day 75 establishing new habits for dealing with cancer

I recently attended Elliot Masie’s Learning 2012 conference and had the pleasure of meeting Charles Duhigg (, a New York Times columnist and author of a fascinating book on habits, who gave a great presentation. In his book “The Power of Habit” Duhigg charts a fascinating approach to changing some of the fundamental behaviors in your life with the promise of improving how you live. 

In an entertaining and well written book, Duhigg summarizes recent research on the neuroscience of habits, laying the ground work for the behavioral analysis that comes later and providing the basis for how you can take on your own worst habits. He makes the case that habits are based on behavioral routines, which allow the brain to cope with the flood of information it needs to manage to allow you to function in a complex environment. These semi-automatic subroutines allow the body to go into autopilot for a period, while the brain can focus on other issues. Duhigg invites you to imagine how much simpler it is to trigger a routine to brush your teeth, as opposed to having to direct each motion involved in detail. Furthermore, while the teeth brushing routine is being executed, the brain can consider other things, such as the day ahead. Imagine if you had to minutely reinvent and redirect each motion that you make during the day! There wouldn’t be much time for anything else, and you certainly wouldn’t be able to think on the fly, which was probably a key to survival a million years ago, and is still very useful today, for example when driving. He describes interesting neuroscience studies that show how the neurons involved become habituated, lowering their activity as the routine is learned. Interestingly, they continue to show elevated activity before and after, as the routine is triggered by a cue and the reward of its completion is realized.

And that’s where things get interesting. What comes before and after the routine are what make it a habit, Before comes the cue – the trigger of the behavior, for example getting up in the morning and going to sink triggers brushing teeth. Perhaps making a cup of tea triggers the habit of having a cookie. And then there is the reward that completes the loop – perhaps the feeling of a clean mouth, or the pleasure of eating a delicious cookie. 

Duhigg illustrates many of these three component loops, and illustrates them. He argues that the cue – routine – reward is at the heart of much of what we do, both good for us and bad. Interesting examples include how Starbucks trains its workers to trigger a specific routine when presented with an irate customer. The goal is to make it truly routine, so that the worker can overcome that visceral adrenaline rush that a truly angry person triggers with rarely a good result. Instead the Starbucks employee is equipped to remain calm and address the issue. Probably the most fascinating part of the book is the description of the impact of altering institutional habits in Alcoa by Paul O’Neill. The idea is that institutions and companies have keystone habits, and that changing them can have tremendously beneficial knock on effects on many apparently unrelated areas. O’Neill focused and improved safety habits and this made Alcoa not only a safer place to work, but also a more profitable one.   

Returning the more personal, Duhigg proposes that careful analysis of the cue and reward can lead to altering the routine. The example in the book, which Duhigg also described at the Masie conference, is his habit to get a cookie every afternoon at work, which he wished to stop but wasn’t able to for more than a day or two at a time. When he dissected the habit loop he discovered that while the cue was a mid-afternoon slump, the actual reward was not the cookie, but to have a break and chat with colleagues. He had been going to the coffee shop, knowing that he would find colleagues there, and bought the cookie almost incidentally to justify his going to there. Once he realized this he was able to reengineer the loop  replacing the cookie with a simple stroll to a colleagues desk for a quick interaction. Making these analyses isn’t always easy, Duhigg points out, but it could be very valuable.

So how does that apply to me, and now? Well, I think when you are under the kinds of physical and mental pressures that cancer can induce, perhaps you are both prone to relying more on automatic behaviors and also to run out of self-control at critical moments. (Another point that emerges in the book is that self control is a resource that is finite, and can be used up in the course of a day battling temptation, leaving you vulnerable at the end of the day.)  Here is one that I have been working on – the snack while watching TV, perhaps the most vulnerable time of the day overall. You know the scene, after a long day you finally get a little time to yourself with a favorite show and a treat. Well, I am trying to switch out the chocolate for an apple. I’m making some progress after several weeks, and now mostly I actually crave an apple when that snack attack hits me. The result has been some success in fighting the chemo weight gain, and feeling better. Meanwhile, I am busy trying to analyze some of my other many bad habits…


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