If all of my struggles with making healthy decisions were purely due to a lack of knowledge, then I would have self-corrected the first time I read any health magazine (I would also have a full head of hair and know the secrets to pleasing a woman). Unfortunately, it is rarely a lack of knowledge that keeps us from better living. There are layers upon layers of cognitive traps that keep us from making the choices we know we should be making.
To understand these traps, we need to talk about our brains. Our brains have three primary goals:
- Stay alive: You’re reading this so you are clearly doing a good job.
- Conserve resources: It would be catastrophic if we randomly and unpredictably ran out of energy. Our brains don’t like to spend energy on things that aren’t worthwhile or at times when we don’t have a lot of energy. When are you most likely to cheat on your diet – first thing in the morning after a good night of sleep or late at night after a stressful day? Burning the extra energy to inhibit the urge to eat a cookie and choosing to eat a carrot is easy when you have a whole bucket of energy. Burning that same energy when the bucket is almost empty is risky. So, your brain chooses the cookie to try to save your life.
- Make the world make sense: The more the world makes sense, the better we can predict what happens. We are constantly forecasting the future. We do this by making logical assumptions and filling in the gaps with what seems to make sense. This is where we often get into trouble.
This trouble comes from our own difficulty with evaluating evidence in the moment. Our brains struggle with the distinction between an in-the-moment thought (This dog is biting me) and a forecasting thought (This dog is going to bite me). This isn’t a logic problem. I am not saying that you get confused between the present and the future. This a feeling problem. We react to both thoughts the same way – we get the hell away from that dog, because the urgency feels the same.
Unfortunately, our brains are equally as sloppy at determining if what we did was effective and essential. If you are actively getting bit by a dog, removing yourself will likely be helpful in reducing pain and be critical to your survival. The alternative would probably lead to negative effects on your health. However, if you believe you may get bitten and leave the situation, you are certainly being effective at preventing that future but you are unsure if your decision was essential. Our brains struggle with the counter-factual – the “what would have happened if you didn’t do that thing you felt you had to do?” In the situation with the dog, this may lead to over avoidance of all dogs. Each successive time you avoid a dog the forecast becomes more believable. Your brain looks at the wealth of learning and says – we have avoided dogs 100 times and we have avoided being bitten 100 times. This avoidance MUST be keeping us from getting bitten.
What does this have to do with nutrition, running and making healthy choices? Take the thought – I am starving. This could certainly be an in-the-moment thought; you may be actively starving and eating is the most crucial thing you can do. This could also be a forecasting thought – if I don’t eat soon, I am likely to die (if you have ever waited at a restaurant with me, you know that this is a common, loudly vocalized thought I have). As a forecast, the objective reality isn’t certain. Unfortunately, objective reality doesn’t matter – it is the feeling that matters. It feels real so we act on it. This holds true for: this is going to hurt or this is too hard for me. In the moment, our brains may confuse the forecast with in-the-moment commentary. We then alter our behavior to avoid this possible, unpleasant future – possibly to the detriment of our own health. Psychologists call this interference “cognitive fusion” – cognitive because it is based in our thoughts and fusion because the thought is fused with experience, emotion and/or expectation.
Do an exercise for me. Think of some label, or statement about yourself, that you struggle with. For some people, it is “I am a failure,” “I am a bad parent” or “I’m fat.” Other people may struggle with a frequently occurring forecast: “I’m going to let someone down,” “I am going to get in trouble,” or “people are going to hate me.” Whatever it is, give yourself five seconds and just give in to it. Tell yourself that story and really try to believe it.
1 . . . . 2 . . . . 3 . . . . 4 . . . . 5 . . . .
I would ask how that felt but I can already assume the answer – pretty terrible but also oddly comforting. This self-talk is an effective strategy to maintain our practical and existential safety (it doesn’t keep us feeling happy or fulfilled but our brains really don’t care about that). If you think “I’m going to fail” and then you decide to quit something, you prevent your predicted failure. Quitting and failing are two very different things. If you fail, you tried and were shown to not be good enough. If you quit, you didn’t stay long enough to get an accurate assessment. Quitting protects your potential at the sake of your success. We also trade off potentially catastrophic disappointment later (failing, letting people down, etc.) by accepting mild disappointment now (quitting something you want to do). That is reinforcing. That is why our brains keep telling ourselves these things.
