How to Change Your Habits, Brain, and Life with CBT

We are all creatures of habits—for better or worse. For example, I go to the gym before work three times a week. It’s just my Monday/Wednesday/Friday morning routine–for better. On the other hand, I recently noticed my habit of spending too much time mindlessly scrolling through Facebook. Now that I am aware of it, I’ll aim to stop it. When you change your habits, you change your life, and you can do it one habit at a time.

Insight Alone Is Not Enough

In my work as a licensed psychologist, people often come to me for treatment because their habits aren’t helping them to be happy or successful in their lives. Many of the people I see know exactly the behaviors they want to change. Some have been in therapy already or have devoured plenty of self-help books and gained valuable insight into themselves. Some individuals have anxiety and avoid any kind of social activity, which leaves them feeling lonely and disconnected. Others have negative thinking patterns that keep them feeling stressed and depressed.

Even though they know what they want to change, it’s common for people to come to me because they haven’t been able to take the step from awareness to action. It takes a consistent focus and practice to build new habits. As you probably know all too well, insight alone is not enough.

Changing a Habit Means Changing Your Brain

Habits are routine behaviors that you do without having to really think about them. They’re below your conscious awareness because they have become automatic patterns in your brain. This is one reason they can be so hard to break.

Intentional actions are handled by your brain’s prefrontal cortex. This part of your brain houses your higher brain processes and executive functioning. Habits are managed in part by your brain’s striatum, an ancient processing center that’s part of the limbic system (sometimes called the “reptilian brain”). The limbic system is involved in automatic behavioral and emotional responses, especially those needed for survival–which is why you can perform habits without thinking.

Changing a habit requires changing what’s happening in your brain. Initially, it will involve shifting your awareness so that the frontal lobe is in charge of your behavior, which is why it takes the deliberate practice of new thoughts and behaviors to break out of your default patterns. Repetitively and consistently thinking and behaving differently alters your brain’s pathways and patterns — and habits — through a process known as neuroplasticity.

Creating New Habits with Cognitive Behavioral Therapy

My treatment specialty is mindfulness-based cognitive behavioral therapy (CBT). CBT is a practical and action-oriented approach for quickly building positive emotions and meaningful engagement in your life.

CBT is known for including “homework” between sessions, but I rarely call it that. “Homework” suggests it’s an add-on to what we do in my office. However, most of the time the work between therapy sessions is as important as the session itself, if not more. After all, I typically see someone for only one hour a week. That leaves 167 hours each week for them to practice the new behaviors we talked about and create real change in their life.

At the end of the session, I usually give each person an activity plan that specifically lists the things they intend to do before our next session. I’ve found that writing down the plan is crucial. No matter how clear the action steps might be in our session, it’s easy for someone to forget them a day or two later. Having the plan in writing also increases the sense of accountability. (I keep a copy in the person’s chart to refer back to.)

CBT Activity Plan

Typically, an activity plan from a session would draw upon the three pillars of CBT: cognitive, behavioral, and mindfulness. I summarize this three-pronged approach as “Think Act Be” — a simple reminder of three ways to develop positive habits.

Think: Cognitive strategies for training your thoughts to serve you well.
Act: Behavioral techniques for choosing actions that build the life you want to live.
Be: Mindfulness practices for experiencing greater presence and connection in each moment.

These three approaches overlap and work together to reinforce one another.

Three Steps to Change Habits

I created The CBT Deck of cards to help you implement this practice on your own. Each card in the deck features a CBT practice — based on the Think Act Be framework — for you to focus on for that day. The nice thing about the card format is that it’s easy to take the day’s card with you as a reminder, just like a written activity plan. Each day you draw one card from the deck to encourage you to continue with your positive change plan. You can alternate drawing from the Think, Act, and Be card options each day, or focus for consecutive days on one category of practices (e.g., doing a week of “Act” cards), as you prefer.

Let’s walk through how to use The CBT Deck with the example of wanting to lower your average level of anxiety. Research has shown that it’s possible not only to reduce anxiety in a specific moment but to actually become a less anxious person by changing your habitual thinking and behavior patterns. Over time, this changes the default operation of your brain.

