What Vietnam Taught Us About Breaking Bad Habits
January 2, 2012
12:01 AM ET
Heard on Morning Edition
Alix Spiegel
8-Minute Listen
U.S. soldiers at Long Binh base, northeast of Saigon, line up to give urine samples at a heroin detection center in June 1971, before departing for the U.S.
AP
It's a tradition as old as New Year's: making resolutions. We will not smoke, or sojourn with the bucket of mint chocolate chip. In fact, we will resist sweets generally, including the bowl of M &Ms that our co-worker has helpfully positioned on the aisle corner of his desk. There will be exercise, and the learning of a new language.
It is resolved.
So what does science know about translating our resolve into actual changes in behavior? The answer to this question brings us — strangely enough — to a story about heroin use in Vietnam.
In May of 1971 two congressmen, Robert Steele from Connecticut and Morgan Murphy of Illinois, went to Vietnam for an official visit and returned with some extremely disturbing news: 15 percent of U.S. servicemen in Vietnam, they said, were actively addicted to heroin.
People, when they perform a behavior a lot, outsource the control of the behavior to the environment.
David Neal, psychologist, Duke University
The idea that so many servicemen were addicted to heroin horrified the public. At that point heroin was the bete noire of American drugs. It was thought to be the most addictive substance ever produced, a narcotic so powerful that once addiction claimed you, it was nearly impossible to escape.
In response to this report, President Richard Nixon took action. In June of 1971 he announced that he was creating a whole new office — The Special Action Office of Drug Abuse Prevention — dedicated to fighting the evil of drugs. He laid out a program of prevention and rehabilitation, but there was something else Nixon wanted: He wanted to research what happened to the addicted servicemen once they returned home.
And so Jerome Jaffe, whom Nixon had appointed to run the new office, contacted a well-respected psychiatric researcher named Lee Robins and asked her to help with the study. He promised her unprecedented access to enlisted men in the Army so that she could get the job done.
Soon a comprehensive system was set up so that every enlisted man was tested for heroin addiction before he was allowed to return home. And in this population, Robins did find high rates of addiction: Around 20 percent of the soldiers self-identified as addicts.
Those who were addicted were kept in Vietnam until they dried out. When these soldiers finally did return to their lives back in the U.S., Robins tracked them, collecting data at regular intervals. And this is where the story takes a curious turn: According to her research, the number of soldiers who continued their heroin addiction once they returned to the U.S. was shockingly low.
A GI lights up a cigarette in Saigon in 1971. He poured grains of heroin into the menthol cigarette, from which he had first removed some of the tobacco.
AP
"I believe the number of people who actually relapsed to heroin use in the first year was about 5 percent," Jaffe said recently from his suburban Maryland home. In other words, 95 percent of the people who were addicted in Vietnam did not become re-addicted when they returned to the United States.
This flew in the face of everything everyone knew both about heroin and drug addiction generally. When addicts were treated in the U.S. and returned to their homes, relapse rates hovered around 90 percent. It didn't make sense.
"Everyone thought there was somehow she was lying, or she did something wrong, or she was politically influenced," Jaffe says. "She spent months, if not years, trying to defend the integrity of the study."
But 40 years later, the findings of this study are widely accepted. To explain why, you need to understand how the science of behavior change has itself changed.
Outsourcing The Control Of Behavior
According to Wendy Wood, a psychologist at University of Southern California who researches behavior change, throughout the 1960s, 1970s and 1980s scientists believed that if you wanted to change behavior, the key was to change people's goals and intentions.
"The research was very much focused on trying to understand how to change people's attitudes," Wood says, "with the assumption that behavior change would just follow."
So researchers studied how to organize public health campaigns, or how to use social pressure to change attitudes. And, says David Neal, another psychologist who looks at behavior change, these strategies did work.
Mostly.
"They do work for a certain subset of behaviors," Neal says. "They work for behaviors that people don't perform too frequently."
If you want, for example, to increase the number of people who donate blood, a public campaign can work well. But if you want them to quit smoking, campaigns intended to change attitudes are often less effective.
