Thread by @DrSherryPagoto

I’m seeing a lot of talk about the role of “personal responsibility” in behavior (& behavioral interventions).

The idea is that if people just took more “responsibility” they would be doing the things we think they should be doing.

This thinking is a dead end.

A thread

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If a person exercises regularly or wears a mask, one might conclude this person has taken “personal responsibility.” But personal responsibility doesn’t actually explain ❓why❓ a behavior has occurred.

It is simply a subjective judgment about one’s character.

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To gain an understanding of why a behavior is occurring we instead need to examine the contextual factors that cue and reinforce the behavior for that individual, both at present and in their past.

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This isn’t a simple or quick task. If you are in counseling or you counsel others, most of your time should be spent on this detective work. Once we thoroughly identify the drivers of behavior we can begin to identify intervention levers.

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Before developing behavioral interventions, it's important to consider 2 scenarios:

1) a person may be experiencing discomfort about their circumstances and want to change it

2) a person may be fine with their circumstances and not seeking to change anything.

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Let’s tackle the 1st scenario. A person enrolls in a weight loss program bc they are worried about their weight and wish to lose 20 lbs. Remember, our first goal is to dive into the contextual factors affecting their weight.

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Contextual factors driving eating and physical activity behavior typically include both internal (biological) and external (environmental) factors. Much of our work will be deep diving into which factors are operating for this particular patient and how that is occurring.

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Once these are identified we can explore which among these factors are levers that can be moved. Some won’t be moveable (e.g., genetic determinants 🧬) but others will be. For example, a person may avoid exercising because they don’t feel safe walking in their neighborhood.

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Dismissing the person as irresponsible for not exercising doesn’t advance our understanding of what is going on, it impedes it. This person’s choice to not exercise actually makes good sense. So now we need to do some problem solving to deal with this quandary.

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I hope it's obvious by now that behavioral counseling is not a matter of telling people silly things like “eat less and move more.” Behavioral counseling is a mix of:

1) Detective work to identify drivers (the why)
2) Problem solving to overcome obstacles (the how)

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Now let’s talk about scenario 2, we have a person engaging in an unhealthy behavior and he is fine with it but his behavior puts others at risk. People refusing to wear masks would fall into this category.

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Dismissing the person as irresponsible doesn’t move us toward understanding his behavior or identifying intervention levers. It’s pretty much just an insult. Instead, we need to explore the context of his behavior to find a lever we can move.

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Perhaps the news he trusts has assured him that masks are unnecessary and the social system he relies on reinforces this via ridicule for masks and praise for defying mask orders. Changing his behavior will involve shifting his cost/benefit ratio for mask wearing.

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In any event, the concept of “personal responsibility” is of no value to behaviorists. It neither explains behavior nor informs our interventions.

It’s an intellectual dead end. ⚠️

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While it may feel good to say we are high in “personal responsibility” when we make healthy choices, such a conclusion ignores the often privileged circumstances that made those choices easier to make and ignores the hurdles that others encounter.

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By replacing the frame of “personal responsibility” with a frame of curiosity (about why behavior occurs), we can better understand our fellow humans which will not only lead us toward more effective interventions, but also, and perhaps most importantly, toward 💜empathy.

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