Kim Mills: Speaking of Psychology is taking a summer break, so we’re rerunning some of our favorite episodes from the past. In 2021, I talked to Katy Milkman, a behavioral scientist at the Wharton School of the University of Pennsylvania, about how to identify and overcome roadblocks that are getting in the way of making the changes you want to see in your life. I hope you enjoy this episode from the archives—we’ll be back with a new episode next week.
Change is hard. When you want to make a change in your life, whether it's eating healthier food, starting an exercise program or saving more money, there are many human foibles that can stand in your way. Impulsivity, laziness, procrastination, or just plain forgetfulness are among them. Libraries are full of books offering multi-step plans and other things to inspire a new you. Often though, these plans fall flat. Our best intentions aren't enough to overcome the roadblocks of human nature that stand in our way.
But in recent years, psychologists have begun to look at behavior change from a different angle. Instead of fighting human nature, this research suggests that we should analyze it and then leverage it to work for us rather than against us. What does that mean? What can we learn from the science of behavior change that can help us make the alterations we want to see in our lives? And how can organizations, companies, and governments use these insights to nudge whole populations into making better choices?
Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association that examines the links between psychological science and everyday life. I'm Kim Mills. Our guest today is Dr. Katy Milkman, a professor at The Wharton School of the University of Pennsylvania and author of the book How to Change: The Science of Getting from Where You Are to Where You Want to Be. Her research explores how insights from psychology and economics can be harnessed to change people's behavior for the better on both an individual and a global scale. She has explored how relatively simple interventions can help people increase their savings, exercise more and even get vaccinated among, other things. She is codirector of the Behavior Change for Good Initiative at Wharton. She also hosts the Charles Schwab podcast, Choiceology, about the science of decision-making.
Dr. Milkman, thank you for joining us today.
Katy Milkman, PhD: Thank you so much for having me.
Mills: So as I said, your book is entitled How to Change, but in the first chapter, you start with a slightly different premise, which is, when to change. You make the point that there are some moments in our lives that are particularly conducive to making change. What has your research found? And if you want to make a change in your life, when should you try to do it?
Milkman: I love that you opened with this question because it's one of my favorite topics that I've studied. And actually it was a question just like the one you asked that started me on this course. I was visiting Google presenting some of my work on nudges and choice architecture and strategies that could be used by HR managers to help their employees make better decisions and invest in new skills, training, wellness programming, et cetera. And I was asked, is there some ideal time to encourage employees to change? And I realized actually there was very little I knew from the academic literature that would help me answer that great question.
So I went back to my research team at the University of Pennsylvania, my former student Hengchen Dai, who's now a professor at UCLA's Anderson School, and also Jason Riis who's the Head of Behavioralize and a Wharton senior fellow. We were all really interested in behavior change. We started talking about this question and had really strong intuitions right away about when it might make sense to change.
The first thing that came to mind for all of us was that we know people make more resolutions and set more goals around New Year’s. So that was well established. We weren't coming up with something wildly new there. But what we got interested in is, whether there was something about that moment that might give us a hint as to other moments in our lives when we might be more open to change. And we started reading the literature on autobiographical memory, the way people think about time. What we learned is that there are moments in our lives that feel like new beginnings. And that's because the way we organize time in our memory is as if our life is a series of chapters and they have beginnings, middles and ends. That's how we think about ourselves, like characters in a book, instead of thinking about time really truly linearly.
And as a result of that, any moment that feels like a break point can feel like a new beginning to us, anytime we're opening a new chapter for any reason. And what happens at New Years and what we found happens at some other moments as well is, we feel like because we're closing a chapter, we can say, that was the old me who didn't manage to quit smoking last year. Didn't manage to go to that skills training workshop. And the new me and the New Year, I'm different and I can do it. So we feel more optimistic.
