Let me tell you why a visit to the dentist changed my life.
First, I should mention that I do not have a great track record with dentists. I freak out at needles, gag when cotton chunks come near my mouth and am disgusted by every flavor of polishing paste (really, can someone disrupt the fluoride industry already?!). I’m also a terrible patient. Every year since I have had teeth, this is how my dental appointment goes:
Every Dentist I’ve ever had: Vanessa, I can tell you’re not flossing. You need to floss more. If you don’t floss you will get more cavities. Maybe an electric toothbrush will help? You have to get it into your nightly schedule. I will know the difference next time you come in. Floss or else!
And this is always my response:
Me: I know. I know. I know. I don’t want the electric toothbrush, but I will take the free floss. I’m sorry. I know.
And then I leave. And nothing changes. In a good month, I floss once per month. A few months ago, I decided to switch to a new dentist a little closer to my house. She—Dr. Vu at Wellness Dental begins my appointment with an exam. Just like normal. But then, everything changes:
Dr. Vu: Vanessa, you have beautiful teeth. I can tell you brush every day. Maybe you even floss once per month? That’s great! That’s more than the average person. I am really happy to see that.
Me: I do?! Yes, I do! I floss once per month and I always brush twice per day.
Dr. Vu: I can tell, that is wonderful and a really good set of dental habits. Now, I see you have a few very small cavities. I think that since you take care of your mouth, we might be able to fight these and definitely prevent more from coming. But we will have to fight them together.
Me: Yes! Yes, let’s fight them together! How can we do it?
Dr. Vu: Here’s what I am thinking. First, I want you to see your progress. I am going to take a picture of every single tooth (cool wand device brought out) and that way you can see exactly the worrisome areas I am talking about. Then when you come back for your next cleaning, we can take new pictures and check your progress to see how we are doing. This is what I think we can fix…
[She pulls up a picture of my tooth on the screen and shows me exactly where there is a tiny dark spot]
Me: Oh wow, I didn’t know you could see it. So you think that I can reverse the damage without drilling?
Dr. Vu: Yes definitely! Enamel can heal if you treat it right, so we are going to go on full attack—last resort is drilling. First, we get you an electric toothbrush, that will really help. Second, we up your flossing. Even once per week would be a tremendous change. I am going to give you some free boxes. Lastly, I am going to give you some prescription fluoride toothpaste.
Me: Ok, definitely I want the electric toothbrush and I think one time per week is doable, but I bet I can do more if I really focus on it.
Dr. Vu: Absolutely! I have no doubt. When you come back we will compare the pictures and see how we did! I am even going to score each tooth with a number for gum health so we can see how much the flossing is helping.
Me: Ok! I hope I can improve my score on most of them.
Dr. Vu: I know you can!
I have flossed almost every day since this first appointment. I did not have to get those two cavities filled because we repaired the damage and I improved my overall teeth scores from average to excellent. For the first time in my life, I don’t dread going to the dentist.
This experience demonstrates far more than how to encourage teeth health. It speaks to an essential part of human nature: Behavior Change.
Why We Want to Change People
We can’t help it: We love to try to fix the people in our life. We give advice to a friend. We tell a family member how they could do something better. We try to suggest, fix and change a partner for the better. Sadly, even though we mean well, changing people usually doesn’t work. In fact, it might even make the person you are trying to help angry at you.
Why are you trying to change me?
I know better!
You don’t understand, my situation is different.
Stay out of it!
Mind your own business.
Yet, we keep trying to ‘help.’
How We Keep Trying
Think of how the dentist tried to change my bad flossing habits. These are the same strategies we try with the people in our life:
Tactic #1: Helpful
As a dentist I would recommend flossing more. You know what really helped me? I have some great advice for you. I just want to help! If I were you I would just try to…
Someone in your life is doing something wrong. You think you could help them out with some advice—if only they could be more like you or do it more like you would do it, everything would be easier! So you offer advice, suggestions, send them tips, articles and books. Sometimes this works, but often it doesn’t. This person comes back to you with the same problems over and over again.
Tactic #2: Incentivizing
My mother: If you floss every night and don’t fight with me about brushing I will get you a new Hula Hoop!
Parents do this a lot with children, but we also do this with colleagues and employees. We offer a reward for behavior change. This can work in the short term, but never holds up in the long term as incentives hold less value over time.
Tactic #3: Threatening
If you don’t floss, you will get more cavities! If you don’t start saving money, we are going to have to sell the car. If you don’t lose weight, you’ll have to buy all new clothes.
Fear mongering and threatening is a typical tactic used by dentists, parents and bosses alike. But the stick is less effective than a carrot (and a carrot wasn’t that all effective in the first place, see above). Threatening only makes you the target of someone’s animosity. People who want to lose weight or eat less calories already know what’s at stake. Threats only add stress, fear and anxiety. This might work temporarily but could destroy your relationship.
