3BI: behavior change as a chronic condition, the optimal amount of free time, and standards of evidence
Happy Friday from Chicago, where it’s finally starting to feel like fall after extended summer weather.
Behavior change as a chronic condition
I finally finished Katy Milkman’s excellent book How to Change this week and loved this metaphor from economist Kevin Volpp:
Kevin offered up some unforgettable words of wisdom: “When we diagnose someone with diabetes, we don’t put them on insulin for a month, take them off of it, and expect them to be cured.” In medicine, doctors recognize that chronic diseases require a lifetime of treatment. Why do we assume that behavior change is any different?
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Study after study (mine included) has shown that achieving transformative behavior change is more like treating a chronic disease than curing a rash.
This is a curious phenomenon. Why do we so often take such a short-sighted approach to psychological change while taking medicine or other treatments for physical conditions perpetually without thinking?
This framing articulates what actually works for long term behavior change.
For one, “treatments” that work are generally needed on an ongoing basis. As stated in the quote, diabetics don’t get a short term boost of insulin. They take it for the rest of their life. Why would our mind work any differently? Think of when we’re driven by a short-term goal: getting in shape for a vacation, running a 5k, or completing a class. How often do the behaviors last after the destination is reached or the structure disappears? For behavioral change to last, we have to choose tactics that are realistic to continue in perpetuity.
A personal trainer is great, but can we afford the time and money for the long term? A coding bootcamp is a good kick start, but will you be able to continue the learning once that structure and accountability is gone?
Another lesson from this metaphor is that solutions are rarely discovered immediately, but through experimentation and iteration. For most physical chronic conditions, a variety of treatments and dosages are tested until the doctor and patient find what works best.
The same experimental approach applies to behavioral change. You’ll rarely find the right mix of effectiveness and sustainability on your first try, but if you keep testing, you’ll figure it out at some point.
If you want to get in shape, you may start by going to the gym, but find you don’t like lifting weights and using cardio machines solo. From there, you can try group classes, sports leagues, or regular competitions like triathlons. One size doesn’t fit all, so experimentation is necessary to find the right personal mix.
The key lesson is patience. If you commit to long-term change with the understanding that it will take a while and become a part of your life, you’ll find a way to get there eventually.
I’d also note that this equally applies when you’re attempting to facilitate someone else’s change. When designing solutions for others, consider how it can be sustainable for the long-term.
Read more in Katy Milkman’s great book How To Change.
Free time is good, but not too much
What’s the right balance of free time and busyness? Most of us wish we had more free time, but how much should “more” be? Research recently published in the Journal of Personality and Social Psychology attempted to get some data for this question.
The researchers analyzed data from two large representative surveys of Americans and conducted two online experiments with more than 6,000 participants to evaluate the relationship between free time and well-being. They found that there’s a delicate balance:
“We found that having a dearth of discretionary hours in one’s day results in greater stress and lower subjective well-being,” said Marissa Sharif, PhD, an assistant professor of marketing at The Wharton School and lead author of the paper. “However, while too little time is bad, having more time is not always better.”
Each study found that, to some degree, well-being increased with additional free time, but only to a point. One survey found that the benefits of free time leveled off at about two hours and began to decline after five.
As with most things in life, it appears some level of moderation is key:
“Our findings suggest that ending up with entire days free to fill at one’s discretion may leave one similarly unhappy. People should instead strive for having a moderate amount of free time to spend how they want. In cases when people do find themselves with excessive amounts of discretionary time, such as retirement or having left a job, our results suggest these individuals would benefit from spending their newfound time with purpose.”
Read more at the American Psychological Association.
We have different standards for confirming or disproving our beliefs
This is a great comic on confirmation bias from SMBC:
We like to think of ourselves as rational and objective evaluators of evidence, but the truth is we generally lack the cognitive bandwidth to do so and rely on previous beliefs to simplify the process. We also subconsciously seek consistency in our thinking, so find evidence confirming existing opinions more satisfying than that which proves us wrong.
We don’t need to spend hours reading scientific papers on every side of an issue, but we do need to be conscious of this and ask which evidence we blindly accept and which we are inherently skeptical of.
I once read bias defined as who we give the benefit of the doubt to versus who we don’t (I wish I could remember the source). It’s worth considering where we place blind trust and skepticism.
Check out the comic at SMBC.
Other stuff
This year’s Nobel Prize in Economics was awarded to David Card, Joshua Angrist and Guido Imbens, who pioneered the use of natural experiments in economics research.
Researchers, including behavioral scientists, prefer formal experiments where, in simple terms, participants are randomly selected into different groups with different conditions. Randomization eliminates bias between the groups so they can evaluate the effect of those different conditions.
In the real world, it’s often extremely difficult or impossible to randomize groups and isolate their differences, especially for complex issues like public policy. These economists developed methods to identify and effectively measure “natural” experiments, where different conditions naturally emerge among similar populations.
Marginal Revolution has a great write-up on this concept and the prize winners’ work, including Card and Krueger’s famous study of minimum wage effects. Read it here.
Have a great weekend!