Changing for Good

by James O. Prochaska

Linear progression is a possible but relatively rare phenomenon. In fact, people who initiate change begin by proceeding from contemplation to preparation to action to maintenance. Most, however, slip up at some point, returning to the contemplation, or sometimes even the precontemplation stage, before renewing their efforts. The average successful self-changer recycles several times. Most people who quit smoking, for example, report three or four serious attempts before they succeed; New Year’s resolutions are typically made for five consecutive years or more before resolute changers achieve the maintenance stage.

However, despite everyone’s best efforts, relapse remains the rule rather than the exception when it comes to solving most common problems.

to some extent, that is the case, but the good news is that the circles are spiraling upward. A successful self-change is like climbing the Leaning Tower of Pisa: First, you walk up, but as you approach the lower part of each floor, you begin to head down. A few steps later you resume your ascent.

Of the contemplators we followed for two years, only 5 percent made it through the cycle of change without at least one setback.

That is why we prefer the term recycle to relapse. The return to contemplation can be an auspicious, even an inspired time for continuing to change. Recycling gives us opportunities to learn. Action followed by relapse is far better than no action at all. People who take action and fail in the next month are twice as likely to succeed over the next six months than those who don’t take any action at all.

Self-changers are readily able to assess their stages of change, but without guidance may have trouble determining the processes they need to use. A vague notion of the importance of willpower can dominate their perspective on self-change. Still,

Myth 2: It just takes willpower When we ask successful changers, “How did you do it?” the universal answer is, “Willpower.” Our research seemed to confirm what everybody already knew. When

Self-changers do indeed use willpower in the first, true sense of the word, but it is only one of nine change processes, the one we call commitment. People who rely solely upon willpower set themselves up for failure. If you believe willpower is all it takes, then you try to change and fail, it seems reasonable to conclude that you don’t have enough willpower. This may lead you to give up. But failure to change when relying only on willpower just means that willpower alone is not enough.

Third, although society only looks at a single self-change attempt, most triumphant self-changers take more than one crack at a problem before they are finished with it. Success can only be achieved over the long haul, and through hard work.

Some precontemplators are so demoralized that they are resigned to remaining in a situation they consider their “fate.” They may have tried to solve their problems in the past, and failed. They believe that even to think about change is to risk failing again. They have admitted defeat and given up on changing.

Waiting for precontemplators to hit bottom is not only painful and inefficient, it is risky. We would not consider this approach with purely physical disorders. If someone shows signs of heart disease or cancer, we would not wait to do something until the disease was undeniable. When people exhibit symptoms of an impending heart attack, even if they refuse to see a physician, their loved ones usually force the issue. Research shows that problems are almost always treated more effectively when they are less rather than more severe, and when they are of shorter rather than longer duration. The longer people wait to change, the more difficult change becomes.

It is extremely helpful, even important, to focus on the negative aspects of your problem behavior during the contemplation stage. However, in the preparation and action stages, concentrating on the negatives seems to hold self-changers back, by keeping them concentrated on the problem rather than on the solution.

A critical barrier to changing many problem behaviors is that serious consequences seem too distant or long-term to matter. By using your imagination to bring the future into the present you can effectively overcome this barrier, and arouse your emotions to the point where you are ready to make a firm commitment to take action. This will be of critical importance during the preparation stage.

Emotional arousal self-assessment Here is a self-assessment to check your progress in using the process of emotional arousal. Be honest and realistic. Fill in the number that most closely reflects how frequently you have used the method in the past week to combat your problem. 1 = Never, 2 = Seldom, 3 = Occasionally, 4 = Often, 5 = Repeatedly FREQUENCY: _____ Dramatic portrayals about my problem affect me emotionally. _____ I react emotionally to warnings about the consequences of my problem.

_____ Remembering reports about illnesses caused by my problem upsets me. _____ Warnings about hazards of my problem move me emotionally. _____ = Score Your score indicates the extent to which you are emotionally aroused by portrayals, warnings, and hazards connected with your problem. In this self-assessment, a score of 10 or more indicates that you are ready to begin moving forward to engage in the prepa...

Make change a priority Since most of us lead busy lives, intentional self-change cannot happen unless it is given a prominent place on our list of goals. We have seen many individuals who make personal behavior change a goal, but a vague one. On their list of things to do, it is relegated to a place somewhere between getting a haircut and going shopping. Such shortsighted plans can hardly be adequate to making a major change in your

At the end of the contemplation stage you decided to change your problem behavior. In the preparation stage you must concentrate on moving this change task to the top of your list of things to do. Change requires energy, effort, and attention. You will not be ready to move into the action stage until changing your behavior becomes your highest priority.

Commitment includes not only a willingness to act, but also a belief in your ability to change, which in turn reinforces your will.

Begin by having faith in all you accomplished during contemplation. You are now aware and informed about your problems, not groping in the dark. Have confidence in your evaluations of the pros and cons of changing, so that you honestly believe your life will be enhanced rather than diminished by the action you are about to take.

more entirely you throw yourself into a new way of behaving, the more likely you are to experience that way as being the best path to follow. In any case, commitment requires you to have faith in your ability to succeed at the action you have chosen to take.

