Cecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for Women’s Voices in many articles over the years.

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Last week, I discussed the issue of change and some of the obstacles that cause our New Year’s resolutions to fail. Many habits can be successfully broken, modified, or created if you understand the behavioral, social, and psychological components that are in play.

Of the three, the psychological aspect of our behavior is perhaps the most complicated. A great deal of what we do is simply learned, and it has been proven that the human mind is much more amenable to change and “plastic” than we used to think (see The Brain That Changes Itself, by Norman Doidge, M.D., 2007).

However, much resistance to change is due to underlying issues and conflicts that we may not even be aware of.

Thus, while most people have bad habits, some of them are motivated by psychological problems that need to be addressed if problems are to be overcome. The most obvious example is the substance abuser who suffers from anxiety and/or depression and “self-medicates” with drinking, drugs, overeating, etc., in order to cope with his or her feelings. In these cases (and it must be acknowledged that everyone indulges in this “quick fixing” from time to time), one is caught in a vicious circle: psychic (and often unconscious) pain motivates the behavior; the self-medication alleviates the pain and makes it both more bearable and less available to be addressed and healed.

Alcoholics Anonymous sees substance abusers as having a million different motives for one destructive behavior, and maintains that the important thing is to stop the behavior and deal with the problems underlying it later. However, it may not be possible for some people to do this without understanding the role that their behavior is playing in their psychological equilibrium. Andrew Tatarsky (Harm Reduction Psychotherapy, 2007) is one of the leaders of the “Harm Reduction” movement, which aims to help those who can’t quit completely reduce their intake of harmful substances. He points out that many treatment programs won’t take on a client unless he/she agrees to complete abstinence. Those who can’t are barred from getting any treatment at all, even though they may be just the kind of clients who need it most.