And we've found in our research that other moments that systematically feel like new beginnings to us and lead to a similar optimism and tendency to pursue goals include dates like just the start of a new week, the start of a new month, the celebration of a birthday, the celebration of certain holidays that we associate with new beginnings. So think more Labor Day and less Valentine's Day. And we've shown in our research that people are more likely to do things like visit the gym at these moments. That they're more likely to set goals on a popular goal setting website around these dates that feel like new beginnings.
And also if we reach out and say when would you like to receive reminders to begin pursuing a goal? Or when would you like to start saving for instance? And we simply label dates differently. If we label a date as an ordinary day, no special label, it's not nearly as attractive as if we give it a label that makes it feel like a new beginning. So for example, in one study, we labeled March 20th as the first day of spring in one condition, but not in the other, it's the third Thursday in March. And we see really huge differences when it's labeled as the first day of spring in how attractive it is as a date to start pursuing a goal, for example.
So we both see correlationally, naturally people take advantage of these moments when they're looking at when to change, and we can run experiments and show that if we change the labels associated with certain dates and add fresh start labels, dates that feel like a new beginning, we see this uptick. So taking that all together, it points to moments that feel like transitions, feel like a new beginning of a chapter in our lives and particularly temporal landmarks that have those features that we've studied include the starts of these calendar cycles.
Mills: Okay. But that's an external nudge in a sense. Now, what if I want to make a change, but there isn't some obvious fresh start right now? Is there something that I can do for myself that would just create a fresh start?
Milkman: Yeah, it's a wonderful question. First of all, I would say there are so many dates that even though they are external, you can sort of look for the next one and jump on it. Monday occurs every seven days. It turns out. So even though you have to wait around for seven days to start, they're fairly frequent. So I do think even with that constraint, they can be useful as moments to lock onto. In terms of whether you can create one for yourself, Hengchen who I mentioned, my former student, she did some work in her dissertation related to a slightly different a fresh start. She calls it a reset. And it's a different way that we—it's not a temporal landmark that wipes the slate clean, but rather a change in the way we're tracking our performance that can wipe the slate clean.
So for instance, I wear a Fitbit and every morning I feel like I have a bit of a fresh start because yesterday I had accumulated maybe a patheticically low number of steps, maybe a really high number of steps, either way I wake up and it says zero again. And that's a reset and a fresh start in a sense. There's all these different ways in which we track our performance, whether it's sales performance if you're in an organization, whether you're a professional athlete and you're tracking your stats for the season. And things get reset at different frequencies. Grades for students, whether it's semester, quarter.
So one thing that we may have some more control over, especially if we're tracking ourselves is when these resets occur. And if we're having a rough time, it turns out resets can be really valuable as a motivator to improve and set goals and do better. Interestingly, her research also finds that resets are harmful, and I think this is very intuitive actually, in cases where we're doing really well. So you want to wipe the slate clean and have a fresh start when things aren't going your way, when you need the motivation to do something you haven't managed to do. But when you're on a roll, it's actually disruptive and harmful to have a fresh start. So we do have to use this particular tool with some caution.
Mills: You started out as an engineering student, and you write in the book that in some ways you approach behavior change as an engineering problem. What do you mean by that?
Milkman: Yeah, it's funny to be on this podcast and I'm often labeled a psychologist. You will laugh. I have literally never taken a psychology class in my entire life. My undergraduate degree and PhD are both in engineering. And so it's a different way of looking at the world. It's looking for problems that you can solve by pulling the right pieces together in order to plug a hole or fix a gap or improve a structure. That is the way that I was trained to think.
And it turns out, I think it's quite a useful way of looking at a lot of psychology problems, especially in my field of behavioral science where we have spent a lot of time down documenting errors in judgment, the ways that people make systematic mistakes. But if you want to actually start correcting some of those mistakes, having this engineering mindset like how can I build a structure that plugs that hole? How can I fill that gap? Is a really useful perspective, I think, and I've tried to bring that to my work. I've always been solutions-oriented and looking for ways that what we know about the human mind, not only presents conundrums and puzzles and problems and exposes limits, but also what we can do to actually overcome and build and grow and bridge those gaps.
