Our actions may not be fully aligned with our long-term goals. But in the moment, there is a reason for what we do. We may want to feel better or avoid immediate pain. We may do something we’ve always done without really thinking. We may act because we feel lonely or frustrated or angry.

You aren’t broken because you made the wrong choice. You’re human. Step back and think, “what does that behavior do for me?” Because whether it’s sugar, YouTube, or heroin, there’s some reason we keep going back. Until we recognize why we do something, it’s hard to have lasting change in our lives. 

“I’m an addict” doesn’t explain anything. It’s a label, and usually not a helpful one. What about  “I like _, because _” (even if you hate other things about it). Be honest with yourself. Sit with that thought. It might be painful. It might make you realize that things aren’t so bad. 

It’ll take compassionate practice to change. But when we realize why we do something, change becomes much more realistic. 

There’s a movement to classify all mental health problems as brain disorders. And to some degree, these advocates aren’t wrong. All of human life is experienced by the brain. We can’t usually identify individual anatomical changes that distinguish one mental disorder from another, but there’s little pushback against the idea that the brain is at the center of our experience.

Brain-based explanations of mental health may also reduce some forms of stigma. And at the same time, we all have a natural tendency to be skeptical of recovery from brain-related deficits.

For example, we know that opioid use disorder (the clinical term for people who continue to misuse substances like heroin, morphine, or oxycodone despite negative consequences) can be convincingly modeled as a chronic, relapsing brain disorder. And at the same time, there are concrete behavioral changes that people can make to recover from opioid use disorder. 

My patients with opioid use disorder absolutely benefit from medications that stabilize the brain-based opioid system, just like someone with diabetes benefits from medications that stabilize blood sugar. At the same time, we can be so much more empowering by exploring behavior and providing coaching on ways to better manage the problem. For opioids, that might include education, changing contacts, identifying cravings, managing triggers, approaching trauma, and so much more. For diabetes, these interventions often fit the same mold. But to say “this is an insulin resistance problem” or “this is a brain-based opioid system problem” without saying “and I want to help you find ways to overcome this” sets people up for suboptimal outcomes. 

Like anything else in life, there are things we can change, and things we cannot. We can reduce stigma by normalizing the things we cannot change. And at the same time, we can empower each other emphasizing the depth, breadth, and reality of effortful improvement. Because at the end of the day, there is always some way we can improve our lives by changing our behavior.

It’s a dumb joke, and I’ll let you suffer through it. But first, let’s talk about relationships.

Every relationship is more than just two people. There is an unspoken middle ground called the relationship system, a constantly evolving construct defined by the interactions between two people. In other words: how I act influences you, and how you behave affects me. Relationship systems have a memory, and past events color how we see each other. A good relationship system can produce trust, shared experience, and so much more. And when people have problems with each other, it’s usually best to start looking at flaws in the relationship system before trying to find fault in either party.

How do you improve a relationship? You have some control over your own behaviors, a little control over the relationship system, and absolutely no control over the other person.

To strengthen relationships, it helps to understand what I call the cardinal rule of mental health: your only real option to improve any situation is to change your behavior. That doesn’t mean that everything is your fault. It’s an acknowledgment that you wait for something unexpected to happen, change your approach, or leave. But you’ll never, ever, be able to force real change in someone else. You can ask them for change, support them, antagonize them, or even cut them off. No one strategy works in every situation. And yet all reasonable options start and end with you.

I’m not trying to minimize the capacity for change in others. I am fundamentally optimistic about our capacity to improve, despite the very real forces of ambivalence and habit. There are reasons why we do what we do, and reasons we want to do better. A good therapist digs deep to uncover motivation, but they can’t build on something that isn’t there. It’s rare outside of therapy to have the permission, skill, and safety to probe others this way. Instead, you get to decide if you can tolerate what’s happening right now.

That is the textbook definition of a boundary: “you can’t do this to me and expect our relationship to continue as it is.” How do you enforce a boundary? By changing your part in the relationship. You don’t have the power to do anything else.

How many psychiatrists does it take to change a lightbulb? How many people does it take to have a positive influence? One. But some small part of the lightbulb has to want to change itself. You don’t have to spend the rest of your life clinging to lightbulbs that refuse to budge.

We fail at our process goals all the time. Need an example? It’s September. How’s your New Year’s resolution going? Do you even remember what you set out to do? 

Process goals are hard because our motivation constantly changes. We want to do something today, but it’s hard to predict how we’ll feel about something in 3 months. And even when we can predict how we’ll feel–I know I’m not going to like that 5:30 am run–we still have to set aside negative emotions and act anyways.

Process goals tend to fall in two camps: things we do once, and tasks that we repeat over and over again.

When we are struggling to complete a single task, the solution is simple: do it now. Act while you feel the slightest amount of motivation. (Seriously, if you can do it now, close this tab and do it.) 

But sometimes, a one-off task is big enough that we can’t complete all of it right now. When this happens, schedule a time to complete it, and do it then. If you fail to complete the scheduled task, it probably means that the task is too complicated to complete in one sitting. Break it down into smaller pieces and act on the smallest possible piece. Don’t beat yourself up for not finishing. Failure gives you information; be compassionate with yourself and learn from your mistakes. 

The real challenge comes when we run up against recurring process goals: working every day, quitting smoking for good, eating less junk food. These goals can absolutely be improved, and we’ll spend a lot more time talking about how to do this. But the basic principle is the same: start now. Do something. If it’s too much, do less. Build small habits first.

Because we experience ambivalence and struggle to learn.

Ambivalence means that we feel two ways. We have reasons to change and reasons to stay the same. And even when we feel perfectly motivated in one moment, a slight change can remind us how relatively comfortable we are right now.

Learning heavily influences change. New behaviors won’t be routine: they require more thought, effort, and desire. Choosing change is always trailblazing, even when we want to rediscover something we used to do. Staying the same takes little effort. Our habits are well traveled roads that we know so well that we show up at our destination without thinking about a single turn we took.

The solution to ambivalence is choosing action. And the solution to learning is to repeat that action until a new path is created. 

Don’t try to abandon every familiar street right away. Try making a single step into the darkness. It doesn’t matter if it seems too small. Take it today. Take it again tomorrow.