Now, I want you to try something else. Close your eyes again (after you finish reading this sentence) and I want you to tell yourself a different story. I want you to tell yourself, and really allow yourself to believe, that you are a banana.
1 . . . . 2 . . . . 3 . . . . 4 . . . . 5 . . . .
How did that go? Did you believe it? Did a moment of panic take over as you lost your human form – your skin thickened and turned yellow, your flesh became gritty and full of potassium? No, of course not. You may have chuckled to yourself at the foolishness of the exercise or became frustrated that I would ask you to do something so dumb. That’s the point.
Your brain saw this story – “I’m a banana.” I hope that you have never tried to tell yourself that story before. If you haven’t, then it is a new story that is not wrapped up in any judgment, evidence or history of learning. Your brain can look at it, hold it, examine it and look for proof.
Is my skin yellow? – No
Am I in a bunch? – No
Am I the size of a hand fruit or the size of a human? – Human
Okay, this is bullshit. I am not a banana. Your brain then passes the thought along without dwelling or ruminating any further. Our unpleasant thought came with piles of judgment and it was dripping with emotions and memories. The thought triggered unpleasant feelings and pain and made it hard to look to see if there was any actual evidence in the moment to justify the thought. At that moment, were you failing at anything? Was there anyone that you were actively letting down? Your brain used the thought as all the evidence it needed to make you feel bad.
It was like the thought was a spoiled tub of yogurt – the moment you open it death seeps into your nose and the only thought your brain can muster up is get rid of this. We have a well-learned strategy to get rid of the thought – act as if the thought is real and then avoid making it come true.
While I often have the best intentions with eating and acting healthy, I almost always get tripped up by my thinking. My brain tells me “you’ve earned this” when I look to chips over fruit. I hear the words, “sleep in today, you’re going to get hurt if you don’t” as my morning alarm goes off.
“If you don’t have a beer, you’re not going to be able to relax and sleep tonight.”
“Stop running, walk for a while.”
Wait, where are you getting all this from?
In my quest to identify the best, most effective strategies for coping with these thoughts (this is part of a longer series of posts), I first need to lay out some background. Cognitive fusion – as it is explained above, comes from a therapy style called Acceptance and Commitment Therapy (ACT). ACT is an application of a theory called Relational Frame Theory (RFT) which is a more contemporary, complex form of the big learning theories (Classical Conditioning, Operant Conditioning and Social Learning Theory).
The goal of ACT is a somewhat radical departure from the goal of other therapeutic approaches. While Cognitive Behavioral Therapy (CBT) and other common therapies have the explicit goal of symptom reduction (get rid of your negative thoughts, eliminate anxiety, etc.), ACT has the goal of increasing the quality of your life (by increasing values-consistent behavior). This is a slight, but important, shift in thinking. In practice, you assume that if you are doing the things you care about/want to do then that must mean your symptoms are going away.
That’s true (well…often, but not always) – but the key feature of ACT is where we put our energy. CBT says put your energy into getting rid of something and hope that valued-living increases as a by-product. ACT says put your energy into living and your symptoms will get better as a by-product. This is because, in reality, our emotions are chaotic. They rely on complex electrical and chemical signals that are hard to predict. You or I can do everything 100% correct today and still wake up feeling depressed tomorrow. If our goal is to have zero depression, then we have failed. If, however, our goal was to go for a walk, then our depression is just something that is happening. We still have the task of walking and ACT as a therapy works to teach us how to be flexible enough to walk while feeling depressed. String together a few days of valued-living and depression is less likely to hang around for long.
With that in mind, I don’t want to necessarily eliminate any of my interfering thoughts – I just want to make them less interfering. The logical question is – “why not just try to uproot them? Fight those fuckers and replace them with thoughts that help you be healthy?” Great idea! Sadly, I would lose that fight. My brain (all of our brains) are logic computers. Remember rule three? Our brains need to make sense and, as an extension, our brains desperately need to be correct. When my brain says, “you need to comfort yourself with that 2am shame trip to Taco Bell” it has a huge stake in that being the 100% objective truth.
Fighting that thought, head on, gets into a logic fight (I don’t need that Taco Bell vs. I do need that Taco Bell). The brain is a logic computer. Getting into a logic fight with your brain takes a lot of energy and is a great example of “cognitive busyness.” Cognitive busyness gets into that second rule – conserve energy. When we feel like we have buckets full of energy we are more willing to spend it on things. When our bucket is low, we don’t want to spend the energy inhibiting urges and getting into fights. Fighting our brains over whether or not Taco Bell is essential makes our brains busy; it burns energy and leaves us prone to impulse control problems (acting cranky, mindlessly eating). If we fight, we will (likely) lose.
