PsyMed Blog

Dr. Joby Morrow's Approach to Helping You Manage Your Behaviors

Building life skills and new behaviors can be fun, exciting and richly rewarding. But to sustain these skills and maintain healthy habits, chances are you'll need to create a system. I'd like to share with you my approach, which I have learned by combining my professional experiences as a psychiatrist with my personal experiences in addiction recovery. 

On a daily basis, you perform many tasks without your conscious awareness or approval. To perform these tasks, your brain automatically takes stock of a lot of factors. When you're driving, for example, your brain is assessing and changing your body position, your car's distance from other vehicles, speed, light levels, weight and force transfer from the foot muscles to the accelerator pedal, amount of force to apply to the steering wheel to make directional adjustments, the level of priority for visual and sound cues around you, and a host of other factors. 

When you make decisions about what you do-- how to spend your time, energy and money, what to say, when to act, and so on-- you often perform these without your conscious knowledge, too. And just like your brain takes a lot of factors into account when driving, it takes many factors into account when making a behavioral decision. Let's begin understanding what those factors are. 

We can start by taking a quick glance at this equation. Don't study it in too much detail just yet; we'll break it down. 0090630001647554877.jpg

What this equation represents is all the factors that go into making a decision that you might, or might not, be aware of. All these factors on the right side of the equals sign, taken together, make up our risk for engaging in an unhealthy behavior, or behavioral pattern. That's what we see on the left side of the picture: "risk of unhealthy behavior."

The right side has a fraction in the parentheses. We'll begin there. Take a look at the denominator-- the part of the fraction on the bottom. It has the words "accountability" and "self-awareness" in it. Just like in math, big numbers in the denominator means the overall total goes DOWN (for example, 3/5 is a smaller amount than 3/4, since 5 is bigger than 4). That means:

  1. The risk for unhealthy behavior DECREASES when accountability INCREASES.
  2. The risk for unhealthy behavior DECREASES when self-awareness INCREASES.

OK, so the more accountability you have, and the more self-awareness you develop, the less likely you are to engage in unhealthy behavior.  So far, so good. 

Let's move to the top part of the part in parentheses-- in math, this is the numerator. Bigger values in the numerator increase the overall value (for example, 3/5 is a bigger amount than 2/5, since 3 is bigger than 2). The words listed here are "internal vulnerability" and "external environment." Increases in these make your overall risk go UP. So: 

  1. The risk for unhealthy behavior INCREASES when internal vulnerability INCREASES
  2. The risk for unhealthy behavior INCREASES when  environmental factors INCREASE. 

 Wondering what I mean when I say "internal vulnerability?" I'm referring to anything in your psyche or in your history that helps drive your behavior, often without your conscious awareness. Examples of inner vulnerability might be a fear of being inadequate, a history of trauma, persistent feelings of shame, or a fear of abandonment. It often takes the help of a professional, like a therapist or counselor, to help identify what internal vulnerabilities you have. That type of work can be challenging, but very rewarding, since learning about them helps you address your vulnerabilities and build self-awareness. 

Whereas "internal vulnerability" refers to your inner life, "external environment" refers to your outer life: the behaviors of the people around you, the types of places you frequent, what you have access to, and what you create opportunities for. For example, if you are trying to stop smoking, but live with a partner who smokes, your risk of smoking is higher. If you keep cigarettes in your home, you're more likely to smoke after resolving to quit. 

So accountability and self-awareness reduce unhealthy behavior patterns. High levels of internal vulnerability and favorable external environments increase unhealthy behaviors. With me so far? Great! Don't hesitate to re-read any section, and be sure to take your time.

OK, so in the picture, the word "resistance" is written in superscript, right outside of the parentheses. That's where you'd normally see an exponent in math. Remember exponents? Small changes in an exponent greatly increase a value: 4 to the 3rd power (4x4x4) is 64, but 4 to the 4th power (4x4x4x4) is 256. And 4 to the 5th power is 1024. 

That's how it goes with resistance. Even a small increase in resistance can drastically increase your risk for an unhealthy behavior. So, what's resistance?

I define resistance as "anything that keeps us from embracing the truth." Here are some common examples: 

  • Denial ("I'm not really hurting anybody.")
  • Rationalization of a problem ("If I tell her the truth, it will just hurt her even more.")
  • Externalizing the blame ("If he didn't complain so much, I wouldn't keep drinking.")
  • Minimizing others' experiences ("Why do you care? It's not your problem.")

Resistance keeps us out of integrity, and often helps us avoid responsibility. It usually requires an outside observer-- a friend, a family member, a colleague, or a professional-- to call attention to our resistance patterns. 

Here's the takeaway: the risk for unhealthy behavior GREATLY INCREASES when resistance INCREASES even a little. Resistance happens when a thought or feeling disallows a person from taking full responsibility for herself or himself. 

Finally, to the right of the picture, after the plus sign, we see "triggers", a word we've heard more often in the last few years. When I use the word here, what I mean is "actions or emotions that create a sense of tension in a person." The presence of triggers, or an increase in their intensity makes unhealthy behavior patterns more likely. The risk of unhealthy behavior INCREASES as triggers INCREASE.

Triggers look different for different people, and understanding your individual triggers helps you understand your risk. In addiction recovery, much of the focus is on avoiding or minimizing exposure to triggers. Anticipating which types of environments are likely to be triggering and learning how to avoid them (or navigate them when it's impossible to avoid them) is a major part of a successful risk management plan 

To sum up, the health of your behavior depends on your levels of: 

  • Accountability
  • Self-awareness
  • Internal vulnerability
  • External environment
  • Resistance
  • Triggers

Now that we understand how our risk for staying in problematic behaviors develops, next we'll start looking at how to reduce our risk for unhealthy behaviors and increase our risk for positive outcomes. Part 2 of this blog will review how to work toward healthier behaviors, using small and gentle steps. Be sure to check this site for news, insights and posts about this topic and many others. Thanks for reading!

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