Andrew
- 14 min read

Four Simple Ways to Harness the Power of the Habit

Did you do your exercises?

Why not?

Well, lucky for you, today we’re talking habits.

This topic is teeming with applications to our work & our practice as physical therapists. So by the end, you’ll have no excuse ...you noncompliant son of a…

I find habits so interesting because they’re something that we all engage in for a significant portion of our lives. Understanding the science of how habits work and having the tools to change my own habits has been extremely useful to me in my life. It’s also helped me in aspects of my practice that used to frustrate the hell out of me.

In this article, we’ll answer the fundamental questions about habits:

What are habits?
Why are they important?
How do they work?
How can we harness the power of the habit for our benefit and our patients’ benefit?

I learned a lot of this information from a book called Atomic Habits by James Clear. I’ve read a couple of books on habits and I think Clear’s is by far the best. It’s heavily informed by research and includes practical wisdom and personal anecdotes that make it an all-around great read.

So let’s get to it!

What are habits?

Habits are, by definition, a behavior that’s

Recurrent
Cued by a specific context
Often occurring without much awareness or conscious intent
Acquired through frequent repetition

This is important because a significant portion of our lives are habitual. We repeat ~40% of our behavior almost daily.

In this way, our habits shape our existence & our future. And if we change our habits, we change our lives.

It’s important to realize that habits don’t just relate to physical behaviors like tasks or activities. All the principles that we’ll discuss also apply to the mind.

Just as we have habits in our external world like our morning and nighttime routines, we also have habits of mind— patterns of thoughts and emotions that are highly influential in our lives. So keep that in the back of your mind as you read to see where other applications might lie for you or the people you work with.

Why are habits important?

1. At the core of what we do is lifestyle & behavior change.

We ask pretty much everyone we work with to change the structure of their life in some way. When we ask them to make time in their day to do exercises, walk, move, stretch, we’re asking them to form new habits or modify their existing habits.

This is not always easy to do. I mean, how many hundreds of times have you said or thought, “…Well if you’d just do your exercises you might be feeling better...”?

But the more we understand habits—how they work and how we can make forming new habits more likely to happen—the more we can work with people to help them change their behavior & their lifestyle.

2. The information problem.

The information problem is the notion that information alone is essentially useless. It’s only when it changes our behavior that it makes a difference.

If we want to elevate our practice, we must be equipped with the tools to change our own behavior.

When we learn something new, we need to be able to implement it into our practice for it to make a difference. And modifying our habits is a huge way that we can do that.

3. Work/life balance.

If you’re a Be A Better PT podcast listener, you’ll know that in my first podcast episode, I mentioned that I want to help you not only be a better clinician, but also achieve a better work/life balance and reduce your stress.

Understanding habits and being able to tap into that understanding to change our behavior is a game-changer when it comes to work/life balance. Being good at this allowed me to survive residency while simultaneously DIY renovating my wife’s and my first home (somehow).

How do habits work?

There are 4 steps that your brain runs through when engaging in every habit.

It’s called the habit loop and it’s made up of four phases:

Cue
Craving
Response
Reward

Let’s go through these one at a time.

1. Cue

The cue is a contextual trigger that prompts your brain to initiate a behavior. It’s a piece of information that predicts a reward.

This is important because, from a habits standpoint, the brain is essentially a reward detector.

Our brains spend a lot of time scanning the environment in search of rewards. Primary rewards like food, water, sense pleasures. And secondary rewards like money, power, status.

Importantly, you don’t need to be aware of the cue for the habit to begin. This is especially important when it comes to breaking habits, where the process really has to start with awareness.

So the cue is the noticing of the reward

2. Craving

The craving is the motivating force behind every habit. Without craving (or desire), we have no reason to act.

Importantly, what we crave is not the habit or behavior itself, but the change in state it delivers— the way it makes us feel.

For people who smoke, for example, it’s not the cigarette itself, but the relief that it provides. The same thing can be said about alcohol, junk food, hugs, sex. What we crave is the change in state.

So the craving is the wanting of the reward.

3. Response

The response is the actual behavior that’s performed.

And remember, the habit can be a task or other outward behavior, or it can be a thought or emotion.

So the response is the obtaining of the reward.

4. Reward

& The reward is the reward. Pretty straightforward.

