Forming Good Habits | Dr. Sal AbiEzzi, M.D.

And if you want to change a habit, you have to have clarity of mind. This is the rider. The rider is the logical part of us. So you really need to know, okay, I need to go from here to there. And then you need to understand the right brain, the emotional part, which is the elephant. Very hard to move the elephant. Very emotional. So you really need to find that emotional connection between your left brain and your right brain. And then shape the path. Change your environment. When I gave this talk, I delved into habits. I'm going to go through this really fast, but really I want to just open it up for questions and we can talk high-tech, low-tech, whatever you want. But let me speed through the habits piece of it. The slides will be available. You can go through them later. So that's, like I said, been a challenge for me with my patients. Obviously, me in my life, in this supernova era, how can I slow down? How can I take care of my health, my family's health, and have that balance in life? And it has a lot to do with habits, it turns out. And so we are creatures of habit. So I delved into the science of habit. I'm going to give you— and I deleted a few of these slides already, but it's still a little bit dense. So again, think of journey as a metaphor. You take one step at a time. That's a saying. that we have in our Lebanese tradition. You go up the ladder one step at a time. You eat a staff of grapes one grape at a time. This is a picture from Lebanon. Does anybody know, who's not Lebanese, what this is? This is— it's hard for you to— but this is Baalbek. It's a city in Lebanon. It used to be called Heliopolis, which is the city of the sun, by the Romans. So the Romans built their grandest temple, it turns out, in that space. This is called the Temple of Jupiter. Only 6 of these pillars out of 46 pillars remain. It was a grand temple. And my kids were there and kind of like tired. Okay, how can we get there from here? So the elephant and the rider. This is a metaphor that goes back to Buddha. Buddha talked about the elephant, the wild elephant and the rider. It's been adopted numerous times by multiple different authors across the ages as a metaphor for how we operate as humans between left and right brain. And if you want to change a habit, you have to have clarity of mind. This is the rider. The rider is the logical part of us. So you really need to know, okay, I need to go from here to there. So you need to have that clarity. And then you need to understand the right brain, the emotional part, which is the elephant. Very hard to move the elephant. Very emotional. So you really need to find that emotional connection between your Left brain and your right brain. And then shape the past. Change your environment. Make it easy. Make it easy. So that's the metaphor. BJ Fogg is a habit super expert from Stanford University who has come up with Tiny Habits. And he has this kind of 3-level mantra. Have an epiphany. OK, I need to make a change. Change your context. Change your context. Again, change your environment. What surrounds you, and then take baby steps. Very profound. He goes on to dissect that down into— you could be motivated, you might have the ability, very complex. But he basically says at the end, attach a new habit to an old habit. That sometimes works very well. He gives you the example, if you really want to do those squats and you're not finding the time to do those squats, but let's say you flush the toilet in the morning. So when you flush the toilet, you do your squats. Do you attach a new habit to an old habit? That's an example. Then I went and read another book called The Power of Habit, which really tried to understand how that works in our brain. Wouldn't it be nice to do all these things? Exercise more. Don't push that snooze button. Let go of that phone. Order a salad instead of French fries without having the force to do it. So he actually, with this book, brought a lot of research in that space. As to how our mind works. And it turns out this is a model that was done in rats where the rats had to go through a maze to find the chocolate at the end of the maze. Initially, they spent a lot of brainpower and then eventually developed— really, they learned their way through the maze and actually the brain got turned off during half that journey. They stopped thinking about it. It became like a habit. Even when they laced the chocolate, made it bitter, they still followed that habit. So ultimately, it's understanding that the brain wants to save energy. So it builds chunks of automatic habits so that when you go from one space to another, you just do it automatically. And it turns out about 50% of what we do is like that in our day or our life. And he broke it down into 3 parts. There's a cue, there's a routine, and then there's a reward. One example, you work hard, you're going to have a glass of wine, and that's going to make you feel good, let's say. And sometimes that might not be good for you to have too much alcohol maybe at the end of the day or have too much ice cream at the end of the day or chocolate. So he really wants you to substitute the routine. You