Listen to this story
How to Break Bad Habits by Simulating Rock Bottom
You decide where you make your turn-around. Here’s how to do it sooner.
There is a common misconception about addiction recovery that a person must “hit rock bottom” before they can change; that they must come to a completely humiliating and dangerous way of life before their motivation to change will be strong enough. The idea is that often people don’t decide to make changes in their lives until things have gotten “bad enough” for them.
This was illustrated in the recent film “To the Bone” when the main character, Eli left an inpatient program for anorexics. The doctor’s comment about her leaving was:
“The problem with treatment for some of these kids is that we won’t let them hit bottom. It’s too hard to watch. But for Eli, the bottom is critical.”
Now there is some merit to the idea that “we”—the families and support systems of people struggling with addiction—have a role to play in this process. But I hate this lazy view on behavior change and want to present another option here.
As a therapist, I see people who need to change to avoid catastrophe. Some of them want to. Some of them don’t. You might find this also in your own life. You know you need to make a change, but you in some ways you enjoy your bad habit. Unaddressed this bad habit will force a “rock bottom” on you and then change will be easier. Obviously, it would be healthier if you could change right now.
The good news is that a person’s “bottom” can be influenced and changed. In fact, as addiction recovery programs become more effective, it becomes possible to intervene sooner. People can recover from an addiction problem with a “high bottom” if they understand the progressive and increasingly disastrous consequences they face by not changing course.
The person wanting to change decides where their “bottom” is. You can apply the technique I’m going to give you not only to addiction but to any kind of bad habit you’d like to conquer.
Clarifying the consequences
When we have negative behavior patterns we want to change, it’s tempting to focus on the absence of the behavior as our goal—or a good replacement behavior we aspire to. But that’s likely not enough.
To illustrate, let's say I want to deal with my tendency to not get enough sleep.
Is “feeling tired during the day” a bottom that will motivate me to make changes to my sleep routine?
Probably not. I may shrug it off and decide I’ll try to “catch up” later and just power through feeling tired.
But if I think through the consequences of being tired during the day, it’s easy to understand that it’s detrimental to my job performance. As a therapist, I certainly can’t be yawning all day. I can’t struggle to stay focused or no patient would ever want to work with me. As a dad, if I can’t keep up with my toddler because I’m tired, I’ll be tempted to let her watch too much television, that has other negative consequences.
Even as I type this, I am feeling more motivated to get to sleep on time and cut out screen time before I go to sleep. This is because I am amplifying the consequences of the behavior.
The slang term for this is “playing the tape out.”
The tape metaphor is dated now, but the idea is that if you “play the tape out” — or “fast forward” — the consequences of not changing reveal themselves to be much more serious. You’re visualizing yourself hitting a more serious “bottom,” and accessing more powerful motivation to make changes now so you can avoid them.
This is one reason that addiction recovery programs often use a system of sharing stories. The similarities in patterns of the stories are striking, and the progressive nature of addiction becomes clear. “Low bottom” stories, in particular, can be wake-up calls to others that they will face the same consequences if they continue along the same path or relapse.
Tony Robbins’ calls this visualization of consequences a “Dickens pattern” where he identifies that you can consciously link the pain caused by bad habits to the behaviors themselves to help motivate change. The name comes from Charles Dickens’ Ebenezer Scrooge character. Visited by the ghosts of the past, present, and future, he sees how his pattern of selfish and cruel behavior will lead to more and more pain in his life. This powerful new association with the behavior helps Scrooge “hit bottom” higher than he would have without this reflection.
A common “playing the tape out” scenario discussed in substance abuse is relapse. Let’s take alcohol. If you’ve been sober for weeks or months and are considering how to handle going to a wedding where there will be ample free alcohol and socially encouraged opportunities to consume it, you might be able to convince yourself that one champagne during the toasts or one shot with the bridal party might not make a difference.
But if you “play the tape out” and imagine give yourself permission to have one drink for this “special occasion,” you can also imagine the subsequent “special occasions” where one or two drinks “can’t hurt”…which you used to tell yourself all the time, while failing to stop at two. Fast forward from there and it doesn’t take long to get back to full-blown binge episodes with their terrible consequences.
Like I said, you can use this technique for less dire bad habits as well. For example, consider dieting. The few attempts I have made to change my diet have all been related to blood test results. Things like high cholesterol or borderline pre-diabetic sugar levels have scared me into making changes to my diet. Were these test results a case of me “hitting bottom?”