So, what do we do about it?
The first, and most powerful, thing to do is to raise our awareness of what is happening. If we can catch the thoughts early we can act on them faster. You will have a far easier time stopping a car as it is pulling out of the driveway than stopping it going 90 mph down the highway. Russ Harris, an absolutely fantastic clinical psychologist, author, and guru of Acceptance and Commitment Therapy, identified six primary ways that cognitive fusion shows up. Being able to identify our typical style(s) of fusion will make it easier to call it out as it is happening. The six primary styles are:
- Rules: These are the “should,” the “must,” the “ought to” and the ever important “if-then” statements. Our brains like things to be predictable. We develop these rules to help add a little bit of reason and logic into our chaotic world. Some of these rules are directly taught to us while others we may learn through observation. I have a lot of rules around eating and exercise. I know, absolutely, where they come from. When I was younger, my mother (what a Freudian way to start) was very loving. The problem with someone who is very loving is that they typically have a hard time seeing the one they love go through discomfort. My mother is also an extraordinarily hard-working woman. She typically worked two jobs when I was younger, or one job while going to school, and she was always involved in what my sister and I were doing. The drawback of this conflict between ocean-deep love and dwindling energy is that there were a lot of food shortcuts and firm-and-fast rules. McDonald’s was a frequent dinner option. We frequently had high processed snack food. Food was a fast shortcut to reward, ease sadness, show love and save time. We were on a firm eating schedule and part of that was eating three times a day – You eat when the clock says food-time, not when you’re hungry.
Growing up and getting into my adult life, I believed that food wasn’t fuel – food was reward, it was comfort and it was boredom killing. Eating helped me to avoid feeling sad, to avoid feeling listless. I learned, not through written rule but through modeling, observation and trial/error, that these feelings were meant to be removed and there is a whole market of things to put into my mouth that can help with that (What a Freudian way to end).
Later, when I got to college, I learned that alcohol can do those very same things. There was never any drinking in the house growing up – these new rules came from social learning and the drunk men and women of St. John Fisher College. Going to a party? You should have at least three drinks before you get there. Did that class go poorly? You should grab a six-pack (who am I kidding, we never bought beer in lower bulk than 30-packs). Wait, you got an A? We have to do a power-hour to celebrate. I learned that Friday meant once class was done we drink. I also learned that Sunday was the best time to day-drink – wringing every last bit of freedom out of the weekend while, at the same time, losing large swaths of time to various shades of brown- and black-outs.
Now, when I get home from work my brain points out the rule – we are home, you have to eat. Sometimes it sounds like – you shouldn’t feel stressed so you should eat something. Other times it sounds like – if you don’t eat you will feel uncomfortable. Friday afternoons – You ought to go have a beer to reward yourself for finishing the week. Maybe it sounds like more – If you don’t drink, then you won’t relax.
- Reasons: Sometimes our brains look for excuses to get us off the hook. While running with my frustratingly fast running partner, my thoughts drift to – “he’s faster because he’s built faster.” Of course, that may be true but that also absolves me of the responsibility of getting faster. If he is just faster due to genes, then I am not responsible for our differing levels of fitness. Sometimes when I get passed in a race I think, “well they probably don’t have a job that has the same time demands that mine does” or “man it must be nice to have had professional training in college. I had to teach myself all this.” It’s a comfort thing. It’s trying to lessen the blow of struggle by discrediting the test. By looking for any place where the playing field isn’t level, it gives me the comfort of “knowing” that I could be good if things were just a little more fair.
Another common reason is – I don’t have enough time. This is a particularly difficult one because, yes, you (ok…I) may really not have the time I would like for the run I want to do. It would be fantastic if I had time to sleep until after the sun came up and then go for a nice long run in the morning before work. It would be similarly as nice if, on the weekends I could take off for 2-3 hours, drive somewhere beautiful and do a 90-minute run. Those things aren’t always possible because I have other responsibilities – I have a job (as well as a second, part-time job), a girlfriend, friends, hobbies and a house to keep-up. Since I don’t have time for the 100% ideal, is it better to take 0%? If I can’t fit in a 5-mile run between getting home from work and eating dinner I should just not run? If the weather gets ugly and I can’t go for that beach run I planned, I should just sleep instead?