"Once a behavior had been repeated a lot, especially if the person does it in the same setting, you can successfully change what people want to do. But if they've done it enough, their behavior doesn't follow their intentions," Neal explains.
Neal says this has to do with the way that over time, our physical environments come to shape our behavior.
"People, when they perform a behavior a lot — especially in the same environment, same sort of physical setting — outsource the control of the behavior to the environment," Neal says.
Outsourcing control over your behavior sounds a little funny. But consider what happens when you perform a very basic everyday behavior like getting into a car.
"Of course on one level, that seems like the simplest task possible," Neal says, "but if you break it down, there's really a myriad set of complex actions that are performed in sequence to do that."
You use a certain motion to put your key in the lock. And then physically manipulate your body to get into the seat. There is another set of motions to insert the key in the ignition.
"All of this is actually very complicated and someone who had never driven a car before would have no ability to do that, but it becomes second nature to us," Neal points out. "[It's] so automatic that we can do it while we are conducting complex other tasks, like having conversations."
Throughout the process, you haven't thought for a second about what you are doing, you are just responding to the different parts of the car in the sequence you've learned. "And very much of our day goes off in this way," Wood says. "About 45 percent of what people do every day is in the same environment and is repeated."
Environment's Key Role In Behavior
In this way, Neal says, our environments come to unconsciously direct our behavior. Even behaviors that we don't want, like smoking.
"For a smoker the view of the entrance to their office building — which is a place that they go to smoke all the time — becomes a powerful mental cue to go and perform that behavior," Neal says.
And over time those cues become so deeply ingrained that they are very hard to resist. And so we smoke at the entrance to work when we don't want to. We sit on the couch and eat ice cream when we don't need to, despite our best intentions, despite our resolutions.
"We don't feel sort of pushed by the environment," Wood says. "But, in fact, we're very integrated with it."
To battle bad behaviors then, one answer, Neal and Wood say, is to disrupt the environment in some way. Even small changes can help — like eating the ice cream with your non-dominant hand. What this does is alter the action sequence and disrupts the learned body sequence that's driving the behavior, which allows your conscious mind to come back online and reassert control.
"It's a brief sort of window of opportunity," Wood says, "to think, 'Is this really what I want to do?' "
Of course, larger disruption can also be helpful, which brings us back to heroin addiction in Vietnam.
It's important not to overstate this, because a variety of factors are probably at play. But one big theory about why the rates of heroin relapse were so low on return to the U.S. has to do with the fact that the soldiers, after being treated for their physical addiction in Vietnam, returned to a place radically different from the environment where their addiction took hold of them.
"I think that most people accept that the change in the environment, and the fact that the addiction occurred in this exotic environment, you know, makes it plausible that the addiction rate would be that much lower," Nixon appointee Jerome Jaffe says.
We think of ourselves as controlling our behavior, willing our actions into being, but it's not that simple.
It's as if over time, we leave parts of ourselves all around us, which in turn, come to shape who we are.
source:
► https://www.npr.org/sections/health-shots/2012/01/02/144431794/what-vietnam-taught-us-about-breaking-bad-habits
8 minute
if you go to this NPR web page, you can listen to the show
____________________________________
Outsourcing The Control Of Behavior
"They do work for a certain subset of behaviors," Neal says. "They work for behaviors that people don't perform too frequently."
If you want, for example, to increase the number of people who donate blood, a public campaign can work well. But if you want them to quit smoking, campaigns intended to change attitudes are often less effective.
"Once a behavior had been repeated a lot, especially if the person does it in the same setting, you can successfully change what people want to do. But if they've done it enough, their behavior doesn't follow their intentions," Neal explains.
Neal says this has to do with the way that over time, our physical environments come to shape our behavior.
"People, when they perform a behavior a lot — especially in the same environment, same sort of physical setting — outsource the control of the behavior to the environment," Neal says.
Outsourcing control over your behavior sounds a little funny. But consider what happens when you perform a very basic everyday behavior like getting into a car.
