Would you like to try something new that can help bring out the best in you?
Toothpaste stickers (TPS) are stickers that go on your tube of toothpaste! They are as simple as they sound and yet the results are profound. These stickers are unusual because they are handwritten by you with an ‘I am … and I can …’ phrase.
Examples would be:
I am improving my sleep and I can turn off my phone one hour before bedtime.’ ‘I am a helping myself be a healthy eater and I can only drink water after 8pm.’ ‘I am a grateful being and I can give thanks for something after I brush my teeth.’
This simple practice uses tiny habit stacking (Fogg, 2020) to combine an already powerful habit (brushing your teeth twice a day), with a positive affirmation (an ‘I am’ phrase that reminds you of your core identity/values). Simultaneously the ‘I can’ phrase empowers positive actions by gently reminding you of something small you can do, which brings out the best in you. When they are combined these tiny changes often produce a keystone habit that can cascade (domino style) to improve other aspects of your life (Duhigg, 2012).
Because you automatically see the sticker at times of the day when you are especially receptive to priming and habit change (on waking and before bed), they can have a powerful influence on your sense of identity and behaviours (Diekelmann & Born, 2010).
Also, if other members of your household see them they may socially commit you to standing by what you value, even though it might involve some teasing.
I have been offering toothpaste stickers in my work as a GP for several years as a tool for empowering individuals to take positive actions to improve their lifestyle, with the intention to humbly facilitate people to align with their authentic self and core purpose and to live well. I have found that this can have a profound impact on peoples’ health and performance (Bodai et al, 2018).
Previous healthy lifestyle conversations in our consultations generated many good intentions (eg to take
a morning walk), but rarely translated into sustained actions and changes of behaviour. People often reported their flagging was due to ‘four Fs’ (fear, fatigue, forgetting and floundering). They would describe feeling a loss of confidence in the behaviour change especially when a life situation became more challenging. This would sometimes lead to a sense of failure, resignation and a reluctance to learn from the experience and to try again. This ‘learned helplessness’ and failure to nurture our sense of agency is a recognised factor in poor outcomes (Maier et al, 2016). So I began inviting people to write a toothpaste sticker during our consultations, at a time when they were in a highly motivated and activated state. Soon they were reporting that they felt empowered and less anxious about habit change, as well as being more able to sustain those changes with less effort. They have also reported a powerful sense of focus for kindness and honesty. If they did not follow the habit that day then the sticker still acting as a friendly reminder rather than a reprimand, offered a fresh start. The helpful recognition that the hero’s journey is challenging but also worthwhile transforms the four Fs from foes to friends. As the sticker is selfwritten in the consultation, so the person has a first mental rehearsal at that time and, with coaching, can recognise potential challenges and be helped to transform obstacles into opportunities to respond helpfully (Bungay & Michael, 2016). The only task required of them is to remember to put the sticker on the toothpaste, which is made easier by sticking it to the back of their hand during the consultation. Perhaps the little discomfort as the sticker is removed acts as a temporal primer for the start of their change adventure and will be a trigger for action. The minty fresh sensation of tooth brushing could feasibly set up an association with making a ‘fresh start’ to their habit-changing adventure every day.
There is good evidence that this process (according to self-affirmation theory) is effective in areas as wide-ranging as improved eating, smoking cessation, mental health, couples relationships, school grades, bullying and working performance (Cuddy, 2015).
There are deeper (meta-cognitive) benefits too. With practise the person who uses toothpaste stickers also develops something that I call ‘A MAP’ to success.
Acceptance, Mastery, Agency and Purpose are a quartet of qualities found in people who ‘succeed’ beyond the limits their circumstances would predict. Such success can translate into significantly better health, wellbeing and performance outcomes (Meijer et al, ). These qualities also feel good, acting as they do as intrinsic motivators, which we know to be associated with improved performance, and contrasting with extrinsic motivators such as financial or physical rewards (Pink, 2009). Common phrases I hear in my practice are ‘I feel alive again’, ‘I believe in myself’ and ‘Now I know I can change that, what else can I achieve?’. From my perspective it feels hugely rewarding to engage with another being as they realise their beauty and potential. I feel too that these interactions have inspired improvements in my own health and wellbeing: something the evidence suggests can ripple out to improve the health of those under my care (Oberg, 2009).
Put simply, a habit is a (often unconscious) behaviour which gets repeated in response to a stimulus. While these automatic processes are indispensable for us to function efficiently they can, as we all know, be unhelpful too: what starts off as a comforting habit doesn’t really help.
So how do habits work? In my experience habits ‘START’ and recycle with five stages.
Setup – these are the internal and external factors that predispose the habit happening, eg cookies on the kitchen shelf and the memory that cookies can be comforting (a mentally rehearsed pathway from previous cycles of habit).
Trigger – these are factors that bring on the habit behaviour pathway. They often relate to situations – a certain time, or place, or persons, and preceding trigger events (eg standing in the kitchen, after a stressful day, when we are in a physiological dip and maybe see someone else eat a cookie on a TV advert). This sense of anticipation and release is initially mediated by the brain’s dopamine system (Wickens et al, 2007) that causes us to want, desire, seek out, and search. As dopamine oscillates in ultradian rhythms it increases our goaldirected behaviour and makes us curious about ideas and information (Pink, 2018; Mihaly, 1990).
Action – is what we do. It is often a default (automatic) behaviour that comforts in the short term but as with addictions, in the long term fails to help, or worse generates other problem, eg transform into a cookie monster, eat lots of cookies, perhaps without really tasting them.