Of course, on paper we can easily see that choosing 0% over 100% too often can lead to just not running. Unless weather conditions are perfect, and we feel perfect, and we have the perfect amount of time – we can easily slip into a habit of aborted runs. This isn’t a goddamn space launch. We (okay, I) need to be less of a NASA runner and more of a Malcolm X runner – any means necessary.
If we see a friend doing this we would likely get frustrated. Of course they may be genetically more inclined towards running but look at how hard they also worked to get there. You don’t know what that person does for work. What about all those single parents running while pushing a stroller? Do they have a cushy go of it? So what if they ran in college? Does that change how hard you should push yourself to get to that level?
This isn’t a friend we are talking to, though. This is our brain. This is our discomfort and our desired relief. This is our goal conflict – do we face the fact that this person is doing better (or, we are struggling) and work through it or do we discredit the evidence and stay the same?
- Judgments: Forgive me if this is offensive; but fuck me – judgments are the bane of my existence. We are judgmental animals. We are supposed to be. If we weren’t able to judge that a cave was unsafe or that a patch of berries was probably poisonous, we would have died out forever ago. In today’s world, however, there are far more shades of gray than our cavemen and cavewomen ancestors faced. Not everything is life-or-death. That doesn’t stop it from feeling that way, though.
Typically, when you break it down, we confuse judgments with observations. When we observe, we are just stating the facts. That chair is red. The temperature outside is 75 degrees. The car is going 50mph. Observations are objective.
When we judge, we shift into the subjective. Our judgments are evaluations of how something is as well as how it should be. That chair is bad (meaning, it has the qualities of a bad chair and it could/should be better). It is too warm outside (and it should be nicer; or – it’s too warm so I can’t run). The car is going too fast (and should be going slower; or – it’s going too fast and the driver is an idiot).
The problem is we base behavior-decisions on our judgments as if they were objective observation. We avoid that bad chair. We stay inside instead of going out. We get angry at the car that is going too fast. So far, not a whole lot of problem with that. What about the judgment, “anxiety is bad”? Or, how about “this run is too hard” or “I’m fat”? When we slip into these judgments, we carry the assumption that something is wrong because things should be different – I shouldn’t be feeling anxious, this run should be feeling easier, I should be running faster, I should look different. Now we are slipping back into that fusion. When my brain tells me these things, I start feeling frustrated, angry, sad, guilty. It’s hard to challenge the thought because it feels objective. How can I argue with reality? I better just believe it and adjust accordingly. Too often that adjustment involves removing the feeling at the sake of long-term progress – avoiding the anxiety vs. challenging it, avoiding challenging runs vs. building up to the difficulty level, quitting the run vs. slowing the pace, abandoning good nutrition and exercise vs. trusting in the process.
A second problem is when our judgments are too strong in either direction (too favorable or too unfavorable). When we creep into the extremes we tend to be setting ourselves up for either debilitating stuck-ness or catastrophic letdown. Sometimes with people I get the judgement “that person is a fucking terrible person.” Now, that person may have done some of the behaviors a terrible person would make. However, laying down a blanket judgment like that closes the door for any possible favorable evaluation. With a person who is 100% terrible, how is my resource-hoarding brain going to waste energy on interacting with this person? It’s not. I have effectively closed the door on any possible enjoyable interaction. If I never see the person again, then there is no real consequence. But what if that is a person I interact with repeatedly? I’m probably going to have a real hard time just maintaining basic, human social behavior.
- Past: I can’t do this because this thing happened. Our past provides evidence for how the future could be. The could be gets confused with the going to be. I can’t lose weight because I have been over weight my entire life. I can’t run well because I was slow when I was younger. I shouldn’t go lifting because I got hurt last time. I’m not going to wear shorts because kids in high school made fun of me. We ruminate and we regret. When unpleasant past memories crop up, they bring with them painful emotions. We slip into avoidance mode. We are more motivated to maintain our present state (where things make sense and we feel just mildly okay) than to risk feeling worse in the name of getting better.
- Future: By now the pattern is becoming abundantly clear. We make predictions. They feel real. We try to avoid that possible future by changing our behavior. What’s that? The feared future didn’t happen? Must be because we did something differently. We would have absolutely gotten made fun of had we gone to that group run. Thank God we re-watched The Office again.
