The Power of Habit: Why We Do What We Do in Life and Business (48 page)

3.2
It’s late on a Sunday
I am indebted to Fox Sports for providing game tapes, and to Kevin Kernan, “The Bucks Stomp Here,”
The San Diego Union-Tribune,
November 18, 1996; Jim Trotter, “Harper Says He’s Done for Season,”
The San Diego Union-Tribune,
November 18, 1996; Les East, “Still Worth the Wait,”
The
Advocate
(Baton Rouge, La.), November 21, 1996.

3.3
described as putting the “less” in “hopeless”
Mitch Albom, “The Courage of Detroit,”
Sports Illustrated,
September 22, 2009.

3.4
“America’s Orange Doormat”
Pat Yasinskas, “Behind the Scenes,”
The Tampa Tribune,
November 19, 1996.

3.5
He knew from experience
In a fact-checking letter, Dungy emphasized that these were not new strategies, but instead were approaches “I had learned from working with the Steelers in the seventies and eighties. What was unique, and what I think spread, was the idea of how to get those ideas across.… [My plan was] not overwhelming opponents with strategy or abundance of plays and formations but winning with execution. Being very sure of what we were doing and doing it well. Minimize the mistakes we would make. Playing with speed because we were not focusing on too many things.”

3.6
When his strategy works
For more on the Tampa 2 defense, see Rick Gosselin, “The Evolution of the Cover Two,”
The Dallas Morning News,
November 3, 2005; Mohammed Alo, “Tampa 2 Defense,”
The Football Times,
July 4, 2006; Chris Harry, “Duck and Cover,”
Orlando Sentinel,
August 26, 2005; Jason Wilde, “What to Do with Tampa-2?”
Wisconsin State Journal,
September 22, 2005; Jim Thomas, “Rams Take a Run at Tampa 2,”
St. Louis Post-Dispatch,
October 16, 2005; Alan Schmadtke, “Dungy’s ‘D’ No Secret,”
Orlando Sentinel,
September 6, 2006; Jene Bramel, “Guide to NFL Defenses,”
The Fifth Down
(blog),
The New York Times,
September 6, 2010.

3.7
Sitting in the basement
William L. White,
Slaying the Dragon
(Bloomington, Ill.: Lighthouse Training Institute, 1998).

3.8
named Bill Wilson
Alcoholics Anonymous World Service,
The A.A. Service Manual Combined with Twelve Concepts for World Service
(New York: Alcoholics Anonymous, 2005); Alcoholics Anonymous World Service,
Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism
(New York: Alcoholics Anonymous, 2001); Alcoholics Anonymous World Service,
Alcoholics Anonymous Comes of Age: A Brief History of A.A.
(New York: Alcoholics Anonymous, 1957); Alcoholics Anonymous World Service,
As Bill Sees It
(New York: Alcoholics Anonymous, 1967); Bill W.,
Bill W.: My First 40 Years—An Autobiography by the Cofounder of Alcoholics Anonymous
(Hazelden Center City, Minn.: Hazelden Publishing, 2000); Francis Hartigan,
Bill W.: A Biography of Alcoholics Anonymous Cofounder Bill Wilson
(New York: Thomas Dunne Books, 2009).

3.9
He took a sip and felt
Susan Cheever,
My Name Is Bill
:
Bill Wilson—His Life and the Creation of Alcoholics Anonymous
(New York: Simon and Schuster, 2004).

3.10
Wilson invited him over
Ibid.

3.11
At that moment, he later wrote
Ernest Kurtz,
Not-God: A History of Alcoholics Anonymous
(Hazelden Center City, Minn.: Hazelden Publishing
,
1991).

3.12
An estimated 2.1 million people
Data provided by AA General Service Office Staff, based on 2009 figures.

3.13
as many as 10 million alcoholics
Getting firm figures on AA’s membership or those who have achieved sobriety through the program is notoriously difficult, in part because membership is anonymous and in part because there is no requirement to register with a central authority. However, the 10 million person figure, based on conversations with AA researchers, seems reasonable (if unverifiable) given the program’s long history.

3.14
What’s interesting about AA
In psychology, this kind of treatment—targeting habits—is often referred to under the umbrella term of “cognitive behavioral therapy,” or in an earlier era, “relapse prevention.” CBT, as it is generally used within the treatment community, often incorporates five basic techniques: (1) Learning, in which the therapist explains the illness to the patient and teaches the patient to identify the symptoms; (2) Monitoring, in which the patient uses a diary to monitor the behavior and the situations triggering it; (3) Competing response, in which the patient cultivates new routines, such as relaxation methods, to offset the problematic behavior; (4) Rethinking, in which a therapist guides the patient to reevaluate how the patient sees situations; and (5) Exposing, in which the therapist helps the patient expose him-or herself to situations that trigger the behavior.

