Breaking Bad: The Invisible Chains that Hold Us Back from Changing Habits that can Kill Us

Back in the day, I was on a journey of self-annihilation. Three packs of Marlboros fit tightly with eight mugs of coffee daily. Sarap! Spice it up with a literally to-die-for diet of crispy, sweet-salty, fatty and spicy foods, paired with regular drinking sprees. Mas masarap! Living by the “work hard, play hard” mantra, I reveled in the adrenaline-driven roller coaster lifestyle, capped with only four hours of sleep. Invincibility was my delusion until a Transient Ischemic Attack (TIA) at age 46 abruptly exposed my vulnerabilities. Yet, facing mortality was insufficient to change my ways.

WHAT

Hundreds of studies underscore the complex challenge of behavior change in response to serious illness, revealing that awareness of risk is just part of the puzzle.

This is what key findings from research shows:

1. “Predictors of Lifestyle Change After Coronary Artery Bypass Graft Surgery" by Clark, A. M., et al. (2003)

   - This study found that many patients fail to make lifestyle changes even after heart surgery. Only a minority of patients (e.g., 20-30%) successfully adhere to recommended lifestyle changes. It highlighted factors like social support, depression, and self-efficacy as crucial predictors.

2. "Barriers to Lifestyle Change in Patients Admitted with Acute Coronary Syndrome" by Aitken, L. M., et al. (2006)

   - Conducted among patients with acute coronary syndrome, this study identified significant barriers including lack of motivation and perceived inability to change despite awareness of risk. Even though 70-80% of patients acknowledge the importance of lifestyle changes, a significant portion (around 50%) fail to implement these changes. 

3. “Cancer Patients’ Perceptions of Patient-Education Programs" by Nielsen, K., & Henriksen, C. (2014)

   - This research showed that cancer patients are often aware of the importance of lifestyle changes but feel overwhelmed or lack the necessary skills and support. While most cancer patients (about 60-70%) understand the benefits of lifestyle changes, less than half engage in sustained behavior modification. 

4. “Psychological Resistance to Lifestyle Change in Patients with Chronic Obstructive Pulmonary Disease (COPD)" by Yohannes, A. M., & Alexopoulos, G. S. (2014)

   - COPD patients frequently understand the risks but exhibit resistance to change due to psychological factors like depression, anxiety, and lack of social support. A very small percentage of COPD patients make effective lifestyle changes, influenced by high psychological distress levels.

5. “Lifestyle Changes After Stroke: Barriers and Facilitators for Follow-Up Consultation" by Heinen, M. M., et al. (2012)

   - Stroke survivors often know (70-80% awareness) the benefits of a healthier lifestyle but face psychological and logistical barriers, such as lack of access to resources and intrinsic motivation. Less than 40% participate in follow-up consultations or programs.

Clearly the behavior changes that constitute “lifestyle change” is not as straightforward as we think.  Factors like mental health, social support, and perceived ability to change play significant roles in whether patients successfully alter their lifestyles. 

SO WHAT

This reality uncovers an essential truth in health psychology: awareness alone won't spark change without the embrace of mental health interventions, supportive networks, and shifts in our surroundings.

What do these interventions, “systems change,” and modifications look like?

For Individuals:

The belief in our ability to change can often feel like an insurmountable obstacle. It is key to recognize the brain's natural resistance, driven by the comfort of the familiar and the fear of the unknown. Change can feel daunting, but understanding this resistance is the first step.

Reflecting on my own story, I’ve faced my demons. Even when I was hospitalized for a “grand mal seizure,” accompanying my TIA I resisted change. Despite the gravity of my EEG results, I secretly smoked and even held work meetings by my hospital bed. Only when my Neurologist laid down the harsh truth—“Without change, you won’t need further consultations because this path could lead to a fatal stroke”—did reality start to sink in. That moment was a turning point, highlighting the immense power of facing brutal truths.

My love for my children and a life of deeper purpose and meaning became my beacons of light in this dark period of my life. 

For Families:

Support systems need to truly see the emotional and psychological hurdles faced by the ones they love. This means offering encouragement and creating accountability that matches where they are in their readiness to change.

For me, it was the candid, no-sugar-coating approach that resonated. Feeling accountable for my actions, especially when no one was watching, became critical. I enlisted the help of my family members, inviting them into my journey of change. They became my allies, offering plain-speaking support and unyielding belief in my ability to transform, even when I struggled to believe it myself.

The detailed daily self-monitoring structure held me accountable. It actually worked for me because it gave me agency and a deep sense of control. And the changes challenged me - quitting smoking cold turkey was surprisingly the start of my “winning streak.” It was like winning, not over someone else or some objective standard, but a triumphant victory over my smaller but deeply egoic and delusional self. It reminded me of how, Phoenix-like, I rose from the dark ashes of substance addiction earlier in life. 

My deep dive into the neuroscience of my condition reinforced what I already knew - that the brain's reward system and fear circuits play significant roles in sustaining old habits. The dopamine-driven reward pathways can hinder change by reinforcing unhealthy habits while fear of failure inhibits the pursuit of new, healthier ones.

This is what “I am my own worst enemy” means. And I realized that I too can be my best ally! 

NOW WHAT

Embracing mindful living is the key to creating the small shifts that lead to profound and lasting transformations. Every effort counts as your journey towards a healthier self.

For Individuals:

Begin by setting small, manageable goals that help rewire the brain’s habitual patterns. Celebrate each step forward, no matter how small. Recognizing these achievements boosts your motivation and reinforces the positive changes you're making.

Reflecting on my personal journey, the smallest victories, like choosing a fruit over a cookie or taking a short evening walk, were monumental. Each triumph fueled my determination, a reminder that change was not just possible—it was happening one decision at a time.

For Families:

Communication is your strongest ally. Engage in heartfelt dialogues with your loved ones, offering your unwavering support. Encourage shared activities that promote a healthy lifestyle, like cooking a nutritious meal together or enjoying a nature walk. 

For my family, becoming part of this journey meant everything. It opened new avenues for connection and reinforced our collective strength.

For Healthcare Support Systems in the Workplace, Healthcare Centers and Community:

Programs focused on building self-efficacy and resilience can be transformative. Create peer-support groups, inspired by the strength of the “AA/NA” approach, where individuals can share their experiences and support each other's journeys.

These systems play a crucial role in facilitating environments where change is not just encouraged but is a natural part of life.

Embracing the Journey

Change is undoubtedly challenging, but understanding its complexity and the intricate dance between our mind and body reveals the potential within us all. By honoring these connections, we can unravel the invisible chains that hold us back and pave the way towards a life that is full, healthy, and whole.

Each step you take, no matter how small, is a victory in itself. Remember, every journey begins with a single step, and with every step, you are crafting a new narrative—one of resilience, hope, and transformation.

-Susan Grace Rivera

Date posted: March 31, 2025

The TLC Solution is a Community of Communities that offers safe and sacred space for individuals and collectives journeying through tough times. Be a member!