- Self: This last form is less forecasting focused and more about confirming the present. Remember – our brain wants the world to make sense. If your brain has developed an assumption about itself then it is far more motivated to confirm that assumption than to risk the chaos of having been wrong. The whole idea is referred to as Self-Verification Theory (an idea most widely attributed to W. B. Swann at the University of Texas at Austin).
Self-verification is a radical departure from the more commonly held idea of self-enhancement. With self-enhancement, the thought is that people are driven to better themselves and, as a result, we make decisions that will align ourselves with positive feedback. Unfortunately, we don’t always see that pattern of behavior. How often do we see friends repeatedly choose terrible boyfriends/girlfriends? What about the kids in high school that seem to chronically be part of an abusive friend group?
A series of experiments by Robinson and Smith-Lovin (1992) looked to test why self-verification is reinforcing. First, they showed that regardless of self-identity (in their study, chronically low and chronically high self-esteem), people like getting praise feedback and dislike discouraging feedback. The difference, however, between the low and high self-esteem people was in how much they believed the feedback they received. People with high self-esteem tended to believe praise more and discredit the discouraging. Meanwhile, those with low-self-esteem found the discouraging feedback more accurate and, on top of that, tended to find the discourager as more likable than the praiser. Follow-up study found that those with low self-esteem not only preferred people that gave criticism but were also more likely to choose to interact with those people instead of those who were flattering.
When you really think about it – the reasons make sense (and Swann, along with other verification researchers, have been able to replicate time and again). We like things to make sense because it makes us feel that the world is more predictable. Let’s say I think I am smart and you tell me I am smart. You and I are agreeing. There is no ambiguity. You are telling me I am smart because I am smart and the world makes sense. Now, let’s say I think I am dumb and you tell me I am smart. Why aren’t we agreeing? Is it because you are just trying to make me feel better? Is it because you want something from me and are trying to use flattery as persuasion? What if you are just as dumb as I am? Or, even worse, what if I am actually smart but just dumb about being smart? These reasons add ambiguity, doubt and confusion. Sorting through it all takes a lot of brain energy. Wouldn’t it just be easier to surround yourself with evidence to support what you already know, rather than evidence that challenges your beliefs?
Some of my labels and self-views are not running-congruent. I am fat is one that I have carried with me since my days of actually being fat (graduating high school at 240 lbs packed into a respectable 5’7” body). Knowing I am fat makes running challenging, as well as making healthy choices challenging. If I am going to be fat regardless of what I do or eat, why would I waste my brain energy making healthy decisions? Sometimes my label becomes “I’m not good at this.” Okay, then why keep going if you are not good (and, the way it’s written out, will never be good)? This isn’t relegated to running and nutrition – it goes with other life stuff too. My story of “I’m a fraud” creates terror in the pit of my stomach whenever my boss emails me. Thinking I am unlovable makes criticism from loved ones sting that much more. So, it’s tempting to avoid situations that may either prove my worthiness or confirm my fraudulence. It is easier to navigate around criticism or employ unworkable strategies that prevent receiving criticism (even if there is still criticism-worthy behavior).
Okay, what does that look like in practice?
The first step is to catch it. Knowing the different forms can help you be a little more vigilant. Pay attention over the course of a day or, even more specifically, during one specific behavior that you find important. Struggling to stick with your running plan? Choose that as the time to be watchful of your thoughts. Eating out of control? Start tracking out what your brain tells you in the moments before, during and right after you eat. Pay attention and write it down. You may be surprised at how predictable your brain actually is.
Once you start learning your thinking habits – name it. What is the story? If you are running and your brain says that you have to stop and walk after every mile (even though your ultimate goal is to run 5-k non-stop) then call it your “early break story.” Get home from work and feel like if you don’t eat something sweet you are going to die? There’s your “sugar story.”
Identifying the habit and catching/naming it in the moment is the most important, and hardest, part of all this. This week (starting on 7/16/18) I started a very structured training program for the Baltimore Half-marathon. I am terrible at sticking to training plans (there’s my training plan story). I also worry about it being too hot (judgement) or that because I struggled in the past I won’t be able to do it now (past focused). For the first week, I have been monitoring and tracking out what is mentally getting in the way. I will check in on my training diary updates (coming out on Sunday evenings) with what some of the typical thoughts/styles have been. Down the road, I will start testing out some different cognitive defusion exercises (ways to weaken the story) as well as some other cognitive coping skills. Stay tuned!