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Actions Speak Louder Than Words In Therapy, Too

Why your "head" and your "heart" will follow your "feet."

Key points

  • Behavior change is a core component of successful therapy.
  • Shifts in attitudes and beliefs can follow changes to behavior.
  • Cognitive dissonance—the discomfort of holding contradictory beliefs, ideas, or values—can motivate positive changes to behavior.

One of the most effective psychological therapies is called "Cognitive Therapy" (CT), and it aims to alleviate psychosocial problems by changing people's thoughts from negative or self-defeating attitudes to more positive beliefs. Ironically, despite extensive research and clinical experience that would seem to validate CT's effectiveness, simply combating irrational beliefs and replacing them with more rational ideas rarely does the job.

Syda Productions/Shutterstock
Source: Syda Productions/Shutterstock

This is because, as we are often told, actions speak louder than words. And when it comes to changing zones of our psychological experience, nothing has the power of corrective action except, in some cases, medication.

This is not to say that approaches involving identifying, challenging, and replacing faulty or irrational beliefs are not helpful. Rather, without behavioral change, the efficacy of most cognitively-based methods will be greatly limited. Because one can act oneself into feeling better much more effectively than one can think oneself into feeling better.

Since action strongly influences thought and feeling, as I’m fond of telling my patients, “Your head and heart will follow your feet." A simple aphorism reflecting the tremendous power of cognitive behavioral therapy methods. Because how one acts (their feet) so shall they think (their head) and feel (their heart).

Importantly, the word “follow” in the phrase not only literally means move in the same direction as, but also lag behind a bit. Because the more complex parts of the brain that govern thinking and emotion require more time to unlearn old patterns and learn new ones than the motor regions that tend to respond and learn more quickly.

How Cognitive Dissonance Leads to Behavior Change

A fascinating aspect of this truth—that behavior strongly determines thoughts, emotions, and attitudes—is the phenomenon of cognitive dissonance; the mental discomfort experienced by a person who simultaneously holds two or more contradictory beliefs, ideas, or values.

Fundamentally, there are two ways a person can reduce cognitive dissonance. One is to change or discard one of the opposing beliefs. The other is to make or keep one’s behavior consistent with one or the other belief.

A helpful example of this phenomenon is smoking cigarettes. Clearly, when people smoke cigarettes (their behavior) they are aware that they are imperiling their health (their cognition). But at the same time, they want to smoke because of the satisfaction it provides. This creates a strong mental tension that can be reduced by either changing their thinking about smoking or changing their smoking behavior (i.e., stop smoking). That is, changing their cognition that smoking is dangerous—through mental gymnastics like denial—or changing their behavior so that it’s consonant with the rational belief that smoking is hazardous would both reduce cognitive dissonance.

So when a smoker does in fact quit smoking, not only do they reduce their dissonance but the attitude they kept—smoking is disgusting and incredibly unhealthy—usually becomes deeply entrenched. Perhaps one reason why reformed smokers tend to be vehemently opposed to the habit and secondhand smoke.

Unfortunately, however, when there is a clash of ideas leading to a conflict between attitudes and behavior, people tend to change or maintain their attitudes to make them consistent with their unhealthy behavior rather than change their behavior to make it consistent with their healthy attitudes. Hence, denial and rationalization often come into play.

Interestingly, cognitive dissonance can be leveraged therapeutically by helping people to engage in positive, healthy or adaptive behavior despite their state of mental conflict. For instance, a person with claustrophobia (an extreme fear of enclosed spaces) will avoid elevators thereby strengthening their fear due to negative reinforcement. But most claustrophobics understand their fear is irrational but are nevertheless terrified of confronting it. Thus their mental conflict or cognitive dissonance. And to reduce their mental discomfort they will avoid small spaces like elevators which confirms the apparent validity of their fearful attitude which keeps them clinging to the irrational fear.

But when a claustrophobic, or any phobic for that matter, confronts their anxiety triggering stimulus/stimuli, they usually jettison their irrational beliefs about their anxiety triggers and hold onto the adaptive attitude that they can successfully manage the challenge.

What’s more, even deeply ingrained and strongly held prejudicial beliefs and feelings like racism can be successfully combated through adaptive and prosocial dissonance reduction. Indeed, research has shown that when put in a situation in which a person with racist attitudes works cooperatively with a member of the race they disdain, after a while, their racist attitudes tend to weaken. At least for the person with whom they worked cooperatively.

So if you would like to change some of your distressing beliefs, attitudes, and feelings, lead with your feet and the rest will follow!

Remember: Think Well, Act Well, Feel Well, Be well!

Copyright 2021 Clifford N. Lazarus, Ph.D. This post is for informational purposes only. It is not intended to be a substitute for professional assistance or personal mental health treatment by a qualified clinician.

Dear Reader: The advertisements contained in this post do not necessarily reflect my opinions nor are they endorsed by me. —Clifford