Habituate Questionnaire

This is your Habituate Questionnaire – it is how you will decide on 3 Essential Self Care Behaviours you will commit to practising over the 60 day coaching program. 

Please get yourself a notebook (real or digital) which you will use for the duration of the program. Making notes is essential in developing the self awareness required to be consistent with practising new behaviour.

Make time to sit down in a quiet spot to do the questionnaire – if you get muddled or agitated just have a break and come back to it. This is a critical part of your engagement in the program so do it mindfully. 

Here you go…

Question: What are the problematic behaviours you want to stop/manage better?

Below is a list of the most common problematic/destructive behaviours people want to stop/manage. Read through the list and acknowledge to yourself any that resonate.

Choose 3 behaviours that you want to stop/manage and write down ALL the reasons why they are problematic for you. Note: 3 is the maximum, if you only have 1 or 2 you want to work on for now that's fine.

The behaviours can come from the list below or they may be behaviours not listed here.

  • Unhealthy eating; unhealthy choices, over eating, under eating, yo-yo dieting etc.
  • Over consumption of alcohol
  • Smoking/vaping, recreational drug use
  • Financial recklessness (over spending, gambling etc)
  • Numbing and escaping behaviour in general
  • Inactivity/Passivity
  • Busyness/hyperactivity
  • Rumination – on the past
  • Worry/anxiety – about the future, relationships, body image, health, money etc.
  • Perfectionism, fixation, obsessiveness
  • Comparison, criticism & complaining
  • Procrastination & avoidance
  • Over consumption social media, gaming & screen time in general
  • Emotional reactivity; outbursts of hostility/aggression
  • Over working/ignoring internal messages of fatigue
  • Poor sleep and rest prioritisation
  • Something not listed here

Question: What are the 3 Essential Self Care Behaviours (ESCB’s) you want to habituate?

Below is a statement formula to help you identify the new, Essential Self Care Behaviours that will gradually disempower the 3 problematic behaviours on your list.

When < cause/condition > happens and I have the urge to problematic behaviour I will take a deep inhalation and say to myself "I notice an urge to < problematic behaviour >" and as I exhale I will say, "I choose to let this urge pass and instead I will < ESCB >".

You need to clearly identify the cause/condition that triggers the problematic behaviour - this is a vital step. Now, write down exactly what the new behaviour/action will be.

The more specific you are with the new behaviour the better. You may need to do a few re-writes/edits to get the statement clear and actionable.

Please use this formula for all 3 problematic behaviours on your list. If you have difficulty with this you are welcome to email me your 3 statements and I’ll help you tighten them up so they are clear and actionable.

Here's an example that I have used (& still do!)
Note that the trigger is detailed and the ESCB is clear and actionable.

When ‘I finish dinner and am feeling satisfied but also tired and a bit emotionally empty’ I often have the urge to ‘eat more’ and when I do I will take a deep inhalation and say to myself ‘I notice an urge to eat more, even though I have just had a satisfying meal' and as I exhale I will say ‘ I choose to let this urge pass and instead I will make a licorice tea whilst I clean the kitchen then I will turn off the kitchen light before I go and watch TV.’

Action: Complete Your Commitment Pledge.

When you have completed formulating your commitment pledges, write (or cut and paste) them into the 3 boxes below and click send.

That's it for now. Once you submit this form you will receive a record of your Commitment Pledge.

I'll be back in touch as the start date draws closer and I look forward to receiving your pledge & statement email in due course.

You may also like to have an Accountability Partner outside the program - if yes, just inform them about your participation in Habituate, email them your 3 ESCB's and keep them up to date with your progress..

If you have any queries...I'm here.

💛 Jo