There are 2 main reasons that we chase rewards, aside from survival reasons regarding our more basic needs:

They satisfy us by giving us temporary relief from craving
They teach us which actions are worth remembering for the future
If a behavior produces an effect that we like, we are more likely to repeat it
If a behavior produces an effect that we don’t like, we are less likely to repeat it

Cue, Craving, Response, Reward.

That’s the habit loop.

These phases are all very dependent on one another: if a behavior is insufficient in any of the four stages, it will not become a habit.

This is exactly how we intervene, by manipulating the habit loop.

How can we harness the power of the habit?

Clear discusses what he calls The Four Laws of Behavior Change, which correspond to each of the four parts of the habit loop:

If we’re trying to form a new habit,

Law 1 recommends that we Make it Obvious (this is related to the cue phase of the habit loop)
Law 2 suggests we Make it Attractive (this relates to the craving phase of the habit loop)
Law 3 calls us to Make it Easy (as it relates to the response phase of the habit loop)
Law 4 is to Make it Satisfying (which relates to the reward phase of the habit loop)

If, on the other hand, we’re trying to break an existing habit, we simply flip the four laws.

Make it Obvious becomes Make It Invisible
Make it Attractive becomes Make It Unattractive
Make it Easy becomes Make It Difficult
Make it Satisfying becomes Make It Unsatisfying

Let’s go through these one at a time. I’ll tell you my favorite strategies using examples for each of the four laws.

Law I: Make It Obvious

When talking about building a new habit, the first strategy is to intentionally cue ourselves to engage in the behavior that we want to.

We want to make the desired behavior obvious so that we remember to do it.

My favorite strategies for doing this are:

Scheduling
Habit Stacking
Visual Reminders

Strategy 1: Scheduling

Time is a very common cue. We rely heavily on time in our lives to inform our behaviors. When we eat, when we sleep, when we work, when we rest, are all temporally influenced. Scheduling is a simple way to tap into this influence to create a new habit.

For example, if I’m trying to help Ms. Magnolia form a new habit of movement or exercise, I might ask her, "When in your day do you think this would fit?"

The process of thinking of a time in her day when she could see herself performing the movement or exercise makes it more likely that she’ll remember when that time comes. If she’s a calendar person, I might ask her to put it in her calendar as an extra obvious layer.

Let’s talk through another example, this one relating to my own habits.

Let’s say I want to boost my clinical reasoning skills by starting the practice of reflecting on my day. If I pick a specific time of day to do that, it’s much more likely to happen. Maybe it’s 6:00, right after I get off work, on my drive home.

Simply selecting this time is a step toward improved reasoning skills because I’m making my desired behavior—reflecting—more obvious.

Strategy 2: Habit Stacking

Habit stacking is the practice of adding something new to an already existing habit. Why start from scratch when we can piggyback a well-established habit?

Say Ms. Magnolia and I decide she will start stretching and walking. She says she can do this at 9:00 am. I might dig into her morning routine to find out what the flow of behaviors looks like in her morning. That way we can see where she can piggyback stretching and walking into her already existing routine.

Let’s say she normally:

Wakes up
Uses the bathroom
Gets dressed
Goes downstairs to get a cup of coffee

We might decide together that she’ll instead:

Wake up
Do some stretches in bed
Use the bathroom
Get dressed
Get her cup of coffee
Go for a walk

One of the best parts about scheduling and habit hacking is that they remove a lot of the decision-making of starting a new habit. The decision of “When should I?” can be exhausting and can be enough to make us avoid doing even simple things that we genuinely want to do and know are good for us.

Making these decisions in advance can make things flow much smoother.

Strategy 3: Visual Reminders

Using visual reminders is the simple act of creating a cue that stands out in the environment to serve as a reminder.

Since starting my nerd journey into habits, whenever people are super consistent with their exercises or other new habits that we discuss, I ask them how they did it.

One of the things that I’ve heard a fair bit from these consistent folks is that they’ll leave the equipment out as a reminder. And every time they see the piece of equipment they’ll do the exercise. Make it obvious.

Using our example from before, if I want to make it even more likely that I’ll reflect in my car at 6:00 on my drive home, I could put a sticky note in my car that says “REFLECT” to remind me to reflect.

…and maybe then I realize that I could practice self-compassion while I reflect so that I learn more and avoid a negative thought spiral. So maybe I add “...but be nice” to my sticky note.

These aren’t the only strategies for making it obvious, and you’ll end up coming up with some of your own. Just remember the concept: all these strategies are ways of making the desired behavior obvious so that we remember to do it.