No, but they held me over a metaphorical pit to show me how far the bottom could be. The problem arises when my changes are only maintained long enough to improve the next test results. Once my cholesterol or sugar levels return to “normal range,” I’m tempted to stop worrying and return to less than ideal diet choices. I’m like Ebeneezer Scrooge if he had raised Mr. Cratchit’s salary a bit but then forgot what he’d learned from the visits of Christmas past, present, and future. I need to keep reminding myself.
I think this idea of “hitting bottom” as motivation to change is related to the idea of loss aversion being twice as powerful as the draw of gains.
In an interview with David Greene of NPR’s Morning Edition, Shankar Vedantam described loss aversion in the following way:
VEDANTAM: Let’s say you go to a casino and you plunk down a bet and let’s say you lose $50. Now the question is do you leave or do you try and dig yourself out of the hole by gambling a little further?
GREENE: I, and most people probably, would stay and try to dig myself out of the hole.
VEDANTAM: Exactly. I spoke with Jeffrey Berejikian. He’s a political scientist at the University of Georgia and here’s how he put it.
JEFFREY BEREJIKIAN: You can do nothing and walk away and absorb that certain loss or you can gamble. And you know that the gamble is biased in the favor of the house. But there’s some chance that you might win and get back to where you were before. When you frame choices in that way, human beings exhibit real consistent risk acceptance.
VEDANTAM: So the interesting thing, David, is that people seem much more willing to place the second bet than to place the first bet. And that’s because with the first bet you’re hoping to win something. With the second bet what you’re really trying to do is you’re trying to head off the loss and loss aversion theory suggests that the desire to avoid losses is wired more strongly into the brain than the desire to achieve gains.
My belief is this loss aversion keeps us in the cycle of hoping our “negative” behaviors will be able to return to a previous level where negative consequences were not as likely. So drug or alcohol abusers try to moderate their use instead of quitting altogether. Serial dieters achieve some weight loss only to return to their unhealthy eating style they wish they could do all the time.
How to Play the Tape Out for Yourself
I recently worked with a patient who was extremely loss-averse but this kept her in a relationship she was unhappy in, feeling unable to advocate for what she wanted. Using the “play the tape out”/”Dickens pattern” exercise with her, we explored what it would be like for her to potentially remain in this relationship forever, always feeling unhappy but feeling unable to talk about how she felt.
In the exercise we discussed what unhappy people tend to do in relationships, whether they take worse and worse care of themselves, or even neglect their relationships with others, we activated her potential for experiencing pain with her current passive tendencies. Even though she felt as though she had to be passive to make the relationship work, we were able to identify that it would only cause her, and potentially others, more pain in the end.
Seeing what this bottom would look like helped my patient give voice to her concerns, and her relationship has grown as a result. She is learning that communicating her feelings is worth potential small conflicts if it helps her avoid larger internal conflicts. She is also learning to advocate for herself in the relationship and speak up before things reach an unbearable level.
Here is a step-by-step system for applying this strategy to one of your own behaviors. Use this to break a bad habit, get out of a difficult situation or stop a pattern of negative thoughts.
- Identify the negative behavior you want to quit doing. Get as much clarity as possible. For example, I wanted to get better sleep; the negative behaviors there were staying up too late and using screens too close to bedtime.
- Think about the consequences of this behavior, in the past, present, and future. Be sure to play the tape out. For example, some of my consequences were losing patients and having an impoverished relationship with my daughter.
- Try to experience the feelings that will result. In my example: fear of not bringing in enough income, shame of failure, heartbreak that I missed the chance to be a part of my daughter’s life. Perhaps even physical pain due to accident or injury.
- Imagine engaging in your new replacement behavior. For me, that’s getting to bed on time and putting away my devices instead of taking them to bed.
- Imagine how this new behavior makes you feel. How is your life different five years from now? For me, I imagine having a vibrant practice and seeing real progress and happiness in the lives of my patients. And I imagine my daughter, happy to see me and to share her future life with me.
- Return to your visualizations frequently, especially that of the new behavior. If you are tempted to “relapse”, play the tape out again.
If we return to the doctor’s statement about his patient in “To the Bone,” if we recognize that Eli’s decision to leave the inpatient program could lead to her death. Death is really the “final bottom” and there’s no hope of recovery once it’s reached.
But if Eli could have “played the tape out” and seen the potential destruction her behavior would cause, perhaps she could have gained the needed motivation to continue in treatment. Instead of sitting idly by to “let” someone hit bottom, helping them to play the tape out—repeatedly and viscerally—could break the progressive cycle.
No matter how far that ultimate bottom might be, this is an exercise that can prevent so much pain, and help us to make the changes we want now.