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Why Change Is Hard: The Science Behind It

- In: Clinical Practice, Professional Development, Caregiver Fatigue

As healthcare professionals, we know that change is inevitable—whether it's a new treatment guideline, an updated protocol, or an entirely new way of delivering care. However, we often observe that implementing these changes can be incredibly challenging. The difficulty in changing behaviors, especially in well-established routines, can be better understood when we consider the brain's response to change.

Our highly adaptive brains thrive on routine and predictability. This preference is wired into our neurobiology, as it allows us to conserve mental energy and act more efficiently. However, when a change is introduced—especially one that challenges existing patterns—it activates several parts of the brain that are involved in stress, decision-making, and habit formation. Understanding these mechanisms can shed light on why change can feel so difficult and uncomfortable.

The Role of the Prefrontal Cortex

The prefrontal cortex (PFC) is responsible for higher cognitive functions like decision-making, planning, and impulse control. When a change is introduced, the PFC is called into action to evaluate new information and weigh options. However, it’s also a part of the brain that requires energy and focus, which can be taxing when multiple new behaviors or procedures need to be adopted simultaneously. Overloading the PFC can lead to decision fatigue and a resistance to change.

The Limbic System and Emotional Response

Another key player in the challenge of change is the limbic system, particularly the amygdala. This region of the brain is responsible for processing emotions and detecting threats. When faced with change, the brain often perceives it as a potential threat—especially if it’s perceived as uncertain or unfamiliar. The amygdala triggers emotional responses such as anxiety or fear, which can further complicate the process of adapting to new ways of doing things. These emotions are often subconscious, but they have a profound impact on decision-making and behavior.

The Basal Ganglia and Habit Formation

The basal ganglia deep within the brain plays a central role in forming and maintaining habits. Once a behavior becomes ingrained, the basal ganglia work to automate it, making it effortless. When change is introduced, the brain has to break these automatic patterns and create new ones. This requires effort, and for many, the process of unlearning old habits is just as difficult as learning new ones. Over time, however, repeated exposure to the new behavior can strengthen neural pathways in the basal ganglia, making the change easier and more natural.

Conclusion

In sum, the brain's resistance to change is deeply rooted in its structure and function. The prefrontal cortex's decision-making processes, the emotional responses generated by the amygdala, and the automatic habits stored in the basal ganglia all contribute to the difficulty of adopting new behaviors. Recognizing the science behind why change is hard can help healthcare professionals approach change management with empathy and understanding, fostering a supportive environment for successful adoption of new practices.

 

    1. The Systems Thinker; The Science of Change: Working With-Not Against-Our Inner Systems; thesystemsthinker.com; 3/27/2025; https://thesystemsthinker.com/the-science-of-changeworking-with-not-against-our-inner-systems/

Georgia Epp-Worth, MPAS, PA-C, is a derm PA with a diverse background that fuels her many interests. She loves spending time hiking in the mountains or sharing a bottle of wine with good friends.