People repeat actions that are either rewarding or familiar, or both. In other words, people do things that feel worth it somehow. You might think immediately about things you do regularly that don't exactly feel rewarding -- maybe work or commuting or taking vitamins. But if you think carefully about the reasons you do each of these, you will see that there is some benefit or "reward" that comes from doing them. It might feel like a different way of looking at it, but the benefit or familiarity exists strongly enough for things you continue doing otherwise you wouldn't be willing to repeat them as you do.

Understanding why people repeat actions helps shine some light on why or how they would stop repeating actions or change a habitual pattern. First of all, changing a behavior pattern is made much easier when it feels worth it! The reasons to change toward doing something new have to feel weightier than what you're getting out of the current behavior. To use a relatively minor issue as an example, if coffee tastes good to you and helps you have energy in the morning (you get something out of it), you're unlikely to change that habit of drinking it every day, unless you have a pretty compelling reason! Maybe a reason like having heart palpitations or increased anxiety or your doctor tells you to stop. But even then, you might not want to stop or might really struggle in stopping, because you really enjoy the taste or you dread the headache you might get from stopping or you might really miss this familiar, comforting habit you've had in your life for many years. Adding to all of that, it might feel awkward or lonely to not drink coffee in the morning with your partner or your colleagues who are all drinking coffee each morning together. That's how the downsides of change start to add up and eclipse your view of the reasons in favor of changing. Now multiply those issues by 100, and perhaps it's easier to understand how difficult it might be to change a more ingrained habit like some people have with drinking alcohol.

In order to change a habit, it has to really feel worth it and the downsides of changing have to either be pretty small to begin with or be shrunk down. For instance, for certain changes -- like perhaps changing one's tooth brushing routine or changing the path of a commute or changing a habit of eating one snack over another -- the downside of changing might be quite small, but if the advantage of the new behavior does not feel compelling, then even those small hassles that are a part of changing might be enough to keep you from trying the change at all. On the other hand, if the reward of the new approach feels clear and salient, those small downsides will be more easily overcome.

I'm talking here about weighing the pros and cons. As a strategy coming from the therapeutic approach of motivational interviewing, detailing the pros and cons of one's current behavior can help illuminate the reasons you want to change (or don't). Also helpful is to detail the pros and cons of making a change (in other words, detailing both the pros and cons of an existing habit like drinking coffee in addition to the pros and cons of changing that habit -- what is good and bad about stopping drinking coffee). This strategy helps to highlight the ways you might influence those reasons or build upon them.

The process of shrinking the downsides of change -- or alternatively, increasing the salient reasons to change -- is something a whole community can participate in! We do it as a community when we tax cigarettes. We do it when we make decaf coffee or nonalcoholic beverages readily available at a gathering. And in a relationship, it can be done by planning together or brainstorming alone about the different upsides and downsides of change that are within your control to influence. Will it be easy for your partner to start a new exercise plan? Are there obstacles in place that you can work together to decrease (for instance, by arranging childcare, changing dinner times, getting the right equipment at home, etc.). You might feel aggravated that the value of being healthy and living longer isn't sufficient reason to motivate your partner toward this change, but remembering the rewards of the current set of habits and the downsides of making the change can help to increase your understanding and empathy. And looking at the pros and cons can also help you think more strategically about how you can work together with a loved one to decrease the obstacles or "cons" to change in your lives.

Alcohol abuse is often treated like a completely different (and shameful) habit to change than others. And there are indeed some important differences when it comes to substance abuse, but the similarities with making big behavioral changes of all kinds are really important (and useful!) to recognize. One important similarity is this idea of behaviors being continued and repeated when they feel worth it (despite what feels from the outside like obvious reasons to stop!). Another is how useful a detailing of pros and cons can be for all involved. Many families and individuals do not address substance abuse early enough because it feels like a problem that is unique and involving character traits that feel intractable (so better to turn a blind eye and hope that's not the case). But in fact even substance abuse can be understood better and addressed more productively when the pros and cons are more carefully understood. If shame gets in the way of thinking about change constructively, the shame itself can be factored into the pros and cons list. Thinking of the ability to make changes as a skill to be honed is also helpful. And one of the ways to build that skill is learning to use strategies like a pros and cons list.

Shame and fear are big downsides to making changes -- but they don't have to be insurmountable obstacles! You can work on shrinking them just like any other downside to change you might encounter: with patience, compassion, planning, starting small, and allowing others to help.

Shrink the downsides to change, enhance the upsides of change, and work together!

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

Nicole Kosanke, Ph.D., is the director of family services at the Center for Motivation and Change, where she specializes in working with family members of people abusing substances and in the assessment process for families and individuals with substance abuse issues. Dr Kosanke has been working in the research and clinical practice of substance abuse treatment for many years. She has most recently co-authored a book called Beyond Addiction: How Science and Kindness Help People Change that is a compassionate and science-based family guide for navigating the addiction treatment world, understanding motivation, and training in the use of CRAFT (Community Reinforcement and Family Training) skills.

You can follow Dr. Kosanke on twitter at @kosankephd and you can follow CMC on twitter (@_TheCMC) or on Facebook.