Fundamentals of changing your Habits

By on March 4th, 2018

In previous posts, we discussed the role of bad habits—texting, sitting, sedentary lifestyles, or driving with improper posture—in contributing to the epidemic of back and neck pain. If good postural habits and routines are vital to relieving our pain, what is the best way to form them? How can we use the habit-making process to our advantage when we have a chronic neck or back condition? It takes time to change one’s daily routine, so it’s important to cultivate patience on this journey. To implement real change, here are some things to consider in making your habits “hardwired” so that they are automatic.

The Three Fundamental Phases of Habit Forming

The “honeymoon” phase is the first phase and is usually the result of something that is inspiring change, such as a New Year’s resolution, an episode of pain, or an appealing image of yourself that you would like to adopt.

However, the key to hardwiring change actually comes in the next phase. The “fight-through phase” is phase two, where one recognizes the scope of the problem. A person essentially asks, “What would happen if I create this new habit?” and conversely, “What would happen—what emotions would I feel—if I didn’t change my habit or reach this goal?”

In this fight-through phase, it is important to project what would happen (using great detail) in the next five years if you do not begin to make these changes. To turn the impetus of the honeymoon intent into a sustainable habit, expect some setbacks. It is important that you win at least two or three “fight-throughs” to convince yourself that change is needed.

The key is to reach stage three where the habit has become “second nature”; it is ingrained and hardwired. A study done at the University College London reported that, on average, 66 days were needed to create a new habit, but this also ranged from 18 to 254 days to reach a 95 percent “automaticity”…In other words, to act without thinking.1 This notion of automaticity turns out to be a central driver for habits. However, it’s important not to misinterpret findings. The study also showed that missing one opportunity to perform a behavior does not  materially affect the habit formation process. It is okay, therefore, to mess up every now and then because building better habits is not an all or nothing process.

The Importance of Fighting Through Setbacks
How many of us have fought months to lose those pounds and change our habits, only to revert back? The reason is that even after a new habit has become second nature, it’s easy to experience an interruption due to a long vacation, illness, or even a long weekend. These interruptions can send you back to the fight-through phase. And yet, once you win two or three
fight-through rounds, you’ll be back to where the habit is second nature. The key is to avoid the discouragement monster where you think thoughts like, ‘This isn’t working and there is nothing I can do’.

It’s also important not to stop short. If you do experience early success, don’t be lured in by the seduction of success, where you are tempted to think you are special, in that you can continue to experience the same great results while short-cutting processes that work. When you experience what seems like a “quick fix,” it can deter you from developing long-term habits that sustain your gains.

The Best Way to Change Your Habits: Control Your Environment

We are more reliant on our environment—rather than our intentions—to trigger our actions and habits. Therefore, in order to radically change your behavior, it is important to first radically change your environment. It would be nice to think that we make our own choices and follow through on them, but we are actually very influenced by the things around us.

In the conclusion of his study on visual cues of portion size, Brian Wansink states, “using smaller than normal size plates, bowls, and glasses might lead people to believe that they had a full portion and make them less likely to ask for an extra (compensating) serving. Similarly, bulk snack products that are repackaged by a watchful parent into small portions and sealed into zip-lock baggies may provide the visual cue that leads a child to believe he or she has had a full serving of a snack when it was actually a fraction of what they might typically eat.”2

If your environment dictates your actions, then you can use your environment to change your behavior. For example, spend time and effort making it easy to form good habits and take steps to make bad habits difficult to engage in.

When your motivation is high (for example, just after eating a big meal or the night before you plan to go to the gym), make sure to pack your gym clothesin a bag and place them in your car. If you are going to physical therapy, make multiple appointments in the future at the same time to eliminate the choices and guarantee that you keep your appointment. Similarly, your home exercise regimen should have clear implementation intentions, such as knowing where and when you will exercise.

In fact, in a study published in the British Journal of Health Psychology, participants who used these implementation intentions (they wrote down exactly when and where they would exercise each week) ended up following through with exercise at least one time per week 91 percent of the time compared to 38 percent follow-through in the control group. Interestingly, those who read motivational material about exercise, but did not plan, showed no increase in exercise compared to the control group.3

Try scheduling tasks during the same time in your daily schedule, including exercise. For example, do certain vital spine exercises—like “Spine Stabilization 101” exercises on my books website: https://www.takebackcontrol.com/spine-stabilization-101.html—at the same time every day, like before your lunch break or as soon as you wake up.


  1. Lally, P., C. H. M. van Jaarsveld, H. W. W. Potts, and J. Wardle. 2010. “How are habits formed: Modeling habit formation in the real world.” Eur J Soc Psychol 40 (6):998-1009.
  2. Wansink, B., J. E. Painter, and J. North. 2005. “Bottomless bowls: why visual cues of portion size may influence intake.” Obes Res 13:93-100.
  3. Milne, S., S. Orbell, and P. Sheeran. 2002. “Combining motivational and volitional interventions to promote exercise participation: protection motivation theory and implementation intentions.” Br J Health Psychol 7 (Pt 2):163-84.


Kamshad Raiszadeh, M.D.

Dr. Raiszadeh's completed medical school at UC San Francisco, orthopedic surgery residency at UC Davis and his Pediatric and Adult Spine Fellowship at the Hospital for Joint Diseases/NYU in New York City. He has 20 years of experience with the broad range of spine surgery including minimally invasive surgery, complex spinal disorders such as scoliosis and kyphosis, and cervical spine disorders. During this 20 years he has noticed a dramatic increase in patients turning to surgery for treatment of neck and low back pain, but many of them not getting their desired long-term result. He therefore became increasingly interested in improvement and standardization of non-operative treatment. By developing the best aspects of non-operative treatment in an atmosphere of empowerment to maximize the body’s own healing capacity, he noticed that many fewer patients required surgery, and the ones who underwent surgery had much better long term results.

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