"Of course on one level, that seems like the simplest task possible," Neal says, "but if you break it down, there's really a myriad set of complex actions that are performed in sequence to do that."
You use a certain motion to put your key in the lock. And then physically manipulate your body to get into the seat. There is another set of motions to insert the key in the ignition.
"All of this is actually very complicated and someone who had never driven a car before would have no ability to do that, but it becomes second nature to us," Neal points out. "[It's] so automatic that we can do it while we are conducting complex other tasks, like having conversations."
Throughout the process, you haven't thought for a second about what you are doing, you are just responding to the different parts of the car in the sequence you've learned. "And very much of our day goes off in this way," Wood says. "About 45 percent of what people do every day is in the same environment and is repeated."
source:
► https://www.npr.org/sections/health-shots/2012/01/02/144431794/what-vietnam-taught-us-about-breaking-bad-habits
8 minute
if you go to this NPR web page, you can listen to the show
____________________________________
Environment's Key Role In Behavior
In this way, Neal says, our environments come to unconsciously direct our behavior. Even behaviors that we don't want, like smoking.
"For a smoker the view of the entrance to their office building — which is a place that they go to smoke all the time — becomes a powerful mental cue to go and perform that behavior," Neal says.
And over time those cues become so deeply ingrained that they are very hard to resist. And so we smoke at the entrance to work when we don't want to. We sit on the couch and eat ice cream when we don't need to, despite our best intentions, despite our resolutions.
"We don't feel sort of pushed by the environment," Wood says. "But, in fact, we're very integrated with it."
To battle bad behaviors then, one answer, Neal and Wood say, is to disrupt the environment in some way. Even small changes can help — like eating the ice cream with your non-dominant hand. What this does is alter the action sequence and disrupts the learned body sequence that's driving the behavior, which allows your conscious mind to come back online and reassert control.
"It's a brief sort of window of opportunity," Wood says, "to think, 'Is this really what I want to do?' "
source:
► https://www.npr.org/sections/health-shots/2012/01/02/144431794/what-vietnam-taught-us-about-breaking-bad-habits
8 minute
if you go to this NPR web page, you can listen to the show
____________________________________
Donald A. Norman, The psychology of everyday things, 1988 [ ]
pp.54-55
Because not all of the knowledge required for precise behaviour has to be in the head. It can be distributed--partly in the head, partly in the world, and partly in the constraints of the world. Precise behaviour can emerge from imprecise knowledge for four reasons.
1. Information is in the world.
Much of the information a person needs to do a task can reside in the world. Behaviour is determined by combining the information in memory (in the head) with that in the world.
2. Great precision is not required.
Precision, accuracy, and completeness of knowledge are seldom required. Perfect behaviour will result if the knowledge describes the information or behaviour sufficiently to distinguish the correct choice from all others.
3. Natural constraints are present.
The world restricts the allowed behaviour. The physical properties of objects constrain possible operations: the order in which parts can go together and the ways in which an object can be moved, picked up, or otherwise manipulated. Each object has physical features--projections, depressions, screwthreads, appendages--that limit its relationships to other objects, operations that can be performed to it, what can be attached to it, and so on.
4. Cultural constraints are present.
In addition to natural, physical contraints, society has evolved numerous artificial conventions that govern acceptable social behaviour. These cultural conventions have to be learned, but once learned they apply to a wide variety of circumstances.
Because of these natural and artificial constraints, the number of alternatives for any particular situation is reduced, as are the amount and specificity of knowledge required within human memory.
(Norman, Donald A., The psychology of everyday things, 1. design, industrial--psychological, aspects, 2. human engineering, copyright © 1988, 620.82 Norman, pp.54-55)
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[state] -> [story] -> [strategy]
Allison Fallon., The power of writing it down : a simple habit to unlock your brain and reimagine your life, 2020
pp.150-151
time heals all wounds, but this is categorically untrue. Not only does time not heal all wounds, but time has a way of cementing into place patterns and habits that were at one time our saving grace (things like lying, or drinking, or pushing away anyone who gets close to us) but are now painful and self-destructive.
