In the last decade, our understanding of the neurology of habit formation has been transformed.
A quiet revolution has upended our concept of the way patterns work within our lives, societies, and organizations. And much of what we have learned has come from studying the simplest of habits — such as why people bite their nails.
In the summer of 2006, for instance, a 24-year-old graduate student named Mandy walked into the counseling center at Mississippi State University. For most of her life, Mandy had bitten her nails, gnawing them until they bled.
Lots of people bite their nails. For chronic nail biters, however, it’s a problem of a different scale.
Mandy would often bite until her nails pulled away from the skin underneath. Her fingertips were covered with tiny scabs. The end of her fingers had become blunted without nails to protect them and sometimes they tingled or itched, a sign of nerve injury.
The biting habit had damaged her social life. She was so embarrassed around her friends that she kept her hands in her pockets and, on dates, would become preoccupied with balling her fingers into fists. She had tried to stop by painting her nails with foul-tasting polishes or promising herself, starting right now, that she would muster the willpower to quit. But as soon as she began doing homework or watching television, her fingers ended up in her mouth.
The counseling center referred Mandy to a doctoral psychology student who was studying a treatment known as “habit reversal training.” The psychologist was well acquainted with what has become known as the “Golden Rule of Habit Change.” Every habit has three components: a cue (or a trigger for an automatic behavior to start), a routine (the behavior itself) and a reward (which is how our brain learns to remember this pattern for the future.)
The Habit Loop
The Golden Rule of Habit Change says that the most effective way to shift a habit is to diagnose and retain the old cue and reward, and try to change only the routine.
The psychologist knew that changing Mandy’s nail biting habit required inserting a new routine into her life. “What do you feel right before you bring your hand up to your mouth to bite your nails?” he asked her.
“There’s a little bit of tension in my fingers,” Mandy said. “It hurts a little bit here, at the edge of the nail. Sometimes I’ll run my thumb along, looking for hangnails, and when I feel something catch, I’ll bring it up to my mouth then. I’ll go finger by finger, biting all the rough edges. Once I start, it feels like I have to do all of them.”
Asking patients to describe what triggers their habitual behavior is called awareness training, and it’s the first step in habit reversal training. The tension that Mandy felt in her nails cued her nail biting habit.
“Most people’s habits have occurred for so long they don’t pay attention to what causes it anymore,” said Brad Dufrene, who treated Mandy. “I’ve had stutterers come in, and I’ll ask them which words or situations trigger their stuttering, and they won’t know because they stopped noticing so long ago.”
Next, the therapist asked Mandy to describe why she bit her nails. At first, she had trouble coming up with reasons. As they talked, though, it became clearer that she bit when she was bored. The therapist put her in some typical situations, such as watching television and doing homework, and she started nibbling. When she had worked through all of the nails, she felt a brief sense of completeness, she said. That was the habit’s reward: a physical stimulation she had come to crave.
At the end of their first session, the therapist sent Mandy home with an assignment: Carry around an index card, and each time you feel the cue — a tension in your fingertips — make a checkmark on the card.
She came back a week later with 28 checks. She was, by that point, acutely aware of the sensations that preceded her habit. She knew how many times it occurred during class or while watching television.
A Competing Response
Then the therapist taught Mandy what is known as a “competing response.” Whenever she felt that tension in her fingertips, he told her, she should immediately put her hands in her pockets or under her legs, or grip a pencil or something else that made it impossible to put her fingers in her mouth. Then Mandy was to search for something that would provide a quick physical stimulation — such as rubbing her arm or rapping her knuckles on a desk — anything that would produce a physical response. It was the Golden Rule: The cues and rewards stayed the same. Only the routine changed.
They practiced in the therapist’s office for about half and hour and Mandy was sent home with a new assignment: Continue with the index card, but make a check when you feel the tension in your fingertips and a hash mark when you successfully override the habit.
A week later, Mandy had bitten her nails only three times and had used the competing response seven times. She rewarded herself with a manicure, but kept using the note cards.
After a month, the nail biting habit was gone. The competing routines had become automatic. One habit had replaced another.
“It seems ridiculously simple, but once you’re aware of how your habit works, once you recognize the cues and rewards, you’re halfway to changing it,” Nathan Azrin, one of the developers of habit reversal training, told me. “It seems like it should be more complex. The truth is, the brain can be reprogrammed. You just have to be deliberate about it.”
Today, habit reversal therapy is used to treat verbal and physical tics, depression, smoking, gambling problems, anxiety, bedwetting, procrastination, obsessive- compulsive disorders, and other behavioral problems. And its techniques lay bare one of the fundamental principles of habits: Often, we don’t really understand the cravings driving our behaviors until we look for them. Mandy never realized that a craving for physical stimulation was causing her nail biting, but once she dissected the habit, it became easy to find a new routine that provided the same reward.
Say you want to stop snacking at work. Is the reward you’re seeking to satisfy your hunger? Or is it to interrupt boredom? If you snack for a brief release, you can easily find another routine, such as taking a quick walk, or giving yourself three minutes on the Internet, that provides the same interruption without adding to your waistline.
If you want to stop smoking, ask yourself: Do you do it because you love nicotine, or because it provides a burst of stimulation, a structure to your day, or a way to socialize? If you smoke because you need stimulation, studies indicate that some caffeine in the afternoon can increase the odds you’ll quit. More than three dozen studies of former smokers have found that identifying the cues and rewards they associate with cigarettes, and then choosing new routines that provide similar payoffs— a piece of Nicorette, a quick series of pushups, or simply taking a few minutes to stretch and relax — makes it more likely they will quit.
If you identify the cues and rewards, you can change the routine.
To learn more — including how to create willpower habits among kids, and what we’ve learned about how habits function within lives, companies and society — please read The Power of Habit: Why We Do What We Do and How to Change or visit www.thepowerofhabit.com.
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Last reviewed: By John M. Grohol, Psy.D. on 17 Jul 2012
Published on PsychCentral.com. All rights reserved.
Duhigg, C. (2012). The Golden Rule of Habit Change. Psych Central. Retrieved on March 11, 2014, from http://psychcentral.com/blog/archives/2012/07/17/the-golden-rule-of-habit-change/