get the same reward. So doing some exercise, for example, is going to give you the same reward. So understanding your cues, routines, and rewards. So that broke it down, but it was too mechanical for me. And then I stumbled on this book, which is a great book. Another book if you really want to read is Atomic Habits. So he goes a little bit deeper into that circle, the golden circle. You've probably heard of the golden circle. This is Stanford— I mean, Apple executive Simic. I think I would say Simon or Simic. He talks about the golden circle, understanding the why, Which is the purpose, why we're doing what we're doing, and then the how and the what. A lot of times we focus on the how and the what, but we forget about the why. So in Atomic Habits, he just changes the naming because he wants to— this is about you. It's not about the company or the project you're talking about. It's about you. So he changes the why to identity. Who do you want to be? That's your identity. And then you talk about the process and the outcome. So really important to really delve into that. He talks again about he has 4 dynamic forces to change your habits. Make it obvious. Make it attractive. Make it easy. Make it satisfying. Again, you think of the emotional rider, the rider on the elephant. You want to make it easy. You want to make it satisfying. And if you have a bad habit you're trying to break, you want to do the opposite. Make it more difficult, less obvious. So visually, it turns out it's very important. If you want to make it obvious, make it visual. So about 18% of the brain processes are visual in nature. So that's why out of sight, out of mind. If you want to have that apple every day, put it in front of you. Put it in a fruit basket in front of you. Then you're going to eat that apple every day. So make it visual. Make it easy. Make it attractive. For example, he talks about he didn't want to touch social media on the weekends. He was running a company. So he had his assistant change the password so he couldn't do it. So he made it difficult. There are different types of habits. Some are effective, ineffective, some are neutral. You really need to— he talks about dissecting it down to the minute, like where, when, what are you doing, and who are you doing it with. You really need to dissect that down, that particular habit. And he wants you to— I will do this behavior at this time in this location. He really wants you to be very specific. And just like BJ Fogg talks about stacking habits or attaching one habit to another, he would like you to do that. Repetition is key. It turns out it's not about time. If you give it time, it's about repetition. So repetition allows you to form new habits. So this is in the brain. Neurons that fire together wire together. So make that a habit so that it becomes automatic. You have to repeat it several times. This is my daughter Sarah. I'll give you a last example. How long do you think it takes for something that you do to become a habit, to do it unconsciously? That's great. That's a great question. How long does it take to do something repeatedly to become a habit, become unconscious? It depends. Depends on the habit. For example, smokers, they always have the craving for tobacco for life. But they can— some of them have this epiphany, they quit it. Sometimes you might still have that craving, but you kind of eliminate that habit. Usually, usually, It's in the order of weeks for most habits that you form a new habit. If you do it for several weeks repetitively on a daily basis, you'll develop new habits. So it doesn't take like a very long time. I've read research that usually it takes 66 days to acquire a habit. There you go. So 66 days. So in the order of weeks. It depends on the habit. Some are easier to form than others, obviously. Some might take a lifetime with a health coach. And some you never conquer. You just learn to live with. So it's very complex. So this is Sarah again. So I tried many iterations with Sarah to exercise. Sarah is a little bit chubby but very healthy. And I failed every time until one day I realized that she's dancing. She would be dancing for 1, 2, 3 hours. So for her, that turned out to be her way to get her exercise. What we did is allow her to have the right space. So in that space, which is her bedroom, she has the iPad where she has her music. She has kind of an inspirational space, a lot of colors and inspiration board. And then here, actually, there's a mirror. And she has a well-lit room. So when she moved into that bedroom, things changed. So a lot of it is to make that environment. And then you try different iterations. And then ultimately, she was able— I'm sorry. We kept harping at her, you got to move. But she eventually found that habit that's making her healthy. So again, think about your day, your life. Do you want to change? Why do you want to change? Again, that inner circle. What habit? Replacing current routines with new ones. Again, think about the 4 pillars, habits. Think about the meaning, purpose, And again, think of health as a journey. And I end up with this slide that always, always take somebody with you on this journey. All right, thank you. So—