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July 12th, 2017

New book outlines two-step process for long-term behavior change

By Enrique Rivero

The three types of behavior

When Sean Young was in graduate school, he received a visit one day from his brother. During the visit his brother became so overcome with pain that he had to be rushed to the hospital, where physicians discovered a burst intestine. The emergency surgery saved his life.

The doctors told his brother, who suffered from Crohn’s disease, an often painful chronic inflammatory bowel condition, to make important lifestyle changes for his health. When his brother didn't make some of the lifestyle changes, Young pondered why an intelligent and health-conscious man like his brother--who came from a family of doctors--would fail to do something beneficial for his health?

“I didn’t understand. I was really scared and worried. I started to study the psychology of why people don’t follow through with things that are good for them,” said Young, founder and executive director of the UCLA Center for Digital Behavior and UC Institute for Prediction Technology.

Many people struggle with how to make lasting behavior changes in their lives, Young said. And too often the “problem” is blamed on the individual person being too undisciplined or lazy to help solve their problem.

“Conventional wisdom teaches us to believe that if we don’t eat right, stick to an exercise routine, or adhere to prescribed medications that it’s because we’re lazy, unmotivated, or undisciplined,” said Young, who is also an associate professor in the Department of Family Medicine at the David Geffen School of Medicine at UCLA. “We’re taught that the only way to make a lasting change in our behavior is if we can fundamentally change our personality to have more willpower, discipline, or become a different person.”

Young’s research has produced "Stick with It," a new book that explains common behavioral issues, such as how to stick to a fitness routine, avoid junk food, curb digital addiction, and follow through on plans that are good for you. The process is based on understanding that there isn’t a one-size-fits-all solution to behavior change.

The answer is not to change the personality, but to change the process. The book describes a process for creating lasting behavior change based on decades of research from psychologists and scientists. It also provides proactive exercises at the end of each chapter to help readers apply this process to their own lives.

Young describes three types of behaviors, which differ based on someone’s awareness of what they're doing and when.  The first is “Automatic,” which one does unconsciously, such as forgetting to take medication, habitual nail biting or impulsively interrupting someone. The second is “Burning,” such as an addiction that one is aware of but can’t seem to stop doing, like compulsively playing video games or checking email. The third is “Common,” which are motivational, like sticking to an exercise routine, adhering to prescribed medications, or learning to stop procrastinating.

Once one determines which type of behavior needs to change, they can turn to a set of seven tools --or forces as Young calls them –that he groups under the acronym SCIENCE.

Stepladders: Break things up into small steps that lead you to your goal. Instead of focusing on that endpoint, which could overwhelm you. For instance, if you want to organize your home office, commit to tackling a shelf or drawer at a time.

Community: Communities are a powerful tool for change because other people can provide you with the emotional support that can keep you going. Support groups for substance abusers are an example.

Important: People will be more likely to change if it’s important for them to change. Smokers who see the damage that cigarettes do to their lungs have been found to have higher quit rates because it makes it more real--and important--to them to quit.

• Making it Easy to Change: This can take many forms. For example, make it a habit to keep prescription medications on you at all times, which makes it likelier that you’ll adhere than you would by leaving them home.

Neurohacks: These are quick mental shortcuts that can reset the brain. Want to start exercising but keep making excuses for not going to the gym? Simply slip into your gym clothes. Once they’re on you’ll be more motivated to go because you’ve already dressed and taken a step toward going to the gym.

Captivating rewards: Not all rewards are the same. They need to be based on things that people care about and that are captivating. Participants in Young’s Harnessing Online Peer Education (HOPE) online community have said the forums have been an engaging way to keep them talking about and caring about health behavior change.

Engrained: Make something a routine so that it becomes ingrained and easy to do. If you suffer from stress, regular meditation can instill a new set of healthier and calmer behaviors.

Tags: behavior change, book, David Geffen School of Medicine, Healthy Living, Mental Health, News & Insights, Psychology, Research, Sean Young, Stick with It, UC Institute for Prediction Technology, UCLA Center for Digital Behavior, UCLA Department of Family Medicine

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