Mills: So some of your first research on behavior change was what you call “temptation bundling.” The idea for which came from a problem that you were trying to solve in your own life. Can you tell us that story and explain what temptation bundling is and how it can help people change their behavior?
Milkman: Yeah, I would love to. This is absolutely me-search, which is a term I'm borrowing—I think another psychologist named Carey Morewedge is the person who taught me that term. I love that term. It's what drew me into the field honestly, was that I was doing some research—so I was a graduate student at the time in engineering and struggling with tough classes and tired at the end of day. And all I wanted to do when I came home and should have been working on problem sets was curl up on my couch with entertainment, a juicy page turner or binge watch Netflix, one of the above. I was struggling to find the motivation to get my work done.
Similarly, I knew that I really needed to exercise regularly. It was important for my physical and mental health. I was a lifelong athlete, but I just could not drag myself to the gym. And especially at the end of those long days when I was feeling worn out, I had this epiphany, a little me-research. And by the way, many other people have had this epiphany independently, which was, what if I only let myself enjoy these indulgent entertainment sources while I'm exercising? Maybe that would actually drag me to the gym. And maybe also I'd stop wasting time at home binge watching TV when I should have been doing my problem sets.
So I tried this out. I made a new rule that I was only allowed to indulge in entertainment while I was exercising. And it was life altering. All of a sudden I'd come home from a long day and all I wanted to do was rush to the gym to find out what happened and the latest—I got into audio books, lowbrow audio books like—well, this isn't very lowbrow, Harry Potter, James Patterson, The Hunger Games, page turners, thrillers. I would want to know what happened next to these characters. So I'd dash off to the gym. I'd get in these great workouts where I didn't even notice that I was exercising. The time was flying so fast. Normally exercise was a drag, but I was so into these characters and the stories I kept going.
And then I'd come home and I was totally refreshed and rejuvenated ready to get my work done and there's no distractions. And I thought, "Wow, this is really working for me. And I should see if this could help other people." So I ended up doing some experiments to test whether or not what I now call temptation bundling, or linking something that you find a pleasure and a temptation with an activity that would otherwise feel like a chore in order to make it more endurable, more pleasant, could help people.
So we've run a couple of experiments now showing that temptation bundling can be a helpful tool to other people, not just me, not an n of one. So one experiment, the first one we did, we randomly assign people to a group where they would be given tempting audio novels that they could load onto iPods and then listen to the first 30 minutes while they were doing a workout at the gym. And we told them if they wanted to hear what happened next in whichever tempting novel they'd picked from a menu of 80 we gave them that had been pretested, well, they would have to come back to the gym because we'd be holding their iPod hostage in a locked monitored locker. They could only access it when they came in for a workout.
And we compared that group's exercise habits to a control group that also did a 30-minute workout at the start, also owned iPods was also given an equally valued gift, a gift certificate to Barnes and Noble which they could of course use to buy audiobooks if they wanted, but we gave them no suggestion to temptation bundle. And what we found is that temptation bundling did increase exercise pretty substantially in the short term. So the study went for 10 weeks. The effects were robust for seven weeks.
Then along came Thanksgiving break. We did this at the university gym. The gym closed, everybody went home. And this was actually, I think another interesting part of the research, the effect was totally wiped out by that period of forced separation from the tempting stimulus. So we've done subsequent studies where we show it can have a more durable effect when you don't have that kind of disruption, but it also links back to what we were talking about with fresh starts and how resets and disruption can be good in some cases, but when you're on a roll can be harmful.
Mills: You get dependent then on your iPod in order to go to the gym. If you don't have it when you go back home, forget it. I'm done.
Milkman: Exactly. Exactly. It break and there's—anyway, all these things, I think part of what makes them so interesting is, there are few things that are just totally unambiguous, always work, there's no moderators. And that's one of the things that's so interesting about studying humans is that there's always interesting complexity to unpack.
