Table of Contents
Introduction: Behaviors are Conserved
Behavior is a complex process and often defies our ability to understand it completely. When a patient comes into the office for a medical condition, behavior is not usually the first topic that comes up. Someone may come in for prescription renewal and check with me on the status of their health. I often start with having them tell me how they feel about their situation. Sometimes I get replies like, “well, that’s me, and that is what I am going to continue to do.”
Behavior does not just say, “Here I am. Now let’s change me.” It seeks to repeat itself.
Behavior is like the current in a river. It is a flow that gets us to or takes us away from a stimulus. We can navigate the river by paddling through it with our conscious efforts and decisions, avoiding the obstacles in our way. Or we can seek to swim upstream it with a tremendous and deliberate force toward a different destination, perhaps even finding a new tributary.
In this article, I write about the theory of neuroplasticity and how our past experiences contribute to our current behaviors and health situation. These concepts are not new, but I shall craft the words with examples and hope that increased sensitivity to behavior could allow someone to forge new and healthier behaviors.
Behavior and Infant Reflexes
All organisms to the cellular level have ways to move toward or away from a stimulus. An infant is born with several reflexes that prepare it for the environment. Two of these are the Moro reflex and the Rooting reflex. The Moro reflex occurs when an infant is shifted back, hears a loud noise, or sees a bright light. It extends the arms out in response and may begin to cry, communicating discomfort. This response may trigger the sympathetic nervous system, resulting in the expression of stress hormones. The Rooting reflex takes the baby’s mouth towards a possible food source, e.g., breastfeeding and touching the face near the infant’s mouth triggers it. As the infant nervous system develops, these newborn reflexes gradually dissipate.
During the first few years of life, the brain goes through essential steps in forging neural pathways, as it gains more than 1 million new neural connections per second while also pruning excess neurons. The infant encounters new stimuli in the background of greater motor output and sensory input and develops more nuanced reflexes through time. This stage is when the brain formalizes its behaviors.
Neuroplasticity: If it Fires, it Wires
In his book Organization of Behavior (1949), Psychologist Donald Hebb wrote that neurons “repeatedly active at the same time become associated so that activity in one facilitates activity in the other.” The theory is a fundamental construct of the nervous system known as neuroplasticity, which applies to behavior and learning. The strengthening of pathways explains why behaviors are not easy to change; it is not a mystery why sometimes “you can’t teach an old dog new tricks.”
A slogan for neuroplasticity as it relates to behaviors could be “if it fires, it wires.” Behaviors are intimately interwoven into the brain and represent the go-to response to a real or perceived stimulus. External cues and internal memories trigger them. Behaviors’ domain is in brain pathways associated with the “fight or flight” and rewards and punishment system. In some cases, the brain calls up coping strategies, many automatic and subconscious, only looking back at the repertoire of an individual’s experience set. It is a cognitive bias and does not know what it does not know.
Going back to the newborn’s reflexes, I propose two basic needs: 1) warmth, comfort, and security (the Moro Reflex), and 2) to satisfy hunger and thirst (the Rooting reflex.) In the most simplified way, the basic need of life is to survive.
An infant cannot survive by itself without the support of its environment, i.e., its parent. With an immature nervous system and an underdeveloped body, an infant requires care, such as being fed every 1 to 3 hours to stay hydrated, being more prone to fluid loss through its thin skin. Since an infant cannot eat by itself or remove itself from an unpleasant environment, hunger and discomfort trigger the “fight, flight, or freeze” response. These early experiences also play a role in how the brain develops.
How Behaviors Impact Health
In the above section, I discussed how most behaviors take an individual closer to a stimulus that could cause pleasure or reduce pain or further from one that could cause increased pain or reduce comfort. The brain wires our behaviors to keep our bodies comfortable and functioning optimally.
The neurologic and vascular systems set up the dynamic regulatory effort to maintain the body, beginning at the cellular level, known as homeostasis. The body functions to persist until it can no longer. However, an organism interacts with the environment and adapts to its pressures. When an external force exerts a stimulus on the body, the body seeks to regain homeostasis, a process known as allostasis. Here is a link that defines both of the concepts.
Could some behaviors develop that can be harmful, even while keeping the body comfortable and functioning well, or at least well enough? Do behaviors that keep us from doing things that may be helpful to our health originate early on in life?
When the environment cannot accommodate the infant’s needs, such as in the setting of violence or neglect, particularly if prolonged and repeated, these stressors can profoundly impact the brain. An extensive survey which became known as the ACE study (Adverse Childhood Experiences Study) (1998) showed that childhood emotional or physical trauma was associated with the development of significant physical and mental health issues, and earlier death, as adults (Felitti). The more events recorded, the more impact it had on health. If it fires, it wires.
How to Model New Behaviors from Old Connections
When greater pleasure comes with something, there is more significant pain without it. When we speak of behavior as a river, the current is stronger and more conserved with some behaviors, such as addiction. There is a strong physical response to withdrawal or separation from a stimulus, where the nervous system has activated the stress response. Dopamine functions to strengthen the drive and creates a craving to repeat the behavior.
Where do we find traction to change a behavior? Here is a list of some suggestions:
Motivation and Mindset
Fortunately, pro-health behaviors can supplant harmful behaviors and become virtually automated through time. However, many of the best intentions fall to old habits a few weeks after New Year’s. It starts with a resolution. It requires motivation, which I define as “the determination to consider a delayed pleasure over an instant one” and mindset, or “grounding and restructuring thoughts to consistently curtail or remove prior patterns or cues that led to the prior behavior.” Dr. Elliot Berkman, a prominent researcher on the neuroscience of behavior change, refers to motivation and cognition as the “will” and the “way,” respectively.
These tools begin to reshape and sensitize the brain in the inception of a behavior change. Each of us embarking on behavior change balances the risks and benefits of change versus keeping the old behavior. It is helpful to represent your thoughts and goals in words and pictures.
Consider a behavior change as a departure from a long, secure path. It may lead to some distress at first, even a revisit to earlier challenges that led to its development. I like to think of the body as the rings of a tree that form through time: all parts communicate simultaneously to change.
Make it a Group Effort and Create Community.
Oxytocin is a hormone associated with physical changes in the body, including uterine contractions, breastfeeding, and orgasm. It is also associated with bonding and social interactions. You can call it the “love hormone,” but it is likely more nuanced than this. Oxytocin can also trigger dopamine in the rewards pathway. One way to look at this is that creating a community leads to pleasure and maybe enough to usurp the drive to repeating an old behavior. This is likely why group causes are more effective for behavior change.
Learn Something New and Repeat
A new behavior comes with uncertainty. Although it may not lead to a “fight” response, it can lead to inaction, procrastination, and rationalization to return to the past if it is too uncertain. A coach or guide might be helpful initially to provide tools and be a resource.
The brain begins to wire to complete the task more quickly the subsequent times. The rewards of this work lead to the increased likelihood of repeating it, as the brain reshapes with more neural connections. The new coping strategy to a stressor replaces the old.
Behavior is the brain’s adaptation to a stressor. Everything in our life is a reflection on the state of our past experiences and contributes to the persons we are today. We are survivors. Sometimes adaptation comes with a potentially harmful behavioral response. It can contribute to disease later in our lives. We can sculpt our behaviors to support our health through mindset and motivation, by garnering group support, and learning new coping strategies – and repeating them.
Here are some other Your Health Forum links on Behavior:
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Dr. Christopher Cirino
Founder Your Health Forum
Felitti V. The Relation Between Adverse Childhood Experiences and Adult Health: Turning Gold Into Lead. Perm J. 2002; 6(1): 44-47.
Other references as linked in the article.