Giving up old habits

The ego is not the master of it’s own house. — S. Freud

The ways we learn have been the subject of scientific interest for many years. Along with the ways we learn are the ways in which our behavior is reinforced or extinguished. The two forms of learning we have all studied in college are classical conditioning and operant conditioning. The first of these two involves using a particular stimulus to elicit a desired behavior response. The classic Pavlov’s dog is an example of this. Pavlov used a bell coupled with food to elicit the response of salivation in dogs so that eventually the bell would cause the response even without food. The second type of learning, or conditioning, involves using a kind of reward to reinforce a behavior the animal is already doing. Giving your dog a treat if the dog sits would be an example.

With each of these forms of learning can come the challenge of stopping the behavior or extinguishing it. Changes in environment or systems can cause such extinguishing events to occur. However, the behavior can, at times, worsen before it goes away. This is described as an extinction burst. We have all likely dealt with the frustration of trying to get a child to stop doing one thing or another. While extinction bursts are frustrating and can task our patience, it is important to understand that consistent reinforcement on our part can, and often does, aid in extinguishing the unwanted behavior.

The hospital system where I am the Chief Medical Officer, has just undergone a major change in electronic medical record keeping. These changes have met with some resistance because we are all going to be asked to give up some old behaviors and adopt some new ones. Undoubtedly, we will encounter some extinction bursts along the way. This is part of the natural evolution of giving up old habits. Change is difficult, and will always be met with resistance. We need to be patient with one another as we adjust to the changing world in which we live. The pandemic, political climate and many other issues that face us today force us to look at the way our lives are changing and we need to be sensitive to the frustration and struggle we all are facing.

— Stephen M. Taylor, M. D.