#3 Creating Neuroplastic Habits

 Often times you run into the problem of not being able to change your habits. In this episode of the ClearHealth Podcast I discuss:

• breaking down the parts of a bad habit
• where habits come from
• the reason why we form habits, and  
• the 7 steps to habit change

Get ready to take some notes!

Transcript 
Welcome to the Clear Health Podcast where we discuss the intersection of life and medicine. Welcome back everybody. Today we're going to talk about making a fresh start. And if you're like me, you sometimes try and go for something or create some type of habit and you don't really make it very well. So if you want to go and start flossing, you'll floss every day of the first week and then the next week it's every two days and then the following week it's every three days and it's not very good. I mean, it's not... going very well, and so you eventually stop doing it. So there's several factors that actually work against us. And what we're ultimately trying to do is create an automation in our head so that we don't expend a ton of energy when we're doing these certain habits that we know are really beneficial for us. And so the behaviors that we... acquired, these are usually shaped by our observations when we're younger and our imitations of other people. And we really try to figure out how to use certain things to the best of our benefit. And so we get these from our family, our friends, our coworkers sometimes and It helps when we can imitate somebody, but when there isn't really somebody there in our life, later on as we grow up, it may be a little bit more difficult to actually change ourselves. Habits by definition are repeated behaviors that we perform on a regular basis. And they become essentially second nature. The issue... arises when we get these habits unintentionally, and especially when we get bad habits formed. So you may be sitting in front of the television and you're thinking, I want to snack, so you actually go to the pantry and then pick out some potato chips and start snacking on them with them sitting right in front of you. And then later on, you may go to the doctor's office and you'll say, Doc, I really don't wanna do that anymore. How do I stop doing that? So the process by which these behaviors become automatic is actually called habit formation and involves three parts. One, the trigger, two, the action, and finally, three, the reward. So if we think about the potato chips, if we are sitting in front of the TV and we turn the TV on, that may be the trigger to go and get those potato chips. is going getting a potato chips and eating them. The reward is a high carbohydrate intake, which raises dopamine levels, as well as the salty taste that's aligned on those potato chips. Our brain is actually neuroplastic, so it means we can change our brain structure by these habits that we do. And so, in the... prefrontal cortex, that's where we make our executive decisions and we can then use these executive decisions to change other parts of the brain, which hold our automatic processes. And one of those is the basal ganglia. So the more we start to brush our teeth at night, the more these neural pathways are laid down in the basal ganglia and eventually this action, the trigger reward, or trigger action reward becomes automatic. The ultimate question is how do we build these new routines? So let's go through seven different steps that can help us to form better habits and ultimately lead to an overall better life. The first step is to actually practice mindfulness. And to me, this is one of the key things that we're actually missing in our schools today. And mindfulness allows us to pause and consciously see our thoughts arising within us. This is extremely important because as these thoughts arise, they then form into actions. And these actions then lead to our betterment or... to artemise. And so when you practice mindfulness, which includes things like meditation and yoga and self-compassion and non-striving, all of these things can lead to recognizing what's actually going on in your brain. And there's a ton of neuroscience research showing the multiple benefits of practicing mindfulness. And if you can just sit and meditate for even two to five minutes, you will then start to realize that there is this chatterbox going on inside of your head. And so if I go back to the analogy of watching the movie, well, that chatterbox on the inside is going, hey, you know what sounds great? Getting a bag of chips from the pantry and... bring it over here and sitting down and eating it. That sounds really awesome. So let's go over there and get them and then come back and sit down in front of the movie. And so you go, yeah, that sounds great. Eventually it comes up to the point of an action and you have a feeling behind it and you have a feeling of this will make me feel good if I go and do this thing. Well, mindfulness allows you to look at that arising feeling. Place it against your basic principles that you've learned about healthy eating, and then go, oh, this does not fit with my principle. I need to do something different so that I can have a better overall life. One of the key things in mindfulness that brings me to my next point is using a journal to reflect on your feelings. and actions that you've taken throughout the day. And through that, you can actually develop a strategy. So you can write down that bad habit, and then say, hey, what is the trigger, action, and reward for it? Now, you can break those parts down and say, okay. If I kind of reverse each one of these, so if I take, let's say, the trigger, right, sitting down in front of a movie, so now in my mind, I have the idea of sitting down in front of a movie, and when I sit down, I can then be prepared for the action that my mind wants to take. So I can write down sitting in front of a movie. And then the next thing I can write down is then standing up. to go and get a bag of chips. And then I can write the reward. Well, the reward is having a salty snack as well as high carbohydrate intake. So how can I reverse each one of these areas? Well, I can one attack at the source and say, okay, the trigger is sitting down and watching a movie. Maybe I should only do that once a week on Saturdays. instead of every day of the week. So on other parts of the week, instead of sitting down, I can say, okay, I'm going to go grab my five pound or 10 pound kettlebell and do a quick workout instead of sitting down to watch a movie. And then afterwards I'll read a book. And what will happen is you'll notice that action gets diffused a little bit. It may still be there, maybe around because of the time. or your mood at that time, but you may have a little more control because the trigger is not present. Now, the next part is the action, going up and getting the potato chips. Well, if you remove those potato chips from your house, then you can't actually go and get them. You can replace them with, let's say, some raspberries, or let's say a lemon in some Italian sparkling water instead of the chips. And the final part, the reward of something that's, you know, a high carbohydrate as well as salty can easily be replaced by something else like I just mentioned. Instead of having something as salty, maybe you get something sweet, like just one piece or two pieces of a chocolate bar and take