Plan to complete whatever preparations, and—rather than waiting for a magic moment—take responsibility for taking action on the date. Be realistic about the nature of the tasks ahead. Underestimating the challenges of change can lead to cockiness and overconfidence. Wishful thinking about the ease of change will lead to disappointment, which in turn may contribute to ineffective action.

Preparing for psychic surgery means that you and those who support you put the operation first and everything else second.

This much disruption may last for several weeks or more. Top priority must be given to recovering from your problem behavior; other areas of your life may suffer for a short while as a result.

At his request, she detailed the things that he could do to help her; in past efforts at dieting she had asked for his help, but then scolded him for nagging whenever she decided to break her commitment. He was wary of falling into these old patterns, and by clearly setting out what each expected of the other, Dan and Gail came up with some ground rules that both were comfortable with.

Offer them instead a comprehensive list of “dos and don’ts.” For example: Don’t keep asking how I am doing. Don’t nag me. Offer to help when I look overwhelmed. Tell me how proud you are that I am doing this.

Next, the cons of changing always decrease from contemplation to action. The second principle of progress states correspondingly that if you are to advance from contemplation to action, you must decrease your perception of the cons of changing your problem behavior. Don’t worry about the pros of changing at this stage. They come earlier.

We use the metaphor of people who would like to run the Boston Marathon. Those who aren’t prepared at all are probably in the precontemplation stage and don’t intend to enter this year’s race. Those who are more prepared and are in the contemplation stage may intend to enter this year’s race, but because of ambivalence about the pros and cons of running, they sign up for the race but do not show up. Those

Think of your problem as an old piano that needs to be carried down a flight of stairs. There is no way you would undertake such a task without calling on a few friends for assistance. Use the same strategy here and let several people help you to bear your problem away.

Since stress often triggers problems, from weight gain to marital discord, it is invaluable to develop ways to cope with stress. Chief among stress-reduction techniques, as always, are exercise and relaxation.

Working to create alternative behaviors is one of the most important and rewarding challenges of maintenance. Individuals with drinking problems, for example, are frequently amazed at the number of activities open to them that do not revolve around alcohol.

Problems may now seem far away and less threatening as you move into the maintenance stage. Being at this

distance now may lead you to minimize the dangers and risks of your unwanted behavior, and maximize its appeal.

Again, the process of forgetting is involved. You may tell yourself that your d...

The goal of maintenance is nothing short of a permanent change that becomes part of your personality. Permanent change is a high ideal, rarely attained without false starts or mistakes. Most

Life without problem behavior is undeniably different, especially when you have given up a substance or a way of life that was once your best friend. Quite often, the euphoria of an initial change gives way to a sense of loss and deprivation, which in turn may wear down your resolve. When we work with people who have given up drugs or alcohol, we encourage them to go through a mourning process. To maintain abstinence, it’s important that they say good-bye to their old friend and trusted companion. Yes, alcohol causes broken marriages, DWI arrests, lost jobs, but for many alcohol is a constant companion and sturdy crutch over the years. Regardless of your problem behavior, regardless of your level of disgust when you enter the action stage, don’t be surprised if you wake up one day missing your old habits. Don’t think, however, that this means you cannot live without your old behavior; you are in the process of making a new self that does not need your old problems.

Guilt and self-blame are actually very ineffective change processes. They tend to cripple change efforts, not stimulate them. We regularly encounter clients whose guilt turns a lapse

Every relapse begins with a slip. But it is foolish to give up hope after relapsing. We can recover from our slips, learn from them, and continue toward our goal of permanent change. Take lapses as signs that you must redouble your self-change efforts.

We mentioned some of these earlier: deciding to keep some beer in the house in case company drops by; buying some of your favorite cookies for the kids; easing up on your exercise program because you feel so good. Such mini-decisions can lead you to begin shifting direction away from maintenance

Also, emotional distress weakens you psychologically, in much the same way a fever weakens you physically. During times of high distress, you are likely to regress to less mature and rational ways of thinking and behaving.

prima facie

have a problem with alcohol and that awareness is not enough. The challenge is in making the

A big challenge is in the long haul. Many individuals find that they must recycle through the stages several times before they are successful in controlling their drinking. You must employ active change strategies over months and years in order to achieve long-term sobriety or nonproblematic drinking. Remain active and vigilant during maintenance, and continue to use your refusal skills. Do not become overconfident. A big danger sometimes lies in the belief that you are free to return to risky situations. Keep reviewing the reasons you have for not drinking, and stay alert for signs of trouble—increasingly frequent urges or temptations to drink, returning to the old haunts, and generally putting yourself in harm’s way.

You may be acutely aware of the difficulties and sacrifices you have made by giving up drinking; now make an effort to focus on the long-term benefits. Your liver, central nervous system, and overall well-being will improve dramatically; your family’s lives

Maintenance strategies prevent ordinary distress from becoming neurotic misery. All of the processes used during the action stage should be used in maintenance, and there are some further strategies to employ. One of the major allies of psychological distress is unstructured time. Empty hours, goalless days, and languid weeks conspire to elevate anxiety and compound depression. Exercise, activity, and diversion can fill the void in the short run, and relaxation training can help you tolerate unstructured time, and even to learn to use it for regeneration. But in the long run, these strategies may not suffice. You need to develop an assertive lifestyle, personal commitments, and a goal-directed life plan.

caprice,