Wellness

Using Cognitive Behavioral Therapy to Break Old Habits—and Create New Ones

Using Cognitive Behavioral Therapy to Break Old Habits—and Create New Ones

Using Cognitive Behavioral Therapy to Break Old Habits—and Create New Ones

In partnership with our friends at Noom

Andreas Michaelides

“Willpower” may be one of the most frustrating words we know: Regardless of context, it often feels like an accusation.

“People often hear the word ‘willpower’ and immediately think of what it means to lack it, and they frame that as a personality flaw or deficiency,” says clinical psychologist Andreas Michaelides. “In reality, most of us are much more disciplined than we give ourselves credit for.”

As an example, Michaelides reminds us that getting out of bed after a morning alarm takes willpower. (If it’s automatic for you, congratulations.) Brushing our teeth, on the other hand, likely doesn’t require willpower because it’s a habit, and habits obviate the need to make choices: You’re not faced with a decision, which means you don’t have to convince yourself to go through the requisite motions.

Michaelides is a pro at reframing and adjusting the kinds of quotidian actions that cumulatively make up a lifestyle. He’s the chief of psychology at Noom, a support system of coaches who help people make daily choices aligned with their goals. Their ethos is that sustainable long-term behavior change starts not with any kind of restriction but instead with identifying thought patterns and moving nonjudgmentally from there.

We asked Michaelides to talk us through the psychology of habit-building—and the tools that make the process easier and most effective.

A Q&A with Andreas Michaelides

Q
What makes a habit a habit and not a decision?
A

Habits are an automation of the decisions we make over time. Every day, we are tasked with making hundreds of decisions, from what to have for breakfast to when to get into bed. If every single decision we made were a conscious effort, it would be too much for us to handle.

That’s where habits come in. Habits take the decisions we make over time and turn them into automatic responses. That said, any automated behavior that is learned can be unlearned. There are a lot of factors that can influence what automatic responses we form, including our environment, stress levels, and emotions. Habit change begins with digging into our individual behavior triggers and understanding the root causes behind the automated patterns we’ve created.

By learning to identify the behavior chains (trigger -> thought –> action –> consequence) behind these automatic responses, we gain a better understanding of where we struggle, and we can make positive changes.


Q
How much of our behavior is about willpower?
A

At its core, willpower is the ability to delay instant gratification and resist short-term temptations; it’s the response to an internal conflict between your body and brain. For example, it takes willpower to get up each morning when your alarm goes off and go to work. It takes willpower to refrain from laying on the horn when someone cuts you off in rush hour traffic. There seems to be a bit of a stigma around the word: People often hear the word “willpower” and immediately think of what it means to lack it, and they frame that as a personality flaw or deficiency. In reality, most of us are much more disciplined than we give ourselves credit for.

Social psychologist Roy F. Baumeister aptly compares willpower to a muscle that can be trained and strengthened with use, which means the more you practice self-discipline, the easier it becomes to practice it. It also means your willpower can get depleted. Just as you wouldn’t do leg day every day because it wouldn’t give your muscles enough time to recover and get stronger, it’s important to recognize that it’s not realistic to accomplish everything you want to do all at once. The good news is that once a habit is truly established in your routine, it will not tap into your willpower supply. Think about brushing your teeth. Does it take willpower to fight the urge to not brush your teeth, or do you just automatically turn to this activity at a specific time? If this action is automatic, then you are both conserving willpower and accomplishing a task.

Given that we’re in the middle of a pandemic, it might be even harder to create a new habit or start a new routine. Right now, for a lot of us, our automated routines have been disrupted, which means our decision-making is in overdrive. If you are not able to accomplish everything you want to right away and all at once, that is absolutely okay. Staying consistent and remaining committed to finding a mentally healthy way to be productive takes time.


Q
Why are some habits so difficult to undo? Why are some habits so difficult to build?
A

The brain forms and uses habits to help us function more efficiently. Our brains do not naturally categorize habits as good or bad. It isn’t until you start intentionally recognizing patterns you don’t like that you consciously categorize those habits as bad.

It’s common to think of breaking or quitting a habit, but most of the time, what we are really doing is replacing one habit with another. Going back to the behavior chain (trigger –> thought –> action –> consequence), it’s much easier to think through changing one part of the chain than destroying the chain altogether.

