C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Make New Habits Stick, Part 3

Takeaway

We can break bad habits in our own lives and help patients do the same by making them unattractive, difficult, unsatisfying, and removing triggers.

In Part 2 of this series, I described how James Clear’s four laws of habit change comprise a system used to help people build good habits. By inverting these four laws, we obtain corollary laws that enable us to break bad habits as well. Though still a work in progress, I am applying these four laws to break a bad habit in my own life (late-night social media consumption). I’d also like to offer an example of how we can use these principles to help patients break a common bad habit (consuming too much junk food).

 

Inversion of the 1st Law: Make it Invisible

One of the easiest and best ways to break a bad habit is simply to reduce or remove exposure to the activity as well as the environmental cues that trigger our cravings for it.

 

Personal Example (reducing social media use): In medical school, I found myself regularly escaping from stress by mindlessly scrolling social media in the evenings before bed. To date, the most effective thing that I have done to break this habit is simply to deactivate my social media accounts. While this may not be the right solution for many people, another simple strategy that has worked for me is to eliminate exposure to the cues that ordinarily prompt me to pull up social media—for instance, shutting off my laptop after a certain time of day.

 

Patient Example (reducing junk food): If the patient is struggling to reduce consumption of a particular junk food item, encourage them to not have the item in the house. Ask them to consider unsubscribing from any advertisements, websites, or other platforms (i.e., foodie accounts on Instagram) that present cues which prompt cravings.

 

Inversion of the 2nd Law: Make it Unattractive

We often stay stuck in bad habits because we focus too much on how good the habit feels, even though we know it is not good for us. A powerful antidote is to remind ourselves regularly of how much we seek to gain from overcoming the bad habit. By reframing how we think about the habit—highlighting the benefits of avoidance over indulgence—the habit becomes less enticing.

 

Personal Example (reducing social media use): Most nights when I do not surf social media, I am able to get better sleep quality and quantity, leading me to feel more energized and to be more productive the following day. When I am tempted to scroll Facebook before bed, reminding myself of how good I will feel tomorrow if I sleep better tonight is sometimes enough for me to put my phone down.

 

Patient Example (reducing junk food): Help the patient identify the negative effects that junk food consumption has had on them (i.e., brain fog, lower energy levels). Encourage them to focus on what life would look like for them by eliminating these roadblocks to health. Leverage the times when they made healthy food choices that led to greater energy or mental clarity.

 

Inversion of the 3rd Law: Make it Difficult

This is similar to the first law, but here we create specific roadblocks between us and the habit we want to avoid. The strength and multiplicity of roadblocks are important, but sometimes having even one extra tiny hoop to jump through can be enough to deter us from the behavior. Clear explains that this added friction helps us realize that we often don’t really want to do the behavior; in the absence of roadblocks, we simply do the activity because it has become too easy.

 

Personal Example (reducing social media use): Many times, I place my phone just 10 feet away in another room and shut the door while I work. If I get the urge to open my Facebook app, I know that I would have to get up, open the door, and walk to the other room to retrieve my phone. Surprisingly, this provides enough friction and time for me to realize that I don’t actually care enough to go through these steps.

 

Patient Example (reducing junk food): Encourage the patient to relocate all junk food items towards the very back of the fridge or deep in the cupboard behind rows of healthy food options. See if they can replace all instant junk food items with foods that may still be unhealthy but which take much longer to prepare.

 

Inversion of the 4th Law: Make it Unsatisfying

We can make our bad habits less desirable by introducing external costs to engaging in the behavior. A practical idea is to have an accountability partner who is utterly committed to your wellbeing, whose opinions you genuinely care about, and who you would hate to disappoint.

 

Personal Example (reducing social media use): I have shared my plan to reduce late-night social media consumption with my fiancé, whose opinions I value above anyone’s. I want her to see me as someone who holds true to his commitments. Quitting my habit is now immensely more satisfying because the costs of continued indulgence have made the habit much less palatable.

 

Patient Example (reducing junk food): Ask the patient to identify someone whom they hold in high regard and is willing to hold them accountable, in a firm but caring way, to their desired behavior change.

 

For examples of how to utilize the laws of habit change to build good habits, see Part 2.

 

For the philosophy behind systems of habit change, see Part 1.

 

 

 

 

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