One basic element to consider in understanding how people struggle with change is self-verification. They develop particular ways of defining themselves and then find ways to support those beliefs. Having a secure sense of who we are is so important that some people choose to cling to it-even when they'd be better off changing.

This way of understanding ourselves fits nicely with the first of Prochaska, Norcross, and DiClemente's five "Stages of Change," known also as the Transtheoretical theory. (It's noteworthy that people often cycle through the earlier stages a number of times before making it to the final, termination stage.) The stages are:

Precontemplation: People in this stage have a problem, but no intention to change in the foreseeable future. They are not fully aware of their problem, though the people around them often are. When they do acknowledge their problem, they blame everyone and everything but themselves. For example, someone in this stage might deny an obvious problem with anger with statements like, "You made me blow up. I wouldn't have gotten so angry if you..." And, given that they don't think they have control over the problem, their situation often feels hopeless.

Contemplation: People in this stage are aware they have a problem and are thinking about addressing it, but they are not yet committed to doing so. They think a lot about the problem and its causes, and they often look for validation of these thoughts. Unfortunately, they frequently get so caught up in thinking that they fail to act (sometimes for years). Eventually, as they move through this stage, they begin to think less about past struggles and more about solutions.

Preparation: People in this stage intend to act in the next month and they make plans to do so.

Action: This is the stage in which people modify their behavior. This often involves interacting differently with others and changing their environment to support change.

Maintenance: People in this stage work on relapse prevention and consolidating the gains they've made during the action stage.

Termination: In this final stage, people are totally confident, don't have to work on relapse prevention, and easily maintain their change even in high risk situations.

When we look at the precontemplation and contemplation stages through the lens of self-verification, they make perfect sense and would even be expected. We all begin in precontemplation-we are going along, accepting and believing our definitions of ourselves. Knowing who we are gives us a sense of safety and confidence in navigating through life; so we are deeply committed to our self-definitions. When faced with problems, we are likely to defend how we see ourselves-not wanting to give up that safety and confidence.

Even if someone has a painful self-definition, such as I am a failure; they at least know who they are. This way of defining themselves guides them in them daily lives (i.e. I won't even try something new because I'll just fail); it also prevents them from seeing conflicting facts (i.e. I have succeeded at some things in my life and might succeed at this). So, they are generally not motivated to even try to change because being different is not an option. And, when they do try to change, it's usually a half-hearted attempt; their first lapse sends them back to the same old "I'm a failure" thoughts.

People generally truly question themselves and consider changing only when they are triggered by some more powerful discomfort or emotional pain. This introspection marks the beginning of the contemplation stage. As they think more about their problem, they begin to understand it better. They gain a fuller appreciation of the particular difficulties they are facing. With a more complete understanding of themselves and their problem, they are ready to begin the preparation stage.

All of this makes intuitive sense to me. It also provides some understanding of what's going on for those who cannot seem to get off the merry-go-round of attempts at personal change.

Although research on the Stages of Change theory yield mixed results, there does seem to be more consistent support for the first two stages of change (precontemplation and contemplation). For example, a treatment called Motivational Interviewing targets this population in a way that fits with the Stages of Change theory, and research has shown positive results.

The Stages of Change and Motivational Interviewing support the idea that change is often hampered by people's inability to break free of prior emotionally compelling self-definitions-to disentangle themselves from the process of self-verification.

Dr. Leslie Becker-Phelps is a clinical psychologist in private practice and is on the medical staff at Somerset Medical Center in Somerville, NJ.

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