Three Principal Problems with CBT in Habit Formation Among High-Withdrawal High Agreeableness Individuals: The Case for SIVHs and the 'Leap of Faith to Action'
First published: 20.03.2025
Leading author: William Parvet
Cognitive Behavioral Therapy (CBT) is widely accepted as a gold standard in psychotherapy, often represented by the triangular model that connects thoughts, feelings, and behaviors. There is substantial empirical backing — both from behavioral and neurobiological research — supporting this framework. Numerous studies have confirmed that sensory stimuli, whether visual, auditory, or kinesthetic, can elicit specific thoughts, which in turn modulate emotional states. Similarly, it is well-documented that behaviors significantly influence one’s internal state; from simple experimental findings, such as participants experiencing mood shifts by holding a pencil in their mouth to simulate a smile (Strack, Martin & Stepper, 1988), to more complex longitudinal studies showing that regular physical exercise can result in positive changes in both affect and cognition (Mikkelsen et al., 2017).
However, despite CBT's broad effectiveness, certain personality profiles — particularly those characterized by high withdrawal (a neuroticism facet) and biologically rooted politeness (a facet of agreeableness) — may encounter significant challenges when attempting to achieve sustainable habit formation through the conventional CBT lens. In this article, I will present three key limitations of CBT when applied to this demographic and propose Structured Internal Value Hierarchies (SIVHs) as a more adaptive framework. Specifically, I will explore how SIVHs, combined with the concept of a “leap of faith to action” and a redefined tolerance for meaningful discomfort, may offer a superior solution to address these limitations.
Three Principal Problems with the Implementation of CBT
From a scientific perspective, Cognitive Behavioral Therapy (CBT) operates on foundational principles that are difficult, if not impossible, to refute. The interplay between behavior, cognition, and emotion is well-supported by behavioral psychology and affective neuroscience (Beck, 2011; Hofmann et al., 2012). The very notion that modifying behavior can influence internal states, or that thoughts shape feelings and vice versa, is firmly established within empirical research.
Yet, despite its robustness, CBT as a model of habit formation may face key conceptual and practical limitations—particularly when applied to individuals with high withdrawal tendencies and biologically driven politeness. These individuals often struggle to translate CBT principles into sustainable action. The first issue lies not in the validity of CBT itself but in how the model is visually and heuristically presented.
Problem 1: False Visual Heuristics
In many CBT frameworks, the model is presented using the iconic triangle — with thoughts, feelings, and behaviorsoccupying equal visual space. This symmetry may unintentionally foster a cognitive bias in clients. Specifically, it can lead individuals to infer that thoughts and feelings hold equal or greater authority over behavior, creating the perception of a 2:1 power dynamic: two internal states (thoughts and feelings) "outvoting" a singular external component (behavior).
For individuals with high neuroticism — withdrawal subtype, this visual representation can act as a reinforcement of passivity. They may subconsciously conclude that unless their thoughts and feelings are fully aligned and supportive, behavioral change is unattainable or premature. This is particularly detrimental in habit formation, where action often must precede emotional clarity or cognitive resolution.
In reality, modern behavioral activation research (Mazzucchelli, Kane, & Rees, 2009) suggests that in many cases, behavioral change should dominate the process. From a functional perspective, behavior is often the primary driver of feedback loops that shift affective and cognitive states, especially for individuals prone to avoidance.
Thus, the equal-sized triangle may unintentionally foster the belief that behavioral change is subordinate to internal alignment, when it may need to be the leading factor. A more accurate heuristic might visually represent behavior as occupying 70-80% of the process, with thoughts and feelings collectively comprising the remaining 20-30% — especially in contexts where overcoming withdrawal and avoidance is central.
This distorted visual heuristic problem may partly explain why individuals with high politeness (agreeableness facet)and withdrawal-prone neuroticism tend to stall at the level of "mental rehearsal," feeling paralyzed in the face of action when inner states have not yet reached harmony.
Problem 2: Categorically Mistaken Starting Point
A widespread issue in the application of CBT — particularly in its standard clinical format — is the default emphasis on addressing thoughts and cognitive associations as the starting point. Many therapeutic interventions begin by helping clients identify, challenge, and reframe dysfunctional thoughts, based on the assumption that cognitive content is the most accessible and modifiable domain of the mind. From a surface-level, mechanistic perspective, this approach seems rational: adjust the internal dialogue, and the resulting positive emotional shifts will cascade into healthier behaviors.