Anyway, so that's the work on temptation bundling. And I've talked about it only in the context of exercise, but just want to point out for listeners who have other kinds of behaviors that they find to be chores or burdens and they're trying to engage in more, it's a tool that theoretically should be applicable to lots of settings in life, not just getting yourself to the gym.
So you can think about only letting yourself listen to your favorite podcast, say this one, while you're doing household chores or cooking fresh meals, if those are goals that you want to fulfill. Or only letting yourself pick up a favorite treat or snack on the way to hit the books at the library, if that feels like a chore, but you want something to make it more of a pleasure. So there's lots of ways we can create temptation bundles beyond exercise, but that is where I first did it and studied it.
Mills: So your book is organized into chapters each covering a different aspect of human nature, a couple of which I mentioned in the introduction, impulsivity, laziness, procrastination. Can you talk about your favorite examples from the book about how we can work with rather than against these traits when we're trying to make change?
Milkman: Yeah, probably my favorite example is one that is it's really well known and yet it's so important. So I'm just going to harp on it anyway. I think it's the power of defaults. And I think this is one of the biggest wins from behavioral science and has to do with laziness. So in general, we humans prefer to take the path of least resistance. Whatever the easiest route is to collecting my paycheck or getting my lunch or whatever it is, whatever goal you have, we're always looking for the shortcuts and the easiest instead of the hardest work path.
And that actually, of course, is a challenge when it comes to trying to get yourself in great physical shape or earning your PhD. The fact that we're looking for shortcuts does not really help. It's often a barrier to change. And so I talk a lot about that in the book. But one of the things that's so interesting is that defaults flip this on its head and turn laziness into an asset. So a default is the option you will end up with in a situation if you literally don't lift a finger, if you do nothing.
So your computer comes with default settings. You turn it on, it has some background screen, it has default fonts. It probably has a default browser. There's all these things that are just there. And if you take the path of least resistance, well, that's what you end up with. And so I think one of the really interesting things is, once you start to recognize the power, and they've been studied in so many different contexts, it's actually not something I've studied, but lots of wonderful scholars in this association have.
I'll just mention, for instance, Eric Johnson and Dan Goldstein have some wonderful work on how much default organ donation policies change our decisions. So countries where you're defaulted into being an organ donor, but you can just opt out trivially easily by checking a box and signing your name on basic form, have vastly higher rates of organ donorship than countries where you have to—I said it the wrong way. No, I said it the right way—where you have to opt in which is what we have in the United States. So in the United States, you go to the DMV, you check a box, you opt in, it's trivially easy, but we have lower donation rates because I had to take some action. And we always look for the path of least resistance.
So anyway, organ donation is a particularly tricky one because it's more than just whether you sign your name and check a box and are opted in or opted out that determines what actually happens with organs, but it shows the power because of these huge differences of a default policy and how important it is to put deep thought into that if you want to change behavior in a positive direction.
So when we have defaults that are structured to help people achieve their goals, we default them into getting apple slices with their meal instead of French fries on the side. Or we default people into say being organ donors, although again, that one has some complexity, all of those choices, they use laziness to help us achieve a goal. So for instance, my browser's homepage is not Facebook or Twitter. It's the New York Times. So every day I encounter some news when I open it up and I don't get sucked into a vortex of something that maybe I'm going to be tempted to waste time with. Instead I'm getting something that I consider enriching.
There's defaults you can have in your pantry in terms of what foods you keep on hand. So it's hard to get the burger and fries or the pizza that you crave that aren't as good for you. If you want to stay healthy, you don't have the cookies in the pantry, you have healthy snacks, and now your defaults and the path of least resistance is aligned with your goals. So I think that's a really powerful tool we can use to set ourselves up for success once we understand the power of laziness and that we can use it and harness it to our benefit.
Mills: And that's a great one to get people to save as well. It always amazes me that every employer doesn't automatically enroll you in the 401k plan. You won't notice it, right? And I think you've done some work in that area as well.
