Understanding the

Power of Habits:
The Psychology of
Habit-Formation

Cris Cannon, D.Min., LPC/MHSP, CCMHC, ACS

Learning Objectives
 Understanding a “habit” from a different
perspective
 Conceptualizing habit-formation as a tool for
change
 Distinguishing the steps involved in the habit-
formation process
 Clarity regarding the length of time it takes
someone to create a habit
 Perceiving habit-formation as a process
 Considering habit-formation as useful to our
patients
Defining “Habit”
 A usual way of behaving: something that a person
does often in a regular and repeated way
 A recurrent, often unconscious pattern of behavior
that is acquired through frequent repetition
 A settled or regular tendency or practice, especially
one that is hard to give up
 An acquired behavior pattern regularly followed until
it has become almost involuntary
 A learned behavioral response that has become
associated with a particular situation, especially one
frequently repeated
Basic Understanding: Habit

“An action done

frequently.”
Why We Must Be Careful About Our
Habits . . .
My Favorite Definition

The automatic
behavioral
engagement in an
activity that serves to
promote
well-being.
Why is this Important for
Coaching?
Consider . . .

Behavioral change may

be achieved through the
creation of new habits.
Where Might Habit-Formation
Be Useful with Our Patients?

 Medication adherence
 Emotional/personal management
 Healthy eating
 Exercise

 Positive self-care
How Does Habit-Formation
Work?

Habit-formation is relatively
simple:
Repeat an action
consistently in the same
context
Habit-Formation Process:
Three Phases
Initiation Phase – defining the new behavior and the
context in which it will be practiced are selected.

Learning Phase – the new behavior is repeated in

the chosen context to strengthen the context-
behavior association.

Stability Phase – the habit has been formed and its

strength has plateaued, so that the habit persists
over time with minimal effort.
Initiation Phase
 Requires sufficient motivation to attempt
habit-formation
 An appropriate context in which to perform the
action must be chosen
 The context - any “cue”: an event “when I get
up in the morning”, a time of day “after
dinner”; some daily connection
 The habit-forming action is performed in a daily
context that is both frequent and consistent
Learning Phase

 Repetition, repetition, repetition, repetition,

repetition, repetition, repetition, . . . and
more . . .

REPETITION
 Contextual Education - learning from the
repetition of the action in the context of the
time of day, cues, motivating thoughts,
times the action was not carried out, feelings
around the process, etc.
Being Faithful to Repetition when
Repetition ISN’T Fun . . .
Stability Phase
 The habit forming action becomes
second nature . . .

 The patient notices when the habit is

not performed

 There is a sense of a need to recover

when the habit has not been performed
How Long Does it Take for A
Habit to Become Automatic?

First, let’s dispel the myth . . .

21 days is not
true!
Dispelling the “21 Day” Myth
“Psycho-cybernetics”, a 1960 book by Dr. Maxwell
Maltz, a plastic surgeon:

‘It usually requires a minimum of about 21 days to

effect any perceptible change in a mental image.
Following plastic surgery it takes about 21 days for
the average patient to get used to his new face.
When an arm or leg is amputated the “phantom limb”
persists for about 21 days. People must live in a new
house for about three weeks before it begins to “seem
like home”. These, and many other commonly observed
phenomena tend to show that it requires a minimum of
about 21 days for an old mental image to dissolve and a
new one to jell.’ (pp xiii-xiv)
Dispelling the “21 Day” Myth

How anecdotal evidence from

plastic surgery patients came
to be generalized across
culture remains unclear . . .
So How Long DOES It Take to
Form A Habit?
2010 research:

 Participants performed a self-chosen health-

promoting dietary or activity behavior (e.g.
drinking a glass of water) in response to a once-
daily cue (e.g. after breakfast), and gave daily
self-reports of how automatic (i.e. habitual) the
behavior felt.
Participants were tracked for 84 days
So How Long DOES It Take to
Form A Habit?
Range: some persons maintained their habit in 18
days; it took others 254 days for their action to
become habitual.

On average, it takes 66 days for a

habit to be formed and become
automatic.
About 10 weeks!
Acquiring A New Habit Requires
TIME . . .
Creating/Managing the Process
1. Patients should choose the behavior they want to
become habitual; we may assist, but they must
own their choice.
2. Encourage small and manageable behavior
changes; simpler actions become habitual more
quickly.
3. Failure is discouraging, thus, momentum must be
maintained and failure normalized as a means of
continuing towards habit mastery.
4. Once smaller changes have been sustained, larger
issues may be considered.
5. Throughout the process, offer encouragement;
success builds self-efficacy.
Replacing A Bad Habit with
A Positive One
The process is much the same:
1.Identify a positive habit and behavior you want to
adopt.
2.Identify the habit you want to break.
3.Recognize the sensory impulses experienced in your
body that occur before you act on the negative habit.
4.Insteadof acting on the negative habit, refocus your
conscious thoughts and attention on the positive
habit.
5.Substitute the new behavior based on the positive
habit.
A Patient Example . . .

Sarah: 42 year old teacher;

overweight and sedentary. She
knows she needs to exercise, and
discusses her many “hit and miss”
attempts to make exercise habitual.
A Patient Example . . .

Sarah states that she “wants to get back on

track but doesn’t know where to start.”
How do we get Sarah back in the habit of
regular, planned exercise?
Sarah has gotten out of her former habit
of taking long walks.
A Patient Example . . .

Sarah is asked to make a simple list of

three actions she wants to accomplish
towards her goal of walking:

Her responses:
•Walk everyday with her dog
•Create reminders to walk
•Walk immediately after work
A Patient Example . . .

Sarah creates a checklist - kept on

“Post-It” note on bedroom mirror which
she sees each morning:
1.Change clothes immediately after work
for walking.
2.Leave walking clothes, shoes, and dog
leash on her bed as reminders.
3.Walk her dog for a half-hour.
A Patient Example . . .

Goal: Working towards habit creation

Week 1: successful 4 out of 7 days
Week 2: successful 5 out of 7 days
Weeks 3 & 4: successful 2 out of 7 days –
(relapsed after being ill with sinus infection)

Week 6: successful 6 out of 7 days

Week 15: successful 7 out of 7 days
A Patient Example . . .
Sarah said she wanted to “get back on track”
with exercise; which becomes her goal.
“Have you ever made lists?”
Coaching aided Sarah to define issues on the
list
Jointly we decided that she would check her
first thing in the morning while she dressed
Habit-Formation Process:
Sarah’s Three Phases
 Initiation Phase:
Defining the new behavior: Making a list; following
tasks
Context in which it is practiced: Checking list every
morning and upon awakening; acting on tasks

 Learning Phase:
REPITITION, REPITITION, REPITITION

 Stability Phase:
Habit largely in place and sustained at 15 weeks
Why This Is Important to Our Work
with Patients . . .
Instead of:
 Becoming upset with them
 Lecturing
 Using “oughts” and “shoulds”
 Berating

Encouraging patients to identify the changes

they want to make and see if we might help
them create new habits!
 Supporting patients in the
creation and use of positive habits
is hopeful, optimistic, and
reassuring.
Assisting what
“might be”
rather than

“what isn’t”
And Remember . . .
Repetition Leads to Success!!
Reference

Gardner, B., Lally, P., & Wardle, J. (2012)

Making health habitual: the psychology of
‘habit formation’ and general practice.
British Journal of General Practice, 62, 664-
666.