3.15
What AA provides instead
Writing about AA is always a difficult proposition, because the program has so many critics and supporters, and there are dozens of interpretations for how and why the program works. In an email, for instance, Lee Ann Kaskutas, a senior scientist at the Alcohol Research
Group, wrote that AA indirectly “provides a method for attacking the habits that surround alcohol use. But that is via the people in AA, not the program of AA. The program of AA attacks the base problem, the alcoholic ego, the self-centered, spiritually bereft alcoholic.” It is accurate, Kaskutas wrote, that AA provides solutions for alcoholic habits, such as the slogans “go to a meeting if you want to drink,” and “avoid slippery people, places, and things.” But, Kaskutas wrote, “The slogans aren’t the program. The program is the steps. AA aims to go much deeper than addressing the habit part of drinking, and AA founders would argue that attacking the habit is a half measure that won’t hold you in good stead; you will eventually succumb to drink unless you change more basic things.” For more on the explorations of AA’s science, and debates over the program’s effectiveness, see C. D. Emrick et al., “Alcoholics Anonymous: What Is Currently Known?” in B. S. McCrady and W. R. Miller, eds.,
Research on Alcoholics Anonymous: Opportunities and Alternatives
(New Brunswick, N.J.: Rutgers, 1993), 41–76; John F. Kelly and Mark G. Myers, “Adolescents’ Participation in Alcoholics Anonymous and Narcotics Anonymous: Review, Implications, and Future Directions,”
Journal of Psychoactive Drugs
39, no. 3 (September 2007): 259–69; D. R. Groh, L. A. Jason, and C. B. Keys, “Social Network Variables in Alcoholics Anonymous: A Literature Review,”
Clinical Psychology Review
28, no. 3 (March 2008): 430–50; John Francis Kelly, Molly Magill, and Robert Lauren Stout, “How Do People Recover from Alcohol Dependence? A Systematic Review of the Research on Mechanisms of Behavior Change in Alcoholics Anonymous,”
Addiction Research and Theory
17, no. 3 (2009): 236–59.

3.16
sitting in bed
Kurtz,
Not-God.

3.17
He chose the number twelve
I am indebted to Brendan I. Koerner for his advice, and to his article, “Secret of AA: After 75 Years, We Don’t Know How It Works,”
Wired,
July 2010; D. R. Davis and G. G. Hansen, “Making Meaning of Alcoholics Anonymous for Social Workers: Myths, Metaphors, and Realities,”
Social Work
43, no. 2 (1998): 169–82.

3.18
step three, which says
Alcoholics Anonymous World Services,
Twelve Steps and Twelve Traditions
(New York: Alcoholics Anonymous World Services, Inc., 2002), 34. Alcoholics Anonymous World Services,
Alcoholics Anonymous: The Big Book,
4th ed. (New York: Alcoholics Anonymous World Services, Inc., 2002), 59.

3.19
Because of the program’s lack
Arthur Cain, “Alcoholics Anonymous: Cult or Cure?”
Harper’s Magazine,
February 1963, 48–52; M. Ferri, L. Amato, and M. Davoli, “Alcoholics Anonymous and Other 12-Step Programmes for Alcohol Dependence,”
Addiction
88, no. 4 (1993): 555–62; Harrison M. Trice and Paul Michael Roman, “Delabeling, Relabeling, and Alcoholics Anonymous,”
Social Problems
17, no. 4 (1970): 538–46; Robert E. Tournie, “Alcoholics Anonymous
as Treatment and as Ideology,”
Journal of Studies on Alcohol
40, no. 3 (1979): 230–39; P. E. Bebbington, “The Efficacy of Alcoholics Anonymous: The Elusiveness of Hard Data,”
British Journal of Psychiatry
128 (1976): 572–80.

3.20
“It’s not obvious from the way they’re written”
Emrick et al., “Alcoholics Anonymous: What Is Currently Known?”; J. S. Tonigan, R. Toscova, and W. R. Miller, “Meta-analysis of the Literature on Alcoholics Anonymous: Sample and Study Characteristics Moderate Findings,”
Journal of Studies on Alcohol
57 (1995): 65–72; J. S. Tonigan, W. R. Miller, and G. J. Connors, “Project MATCH Client Impressions About Alcoholics Anonymous: Measurement Issues and Relationship to Treatment Outcome,”
Alcoholism Treatment Quarterly
18 (2000): 25–41; J. S. Tonigan, “Spirituality and Alcoholics Anonymous,”
Southern Medical Journal
100, no. 4 (2007): 437–40.

3.21
One particularly dramatic demonstration
Heinze et al., “Counteracting Incentive Sensitization in Severe Alcohol Dependence Using Deep Brain Stimulation of the Nucleus Accumbens: Clinical and Basic Science Aspects,”
Frontiers in Human Neuroscience
3, no. 22 (2009).