While this logic is intuitively appealing and supported by certain mild-to-moderate symptom interventions, it is largely inadequate in the context of habit formation, particularly when dealing with entrenched avoidance tendencies found in high-withdrawal individuals (Craske et al., 2014). In cases where behavioral patterns have deep emotional inertiabehind them, cognitive restructuring alone often fails to disrupt the behavioral feedback loops that maintain avoidance, procrastination, or compulsive tendencies.
Behavior as the Correct Starting Point
The deeper issue is that this approach overemphasizes the cognitive gateway at the expense of the most influential driver: behavioral initiation itself. Research in behavioral activation and action-based therapies has shown that when individuals face meaningful or challenging changes — such as breaking long-standing avoidance cycles — the entry point must often be direct action, not cognitive pre-processing (Jacobson et al., 1996).
Critically, many habit formation challenges present no immediate positive cognitive or emotional shift when action is taken. In fact, initiating new behaviors may be accompanied by discomfort, fear, or internal resistance — especially for those with high neuroticism or biological politeness (a subtype of agreeableness linked to conflict avoidance and excessive self-restraint). Thus, if an individual is conditioned to expect internal harmony before taking external action, they risk reinforcing passivity.
Instead, the correct framework should position behavior as the initiating driver, with thoughts and feelings framed as consequences or emergent properties of sustained action over time. By reordering the process, behavior is decoupled from the prerequisite of positive internal states, reducing the tendency to ruminate or delay action under the guise of “mental preparation.”
Trivial vs. Significant Change
While initiating change via thoughts may sometimes work for minor behavioral shifts (e.g., trying a new hobby, adjusting a routine), it frequently breaks down in the face of major behavioral reconditioning. This includes scenarios like:
overcoming avoidance at work or in social settings,
breaking chronic procrastination cycles,
or forming identity-level habits (e.g., exercising despite inner discomfort).
In such cases, successful habit formation often requires a disconnection from the expectation that thoughts and feelings must become supportive before action is sustainable.
Problem 3: Overemphasis on Goal-Orientation and Compounding Achievements
The third principal issue with CBT implementation lies in its goal-focused framing — particularly in how habit formation is presented in therapeutic and coaching contexts. While most CBT practitioners acknowledge that micro-changes can gradually build momentum, there remains a pervasive inclination to frame success around the achievement of long-term external goals, rather than the intrinsic transformation of identity or values that precedes sustainable behavioral change.
Popular culture and even clinical analogies often present habit formation as a “compound interest” process. Stories such as The Thread that Wove a Cloak (where a tailor collects a small golden thread daily until he crafts a cloak), The Ant and the Empty Pantry (crumb-by-crumb collection to fill a food store), or The Candle and the Endless Night (gradual illumination of darkness) exemplify this mindset. In such narratives, the focus is placed on small daily wins that cumulatively produce significant external outcomes over time.
While this incremental view is not inherently wrong — it aligns with research on behavioral shaping and habit stacking(Clear, 2018; Lally et al., 2010) — it often fails to address a deeper psychological challenge. Specifically, for individuals high in withdrawal and biological politeness, this goal-centric orientation may inadvertently reinforce feelings of inadequacy, especially when initial behavioral transformations do not produce immediate, measurable external gains.
Behavioral Transformation vs. Outcome-Focus
From a psychological transformation perspective, the true success of habit formation lies not in external compounding results but in the internal realignment of values and identity. In other words, the individual’s capacity to tolerate periods of stagnation, discomfort, or even temporary negative outcomes while maintaining the new behavior is what determines long-term resilience and success.
Here, the Structured Internal Value Hierarchy (SIVH) model becomes crucial. Rather than promoting behavioral change as a means to an external goal, SIVHs prioritize behavioral transformation as an end in itself, anchored in core values like truthfulness, responsibility, and personal actualization. This reorientation helps individuals persist through periods where external feedback is lacking or where early actions may seem to lead to short-term setbacksrather than immediate rewards.
The Pitfall of “Fairy Tale” Progress Narratives
The CBT goal-compounding narrative, while motivational for some, can be counterproductive for individuals prone to high neuroticism and avoidance, as it creates a subtle expectation that progress must feel consistently rewarding or at least incrementally positive. When this expectation is unmet (as is often the case during early habit formation), it may fuel discouragement and regression into passivity.
