Transforming Chained Behaviors: Case Studies of Overcoming Smoking, Eczema, and Hair Pulling (Trichotillomania)^a

The authors describe the format of a holistic health class provided to undergraduates at San Francisco State University in California. The class initially emphasizes self-monitoring and record keeping to enhance the students' self-awareness of negative emotions, symptomatic behaviors, and other “chained behaviors” leading to various problems, such as smoking or eczema. The students cultivate a variety of positive self-care behaviors and self-regulation skills, such as mindfulness, relaxation skills, visualization techniques, and seeking social support. Finally, they learn to substitute these self-care practices for the negative emotions and behaviors, in the moments of emerging awareness, thus interrupting the “chain of behaviors” leading to problems. The authors provide case narratives of three students implementing this program to address personal illnesses or problems (smoking, eczema, and trichotillomania).