p.151
These may have been patterns or behaviors that protected us or even saved our lives at one point or another. But later, they become the very thing that tears us apart.
p.151
You can probably think of someone in your life right now who has patterns of behavior like this ── solidified over the passage of time ── that are toxic to their very existence.
p.151
Without careful reflection, attention, committed action, and ── sometimes ── trained help, these patterns in our lives don't change. In fact, they continue getting more deeply ingrained and detrimental.
pp.151-152
Dr. Joe Dispenza puts it this way in his book, Breaking the Habit of Being Yourself:
p.152
If you've been devoted to feeling negatively for years, those feelings have created an automatic state of being. We could say that you are subconsciously unhappy, right? Your body has been conditioned to be negative; it knows how to be unhappy better than your conscious mind knows otherwise. You don't even have to think about how to be negative. You just know that's how you are. How can your conscious mind control this attitude in the subconscious body-mind?
p.152
And there's the part from Dispenza that really gets me ...
I want to be clear that, by itself, positive thinking never works. Many so-called positive thinkers have felt negative most of their lives, and now they're trying to think positively. They are in a polarized state in which they are trying to think one way in oder to override how they feel inside of them ... When the mind and body are in opposition, change will never happen.2
p.152
if you tend to feel negatively about the world, yourself, your relationships, or your challenges, most likely it's because this negative state is memorized in your body and your brain. Not only that, but positive thinking won't even touch that memorized state!
pp.152-153
Dr. Pennebaker says,
We are often surprisingly ignorant of our needs, motivations and conflicts.
When out of control, anxious or upset, we naturally change our thinking style.
Although low-level thinking can reduce our pain, it can also narrow our thinking to such an extent that we fail to see that something is the matter.
We can then become the central feature of our self-constructed paradox: if we naturally escape from the knowledge that something is wrong, how can we ever know about it?
How can we ever hope to control the problem or change our lives?
p.153
writers who have trusted me with their stories and their writing process
we were cultivating awareness.
We were starting to see things more clearly.
We were standing outside of our stories, outside of our circumstances, and seeing them from a new perspective.4
p.153
The great thing about this is that awareness is the beginning of change.
p.153
In fact, in therapeutic models of change, the step before the first step is called precontemplation. Precontemplation is the stage where in the person who needs to change hasn't even recognized the problem yet.
(The power of writing it down : a simple habit to unlock your brain and reimagine your life / Allison Fallon., summary: “for anyone feeling stuck and looking to make sense of life, author and writing coach Allison Fallow shares a simple practice and proven method to reclaiming your narrative, increasing your emotional and spiritual health, and discovering more clarity and freedom in ‘The Power of Writing it down’” ── provided by publisher., (print) (ebook) (hardcover)
(ebook), subject: writing ── psychological aspects. | behavior modification | written communication., BF456.W8 F35 2020 (print), BF456.W8 (ebook), 158.1/6──dc23, 2020, )
____________________________________
[state] -> [story] -> [strategy]
https://www.fastcompany.com/75905/three-keys-change
01.02.07
The Three Keys to Change
In this excerpt from the introduction to his new book, Change or Die: The Three Keys to Change at Work and in Life, Alan Deutschman discusses the framework to successfully change yourself.
BY ALAN DEUTSCHMAN
LONG READ
Change or die.
What if you were given that choice? For real. What if it weren’t just the hyperbolic rhetoric that conflates corporate performance with life or death? Not the overblown exhortations of a rabid boss, or a maniacal coach, or a slick motivational speaker, or a self-dramatizing chief executive officer or political leader. We’re talking actual life and death now. Your own life and death. What if a well-informed, trusted authority figure said you had to make difficult and enduring changes in the way you think, feel, and act? If you didn’t, your time would end soon–a lot sooner than it had to. Could you change when change really mattered? When it mattered most?
Yes, you say?
Try again.
Yes?
You’re probably deluding yourself.
That’s what the experts say.
They say that you wouldn’t change.
Don’t believe it? You want odds? Here are the odds that the experts are laying down, their scientifically studied odds: nine to one. That’s nine to one against you. How do you like those odds?