Instead, what is needed is a framework that redefines success as staying aligned with one’s SIVH, irrespective of short-term fluctuations in external outcomes. Behavioral change then becomes a moral or existential commitment, not a transaction with the external world for immediate validation.
In summary, while CBT is a powerful tool with undeniable empirical support, its implementation bias toward cognitive entry points, heuristic misrepresentation of behavior’s role, and outcome-based framing can undermine its efficacy for individuals with specific trait vulnerabilities—namely, high withdrawal and biological politeness profiles.
In such cases, SIVHs offer a structural antidote, allowing for a more values-driven approach that enables individuals to sustain meaningful behavioral change, even when external reinforcements are delayed or absent.
The Proclivity to Inaction: The Role of Serotonin and Withdrawal
When analyzing personality traits related to habit formation, the common assumption is that low intrinsic assertivenessor low orderliness are the primary drivers behind an individual's inability to sustain new behaviors. While both traits undoubtedly play a role — particularly in the initial stages — this explanation is incomplete and overlooks a critical neurochemical factor.
The reality is that habit initiation and habit maintenance are governed by distinct psychological and neurobiological processes. The first step — the “leap of faith to action” — is often supported by assertiveness (a sub-facet of extraversion) and can help push individuals to overcome inertia. Assertiveness contributes to the willingness to engage with uncertainty or discomfort in the short term, making it a useful catalyst during the activation phase.
However, the ability to maintain consistent behavioral patterns over time is more heavily influenced by neuroticism, particularly the withdrawal sub-trait, which is closely linked to serotonergic functioning.
The Neurochemical Barrier to Action
At the neurochemical level, sustaining effortful behaviors is contingent on a person’s baseline levels of serotonin. Serotonin plays a key role in mood stabilization, impulse regulation, and behavioral persistence (Cools et al., 2008). When serotonin levels are suboptimal—as is common in individuals with chronic anxiety, depression, or high withdrawal—the individual may not even experience the internal motivational conflict necessary to engage in the “dopamine-driven” pursuit of a reward (Tops et al., 2010).
In other words, if withdrawal-driven neuroticism is sufficiently high, there may be no active negotiation between “internal master commands” and external action. The person does not enter a conscious debate about whether to act or not; the body and mind default to passivity.
This is not a case of rationalizing inaction or substituting avoidance with more pleasurable activities (e.g., procrastination by scrolling social media). Instead, many high-withdrawal individuals enter a state of blunted agency, where inaction is accepted with relative emotional neutrality.
The Quiet Withdrawal Mechanism
One of the subtler dangers here is that such individuals may not even experience strong emotional discomfort about their inaction. Rumination, lethargy, and low mood become so internalized that the absence of action no longer triggers significant inner resistance. The serotonergic system fails to facilitate the internal "energization" necessary for initiating or sustaining behavior, especially under stress.
This is distinct from active avoidance, where a person may consciously seek distractions or emotional soothing. In quiet withdrawal, the behavior is marked by a detachment from the drive to resolve the inertia—a passive acceptance of inaction, rather than an active evasion.
Clinical Implications
This has serious implications for therapy and coaching. Simply teaching cognitive reframing or setting goals (as CBT often does) might prove ineffective if the individual is trapped at the neurochemical level, lacking the serotonergic activation needed to even "enter the arena" of behavioral decision-making.
Thus, intervention must account for underlying mood regulation and emotional withdrawal patterns, possibly through:
behavioral activation tailored to small, manageable actions,
integration of SIVH-based value structures,
and where applicable, serotonin-modulating interventions (e.g., lifestyle changes, SSRIs, or psychodynamic work on the roots of depressive rumination).
False Calibration of Action: The Fivefold Overestimation Bias
A commonly overlooked barrier in successful habit formation among individuals with high neuroticism, particularly those prone to withdrawal, is the systematic overestimation of their ability to perform new behaviors consistently. This phenomenon occurs despite widespread acknowledgment — both in therapy and in self-help literature—that sustainable change often requires starting with “micro-habits” (Fogg, 2019).
