Install a competing response that blocks the habit physically

Pre-load a specific muscle action that makes performing the habit impossible — and hold it for one minute.

Why it works

The competing response works by occupying the motor output channel that the habit would use. Because two incompatible motor programs cannot run simultaneously, the competing response physically prevents the habit from completing. The one-minute duration covers the typical peak of a habit urge — urges follow a wave-like pattern and subside if not enacted.

How to do it

1. Choose a motor behavior that is physically incompatible with the habit (for hair pulling: fist hands and press against thighs; for nail biting: press fingertips together).
2. The competing response must be: physically incompatible with the habit, possible to do in any social setting, and holdable for at least one minute.
3. At the first sign of the urge or the habit beginning, immediately initiate the competing response.
4. Hold it for one minute or until the urge passes — whichever comes later.

Evidence

Competing response practice is the active ingredient of HRT in most component analysis studies. Trials isolating competing response alone show significant reduction in target behaviors for tic disorders and BFRBs. A randomized controlled trial pairing HRT with acceptance and commitment therapy for trichotillomania extended the competing-response evidence to hair-pulling specifically. (rct)

RCTs are primarily for clinical tic disorders and BFRBs (trichotillomania, excoriation). For non-clinical habits like nail biting, evidence is from case studies and small trials.

Sources

• Azrin, Nunn & Frantz (1980), "Habit reversal vs negative practice treatment of nervous tics", Behavior Therapy
• Piacentini et al. (2010), "Behavior therapy for children with Tourette disorder", JAMA
• Azrin, N. H., Nunn, R. G., & Frantz, S. E. (1980). Habit reversal vs. negative practice treatment of nervous tics. Behavior Therapy, 11(2), 169–178.
• Piacentini, J., Woods, D. W., Scahill, L., Wilhelm, S., Peterson, A. L., Chang, S., Ginsburg, G. S., Deckersbach, T., Dziura, J., Levi-Pearl, S., & Walkup, J. T. (2010). Behavior therapy for children with Tourette disorder: A randomized controlled trial. JAMA, 303(19), 1929–1937.
• Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006). A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania. Behaviour Research and Therapy, 44(5), 639–656.

Common mistake

Choosing a competing response that is socially conspicuous or uncomfortable to maintain — it must be something you’ll actually do in public when the urge arrives, not only in private.