The Secret of
Behavior Change
by Brian D. Carr, Ph.D. Licensed
Psychologist
Program Director,
Behavioral Health Services
So how does one change
habits that have been deeply engrained? The first step involves
helping the person to develop a sense of introspection.
Introspection is the ability to step outside of yourself and examine
what is happening, both from within your mind and from outside.
Habits are usually found at a level of sub-awareness secondary to
their regular use. We often do not even realize the act of a habit
such as biting a pen, rubbing our hands together, or scratching
ourselves.
Let us look at the extent to
which habits influence our eating pattern. First, you must separate
the concept of hunger or appetite from that of need for food. For
most of us in America, we habitually sit down for a meal three times
a day. Usually our largest meal is found in the early evening while
we may skip breakfast. Contrast this to our European neighbors.
Their heaviest meal is likely to be lunch, and the evening meal is
usually light and eaten much later. We know that eating a large meal
before going to sleep contributes to problems such as insomnia as
well as gastrointestinal complaints, and ultimately, heart disease.
Hunger as an instinct makes
perfect sense. When the dinosaur encountered something perceived as
eatable, there was no hesitation in action. The dinosaur would
quickly consume the item, fearing that any delay might result in
some other animal getting the food. In a world where food was in
short supply, the instinct of hunger was very helpful. The quick
action governed by hunger was necessary for survival. Those animals
without that ability eventually would starve and eliminated from the
gene pool.
But what of a world where
food is plentiful. I suspect that part of the reason we have such
difficulty with obesity in our country is related to the manner in
which we keep our grocery store shelves packed. Every item of food
is available around the clock. For those who cannot get to the
store, the food is delivered quickly to their home. No one must wait
to eat.
In this environment the
instinct of hunger becomes destructive. People respond to their
hunger and gorge themselves on a rich supply of fats, calories, and
artificial ingredients. Lumbering through their houses at night they
"stalk the wild refrigerators" and satisfy their instincts.
Learning to control your
eating involves becoming more aware of your urges. What is an
urge? Why do we feel such pain when an urge occurs, and how can we
tolerate ourselves until it passes? In considering an urge, let me
take you on a drive in West Texas.
West Texas is a broad
stretch of land that is the absolute definition of "flat". Still
primarily agricultural-based in industry, the towns in the region
often are separated by many miles. Driving in West Texas you
develop a sharp awareness of the need for restroom facilities
between communities. The urge to empty one's bladder can be strong,
but lacking any facilities (or trees), you attempt to delay until
something becomes available. You discover that the urge may come on
quickly, but within a few moments reduces back to a tolerable
level. You drive a few miles further and then there is a recurrence
of the urge. Again battling the urge, you cross your legs and begin
a series of distractions, such as singing with Willie Nelson or
trying to recall the names of your classmates in the fifth grade.
The urge again dissipates
and finally you see the skyline of the approaching town. This
vision sparks a return of the urge and you challenge the speed limit
for the dash into the first store you can find. At last you are
relieved of the urge and can relax.
The point to be made is that
often urges can be delayed when circumstances prevent
gratification. If this were not so, each of us would have only a
reflexive response with no latitude. Knowing that one can delay
gives great power over controlling an urge that might prove to be
destructive.
A second way to appreciate
an urge is to listen to people who have managed to handle their
urges for alcohol or other drugs. For them, "One drink is too many
and a million not enough". Learning to delay for the moment is at
the heart of managing the urge for a substance.
Within circles of people
with substance abuse problems, you learn that one is powerless
against the disease and that you must cope one day at a time. For
many people with a history of substance abuse problems, they learn
to remain sober one second at a time. Those maintaining soberity
are considered as "recovering" (in the present tense) although it
may have been several decades since they last drank or took drugs.
Recognizing that the urge to use can wax and wane, they fight the
desire on a moment by moment basis. It is this understanding of
"staying in the present" which gives them control over their
urges. Reminding themselves to not drink or drug "right now" and
setting goals of not using for the next five minutes or the next
hour, is a responsive approach to staying sober.
On the flip side is the
recognition that people will, and do, relapse. For those who return
to the use of a substance, the community of recovering addicts will
encourage them to get back with the program. The people who relapse
are invited to return for meetings even if they are substance users
again. The hope is that by extending support and acceptance, they
again may make the decision to curtail the habit.
