterns, taking time to meditate and ‘being healthy’. The problem with motivation is it is ephemeral; we feel it passionately and strongly in the moment and then it quickly disappears. Motivation does not sustain us through the desire to eat chocolate while watching a great film. Motivation might make us join the gym, but it doesn’t keep us going to the gym. Far more effective than motivation is HABIT.
‘We are what we repeatedly do. Excellence then, is not an act but a habit’
William Durant philosopher 1926
The greatest pathway to a new routine that has a stronger focus on self-care is HABIT! It is estimated that 43 percent of our daily behaviours are controlled by habit. Good and bad habits are driven by routine rather than active thought. Our brains are essentially lazy and are primed to continually default to behaviours that never rise to a level of conscious experience. Think about where you park your car each day at work. Chances are within a few days of commencing at work you got in a habit of parking in a particular area. How aggrieved do you feel when that park is not available? The habit of repeatedly parking in the same place means you can wander out even after a night duty and without thinking find the car. Should you arrive at work at a different time than your normal routine and park somewhere else it expands an awful amount of brain power to remember where the car is!
In the book ‘The Power of the Habit’ by Charles Duhigg he explains that ‘habits’ are mental shortcuts that assist our brains to go into autopilot and seemingly make our lives easier. This is why trying to ‘break a habit’ is so hard. Habits are a 3-part cycle:
Cue
Behaviour
Reward
Even if that reward is short-lived. This is why most of us thrive with a routine. We cannot easily ‘break’ a habit, we must intentionally CHANGE a habit. Changing a habit can be challenging, it must be active, and deliberate. Neuroscience suggests that when we are hungry, tired, angry, or stressed our brains are easily distracted making us far more likely to fall back on old and comfortable habits, such as the 3pm sugar hit. If the mind is preoccupied with stress or fatigue than our unconscious mind and habits have greater control of our actions (cue pulling in for fast food after a long shift). If you want to eat better after night duty you may need to drive a different way home to avoid the temptation and have some fruit cut up and ready to go in the fridge when you walk through the door. The more cues we give our brain the greater the chance of success in changing our behaviours. Another example may be leaving your gym clothes and shoes packed and ready at the end of your bed for when you wake up in the morning. Doing this the night before reduces the decisions required the next day on what to wear and the type of exercise you plan to engage in. Incidentally, if increased movement or exercise is one of your resolutions for 2024 the greatest chance of success is organising a habit with another person. Knowing someone is waiting for you in the gym or at the end of the street will often cue you in to action. Another example may be if you are trying to have less screen time in 2024 than help your brain not receive a cue by deleting many of the apps on your phone that you tend to mindlessly open when you have a minute or two spare. Charge your phone in a room separate to your bedroom and put a novel by your bed. All new cues to drive a new behaviour. Habits are hard wired into our brains, and we need to create change to change our habits. Research reports vary when it comes to how long it takes to develop a new habit with results reporting between 59 to 91 days. Duhigg says the amount of time it takes to create a new habit will vary from person to person and will take patience, self-discipline and commitment. For most of us that means that it will take over a month of new cues before it gets easy. If we characterise habits as automaticity than we must have very strong and easy cues to make it easy for our brain to adapt to the new change.
The other important element is to have a strong sense of self-awareness. As soon as I am stressed, I want to eat crisps/chips/fries. If there are no crisps in the cupboard it makes it much more challenging to eat them. It allows a delay in my brain to stop and not automatically begin consumption. Habit often occurs without any intention, awareness, or control so while you are trying to create new habits control your environment as much as possible. Habit can override motivation and intention, so habit formation is critical to the success of sustainable health-promoting behaviours.
Lauria and colleagues have written an interesting paper ‘Force of Habit: developing situation awareness in critical care transport’ demonstrating the importance of habit even in resuscitation situations. They propose a series of cues that are highly relevant to changing habits in any setting:
- Tie the new behaviour to a trigger than is virtually inescapable as a ‘force function’.
Eg- sleep in your gym gear so you would actively have to change your clothes to avoid exercise.
- Make the routine that follows the trigger (cue) very specific. Eg I sleep in my gym gear, I go to the toilet, brush my teeth, put on deodorant and walk straight out the door (I am being very prescriptive here because that is what our brains like and because there are people at my gym at 5.30am who have missed these steps ☹!!)
- Repetition and deliberate practice. If you want to make movement and exercise a new habit it will be very helpful to do something EVERY day for the first few weeks until the habit is established. It is much easier to build a new habit when it is automated.
- Evaluate the new routine and if something isn’t working tweek it (don’t stop completely). Sometimes by Friday if I know I am going to be too tired to do a workout on my own I book into a class. This forces me to be at the gym at a certain time. If running bores you join a group. If everything hurts download a great novel and listen as you walk.
We cannot build a new routine without at first building new habits. Habits need to be deeply engrained in our lives so that when they don’t happen, they feel uncomfortable.
“ninety-nine percent of the failures come from people who have the habit of making excuses”
George Washington Carver
The other mistake we all so commonly make at this time of year is trying to create too many new habits at once. Being aware of how much cognitive load it takes to create new habits it is important to tackle one goal at a time. Make it an achievable goal and when it is a firmly developed habit move to the next goal. So maybe start with “I am going to drink more water every day”.
- Cue- Fill a 1.5 litre (3.2 pints) bottle of water.
- Behaviour – carry the water bottle with you into work and leave it somewhere you can access it easily during the day.
- Reward- celebrate when your pee is clear and know you are hydrated. 😊
In conclusion, we are all very busy healthcare professionals working in environments with too far resources and not enough time in professions that request us to constantly be in the service of others. So often many of our ‘rewards’ are based on cues of fatigue and behaviours that I think are ‘self-soothing’. We have the cue “I worked a long day”, “I saw too many distressing things” we have a mindset of “I deserve” or “I need” as we try to soothe ourselves with a balm that is often a behaviour and reward of chocolate/beer/wine/crisps/6-hours lying on the couch watching the telly. The problem is that while these rewards feel very good as we indulge in them, they rarely result in better health physical or mental, to sufficiently arm us for the following day. Start small. More water, 15 minutes earlier to bed, a walk around the block with the dog, the kids, or your partner after dinner. When it starts to feel good (I promise this will happen) than build on it. Always have a treat night (I always eat crisps and have an ice cream for a film) and be clear of why your new habit may be important. Also try not to be an ALL or NOTHING person. Remember how hard new habits are to create. If you have one or two ‘bad’ days, please don’t give up. Be compassionate with yourself and remember tomorrow is another day.
Happy New Year, take care.
Liz
@LizCrowe2
Bibliography
DePaul, K. (2021) What Does It Really Take To Build a New Habit?: HBR, 2nd February. https://hbr.org/2021/02/what-does-it-really-take-to-build-a-new-habit
Duhigg, C (2013). 2013. The Power of Habit. London, England: Random House Books.
Gardner, B; Rebar, AL; Lally, P; (2019) A matter of habit: Recognizing the multiple roles of habit in health behaviour. British Journal of Health Psychology, 24 (2) pp. 241-249. 10.1111/bjhp.12369
Lauria, M; Ghobrial, M; Hicks, C; (2019) Force of Habit: developing situation awareness in critical care transport: Air Med J, 38(1) doi: 10.1016/j.amj.2018.09.007
