Managing fibromyalgia involves making multiple lifestyle changes. I think it is like having a black belt in New Year’s resolutions. In the past six years, I have added daily stretching, meditating, walking, resting, and supplements to the things I do almost every day. I have found it to be very difficult to stick to making new habits, with lots of false starts and relapses into bad habits.
The intentional mind can change quickly because what we wanted to do in the past may be different from what we want to do now. The habitual mind is much harder to change because our behavior is automatic – in fact, we are on autopilot 40% of the time. It is hard to sustain the willpower to change and easy to revert to old habits. However, by understanding the science behind habit formation, it can be much easier to stick to the lifestyle changes that you have decided to make.
When you first try to start a new habit, you engage goal-directed brain regions in the prefrontal cortex. As you repeat your habit in the same context, such as always brushing your teeth in the bathroom before bed, the part of your brain you use to maintain your habit shifts to the ‘sensory-motor loop.’ This is the habitual part of the brain that functions mostly outside of our awareness, by associating situational cues with a behavioral response. For example, when you stagger into the kitchen in the morning and make coffee, you are on ‘autopilot,’ and not making a conscious, intentional decision – your brain associates waking up and going to the kitchen with coffee.
Habits can be broken down into three parts:
- The Cue – a trigger, internal or external, that reminds you perform an action
- The Action – the habit behaviour you are trying to put into place
- The Reward – the reward your brain receives for implementing the habit
The Cue – The first step to creating a new habit is often to break the old habit. This means removing a situational cue that triggers the habitual response. When my husband and I decided we would try to walk every day after he got home from work, the first obstacle was to avoid sitting down in front of the TV soon after he came in the door. It was so much harder to get up the motivation to go outside after we had already begun to watch a show, even if initially we said “we’ll only watch one.” So instead, he now immediately gets changed and we head out the door, avoiding the couch altogether. Another helpful tactic is to remove any visual reminders, such as moving junk food to a higher shelf if eating healthier is a habit you’re trying to create. Think about how to remove negative cues that keep you stuck performing a bad habit.
The next part is to choose a positive trigger that will remind you to repeat the new habit you’re trying to cultivate. The most effective way to do this is to use something you do automatically already as your cue. For example, doing yoga after brushing your teeth in the morning. Alternatively, create a visual reminder, such as putting your smoothie blender beside the coffee maker or a note on the bathroom mirror to floss your teeth.
The Routine – put simply, repeating an action turns it into a habit. It only becomes automatic after you do it regularly. One of the biggest mistakes is trying to implement multiple new habits at the same time. I’ve been guilty of trying to make multiple lifestyle changes at the same time in order to improve my fibromyalgia, like taking new supplements, exercising, meditating, and resting daily. I think this can just lead to treatment burnout where you lose the motivation to stick with any good habits. It’s also important for new habits to be realistic. You know yourself the best, so start with a real change and be patient.
The Reward – there’s a reason that bad habits stick around, and it’s because of the reward system in the brain that lights up when you eat sugar, play online games, or drink a lot of caffeine. While eating healthily or exercising more eventually become their own rewards, it can be helpful to consciously reward yourself when you cultivate new habits. This could be a small piece of dark chocolate or a mental pat on the back for accomplishing your goal for the day.
Research shows that tracking your habits is one of the most effective means for sticking with a new lifestyle change. This could be a simple checklist on a piece of paper that you mark every day or downloading one of the multiple habits tracking apps onto your phone. Keeping a log of your progress helps to improve motivation, keep you accountable and note any obstacles or solutions to work on. I have found it helpful to just add a new habit to my daily pain journal. At the moment I am tracking my physiotherapy strengthening exercises and daily step count. Filling it out reminds me to keep up with it and also helps me see how it improves my pain levels during the day.
I believe that underneath the trigger and behavior nature of habit formation is a more crucial factor – namely, your relationship with yourself. How do you respond to yourself when you make a mistake? It’s inevitable when you try to make a new change that there will be days when you fail and forget to do the one thing you swore you would do every day in 2019. If you react harshly, condemning yourself for your mistake and doubling down on negative self-talk, then you are actually less likely to stick to your new habit. This is because of “all or nothing thinking” which goes something like this: if you didn’t meditate one day this week then you consider your New Year’s resolution to be a complete failure and decide that you may as well just give up. In contrast, if you are compassionate to yourself for making a mistake – after all, making mistakes is something every person does – then you are more likely to keep up with your new habit. Be kind to yourself. You can always begin again. Try noting the negative thoughts in your daily log and then reframing them in a more helpful light. For example, “I can’t believe that I didn’t do my physiotherapy exercises this morning, I am never going to get this right, so why even bother?” can be changed to “it’s frustrating that it slipped my mind today, but I know that’s going to happen sometimes. It’s better that I do it more often than never, some I’m just going to begin again tomorrow.”
Cooper, B. ‘Why you should be tracking your habits’. Lifehacker (www.lifehacker.com)
Science Daily. ‘How we form habits, change existing ones.’ (www.sciencedaily.com)
Fibro Women Blogs
Chronic Woman Blogs
Chronic Illness Blogs
Official Fibromyalgia Blogs