“I chopped down a corn stalk yesterday!” my patient (I will call Susie) said as she sat down for our session. She had binge eating disorder, and was in the habit of restricting her intake severely during the day, then after work she would pull into the drive-through of several different fast food establishments on her way home. First for several double burgers, fries and giant milkshake. Then, Dunkin Donuts for a bagful of donuts and large coffee drink. She would gobble this down with predictable feelings of guilt and remorse afterwards. No matter how much resolve she had the next morning (“that’s it! I am starving myself today, I don’t deserve to eat. I will make up for it. And today, I won’t do it” ) by the time 5 pm rolled around, her starving body screamed at her and her conditioned brain went into automatic pilot. Her car just seemed to turn automatically into that darn entrance with the sign that said “Drive-Thru Entrance Here”along with the giant yellow arrow to be sure you do not miss it.
Maybe you can’t relate to this behavior, maybe there is some other behavior that you do that you wish you could stop. Bad habits are complicated and more difficult to change than one would imagine. Sometimes, we look at others and think “how could they do that? why don’t they stop ______” Fill in the blank. Smoking, drinking too much, watching too much TV, not sleeping, starving themselves, binge eating, purging……all detrimental to our health. Why can’t we have more willpower? When my patients start bashing themselves (don’t we all feel kind of bad when we just can’t do what we thought we could do?), it typically is a pattern. We get into what you might consider “automatic pilot” mode, both with our thinking and with our behavior. You may have heard of “behavior chains” . Susie’s might look something like this:
Skip Breakfast and Lunch->Leave Work->Drive by McDonald’s->Turn in Drive Thru->Order Food->Eat in Car->Feel Guilty->Drive by Dunkin Donuts->Turn in Drive Thru-> Order Donuts->Eat in Car->Feel Guilty->Go Home->Eat More, go to bed->Wake up, Skip Breakfast, Skip Lunch, Leave Work and REPEAT CYCLE
My patient Susie wanted desperately to change this behavior, but her expectations of stopping totally and miraculously going home to eat a healthier dinner was not reasonable. Part of the reason is NOT lack of will power, but the reality that our brains are not always under our control when it comes to bad habits. To help patients understand this, and also because I am a visual learner, meaning, I need pictures to learn things, I use a “corn stalk” analogy to explain this phenomenon. First, identify a behavior you want to stop (for Susie, she wanted to stop binge eating fast food after work). Next, imagine what healthy behavior you wish you could do instead (Susie really wanted to be able to drive straight home and prepare a healthier and normal sized meal and not feel guilty). Now imagine your brain as a very thick field of corn stalks. You have to get to the other side to your “behavior” or outcome. You see a beautifully paved path leading somewhere. It is shiny, made out of beautiful marble, glistening in the sun. So of course, you head down this path because it is so easy, and it is actually somewhat enjoyable.
Unfortunately, at the end of the path lies the exact behavior you have been trying to stop. For Susie, at the end of her nice shiny easy path is McDonald’s. And Dunkin Donuts. And binge eating, followed by guilt. What Susie really wants at the end of her path is a nice healthy meal, and feeling good. But there is no path to that scenario. She needs to make one.
Do you think it is easy to make a paved path through a giant field of corn stalks? No, it is not. Neither is changing behavior. Neither can be done overnight. For Susie to forge a different path, she needs to get herself a hatchet and knock down one cornstalk at a time. After lots of hard work, sweat and tears, eventually a path, albeit bumpy and conducive to tripping…well a path will slowly appear. Susie will actually be able to get down that path to the place she wants to be. Her old smooth beautiful path will still be there. But eventually, that old smooth path will start to be less smooth and easy as new baby corn stalks begin to grow. She will still be able to get by, but it won’t feel as easy or right. Eventually, over time, that old pathway will be covered and pretty much gone. The new path will start to be nice and smooth and very easy to walk down. Maybe not made of marble, maybe some smooth sand, but walking down it will feel pleasant and good, not like in the beginning.
How does this look in Susie’s “real” world? Take a look at her “behavior chain”. What Susie did was pick a place in the chain where she felt she could do something different. She told me “I don’t need to go by Dunkin Donuts. That is actually the long way home”. So the first hard work she did, that first corn stalk chopped down was taking a different road home and skipping Dunkin Donuts. She still went to McDonald’s, still ate too much, still was starving during the day, but she was able to make this change. She felt pretty proud of herself and had some hope. The next step was at the beginning of the chain, the skipping of breakfast and lunch. She did not want to eat breakfast, but agreed to starting to eat something at lunch. This helped her be less starving on the way home and eventually she was ordering a smaller amount of food at McDonalds. Another corn stalk down.
I have had many patients like Susie, all with different issues and behaviors they wanted to change. Those who accepted that change did not happen overnight often went on to change their brains by changing one little thing at a time. Most of us are not that patient, it seems, and so we try to change all at once. When we fail, we blame ourselves. Instead, if we stop and think about the corn stalk field in our brains, maybe we can accept that chopping down one corn stalk, changing even one little thing at a time will eventually get us where we want to go.
So can you think of any unhealthy behaviors you want to change? Then pick up that hatchet, it’s time to chop.