Milkman: Absolutely. Probably one of the most famous examples and most useful examples besides the organ donation is that employers, and this is worked by Bridget Madrian and Dennis Shea that first showed this in about, I think 2003, when one employer switched from having new employees enroll by checking a box and signing their name. And they'd start having a portion of every paycheck sent to their savings account. They just made a little change in the paperwork. And now you had to check a box and sign your name to say, "I don't want that done."
And overnight they saw almost a 40% increase in enrollment in their 401k program, which led to huge increases in people's savings for retirement. And so now it's actually tax-advantaged for companies to make savings in their 401ks the default. There was the 2006 Pension Protection Act I believe passed that was nonpartisan. Just everyone agreed. Let's harness laziness to make sure that Americans have better financial security. And it's a terrific example of a tool that policy makers can use.
We can certainly also use it ourselves. Like you can go into almost any bank account today and create a recurring deduction or movement from one to another. And once you set it once, you'll never think about it again, no one's ever going and changing these things, because you're lazy and on the path of least resistance. So if you're just one time, maybe at one fresh start when you're feeling motivated to increase your savings rate, you set up that auto-deduction from every paycheck into a savings account that you don't touch, you are going to accumulate more. So that's a really powerful tool.
Mills: That raises a question around how an individual can identify strategies that are going to work in a particular situation. For the listener who wants to change, what should they be going through mentally in order to find that strategy that's going to work for them?
Milkman: Yeah, I love that question. And honestly, that is a very question that I would say to some degree was the impetus for writing the book, is that I felt like what I'd realized is, when I talked to individuals, when I talked to organizations that were looking at behavior change challenges, which is what I often do in my research, there was this tendency to just look for off-the-shelf solutions that sounded good, and maybe they'd been proven effective in some other situation, but there was very little effort made to diagnose what was the barrier to change.
So there wasn't this matching. There wasn't an appreciation that it mattered that you understood what was obstructing you in order to choose the right tool to overcome that challenge. And so I tried to write this book to actually both share everything I knew about the science and behavior change after a career spending it, but also I organized it around, okay, there are a set of pretty predictable barriers that are actually very recognizable when you are facing a problem, you will pretty easily once you have read the book or read through this list, you'll say, "Oh yeah, that's a forgetting problem. The reason I'm not taking my medications at night is I always forget. It's not that they have awful side effects and it's miserable. It's not that I'm procrastinating because I'd rather do it tomorrow than today." That's a forgetting problem.
Once you recognize the types of problems that are systematic, it's actually very easy to see and diagnose what kind of barrier you are facing to change. And then once you know it, there's a whole lot of science that suggests, okay, if it's a forgetting problem, here are the kinds of reminders that work, here are the tools and strategies, but if it's a barrier of procrastinate, you need a really different suite of strategies. So I would say actually the diagnosis part is as simple as having a little bit of exposure. And the book that I wrote provides that, but getting a master's in psychology or even picking up a textbook and learning about the judgment decision making literature, it's not hard or at all, it's just a step we normally skip.
We normally go right for the, oh, I'm not achieving my goals. I must need to build tiny habits or I must need to set bigger, more audacious goals or visualize success instead of thinking, "Wait, okay, first before I try to solve this problem, what is the barrier? And the barrier is going to guide me towards the right solution." Because there are many solutions. There's a whole slew of them. And so you said there's self-help books all over the place. And lots of their solutions are science-based I should say. It's just rarely did they get into like, oh, this is really a solution for this type of problem.
Mills: What about peer support and the idea of making a commitment to another person? If you're held accountable somehow, are you then more likely to follow through?
Milkman: Yes. This is the easiest answer I got to give you. Just yes.
Mills: Okay, let's move on.
