There are people in the world who live a way for their whole life and then have some (seeming) epiphany that the way they are living should no longer be. They go to sleep a drinker and then they never touch the stuff again. Or you see someone who has struggled with obesity for years suddenly wake up, join a gym, and start eating right.
Psychologists were baffled by these people for years. They studied their changing processes trying to figure out how people change. If they could just figure out the how then they could use it for people who are hesitant to change. Generally these people are addicts, but it can apply to anyone. Change is important in medicine. Doctors often have high-risk clients like the pre-diabetic and the high cancer risk patients who refuse to change their risky patterns of behavior. The scholarly community was desperate to figure out how people change so we could begin to apply those naturally adapted patterns to those who didn’t have the innate abilities to change.
The Stages of Change
Then Dr. James Prochaska developed the Transtheoretical model of change and then collaborated with his buddy Dr. Carlo DiClemente . This ish blew scholars’ minds. Why you ask? Well you see, people had been watching the process of change. They had been all wrapped up in what people do when they are changing. They were only looking at half of the puzzle. Most of the changing starts before a behavior change occurs. They discovered and identified five distinct stages of change.
Pre-Contemplation – I’m sure you can guess what this stage is all about. This is really before any thoughts of changing occur. There is awareness that these is a problem, like in most addictions when people have already tried to curb their use or stop altogether. This stage is characterized by denial and possibly ignorance if this behavior is something like overeating. Unless warned of the health risks, people may not know what they are doing.
Contemplation – This is when there is acceptance of a problem. There is no longer the rose colored glasses that have been obscuring the “problem”. However, there is a lot of ambivalence here. It’s a person realizing all of the work that it is going to take to really change. Giving up a behavior that is familiar can be emotional. If a person’s only coping mechanism has been eating, drinking, using sarcasm as a defense mechanism, you name it… there is going to be emotion over giving this thing up.
Preparation – This is when information collection begins. You may have experience in your life deciding “I’m going to change _____” but then you never develop a plan and you fail. You cycled through pre-contemplation and contemplation, but never entered preparation. This stage is marked by small changes the equivalent of dipping your big toe into a pool to check the temperature. A plan is also developed. Changers begin doing the research needed to make a permanent change.
Action – YAY! This is where the actual change occurs. The car has been moved out of neutral and is fully in drive now. People start noticing this change. It’s important that outside support is found and rewarded for success in change. If you’re trying to lose weight, people notice the changes you’re making inside and out. I don’t know if any of you out there have ever made a change for the better, but when I started seriously working out and someone noticed for the first time I was back in the gym that night like, “Yeah! It’s working!”
Maintenance – This is the tough one. This is where the new behavior becomes a habit instead of a conscious decision every day. It’s getting out of bed at 5:30 a.m. for a morning workout EVERY DAY. It’s abstaining from substances which are bad for you, no matter the temptation. You’ve seen the good things the change does for you in your daily life and you understand it’s better to keep up this behavior then to revert back. Sure, slipping and having chocolate cake on a healthy eating plan is okay. Having cookies every day is not maintenance. This is the place where a lot of people relapse. It’s okay though! Life isn’t about being perfect, it’s just about making it through that day of behavior change.
So those are the Stages of Change. If you are looking to make some changes in your life, realize it has to change in the way you think about your behavior before any real change can come about permanently. Also, three things should be considered before you start changing:
1. Readiness to change – are you prepared to make the changes necessary to make this happen? So, if you are changing your eating habits and your family isn’t, are you prepared to eat different things and work at making your own meals?
2. Barriers to change – if you want to lose a significant amount of weight, do you have the knowledge and the equipment to do so? If you want to run a marathon, do you have running shoes? It’s all little things like shoes and all big things like changing daily habits. If you go to McDonald’s every day for lunch, then you’ll have to change that daily habit.
3. Anticipate failure – Few people ever change perfectly. We have relapses. Alcoholics might slip or even go back to drinking several times before they hit the maintenance stage. If you’re going on a diet, it’s okay if you accidentally (or intentionally) eat something you shouldn’t. Just remember, your thoughts need to change. You can’t justify a slip because you know you’ll relapse. Practice self-compassion and forgiveness with others and yourself as you make these changes. It’s not going to be perfect, but you’ll be trying. That counts for something.
“When people are ready to, they change. They never do it before then, and sometimes they die before they get around to it. You can’t make them change if they don’t want to, just like when they do want to, you can’t stop them.” – Andy Warhol
P.S. You can read my post today on creating a therapeutic alliance with self-disclosure on the ACA website here.