Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Make New Habits Stick, Part 2 


We can build good habits in our own lives and help patients do the same by implementing the four laws of behavior change: make it obvious, make it attractive, make it easy, and make it satisfying. 

This is the second article in a three part series. For the philosophy behind systems of habit change, see Part 1. 


In “Atomic Habits,” James Clear presents four laws of habit change comprising his system for helping people build good habits. Here, I briefly summarize each law and offer an example of how I have used this system to build a good habit (journaling), and how we can help our patients create a commonly desired habit (exercising). 


The First Law: Make it Obvious 

The most effective way to begin and sustain a habit is simply to make the activity visible. This means weaving the desired activity into the threads of daily life. The idea is to lower the activation energy needed to do a new activity by seamlessly integrating it into our normal routines rather than detouring out of our regular schedules to execute it.  

One way to achieve this is to design your environment to make the tools needed to do the new habit visible and easily accessible. Write down your intention to do the activity at a specific time and place (the more specific these details, the less wiggle room you have to evade the activity). Finally, pair the activity with something you already ordinarily do, like brushing your teeth. 

For example, the new habit in my life that I want to start is daily journaling. So, I designated a desk in my kitchen specifically for leisure reading and journaling. I leave my journal on the desk open to a blank page. I see it each morning when I go to the kitchen to make coffee. When I was initially trying to build this habit, every evening I would write down specifically how I would incorporate journaling into my routine the following morning. Immediately after I wake up, I brew coffee. When the coffee is done brewing, I pour out a cup and take it to my desk, where I sip on my coffee while I journal. 

An example of helping a patient start a daily exercise habit is have the patient identify a route home after work that requires passing a gym. Before they leave work for the day, ask them to write down a clear plan to stop by the gym and exercise on their way home. In doing so, they pair exercise with a common daily event (driving home after work).  


The Second Law: Make it Attractive 

A good habit is much easier to stick to when it’s appealing. Shape the circumstances surrounding the activity to make it desirable. One method is to create a motivational ritual, in which you “pump yourself up” to do the activity and then immediately transition to doing it. Another is to join a community or culture in which the desired habit is normal and encouraged.  

To keep up with my new journaling habit, I pour myself a cup of coffee each morning, I think about how journaling will set my mind in the right place to guide the rest of my day. I also take part in an online self-development community in which people journal and share their entries regularly. 

For the patient example, suggest they play songs or podcasts that motivate them on their drive to the gym after work. Encourage the patient to take advantage of group workout classes at the gym or to exercise with friends or coworkers for added accountability.  


The Third Law: Make it Easy 

Make the desired activity as easy to do as possible, which makes it easy to stick to long-term. Also, reduce the new habit down to a bite-sized piece that you know you can do each day, and then scale up with time.   

For example, I wake up each morning with plenty of time to journal before leaving the house for work, thereby reducing time constraints. When I started journaling, I committed to three sentences a day, which I knew I could do in three minutes. This gradually increased over time and now I am able to write at least a page each day with ease.  

In the patient example, see if the patient is able to pack their workout bag and place it in the car the night before. Recommend that they master their consistency in doing short exercise routines before increasing their regimen. 


The Fourth Law: Make it Satisfying 

We repeat activities that make us feel good. One effective way to use this is basic reinforcement: give yourself an immediate reward upon completing the habit. Another is to use a habit tracker that helps you visualize your progress and successes.  

For example, after I journal each morning, I reward myself with a healthy and tasty breakfast. Dating my entries is a way for me to track my journaling habit; the more consecutive entries I flip through, the more satisfied I am with my progress and motivated to continue my streak.  

In the patient example, encourage the patient to give themselves a healthy reward after each workout like a nutritious meal and/or a hot shower). The reward should be consistent with their overarching goals; eating a pizza after every workout is akin to “casting votes for two different identities,” as Clear puts it. Suggest the use of an exercise app or calendar that allows them to visualize their progress.  

In Part 3 I’ll explain how to invert these laws to break bad habits. 






This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.