Milkman: Yes. Of course, it's more complicated than that, but yes, yes, yes. Peer support is so powerful. There's a couple of components of peer support that matter. You touched on accountability and accountability absolutely matters because when we basically increase the price of our or vice, whatever the thing is that's bad for you—like not studying or not saving for retirement or not eating a healthy diet or not getting your report to your boss in time—if there's a bigger cost, then your general tendency to procrastinate and to prioritize what's fun in the moment instead of what's good for you in the long run, well the bigger the cost, the less that is likely to happen. So you can up the cost of bad behavior and you'll see less of it. This is very simple map. And one way to up the cost is accountability because shame and feeling that you've let someone else down, those are big costs that we don't like to pay.
So absolutely one of the reasons peer support matters is because it can create accountability and it can create those extra costs for failing to follow through. But peer support has a lot of other benefits besides accountability. One of the biggest I think, which has been studied maybe most impressively by folks like Solomon Asch in the 1950s, and then more recently Robert Cialdini, has studied social norms.
And that is when we look around and see what other people, our peers are doing and what they're achieving, it gives us knowledge about what's normal and that tells us what's possible and what will be rewarded socially, like how we'll have friends, so you want to fit in. And you actually see what you're capable of in other people's achievements. So not only is there accountability when you have peer groups and you look to those peer groups and they know about your goals, but you can create peer support systems in other ways and you can gain valuable knowledge from your peers about what you can achieve when it comes to goals.
So it's really important actually to think carefully if you can, if you have the power to structure your peer group in some way—and you moms know this, and dads know this too. Sorry to be sexist. My husband is probably a more engaged caregiver in many ways than I am in shaping our son’s peer groups. So it's really important to think about who you're surrounded with. If you're surrounded with people who are role models, who are showing you this is possible. You want to run marathons, they're running marathons. They're really doing a great job, or they're vegetarians, you want to be a vegetarian, that's the lifestyle you aspire to lead. Your peers show you the way and they can show you how to get where they are if you look. And you can literally, deliberately, strategically copy and paste tactics that they use to successfully achieve their goals. So anyway, that was a long answer after yes, but peer support has a big role to play in behavior change.
Mills: So that brings me then to vaccine uptake. Okay. Because a lot of the thinking early in the pandemic once we had vaccines was that pressure, peer support, peer example, would make people get vaccinated. And we're finding it works for some people, not for a lot of people. What are we doing wrong?
Milkman: Oh gosh, we could have a two-day conversation about this.
Mills: Yeah.
Milkman: I don't think we were wrong that peer support, social norms, would matter for vaccination. I actually think that's true. We just would've been naive to say, and here I'm coming back to problem-solution matching, that for everyone, the barrier was going to be solved by seeing others around them getting vaccinated. Okay? So for some people, the reason you might not get a vaccine might be, well, gosh, this sounds new and scary. I don't know. We'll see if other people do it. If other people do it and it works out fine for them, maybe I'll feel more comfortable and their peer norms are going to be really important. Seeing lots of selfies of people you trust or in your community taking this vaccine, that is going to help.
And I think that did do a fair amount of work. If you look at surveys from a year ago, last September, only about half of Americans said they would feel comfortable getting a vaccine and we're past 70% of adults now having had their first shot. So that's more than half of Americans who had the opportunity to get a shot doing it. So we're way better off than we were year ago. And I suspect part of that, there's so many things, but part of it may have had to do with seeing their peers, seeing hundreds of millions of people have done this and now it feels comfortable.
But the thing is, that wasn't the only barrier. There's misinformation, which is a major barrier. There's another barrier that I think is important to acknowledge, which is cost. There's real cost in terms of time off from work, having childcare, having symptoms, that is important to acknowledge and recognize, especially in a country where we have so much income inequality, so much inequality of opportunity more generally, and just making something available for free is not covering all of the costs associated with it.
So really wide range of different barriers. And so we need a lot of different solutions to overcome all of that. And of course, it's been politicized and that didn't help things. And I have lots of brilliant colleagues who could say much smarter things on this podcast about how to tackle that. That's not my specialty, but I do admire the great work being done in this field on the issues of polarization.