This revelation unnerved me when I heard it in November 2004 at a private conference at Rockefeller University, an elite medical research center in New York City. The event was hosted by the top executives at IBM, who invited the most brilliant thinkers they knew from around the world to come together for a day and propose solutions to some of the world’s biggest problems. Their first topic was the crisis in health care, an industry that consumes an astonishing $2.1 trillion a year in the United States alone–more than one seventh of the entire economy. Despite all that spending, we’re not feeling healthier, and we aren’t making enough progress toward preventing the illnesses that kill us, such as heart disease, stroke, and cancer.
... ... ...
Speaking to the small group of insiders, they were unsparingly candid. They said that the cause of the health care crisis hadn’t changed for decades, and the medical establishment still couldn’t figure out what to do about it.
Dr. Raphael “Ray” Levey, founder of the Global Medical Forum, an annual summit meeting of leaders from every part of the health care system, told the audience: “A relatively small percentage of the population consumes the vast majority of the health care budget for diseases that are very well known and by and large behavioral.” That is, they’re sick because of how they choose to lead their lives, not because of factors beyond their control, such as the genes they were born with. Levey continued: “Even as far back as when I was in medical school”–he enrolled at Harvard in 1955–“many articles demonstrated that eighty percent of the health care budget was consumed by five behavioral issues.” He didn’t bother to name them, but you don’t need an MD to guess what he was talking about: Too much smoking, drinking, and eating. Too much stress. Not enough exercise.
... ... ...
CHANGE OR DIE. Copyright © 2007 by Alan Deutschman.
____________________________________
Tim Ferriss, Tools of Titans, 2017 [ ]
p.212
Tony Robbins
[state] -> [story] -> [strategy]
This is because you started in a negative state, then attempted strategy but didn't succeed (due to tunnel vision on the problems), and then likely told yourself self-defeating stories (e.g., “I always do this. Why am I so wound up I can't even think straight?”). To fix this, he encourages you to “prime” your STATE first. The biochemistry will help you proactively tell yourself an enabling STORY. Only then do you think on STRATEGY, as you'll see the options instead of dead ends.
(Tim Ferriss, Tools of Titans, 2017, 081 Ferriss, )
____________________________________
Daniel Coyle, The little book of talent : 52 tips for improving skills, 2012
pp.22-23
Precision especially matters early on, because the first reps establish the pathways for the future. Neurologists call this the “sled on a snowy hill” phenomenon. The first repetitions are like the first sled tracks on fresh snow: On subsequent tries, your sled will tend to follow those grooves. “Our brains are good at building connections,” says Dr. George Bartzokis, a neurologist at UCLA. “They're not so good at unbuilding them.”
When you learn hard skills, be precise and measured. Go slowly. Make one simple move at a time, repeating and perfecting it before you move on. Pay attenion to errors, and fix them, particularly at the start. Learning fundamentals only SEEMS boring--in fact, it's the key moment of investment. If you build the right pathway now, you'll save yourself a lot of time and trouble down the line.
p.19
Soft skills are about the three Rs: Reading, Recognizing, and Reacting.
The point of this tip is that hard skills and soft skills are different (literally, they use different structures of circuits in your brain), and thus are developed through different methods of deep practice.
p.19
which skills need to be flexible, and variable, and depend on the situation? Which depend on instantly recognizing patterns and selecting one optimal choice? These are the soft skills.
p.27
As you probably recognize, most talents are not exclusively hard skills or soft skills, but rather a combination of the two. For example, think of a violinist's precise finger placement to play a series of notes (a hard skill) and her ability to interpret the emotion of a song (a soft skill). Or a quarterback's ability to deliver an accurate spiral (a hard skill) and his ability to swiftly read a defense (a soft skill).
pp.117-118
myelin
Myelin is an insulator (you might recall the term “myelin sheath” from biology class). This refers to its function of wrapping the wires of our brain in exactly the same way that electrical tape wraps around an electrical wire: It makes the signal move faster and prevents it from leaking out. For the past hundred years or so, scientists considered myelin and its associated cells to be inert. After all, it looked like insulation, and it didn't appear to react to anything.
