A few days ago I was talking to a friend who had made some very noticeable and very positive changes in her life. She talked about how difficult the journey had been and how long it took to get there, but how much happier she felt that she had succeeded. She also commented that although she was proud of what she had done so far, she knew that there was more work to do.  

Change is hard. And it's easy to get discouraged when you try and don't get the results you were hoping for. But the reality is that just making the effort is, in fact, progress. Change is not an event with an exact start and stop point; it's a process. Each step you make, even if it's a relatively small step such as making the resolution to change, is still a step in the right direction, bringing you closer to your ultimate goal.

It's also important to recognize that even if you take a few steps back, it's not the end of the world. In fact, research has found that change rarely occurs in a straightforward, linear sequence, and when people falter, they usually don't fall all the way back to where they first began the journey. In fact, if viewed and used correctly, the missteps can serve as learning opportunities, helping you become better prepared for the next leg of the trip.  

The Five Stages of Change:

Although several models of change have been developed and researched, one of the most referenced models is the transtheoretical model (TTM) developed by James Prochaska and Carlo DiClemente. The model presupposes that individuals who are trying to make changes are in one of the five stages of change at any given point in the process. The model proposes that each stage prepares the person for the following stage and that different strategies are needed at different stages to succeed. Although most of the research on TTM has focused on addiction (alcohol, drugs, and smoking), it can be applied to other behaviors where the ultimate goal is a significant lifestyle change, like weight loss.

The image below depicts a spiral model of the stages of change taken from Harvard's Women's Health Watch article, Why It's Hard to Change Unhealthy Behavior. The spiral was adapted from the model developed by Prochaska and DiClemente. Alongside the graphic is an more detailed explanation of the stages.

Source: Harvard Health Publications

Precontemplation.: In the precontemplation stage, individuals aren't yet consciously aware that change is necessary or desired. This may be because prior attempts to change failed or it may be due to lack of insight or awareness of a problem. In order to move past this stage, individuals must somehow become aware that there is a problem and that change is required to accomplish a goal or aspiration. This awareness might come about on its own over time, through others pushing for change, through court-ordered interventions, or through media or public education.

Contemplation: In this stage, there is some awareness that change is needed or wanted, but there is no commitment yet to actually change. These individuals are "on the fence." They recognize that their unhealthy behavior is causing unwanted consequences, but they are weighing whether changing will be worth it.

Some people remain in the contemplation stage forever, never actually making a commitment to do something differently. For others, the process takes a few days or a few weeks. But regardless of how long it takes, the positive aspect of being in this stage is that at least there is an openness to hearing and learning about the unhealthy or unwanted behavior, which over time may create the push needed to get to the next stage of change.

There also are other ways to get someone to the next level. According to Harvard's Women's Health Watch, educators and counselors use a variety of strategies to help contemplaters move beyond this stage, one of which is "to make a list of the pros and cons, then examine the barriers (the cons) and think about how to overcome them. For example, many women find it difficult to get regular exercise because it's inconvenient or they have too little time. If finding a 30-minute block of time to exercise is a barrier, how about two 15-minute sessions? Could someone else cook dinner so you can take a walk after work? If you feel too self-conscious to take an exercise class, what about using an exercise video at home?"

Preparation: This is the stage where individuals start making plans to change. They may start to do research on what they need to do to be successful in their attempt to change and they may take small steps toward action. For example, someone with an anger control problem may find a therapist to learn strategies to better control her emotions and actions; someone who wants to lose weight may join a gym.

It's important at this stage to recognize that there will be situations in the environment that are stimuli for the unhealthy or unwanted behavior and steps should be made to avoid these stimuli whenever possible. If you're trying to lose weight, but can't resist donuts, you should not agree to run into Dunkin Donuts to pick up a dozen for an office party. Whatever triggers the unhealthy behavior should be avoided as much as possible.

It's also important to make action plans realistic and achieveable. If you're a workaholic and your plan is to spend more time away from the office doing something you enjoy, don't make a plan that include spending ten hours a week on "me time." Start off with something more realistic, like 15 or 30 minutes a day. Once you see that you can accomplish this, you can then extend the time if you'd like.

Action: At this stage, you put your plan into action. You begin to make the changes you desire and you try to cope with the challenges that come with making those changes (i.e, the temptations that entice a return to the unhealthy or unwanted behavior). To stay successful, you'll need strategies to maintain the changed behavior and resist the unhealthy behavior. These strategies may include self-generated strategies (going to a class or session; exercise; positive self-talk; reading to stay educated on a specific topic) or external reinforcement (letting friends know what you're doing so they can serve as sources of support when you feel yourself weakening). 

Maintenance: When you reach the six month mark and your new behavior remains stable and consistent, you're into the Maintenance stage. The work now is focused on enjoying the new you and preventing a return to the old unwanted or unhealthy behavior. Coping strategies are strengthened or modified to make sure maintenance is sustained.

What about regression/relapse? The reason visual models of TTM depict spirals or circles is because movement through the stages is not always forward. As noted previously, change is hard and there are likely to be periods of regression or relapse. That's why the model anticipates them. It's not uncommon for individuals trying to overcome addictions to relapse many times before they succeed, and even then, they continue to have to work hard to maintain continued success. However, returning to the unhealthy or unwanted behavior isn't all negative. If you can learn something from the regression to help you be less vulnerable in the future, you'll be all the more stronger the next time you try. So if you've tried to change and didn't succeed, try again ... and again ... and again. Learn what you can from each relapse and keep moving ahead. 

Factors associated with successful change: (next page)

  • When the change is self-motivated
  • When the change is rooted in positive thinking as opposed to guilt, fear, or regret
  • When the goals are specific (i.e., I will walk one mile at least four days each week as opposed to I will exercise)
  • When you limit your goals to a managable number
  • When you develop a practical, realistic plan for accomplishing your goals (If you work 100 hours a week, it's unlikely that you will have the time to walk one mile at least four days a week.).
  • When you incorporate avoidance of triggers in your action plan
  • When you spend time with others who are positive role models for the change you're trying to make (i.e., those who don"t have the habit or those who have successfully changed).

Change is hard. But people tackle hard projects all the time. It can happen. You just need patience, persistence, and a strong commitment to improve your life by making changes for the better.It's normal to be discouraged when you get off track and fall back into the old behavior, but use the relapse as a learning experience and get back in the saddle and try again. In the words of life coach and author, Alan Cohen,

It takes a lot of courage to release the familiar and seemingly secure, to embrace the new. But there is no real security in what is no longer meaningful. There is more security in the adventurous and exciting, for in movement there is life, and in change there is power.

© 2012 Sherrie Bourg Carter, All Rights Reserved

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Sherrie Bourg Carter is the author of High Octane Women: How Superachievers Can Avoid Burnout (Prometheus Books, 2011).

About the Author

Sherrie Bourg Carter Psy.D.

Sherrie Bourg Carter, Psy.D., psychologist and author of "High Octane Women: How Superachievers Can Avoid Burnout," specializes in the area of women and stress.

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