Tactic #4: Pleading
Do it for me! Do it for your future kids! Think of all the money we have spent, don’t let it go to waste!
When we are really desperate for someone’s behavior to change, we plead with them. We beg them to change and point to a higher purpose—the future, money, religion, children. We hope that by tying the mission to something bigger it makes people pay attention. Typically this only makes someone feel more alone, not more inclined to change.
Tactic #5: Shaming
Your oral hygiene is below average. Your weight is disgusting. Aren’t you embarrassed by your debt problem? I would be humiliated if I were you! I would never show up late all the time, it is so rude.
Shaming is a standard tactic for behavior change—you see it a lot on weight loss reality shows for example. The problem is that shaming can work, but it has devastating consequences on someone’s self-worth and long-term health. When you shame someone into changing their behavior they work out of a negative space and attack their own sense of worth. Even if they end up changing the behavior they often have a hard time getting back their self-esteem.
Ok, so all of these tactics don’t really work in changing someone’s behavior. What does?
How to Change Someone’s Behavior
Dr. Vu did something powerful with me that day in her office. She showed me how to really get someone to change behavior. Here is what she did:
Step #1: Pride
Dr. Vu started out by invoking feelings of pride. She told me I had beautiful teeth. She also mentioned that I do floss and that was ‘better than average.’ This immediately made me feel proud of the little I do floss as opposed to ashamed about how much I don’t. This is a major difference. Pride makes us want to rise to do more, it makes us feel powerful and we want to live up to the definition. If you want to change someone’s behavior make them feel proud.
- Point out what is going well
- Praise them for what they are doing right
- Invoke their feelings of pride so they live up to the label
Step #2: Togetherness
Dr. Vu also uses “we” more than “you.” It took me a while to notice this, but when I did I realized it made me feel calmer. She wasn’t accusing me of bad dental hygiene, nor was she saying I was on my own. In fact, she was putting me on her team. She was saying that we would fight cavities together and I was not alone in the battle. If you want to change someone’s behavior put them on a team.
- Say ‘we’ not ‘you’
- Join their cause
- Find them people or allies to change with
Step #3: Progress
The next thing Dr. Vu did was to help me catalogue my progress. She took pictures of each tooth and gave my gums a score. This gave me a benchmark—it’s like seeing how much you have in savings or weighing yourself. Specific, measureable goals are always easier to achieve. I could see the little dark spot on my tooth—and I wanted to get rid of it. I could see my teeth scores—and I wanted to improve them. She made my target defined. Other dentists would just tell me to floss more. I had no idea if it was working or not and my only measure was if I didn’t get any cavities. That’s not enough for sustained behavior change! Every night when I floss, I imagine how much my score will improve and that little dark spot fading. That is a powerful motivator and mental image to floss more.
- Define a measurable benchmark
- Track progress
- Make it easy to visualize change
Step #4: Tools
The last thing Dr. Vu did was give me specific tools and steps. I had heard all of these before, but never in such a direct, prescriptive way. When I heard them before they felt like annoyances. But after Dr. Vu’s first 3 steps, they felt like powerful weapons! She broke it down into 3 steps and promised a measurable outcome. I was hooked.
- Give steps
- Provide helpful tools
- Make a clear path to change
These 3 steps to behavior change work in any kind of environment. For example, let’s look at a parent trying to get their child to clean their room more:
Tactics that don’t work:
- Helpful: If you cleaned your room more, you would be able to get ready for school on time.
- Threatening: If you don’t clean your room you will be grounded!
- Incentivizing: If you clean your room every day for the next month I will buy you a new video game.
- Pleading: I am begging you to clean your room, it would make me so happy for when guests come over!
- Shaming: Your room is disgusting! It is shameful and a total pigsty, I would be so embarrassed to have friends over if I were you.
Steps that do work:
- Pride: Thank you for always packing your backpack at night, it saves us so much time in the morning. You are so organized with your school stuff. I also really like the new posters you made for your walls. They look awesome, your friends will love them when they come over.
- Togetherness: I would love to help you get your room clean. What can we do together to make that work? How about we use the dishes and laundry schedule to help?
- Progress: I am going to keep a calendar of laundry days and do the dishes every morning. This way you know exactly when to bring things down and when I will be coming up there—so you don’t feel like I am dive bombing your room randomly. I am going to keep track of when you bring down yours. If we can do it 3 of the 7 days of the week that would be great.
- Tools: I am going to get you your own laundry basket. I also got you a Nalgene bottle for your room you can refill upstairs instead of using the water glasses. That should save a lot of time. I also just ordered these sheets that make it easier to strip and make the bed. They are pretty cool.
This is a totally different approach to behavior change. It goes against our instincts, but actually gets results without making people feel bad in the process. We all have bad behavior, it’s great to get some compassionate help sometimes. Use these steps to help someone break free of their bad habits. Oh, and thanks so much Dr. Vu! You are the best = )