Interrupt Chained Behaviors: Overcome Smoking, Eczema, and Hair Pulling

“I am proud to label myself a nonsmoker… diligently performing practices has profoundly helped me eliminate my troublesome craving…The conscious efforts I have made over the past month have helped me regain control of my life.”   –L. F., a college student who became a non-smoker after smoking up to two packs a day since age 11. At 18 month follow-up L. F. is still a nonsmoker.

“I have been struggling with eczema for most of my life and until I began this course, I was feeling very hopeless in managing this condition without the use of costly, and potentially dangerous drugs. My self-healing project proved to be empirically successful. My eczema shrunk in size from 72 mm in length and 63 mm in width as measured at baseline to 0 mm in length and 0 mm in width by the final day of this project.”   –L. C., a college student who experienced recurring scaly skin patches since childhood.

In our recent published paper, Transforming chained behaviors: Case studies of overcoming smoking, eczema and hair pulling (trichotillomania), we describe an approach by which students learn self-healing techniques which they practice as part of a semester long class project. After four weeks of of self-healing practices many of the students report significant decrease in symptoms and improvement of health as shown in Figure 1. Their success includes  smoking cessation, eliminating hair pulling and eczema disappearing.

Slide1Figure 1. Students’ self-rating of success in achieving health benefits after four weeks of practice.

One component of the self-healing process is interrupting chained behavior. We react automatically and respond instantly with sadness, anger, neck and shoulders tension, eating too much, veg’ing out watching videos, or playing mindless digital games. After a time, we may notice that we are smoking more, experiencing an upset stomach, back pain, headaches, high blood pressure, or even more skin eruptions.  The first step is to sense the initial reaction that leads to the symptom development. Then, the person performs an alternative health promoting behavior and interrupts the chained behavior that triggers symptoms as shown in Figure 2.

Slide2Figure 2. Interrupting and transforming the chained behavior. The moment person become aware of the trigger or behavior that is chained to the development of the symptom, he/she interrupts and performs an active new health promoting behavior as illustrated by the dashed lines.

Overtime these automatic patterns may contribute to the development of autoimmune diseases, increased vulnerability to infections or other chronic diseases. The challenge is to develop an awareness to recognize and interrupt the beginning of the ‘chain of behavior.’ The instant you become aware of the first reaction, do something different, such as,

  • Shift your focus of attention to something joyful
  • Chang your body position and smile while thinking, This will also pass.
  • Practice a quick relaxation technique.
  • Imagine a positive self-healing process.

The longer the person waits to interrupt the chain, the more difficult it is to redirect the chained behavior. Awareness and immediate interruption appears to be major factors in achieving success. It means practicing the interruption and new behavior all day long. This is different from from practicing a skill for twenty minutes a day and the rest of the time performing the old dysfunctional behavior.

Mastery of this process consists of three steps:

  • Becoming aware of what is happening when the chain reactions.
  • Learn a more functional alternative health behavior such as breathing, relaxing, focusing on empowering thought, eating other foods.
  • Substitute the alternative behavior the moment you become aware of the triggered dysfunctional behavior.

After having integrated this into daily life, many students report experiencing a significant reduction and even elimination of symptoms and behaviors.

“I will continue to do the practices outlined not only to overcome trichotillomania but also to control my anxiety and, therefore, lead a less stressed and happier life. Knowing I have the power to heal myself is such an inspiring feeling, a feeling that can’t adequately be put into words.”    –G. M., a 32 year old student with trichotillomania, who reduced her hair pulling, anxiety, and stress

 “I have gained much wisdom from this project…I am ultimately responsible for my own health and well-being…I feel empowered, optimistic, and appreciative of every moment.”   –L. C., a college student who experienced recurring scaly skin patches since childhood)

For background, specific techniques and successful case reports, read our published paper, Peper, E., Lin, I-M, Harvey, R., Gilbert, M., Gubbala, P., Ratkovich, A., & Fletcher, F. (2014). Transforming chained behaviors: Case studies of overcoming smoking, eczema and hair pulling (trichotillomania). Biofeedback, 42(4), 154-160.


5 Comments on “Interrupt Chained Behaviors: Overcome Smoking, Eczema, and Hair Pulling”

  1. this is another great work done by Erik Peper, et al. Often what he can document makes so much sense right away but have good science back it up is the way to go …

  2. mrsportpsych says:

    The Biofeedback Federation of Europe BFE Annual Meeting – March 24-28, 2015 – Rome
    Meet the Presenters – Workshop Abstracts – Meet the Presenters
    http://bfe-meeting.blogspot.ca/p/workshop-abstracts.html

  3. Wonderful Dr. Peper! You always so clearly outline your research in a way that empowers others and makes tangible your data. I see how I can share this research with my Qigong students to show how interrupting chained behavior with Qigong exercise could be a valid intervention option. I also feel our WujiTech WujiBrainwave app could also be an interesting “chain interruptor” allowing a person to become not only mindful, but alert to their brainwave changes. Thank you always for your inspiration and good work. Peace… Francesco Garri Garripoli

  4. What I appreciate so much in the work of Erik Peper is that he can translate academic discours in a language that is understandable for any well-educated lay person; thus, making his advice and instructions clar and understandable

  5. pammartinez1 says:

    Dr. Peper,

    Thank you for sharing all these great posts! I love reading the stuff on your blog. It always gives me courage and hope to keep going on self-healing processes and simple meditations for everyday life!

    Pamela Martinez


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