By Karen Flannery, M.D.
Founder & Medical Director, Palm Beach Wellness Institute
Most of us already know many of the things we could be doing to improve our health: exercise regularly, get enough sleep, eat nourishing foods, manage stress, spend less time on our phones, or drink less alcohol. Knowing what to do is rarely the whole problem. The harder question is why it can be so difficult to consistently do what we know is good for us.
Throughout my career as a physician, I have become increasingly interested in this gap between knowing and doing. Sustainable behavior change requires more than information and willpower. It also requires an understanding of our habits, our nervous system, and what our brain has learned from experience.
Your Brain Learns What Works
When a behavior makes us feel good – or simply helps us feel less uncomfortable – our brain takes note. Imagine having a stressful day and pouring a glass of wine. For someone else, the response might be reaching for something sweet, scrolling through social media, shopping online, or continuing to work long after they intended to stop. The behaviors are different, but the brain may learn a similar lesson: when I feel this way, doing this helps.
With repetition, the connection between a trigger and a behavior can become stronger and increasingly automatic. This is one reason knowing that something isn’t good for us may not be enough to stop doing it. Our conscious intentions are competing with patterns that have been learned and reinforced over time.
Many Unhealthy Habits Started as Solutions
Instead of asking, “Why do I keep doing this?” it can be much more useful to ask, “What is this behavior doing for me?” Food can soothe us. Alcohol may temporarily quiet an anxious mind. Our phones provide distraction. Work can create a sense of accomplishment or control. Behaviors that eventually become counterproductive often began because they successfully met a need in the moment.
Sustainable change therefore requires more than simply removing a behavior. We need to understand what that behavior has been providing and develop healthier ways of meeting the same underlying need.
Your Nervous System Matters
Our internal state also influences our choices. When we are rested, relatively calm, and emotionally regulated, we generally have greater capacity to pause and make decisions consistent with our longer-term goals. When we are stressed, anxious, overwhelmed, or exhausted, we are more likely to fall back on familiar patterns – particularly behaviors that have provided quick comfort, distraction, or relief in the past.
This is why nervous system regulation can be an important part of behavior change. Rather than focusing exclusively on what you are doing, it is often helpful to understand what is happening within you when you do it. Addressing stress, sleep, emotional health, and other factors that influence our internal state can make healthier choices easier to access.
Awareness Creates an Opportunity for Change
This is also where mindfulness becomes particularly valuable. Mindfulness is often thought of simply as a relaxation technique, but its role in behavior change goes much deeper. Mindful awareness helps us recognize our patterns while they are happening: noticing that we are stressed, reaching for our phone, looking for food when we aren’t hungry, or pouring another glass of wine.
That awareness creates a pause between the trigger and our usual response. Within that pause, we have an opportunity to ask, “What do I actually need right now?” The answer might be rest, movement, nourishment, connection, quiet, or simply a few moments to experience an uncomfortable emotion without immediately trying to make it disappear. We will not always choose differently, nor do we need to. The goal is not perfect behavior; it is becoming less automatic and more intentional.
Start With Curiosity
If there is a behavior you have been trying to change, try observing it before trying harder to eliminate it. For one week, notice what happens immediately before the behavior, how you are feeling physically and emotionally, what you hope the behavior will do for you, and how you actually feel afterward.
You may discover that an afternoon sugar craving consistently follows a poor night’s sleep, that wine becomes more appealing after particularly stressful days, or that scrolling tends to appear when you feel overwhelmed or disconnected. These patterns are not failures; they are information. Understanding them gives you something much more useful to work with than another list of things you “should” be doing.
From Knowing to Doing
Modern medicine is very good at identifying many of the behaviors that support long-term health. The harder challenge is helping people incorporate those recommendations into complicated, stressful, real lives. That gap between knowing what supports our health and consistently living that way is where behavior change becomes so important.
At Palm Beach Wellness Institute, our physician-led, interdisciplinary approach helps clients understand the behavioral, emotional, environmental, and lifestyle factors influencing their health and develop practical strategies for sustainable change. Because lasting change rarely comes from simply knowing more. It comes from better understanding ourselves and learning, through practice, how to respond differently.
Ready For a Change?
If you know what you want to change but have struggled to make it stick, the answer may not be more willpower. It may be a better understanding of what is getting in the way.
Explore our personalized programs and discover how a physician-led, neuroscience-informed approach can help you build healthier patterns that last.