And so what do we do from here? My team has spent a lot of time thinking in the last year and studying this problem and looking at different tactics from—we ran some, we call them mega studies, really, really massive randomized controlled trials where instead of testing a single hypothesis, we test literally dozens at the same time in parallel. We've run these studies with Walmart pharmacies and with two large healthcare systems to test out different text messaging communications encouraging people to get a vaccine and see what worked best.
We found a tactic that did then prove useful. We were studying it in the context of flu shots last fall. Hoping it would pour over to COVID. And actually I mentioned Hengchen Dai when I was talking about flu shot, excuse me, when I was talking about the fresh start. She took a best performer from our two mega studies on flu shots and proved that it then was effective in encouraging COVID-19 vaccinations and had a paper about that come out in Nature with Silvia Saccardo and some other coauthors in the last couple weeks. And that message was, it's waiting for you. It's reserved for you. It belongs to you. Come claim it.
So an ownership message conveys recommendation, uses the endowment effect or the fact that we value things more that we feel belong to us. And also probably makes it feel like it's not going to be a hassle because it's already been reserved for you. So I'm not going to have to fight to get mine. All of those things probably are part of what makes it work, that we did not study, the mechanism. We just showed in multiple large trials that this was the top performer of a big suite of things we tested. So we've been recommending using its reserve-for-you language. I don't think at this point in the pandemic that's going to solve the problem with vaccination. I don't think we just need text messages at this point, but it's one insight that we, and it may be helpful with things like second shots and booster shots to try to use that optimal language when we communicate about it.
Mills: And it may counter some of the thinking around the fact that in the beginning, it was very hard to get a shot. It wasn't there. You had to make phone calls and find secret ways to—
Milkman: Beg. Yes. Can I get on your wait list? Could you please call me? I'll call you again tomorrow.
Mills: Yeah.
Milkman: That's right.
Mills: Yeah.
Milkman: Yeah, but it's a different moment now and I think we need different tools and tactics.
Mills: Well, what about making lasting change for the long term? You recounted in the book a conversation you had with a physician friend, were you lamented that in one of your experiments, you were able to get participants to go to the gym more often, but the effect wore off when—we talked about that a little while ago—and your friend said, "We wouldn't expect to give someone with diabetes insulin once and they're cured forever." And that makes sense. So what do we have to do to make lasting change? Does a change ever just stick without a conscious effort to maintain it?
Milkman: Yeah, it's a really wonderful question. I wish I had a really simple answer. I think honestly this is probably something I'll keep studying for the next, hopefully 40 years of my life if I eat right an exercise regularly and save well for retirement. So Kevin Volpp is the scientist who made this great point to me and it was glaringly obvious once he said it, but hadn't clicked for me before he pointed out that we shouldn't be treating behavior change as a one-and-done. We would find a solution that was magical the way that you want to cure a rash, but that we should think about behavior changes more like facing a chronic disease and trying to look for a suite of solutions because human nature doesn't just turn off. All of the barriers to change that I write about in the book, you can't just make them go away. You're going to be struggling with forgetfulness and procrastination and laziness for your whole life.
I do think there's wonderful research on habits that occasionally suggests we can put things on autopilot. And I just want to point to Wendy Wood of the University of Southern California as I think the leading thinker in this area. And it does seem that there are certain things that we can put on autopilot to some degree following the kind of reinforcement we've seen in animal models that if you engage in the behavior and then you even reward, and then you repeat and you do this enough times, certain things do become automatic, like making coffee in the morning or shampooing your hair, flossing your teeth, hand sanitizing if you're a caregiver in a hospital. These are the kinds of things that do seem to be where it is possible to really habituate it and have it for the most part continue.