While therapists frequently advocate for small and achievable behavioral targets, individuals with chronic avoidance patterns or biological politeness tend to miscalibrate what qualifies as "small". This is not simply a misjudgment of physical capability but an underestimation of psychological variables such as mood fluctuations, energy depletion, and unexpected environmental stressors that influence day-to-day follow-through.
The Fivefold Overestimation Bias
In practical terms, many individuals base their micro-habit goals on a snapshot of their current capacity—how much they can perform “on a good day” with normal effort. For example, a person might set a walking goal of 3 kilometers per day, assuming that this is a manageable and modest distance. However, for individuals with high neuroticism, who experience significant mood volatility and withdrawal tendencies, the baseline for sustainable action is often grossly inflated.
When factoring in:
emotional lability,
lower serotonergic activation (linked to motivation deficits),
and the effects of minor setbacks or external stressors,
the realistic sustainable threshold is often closer to 20% of the initial target. In this case, a more psychologically sustainable walking distance might be 600 meters, not 3 kilometers.
This pattern constitutes what can be described as a “5x overestimation bias”, where the initial micro-habit is set approximately five times larger than what is realistically executable on the majority of days.
Why Ridiculous Goals are Sometimes the Right Ones
The paradox here is that properly scaled micro-habits often appear trivial or even absurd when first proposed. A target so small—such as putting on walking shoes and stepping outside for five minutes—may seem laughable to individuals accustomed to traditional notions of goal-setting and productivity.
However, this "ridiculousness" is an important psychological cue:
It signals that the behavior is appropriately calibrated for habit automation under conditions of high neurotic withdrawal,
and that the habit is likely to survive the inevitable dips in mood and energy.
The Compounding Effect of Undershooting
Ironically, under-calibrated micro-habits tend to outperform larger, more "rational" goals over time. The modest entry point builds self-efficacy, reduces the likelihood of habit rupture, and increases the chances of spontaneous upward scaling once the foundational behavior is automated.
Without this deliberate undershooting, individuals with high neuroticism risk creating a habit framework that only functions on "good days", leading to inconsistency, self-blame, and eventual habit abandonment when low-energy or emotionally turbulent days arise.
Focus on Gain Rather Than Pain: A Problematic Bias in Motivation Framing
A persistent issue in modern cognitive-behavioral approaches to habit formation is the disproportionate emphasis placed on positive visualization techniques. Clients are frequently encouraged to focus on the bright future that awaits them once their goals are achieved — whether that be improved health, career success, or a more fulfilling personal life. While this technique can serve as an effective secondary motivator (Oettingen & Gollwitzer, 2010), its limitations become evident when applied to individuals high in neuroticism, particularly those prone to withdrawal.
For these individuals, future-oriented positive imagery often lacks the emotional salience needed to drive consistent behavior. Abstract rewards that exist only in a distant horizon fail to counteract the immediate emotional inertia experienced during habit execution, particularly when such habits are tedious, energy-draining, or provoke internal discomfort.
Facing the Pain: The Power of Negative Visualization
In contrast, focusing on the destructive consequences of inaction — the “pain” of failing to act — has proven more effective for long-term habit persistence, especially for those with heightened threat sensitivity (linked to neuroticism and serotonergic dysregulation) (Cools et al., 2008). This approach, often referred to in existential psychotherapy as “memento mori awareness” (Yalom, 1980), acknowledges that avoidance of existential threat or moral failure can be a stronger motivational driver than idealized future visions.
From an SIVH perspective, the key motivator is not the reward itself but the fear of failing to live in alignment with one’s singular, top-tier internal value. The individual is compelled to act altruistically toward their highest value, regardless of emotional state or external incentives.
While focusing on negative outcomes may initially increase vulnerability to depressive affect, this is a necessary discomfort. Facing the ugly reality of inaction — whether it is stagnation, decay, or a slow drift into meaninglessness—can catalyze the internal shift required to sustain boring, repetitive, and emotionally unrewarding behaviors over time.
Why Many CBT Practitioners Avoid This Approach
Many CBT practitioners hesitate to integrate negative visualization or consequence-based thinking, fearing it may exacerbate feelings of guilt, shame, or hopelessness. However, in the presence of a strongly implemented SIVH, these concerns are mitigated. The individual no longer ruminates aimlessly on fear but channels it toward constructive behavioral outputs, driven by the imperative to remain loyal to their self-defined hierarchy of values.