that back to the couch. Don't take the whole chocolate bar, just take the couple pieces and using that instead of getting the... salty hit from the potato chips. The next thing that we're going to write down in our journal is how much value do we get from the new habit versus the old habit? So it's kind of like what are the pros versus the cons of doing this? And so you can write down at the top, potato chips versus sparkling water with lemons. and then write down all the pros, you know, of on one side of eating the potato chips and then the cons of eating the potato chips and then all the pros of eating or drinking the sparkling water with lemon versus the cons of drinking that sparkling water with lemon. And in your mind, you'll be able to better compare it and it will make you think about, okay, When I go to get these potato chips, it's contributing to my cardiovascular disease and because of the high quick carbohydrate intake and I may not feel as good afterwards as when I eat these raspberries. And so writing this down in the journal also increases the neuroplastic change and allows you to build this new habit. Number four is to actually mentally rehearse your new good habit. And when you do this, you may realize that there is a ton of turbulence in the mind and that emotions arise left and right. And you're kind of trying to battle against these emotions and get through to the good habit. And ultimately, you're trying to reach your own principle that you've created. So you're trying to eat healthier and yet there's all of these other emotional states kind of getting in the way a little bit. And that's okay, that's part of life. And so what I would do is sit somewhere where you won't be disturbed, sit up straight and then close your eyes, take a few breaths in and then let them go out. then vividly rehearse your new habit. So imagine that you're going to sit down, what time of day it is, how is the room hot or cold, what are you wearing, are you under a blanket, is the fireplace on or is there a candle on, and what movie or show are you about to watch, and then start to think about your next action after you turn this movie on. Or maybe it's even before the movie, maybe you're getting ready for the movie and you're thinking about already, hey, I need to go grab a snack out of the pantry. As you imagine, instead of going to the pantry, maybe you need to direct yourself towards going to the refrigerator. And in the refrigerator, there might be an apple that you can chop up and put in a little bowl, which may mimic things like potato chips and popcorn. And so, You imagine you're walking there, how does the floor feel? And how do you feel going towards the refrigerator? Do you feel better than if you were to go to the pantry and get potato chips? How do you actually really feel on the inside knowing that you're about to accomplish your goal? And so you get there, you pull the apple out and it's shiny and you chop it up. What knife are you using? How does the apple smell? And then what bowl are you pulling out? It's just a plain white bowl. Is it decorated somehow? And you're putting the apple in it and then walking back to sitting down on the couch. And so once you sit down, you eat the apple. Now imagine how you feel. Just take a second. Take a second to realize that, oh, this is something a lot better than I'm used to and something that I... actually want to do. Step five is to actually take action. So look in your journal or write in your journal when you're going to actually carry out this new habit. Pick a day, maybe it's Friday, when you watch your favorite movies that have come out and you say, okay, I'm going to actually do this habit of sitting down and then the next step I'm going to do is go get that apple, chop it up, put it in a bowl bring it back. And yeah, you may not do it. And that's okay. You don't have to beat yourself up. This is a lot about self-acceptance because if you beat yourself up, well, basically you are just wasting your time. You're wasting your time thinking about, well, what could have happened versus what I did. And let's say you aren't going to even watch a movie the following day after you... got those potato chips, well, the following day, chop an apple up during lunch. Just do it anyways. Do it when you would sometimes also have potato chips or also have maybe French fries with a burger. Chop up that apple and eat that instead. So at least you have one part of the action down. And then when Friday comes around again, you can have that action somewhat ingrained in your brain. and it's a lot easier to repeat once you sit down to watch that movie. So the next to last step is actually thinking back on how you performed throughout the week. So take some time, Saturday or Sunday, or a day when you're off from work, to reflect back and see, hopefully you've written it in your journal, what you did that week. And you can take it and go, oh, okay, I need to... actually do a little bit tweaking here and change up this habit that I'm trying to reinforce. So look back in the journal, jot down how you think you can change it, and then move on from there. The last and most important part is an accountability partner. Let's say you've tried all of these steps and you can't figure out how to make yourself progress forward. Well, the best way to do this is to actually get a partner that says, hey, why don't we set up a time to meet or a time to chat over the phone and speak to them once a week for support in order to keep that habit down. And it doesn't have to be a long, you know, 30 minutes to an hour chat. It can be 10, 15 minutes and you go, okay. I did this, this happened, and they'll help you to motivate yourself again. Maybe you've failed once and they'll say, well, hey, you know what? Everybody fails. It's okay. Let's keep going on forward and going to the next Friday where you can accomplish this goal that you've set out to do. To reinforce the meeting, you may set up a play date with, let's say, your children together. Maybe you wanna just play chess together or have a certain type of holiday coffee together at Starbucks. Maybe you wanna make a spa day out of it. Meeting every two weeks or once a month to discuss, hey, what's going on in my life and have I been able to change into the new person that I want to be? And remember, the mind is like the ocean. Sometimes it's very tumultuous. and you have to go through certain rifts up and down in life. And if you just sink below that, if you just go a little bit below those waves, you'll begin to understand that the mind can actually be calmed underneath all of these up and down thoughts. And it's okay if you miss one of your habits, maybe the mind is... too erratic at that point or too stressed at that point. And so if you can fall back a little bit and understand that, hey, this is just something that happens in daily life, we'll remiss this habit, but we can always come back to it. And we practice a little bit of patience and non-striving, and eventually we become the person that we imagine ourselves to be. Thank you so much for tuning in. Please note that Clear Health Podcasts is for general informational purposes only. and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice, and no doctor-patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 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