For this example, I’ve chosen cards from the deck with practices that work well with lowering anxiety. As you’ll see, some of these practices would apply well to other challenges, like depression. In general, I designed the cards to be flexible based on what a person is dealing with. And remember, you would choose one card to practice at a time, generally one per day. If you wanted to practice the same card for multiple days — even for a week — you could do that, too. It’s your deck, and you get to choose!

THINK: Training Your Morning Thoughts

If you’re highly anxious, you probably have anxious thoughts before you even get out of bed. For example, as you mentally run through your day, you might imagine things that could go wrong. Perhaps you have a general sense that you’re bound to make a serious mistake or be overwhelmed, or will disappoint your boss.

This card encourages you to plan in advance how you want to mentally greet the day so you can practice new ways of thinking before your feet touch the floor. For example, as the card instructs you can list things that are likely to go right today. Instead of imagining being stressed out and overwhelmed, you could remind yourself, “I have everything I need to meet the day’s challenges.”

The positive thoughts you plan to practice should be believable. If they’re not realistic, you’ll see right through them, and they won’t be helpful to you. For example, it wouldn’t be useful to tell yourself that “everything will go my way today” — maybe it will and maybe it won’t. That’s why on the card I suggest listing some things that are “likely” to go right today, which acknowledges life’s uncertainty.

ACT: Stare Down Your Fear

Nothing rewires the brain like deliberately facing and moving through your fears. As you follow this card’s instructions, you’ll want to pick an easier situation to face at first –aim for an activity that’s challenging but manageable. Then use a gradual, steady approach to move on to more difficult ones as your confidence grows and your fear shrinks. Research shows that approaching the things you’re afraid of alters the brain’s activity to lessen the fear reaction.

If you were facing a fear of spiders, for example, you might start with choosing to stay in the same room where you know a small spider is. Once you get accustomed to that level of challenge, the next steps might include looking at pictures of spiders, standing close enough to a spider that you can see it in full view and being right next to a spider for an extended period of time.

Decades of research has shown that repetition is really important for lowering fear. A “one-and-done” approach won’t change habits. For this reason, aim to face each fear multiple times, until you’ve conquered it.

BE: Embrace Uncertainty

Anxiety is driven by fear of the unknown. Your brain is wired to crave certainty and predictability, which increase the chances that you’ll survive and pass on your genes. However, too much focus on trying to be certain of things isn’t good for your well-being — especially when the outcomes aren’t directly under your control.

Rather than spending your mental and emotional energy worrying about things you can’t control, focus your attention and effort on the things you can. Shifting your focus this way calms your nervous system and frees you from the exhausting habit of trying to figure out what’s going to happen in the future. By allowing the future to be uncertain, you can rest in the present.

We create a lot of needless worrying when we become too attached to specific outcomes and stress about things going the way we want them to. Oftentimes what you like, want, and think you need isn’t going to be for the best, or even get you to your goal. By trying to force one particular outcome, you limit other possibilities that could bring what you were seeking in the first place. The goal is to stay open.

Putting It All Together

As you do these practices, notice how they can work together. For example, practicing the thought “I can face today’s challenges” in the morning can help you to stare down your fear later in the day. Similarly, embracing uncertainty can be one of the mindsets you practice in the morning. Our habits — whether healthy or unhealthy — reinforce each other.

Finally, remember that you’ll never be completely rid of anxiety. It’s just not a realistic or worthwhile goal. Some degree of stress is even useful and is your brain’s way of looking out for your safety. Your goal is to learn to manage anxiety and work through your fears to create the life you want. Even after you’ve worked through fears, you may still have periods of very high anxiety at times. However, the consistent practice of CBT and mindfulness techniques can rewire your brain and reset your baseline anxiety. Tools like The CBT Deck can help you do that.

What is one habit you would like to change? Make a plan to work consistently in that direction, taking daily action to design the life you want to lead — starting right now.

Guest Author

Seth J. Gillihan, Ph.D., is a licensed psychologist with a private practice in Haverford, PA. He is the author of The CBT Deck, Retrain Your Brain, and Cognitive Behavioral Therapy Made Simple, and co-author with Dr. Aria Campbell-Danesh of A Mindful Year: 365 Ways to Find Connection and the Sacred in Everyday Life. Dr. Gillihan hosts the weekly Think Act Be podcast, which features a wide range of conversation on living more fully.