When done correctly, this model creates a psychological contract where even reluctant, tiresome, or low-motivation actions become non-negotiable acts of service to one's deepest commitments, irrespective of transient feelings.
This values-first approach aligns with existential and logotherapeutic traditions (Frankl, 1946) where meaning is derived from service to something greater than the self. In this sense, fear of failing to live truthfully becomes a fuel source for daily behavioral resilience — an antidote to both the cognitive distortions and emotional passivity often found in high neuroticism profiles.
SIVHs as a Habit Formation Tool: The Leap of Faith and Meaningful Suffering
Structured Internal Value Hierarchies (SIVHs) offer a robust alternative to the limitations of standard CBT-based habit formation frameworks, particularly for individuals with high neuroticism and a tendency toward withdrawal. Emerging empirical evidence and case studies suggest that when SIVHs are implemented correctly, they not only facilitate sustainable behavioral change but also realign the individual’s relationship to discomfort, sacrifice, and long-term goals.
1. The First Principle: Leap of Faith to Action
Addressing the first key problem with traditional CBT — the distorted focus on thoughts and feelings as co-equal with behavior — SIVHs take a decisively behavior-first approach. Rather than encouraging individuals to wait for cognitive clarity or emotional positivity, SIVHs emphasize what could be called a “leap of faith to action.”
The individual is tasked with initiating micro-behaviors (such as minimal but consistent new habits) while fully accepting that internal resistance — whether in the form of negative thoughts or unpleasant emotions — is expected and irrelevant in the short term.
Unlike the CBT triangle, where behavior is one of three competing factors, SIVHs prioritize action as the primary vehicle for self-alignment. Thoughts and feelings are positioned as secondary by-products of action, not as prerequisites. This reframing resolves a common stumbling block for individuals with high withdrawal, who may otherwise wait indefinitely for internal states to “improve” before engaging in behavior change.
2. The Second Principle: Alignment with Singular Top Value
The most profound differentiator between SIVHs and traditional CBT frameworks is their focus on value hierarchy alignment. Whereas CBT often relies on the pursuit of incremental outcomes or measurable external goals, SIVHs reposition the source of motivation entirely. Here, the habit is not performed for a future gain, but as a sacrificial act of allegiance to one’s singular top value — the ultimate principle that governs one's internal hierarchy.
This creates intrinsic meaning within the habit itself, transforming what might otherwise be a monotonous or emotionally unrewarding behavior into an act of moral commitment. In this way, the individual no longer performs the habit “to get something” but because not acting would violate their core value system.
3. The Third Principle: Meaningful Suffering and the Rejection of the Compounding Fairytale
The traditional compounding gains model of habit formation — so often compared to incremental progress narratives in folk tales — is, under the SIVH model, reframed. Instead of focusing on accumulating minor improvements that will one day lead to external success, SIVHs emphasize the idea of “meaningful suffering”.
The pain and discomfort experienced in the early stages of habit formation are accepted and embraced as necessary sacrifices. They are meaningful because they prevent an even deeper, meaningless suffering—the existential decay that results from inaction, passivity, and misalignment with one’s structured value system.
Indeed, this deeper psychological truth resonates far more with ancient religious and philosophical frameworks than with modern goal-oriented self-help narratives. A fitting symbolic example is found in Matthew 9:9 and Luke 5:27-28, where Jesus calls Matthew, saying simply:
“Follow me.”
Matthew, without deliberation, “rose up and followed him,” leaving behind the comfort of his previous life, despite the immediate loss of wealth, stability, and social standing.
This is the archetypal leap of faith inherent in SIVH-driven habit formation. The individual acts not for immediate emotional or material reward, but to orient themselves toward a singular purpose — toward long-term meaning over short-term comfort. The initial behaviors are often marked by sacrifice and friction, but these very sacrifices solidify the internal commitment that sustains action over time.
SIVHs vs. CBT: A Paradigm Shift
While CBT seeks to foster small wins that compound into larger gains, SIVHs foster an existential and moral commitment to action itself, independent of emotional reinforcement or early external results. This makes them uniquely suited to individuals who:
experience high neuroticism,
are prone to withdrawal or emotional passivity,
or who struggle with the disconnection between goal pursuit and daily behavior.
SIVHs create a bridge between habit formation and identity-level transformation, allowing actions to become acts of service to one’s deepest commitments.
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