Except the early scientists were wrong. It turns out that myelin does react--it grows in response to electrical activity, i.e., practice.
p.118
In fact, studies show that myelin grows in proportion to the hours spent in practice. It's a simple system, and can be thought of this way: Every time you perform a rep, your brain adds another layer of myelin to those particular wires. The more you practice, the more layers of myelin you earn, the more quickly and accurately the signal travels, and the more skill you acquire.
p.118
“What do good athletes do when they train?” asks Dr. George Bartzokis, a professor of neurology at UCLA. “They send precise impulses along wires that give the signal to myelinate that wire. They end up, after all the training, with a super-duper wire--lots of bandwidth, a high-speed T-3 line. That's what makes them different than the rest of us.”
p.118
Action is vital. Myelin doesn't grow when you think about practicing. It grows when you actually practice--when you send electricity through your wires.
p.118
Myelin wraps--it doesn't unwrap.
p.118
Once a skill circuit is insulated, you can't uninsulated it (except through age or disease). This is why habits [and addictions] are tough to break (see Tip #46).
p.119
Studies have linked practice to myelin growth and improved performance in such diverse skills as reading, vocabulary, music, and sports.
(Coyle, Daniel., The little book of talent : 52 tips for improving skills / Daniel Coyle., 1. ability., 2012, BF431.C685 2012, 153.9--dc23, )
____________________________________
Daniel Goleman, Working with emotional intelligence, 1998
hardcover
658.409
Goleman
pp.327-328
Gauging Readiness
Extensive research (on more than 30,000 people) by James Prochaska, a University of Rhode Island psychologist, establishes four levels of readiness people go through during a successful behavior change.
■ Oblivious: As G. K. Chesterton, the British pundit, put it, “It isn't that thy can't see the solution ── they can't see the problem”. People at this stage aren't ready at all; they deny they have any need to change in the first place. They resist any attempt to help them change ── they just don't see the point.
■ Contemplation: People at this stage see that they need to improve and have begun to think about how to do so. They are open to talking about it but not quite ready to pursue development whole heartedly. Ambivalence is rampant; some wait for a “magic moment” of readiness, while others leap into action prematurely but meet failure because they are halfhearted. People at this stage are as likely to say they intend to take some action “next month” as they are to say they'll do it “in the next six months”. Prochaska notes that it's not unusual for people “to spend years telling themselves that someday they are going to change”. They substitute thinking for acting. Prochaska cites the case of an engineer who spent five years analyzing the factors that had made him passive and shy ── but didn't think he understood the problem well enough to do anything about it.
■ Preparation: Here people have begun to focus on the solution ── on how to improve. They are on the verge, eager to develop an action plan. They are aware of the problem, see that there are ways to solve it, and palpably anticipate doing so. People are sometimes propelled to this heightened stage of readiness by a dramatic event ── a heart-to-heart talk with a supervisor, a disaster on the job, a crisis in their personal life. One executive was jolted into bolstering his self-control competence when the police stopped him on the way home from a business dinner and arrested him for driving drunk. At this point people are ripe for change; this is the time for formulating a specific, detailed plan of action.
■ Action: Visible change begins. People embrace the plan, start practicing its steps, and actually change how they act ── their emotional patterns, the way they think about themselves, and all the other facets of transforming a long-standing habit. This stage is what most people think of as “making the change”, though it builds on the earlier steps in getting ready.
“”─“”‘’•“”
p.328
At the neurological level, cultivating a competence means extinguishing the old habit as the brain's automatic response and replacing it with the new one. The final stage of mastering a competence comes at the point when the old habit loses its status as the default response and the new one takes its place. At that point, the behavior change has stabilized, making a relapse to the old habit unlikely.
“”─“”‘’•“”
Daniel Goleman, Working with emotional intelligence, 1998
hardcover
658.409 Goleman
other books by Daniel Goleman
Emotional Intelligence;
Vital Lies, Simple Truth;
The Meditative Mind;
co-author, The Creative Spirit.
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