But I think most of the things we care about in life—and also you can put on autopilot your retirement savings. So there are some magic exceptions, but I do think a lot of the goals we have in life, a lot of the things that require effort and thought and deliberation, it's going to be very hard to autopilot them. I'm not sure it's possible. And instead, what I have come to appreciate is the right path to change is to create structures and strategies that you're okay relying on to help you get through the barriers just permanently.
So for instance, I still temptation bundle to go to the gym and that works for me. Well, and during COVID, I haven't been going to a gym. But to get my exercise I look for ways to do that and always will and I don't feel like I needed to ever end that strategy. Some of the, I'll call them crutches that we can use to get ourselves to succeed, like accountability or temptation bundling as we've talked about, there's no need to set them aside. There's no need to say, "I'm going to use this for a month and then I'll be off to the races and I won't need this tactic anymore." Instead, I think we should expect to use them forever and not see that as a downside. It's just we need these tools to achieve our goals and we should keep using them. And that's how we get where we want to be.
Mills: And there's always another good book to listen to.
Milkman: Absolutely. Yes.
Mills: You'll never run out.
Milkman: That is a wonderful thing about entertainment. There's so much of it.
Mills: So what next? What are the big questions that you're looking to answer now?
Milkman: Thank you. That's a great question. The last year has been truly very focused for my team on the issue of vaccination and COVID-19, and we're working on some papers right now about that. We launched a vaccine sweepstakes in my hometown of Philadelphia and partnership with the city government that we designed using a regret lottery, which is a very specific type of lottery that capitalizes on people's fear of regret.
So everyone in the city was automatically entered and they could get a phone call if their name had been drawn, but they would have to decline the prize if they couldn't prove they'd been vaccinated. So the idea is, how much would you regret getting that call, finding out you had won the grand prize and having to decline it? That just that visceral fantasy of the anticipated regret might motivate some extra people to go get a vaccine above and beyond what you'd see in a typical standard lottery where you're only entered if you're eligible because you've gotten a vaccine.
So we've done that. And we had randomly assigned zip codes that actually had extra probabilities of winning. So we're working on analyzing that and trying to be able to come out with some policy recommendations for what are the best practices that we can use at this phase in the pandemic and as we roll out probably booster shots and as other countries reach the phase we've reached.
But really looking further forward the next couple months, I think we touched on it a bit in your prior question. You asked about enduring behavior change. And even though I gave you an answer that I do completely agree with, I believe in very much that the answer is we keep using tools, I still study often tactics that an employer or a school or a gym, an organization that's trying to help people create positive lasting change, can wrap around beneficiaries to help them achieve that durably.
And so I'm looking into what are the tools that those kinds of organizations can offer to their employees, their members or students that will carry them forward for as long as possible? And what are the kinds of features of programming that make it the most effective? Is it mindset? Is it social? Are there other tactics we haven't studied yet that do create more lasting change? So I'm really eager to explore that. I'm also really interested in understanding better when people have goal failure, how they stand up again. Fresh starts are part of it, of course, and there's other tactics in the book too, but I think recovering from failure, it's so important because we almost always fail when we set out to achieve a goal, at least once. We have to get back up again if we're going to get to our final destination. And I think there's a lot more to know about how to do that.
Mills: Well, Dr. Milkman, this has been really interesting. I think you're doing extraordinarily important work and I want to thank you for joining us today.
Milkman: Thank you so much for having me. This was a really fun conversation.
Mills: You can find previous episodes of Speaking of Psychology at www.speakingofpsychology.org or on Apple, Stitcher or wherever you get your favorite podcast. And please where you can leave us a review. If you have comments or ideas for future podcasts, you can email us at speakingofpsychology@apa.org. That's speakingofpsychology, all one word, @apa.org. Speaking of Psychology is produced by Lea Winerman. Our sound editor is Chris Condayan.
Thank you for listening. For the American Psychological Association, I'm Kim Mills.
Katy Milkman, PhD, is the James G. Dinan Professor at The Wharton School of the University of Pennsylvania, host of Charles Schwab’s popular behavioral economics podcast 