3.22
graduate student named Mandy
“Mandy” is a pseudonym used by the author of the case study this passage draws from.

3.23
Mississippi State University
B. A. Dufrene, Steuart Watson, and J. S. Kazmerski, “Functional Analysis and Treatment of Nail Biting,”
Behavior Modification
32 (2008): 913–27.

3.24
The counseling center referred Mandy
In a fact-checking letter, the author of this study, Brad Dufrene, wrote that the patient “consented to services at a university-based clinic which was a training and research clinic. At the outset of participating in therapy, she consented to allowing us to use data from her case as in research presentations or publications.”

3.25
one of the developers of habit reversal training
N. H. Azrin and R. G. Nunn, “Habit-Reversal: A Method of Eliminating Nervous Habits and Tics,”
Behaviour Research and Therapy
11, no. 4 (1973): 619–28; Nathan H. Azrin and Alan L. Peterson, “Habit Reversal for the Treatment of Tourette Syndrome,”
Behaviour Research and Therapy
26, no. 4 (1988): 347–51; N. H. Azrin, R. G. Nunn, and S. E. Frantz, “Treatment of Hairpulling (Trichotillomania): A Comparative Study of Habit Reversal and Negative Practice Training,”
Journal of Behavior Therapy and Experimental Psychiatry
11 (1980): 13–20; R. G. Nunn and N. H. Azrin, “Eliminating Nail-Biting by the Habit Reversal Procedure,”
Behaviour Research and Therapy
14 (1976): 65–67; N. H. Azrin, R. G. Nunn, and S. E. Frantz-Renshaw, “Habit Reversal Versus Negative Practice Treatment of Nervous Tics,”
Behavior Therapy
11, no. 2 (1980): 169–78; N. H. Azrin, R. G. Nunn, and S. E. Frantz-Renshaw, “Habit Reversal Treatment of Thumbsucking,”
Behaviour Research and Therapy
18, no. 5 (1980): 395–99.

3.26
Today, habit reversal therapy
In a fact-checking letter, Dufrene emphasized that methods such as those used with Mandy—known as “simplified habit reversal training”—sometimes differ from other methods of HRT. “My understanding is that Simplified Habit Reversal is effective for reducing habits (e.g., hair pulling, nail biting, thumb sucking), tics (motor and vocal), and stuttering,” he wrote. However, other conditions might require more intense forms of HRT. “Effective treatments for depression, smoking, gambling problems, etc. fall under the umbrella term ‘Cognitive Behavioral Therapy,’ ” Dufrene wrote, emphasizing that simplified habit replacement is often not effective for those problems, which require more intensive interventions.

3.27
verbal and physical tics
R. G. Nunn, K. S. Newton, and P. Faucher, “2.5 Years Follow-up of Weight and Body Mass Index Values in the Weight Control for Life! Program: A Descriptive Analysis,”
Addictive Behaviors
17, no. 6 (1992): 579–85; D. J. Horne, A. E. White, and G. A. Varigos, “A Preliminary Study of Psychological Therapy in the Management of Atopic Eczema,”
British Journal of Medical Psychology
62, no. 3 (1989): 241–48; T. Deckersbach et al., “Habit Reversal Versus Supportive Psychotherapy in Tourette’s Disorder: A Randomized Controlled Trial and Predictors of Treatment Response,”
Behaviour Research and Therapy
44, no. 8 (2006): 1079–90; Douglas W. Woods and Raymond G. Miltenberger, “Habit Reversal: A Review of Applications and Variations,”
Journal of Behavior Therapy and Experimental Psychiatry
26, no. 2 (1995): 123–31; D. W. Woods, C. T. Wetterneck, and C. A. Flessner, “A Controlled Evaluation of Acceptance and Commitment Therapy Plus Habit Reversal for Trichotillomania,”
Behaviour Research and Therapy
44, no. 5 (2006): 639–56.

3.28
More than three dozen studies
J. O. Prochaska and C. C. DiClemente, “Stages and Processes of Self-Change in Smoking: Toward an Integrative Model of Change,”
Journal of Consulting and Clinical Psychology
51, no. 3 (1983): 390–95; James Prochaska, “Strong and Weak Principles for Progressing from Precontemplation to Action on the Basis of Twelve Problem Behaviors,”
Health Psychology
13 (1994): 47–51; James Prochaska et al., “Stages of Change and Decisional Balance for 12 Problem Behaviors,”
Health Psychology
13 (1994): 39–46; James Prochaska and Michael Goldstein, “Process of Smoking Cessation: Implications for Clinicians,”
Clinics in Chest Medicine
12, no. 4 (1991): 727–35; James O. Prochaska, John Norcross, and Carlo DiClemente,
Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward
(New York: HarperCollins, 1995).