Changing even one part of the chain can be challenging. It requires that you to consciously combat natural impulses and solidified behaviors. That process involves identifying thought patterns and changing the behaviors associated to align better with long-term goals. There are certain tools that make the process easier:

1. Break down big goals into smaller, more manageable ones. At Noom, we use the SMART goal system, which means we challenge clients to create weekly goals that are specific, measurable, attainable, relevant, and time-bound. For example, instead of saying “I want to work out more,” a SMART goal might be, “I will attend workout classes on Monday, Wednesday, and Friday of this week.” Breaking things down into smaller goals helps give you the confidence of a win while moving you toward the bigger picture of a long-term goal. Eventually, with enough repetition, these goals become habits that don’t require the same amount of effort to execute.

2. Identify rewards along your journey. Rewards reinforce behaviors (both positive and negative), and when you reinforce behaviors, you build habits. However, you don’t want to use rewards all the time. In fact, that can decrease those desired behaviors, because you can become less motivated by the rewards over time. Rewards come in many shapes and can be tangible items, showing yourself a little love, or investing in your health.

3. Connect with people who can encourage you. Social support can play a big role in helping you move forward when your motivation is low. Having cheerleaders in your corner will prevent you from catastrophizing a slip-up and help you stay focused on your goals.

4. Be kind to yourself. One of the biggest reasons people fail to create habits is because they give up too early. Most of us have a fear of failure, so when we can’t keep a newly formed habit, we’re scared that we aren’t capable of change or that we’ve done something wrong, which is absolutely not the case. Going against ingrained habits is difficult, and it’s normal to slip back into old patterns of behavior, especially in times of stress or high emotion. When it comes to creating new habits: Give yourself some grace, expect that you’ll mess it up more than a few times, and keep moving forward.


Q
Is there a cognitive difference between building a habit from a clean slate and building one to replace another habit? Is there a way to give ourselves a clean slate, if so?
A

We are rarely, if ever, given a clean slate. We are literally creatures of habit. While there are no true clean slates, this pandemic has definitely created a new normal for most people. For some, this can make it easier as they are forced to make new decisions and are able to establish habits that are more aligned with their goals without having to undo existing habits. For others, this situation can make developing new habits even more difficult as they are suddenly overwhelmed by the changes that have been forced upon them.

One trick is temptation bundling. Conceptualized by Katy Milkman at the University of Pennsylvania, temptation bundling is the idea that a new habit becomes easier to stick with if you bundle it to an existing habit.

For example, if your goal is to integrate more active movement into your day, then listen to your favorite podcast only while out on a walk. This gives you the immediate gratification of listening to your favorite podcast while also building the long-term habit of getting more active. A study from Cornell found that more-frequent and immediate gratification can ultimately lead to higher intrinsic motivation, so there could very well come a time when you get moving regardless of whether you have a new episode in your podcast queue.


Q
How does cognitive behavioral therapy help?
A

To create sustainable and maintainable habits, you need to dive deeper to understand your personal barriers, goals, and areas of opportunity for change. Cognitive behavioral therapy helps people identify chains of behavior and break routines that may be preventing them from reaching their goals. CBT also helps you recognize common downbeat thoughts, understand the actions that prompt them, and ultimately replace them with new, positive ideas. Evaluating thoughts and ideas like this can be challenging and at times uncomfortable, but it’s an important part of CBT.

One common behavior chain is automatically eating a sweet treat after dinner, regardless of whether you desire dessert. Once you identify this behavior (eating sweets) and the trigger (finishing dinner), you can come up with an alternative action, like moderating the sweet, brushing your teeth, or making a cup of tea. Not every solution will work for you, which is where a coach who can talk through it with you becomes especially helpful.

Another way to combat thought distortions is to change your triggers. While you often cannot avoid negative triggers, you can turn them into positive ones. For example, if your partner normally picks up takeout, suggest a healthy recipe to prepare at home together. If your coworkers invite you out to eat, suggest a healthy option nearby.

It is also sometimes easier to build habits when you understand the “why” behind the things you do; this will help you understand what’s driving your desire for change. The idea behind CBT is that if you can shift your thoughts, you can choose an action that better reflects the changes you’re trying to make.


Dr. Andreas Michaelides is a clinical psychologist and the chief of psychology at Noom.


This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of goop.

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