How many therapists does it take to change a lightbulb? Hold that thought. We will get to the answer shortly in this column, which addresses how difficult it is to make a change, despite our best intentions. Consider how many people engage in self-defeating patterns of behavior despite negative consequences:

Smoking, obesity and problem drink­ing can lead to chronic illness and premature death. Never­theless, recent large-scale surveys of adults by the Centers for Disease Control and Prevention have found that more than 20 percent of American adults continue to smoke, more than 30 per­cent are sig­nificantly overweight and approx­imately 15 percent are binge drinkers.

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