Change is Hard!

May 15, 2019

If you are trying to change a habit, like drinking too much, eating too much, or taking too many pain pills, you have probably realized that changing behavior patterns is a complicated and often a very difficult process. Sometimes you may find that engaging in the behavior feels “compulsive,” like you can’t quite resist the urge to do it even though you have a mountain of reasons why you don’t want to do it. Turns out, research is finding that the brain and things out of our control (like your neurotransmitters, for example) play a very significant role in both the process of changing and maintaining behaviors.

Many compulsive behavior patterns that are “learned” and occur over time are the result of positive reinforcement. This term refers to any reinforcing stimulus (e.g. a pleasurable feeling, something rewarding) that makes it more likely that a given behavior will occur again. For example, when you think about your reasons for using drugs, you may find that relief from stress is a serious “benefit of use.” This usually means that at some point (maybe years ago) you began using a substance (e.g., having a drink) to manage your “stress,” to calm down, or to “take the edge off.” Because the chemical properties of alcohol tend to have a calming effect on the brain (at least initially), “having a drink” is a positively reinforced behavior since it results in relaxation! Over time, your brain learns to associate stress as a signal to take a drink, reinforced by the positive feeling of relaxation.

The problem is that the more we repeat a behavior that is rewarding in some way, the more fixed the neural connections in the brain become. Each time the activity is repeated, the neural connections associated with it in the brain become a little stronger. In addition, each time it is repeated more neurons in your brain are recruited (essentially widening the scope of triggers that get linked with the behavior). For example, if you start to have a drink after work every time you feel stressed, your brain will begin to associate drinking with stress reduction regardless of the source of stress. Eventually, each time you feel stressed (even if it’s on a Saturday afternoon after an argument with your spouse), your brain will think, “drink.” In addition, the more you drink, the more other stimuli become associated with drinking. Now, every time your brain is exposed to the “triggers” related to the “after-work drink” (5:00, the train ride home, the walk past the bar, your end-of-day meeting), whether you are stressed or not, it will think, “drink.”

Once so many circuits have been generated in your brain all leading toward one behavior (e.g., drinking or some other positively reinforced behavior), not engaging in that behavior means resisting many powerful signals to get the “reward” your brain has been trained to seek. That is what makes changing habits so hard!

The good news is that we can all “rewire” our brains. To alter the neural connections that have been created and maintained by a highly rewarding and highly repeatable behavior like substance use, you must engage in novel, unfamiliar activities that create new neural pathways. Repeating the same behavior in response to a trigger (drinking when stressed) only maintains the already well-established connections. The problem is, finding other ways to manage the original trigger (e.g., feeling stressed) may be unfamiliar and even difficult at first. For example, getting to a gym, asking for help, and confronting long-standing underlying issues may all sound like good ideas, but when push comes to shove these new actions may be really hard to put into place.

Since giving up familiar behaviors is difficult AND since trying new things can also be difficult, it’s important to approach the change process with patience, persistence, and curiosity. Try to stay open to trying new things, even though they may not be immediately satisfying. Staying open (instead of closed and/or pessimistic, assuming the worst) will go a long way towards helping you tolerate the time it will take to find new behaviors that are as gratifying, interesting, and as important to you as the compulsive behaviors you are trying to give up or reduce.

Remember, most enjoyable activities do not start out as being natural or easy. They demand effort, but once you have experienced them they can lead to an increase in other rewards, such as feelings of accomplishment or achievement. Be prepared to struggle. Be prepared to feel awkward and uncomfortable. If you stay with it, new behaviors will eventually become as routine as the ones you are trying to give up or reduce. Simply accepting that you will feel these feelings of discomfort can help you tolerate the process of change.

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