The Process of Change: Working with the stages

The Stages of Change is a model that describes human behavior related to making changes in our lives. The developers of this model, Prochaska and DiClemente, identify five stages: Precontemplation, Contemplation, Preparation, Action, and Maintenance.

As discussed previously, the concept of successive approximation complements this model by accounting for our natural tendency to struggle with change and periodically dip back into former habits. Given our brain’s tendency to seek comfort in the familiar, how can we best support it in the process of change? Let’s look at it through the lens of the stages:

1. Precontemplation

In this stage we’re pretty closed-off to the idea of making a change, either because we don’t realize our current behavior is problematic or because we’re highly resistant to what we perceive as the cost of making a change. Our attitude in this stage is often fed largely by subconscious fear.

Since we’re not really open to change in precontemplation, the guidance for how to work with this stage is broad and applies more generally to life as a whole: For those of us interested in personal growth, one of the most important things we can do is remain open and curious about whatever life throws at us. This is the surest way to be in a position to receive new information and notice when we may benefit from change.

Side note: If you're concerned about someone you love who appears to be in precontemplation, I know it can be terribly frustrating and even painful. The hard truth is that you cannot force anyone else to change their behavior. What you can do is express your concern (ideally from a nonjudgmental, loving position). Like so many relational challenges, there is no one-size-fits-all answer, but in this case the overarching focus is typically on boundaries and communication. Check out this article by Steve Rose, PhD on the subject of helping someone you love make a change.

2. Contemplation

Once we’ve moved into contemplation, we’re doing a cost-benefit analysis of making a change. Since contemplation is where ambivalence is at its peak, use this time to discover your “why.”

▶ Make a list of pros and cons. Reflect on what it would take to make this a priority in your life. To get here, sometimes it helps to identify why it’s not already a priority. What has kept you from living this way in the first place? Consider these prompts to dig a little deeper.

3. Preparation

This stage is exactly what it sounds like: We’re preparing to make a change.

▶ Gather information and resources. What do you need to know or learn about the change you hope to make? Do you need to research smoking cessation techniques? Do you need to find a local gym? Do you need to seek out 12-step meetings? Do you need to find some apps that will help you track your progress? Try talking with a friend or therapist to brainstorm here.

▶ Plan for accountability and support. Who or what is going to help keep you on track, or encourage you when you’re feeling frustrated?

▶ Prepare for contingencies. What if things don’t go as planned? What shifts can you make to stay on course while not getting bogged down in shame?

▶ Maybe even develop some “SMART” goals. Consider setting goals that are Specific, Measurable, Achievable, Relevant, and Time-bound.

There’s some inner work we would be wise to do during the preparation stage, too.

▶ Explore your fears. As noted in the precontemplation stage, our fears are often holding us back on a subconscious level. And as we saw during contemplation, there are pros and cons associated with this change. Sure, the pros have won for now—otherwise we wouldn’t be in the preparation stage. But those cons are still in there and could come back to bite us if we’re not fully conscious of their influence. So explore those cons, those fears associated with change. Here are some prompts to help you get started.

▶ Treat your resentments. Resentment is a huge topic that I highly encourage everyone to dig into a little deeper at some point if they haven’t already. For our purposes, resentment refers to feelings of anger, bitterness, or indignation about something we see as unjust, unfair, or just plain wrong. We often experience resentment toward others when they’ve hurt us or treated us unfairly, but we can also feel resentment toward the Universe, God, or just life as a whole.

Sometimes this feeling of life not being fair is what gets in the way of making or maintaining a change. Let’s say my goal is to lose weight. In this culture, we still tend to promote a lot of unrealistic body standards across the board. For many of us, this leads to a host of resentments—toward ourselves for not matching that ideal; toward life/God/genetics for giving us this body instead of that one; toward people who we think embody the accepted standards better than we do; toward the people or institutions that uphold this standard.

Left unchecked, these resentments are going to interfere with our ability to sustain change sooner or later. We’re going to have a bad day, see a social media post, feel judged, or meet up with a friend who is naturally thinner/more muscular/whatever—and that resentment is going to show up. The ultimate goal is to heal the resentment entirely so it doesn't trip us up, but for now, maybe the goal is just to be aware of it and tend to it when it starts telling us, She’s way prettier than you, you’ll never look like that, why even bother?

If we get to know and begin treating our resentments during the preparation stage, it could save us a relapse down the road.

Here are some prompts to get you started in thinking about resentments related to the change you’d like to make.

4. Action

In action, we implement our plan. For most changes, it’s helpful to take a “one-day-at-a-time” approach.

▶ Focus on the day at hand. Yesterday has passed and tomorrow hasn’t arrived yet. In addiction recovery, sometimes we have to zero in even further on a given moment, taking things one hour or one minute at a time. Particularly profound changes are often like that, because our brain chemistry and neural pathways come to bear on the work we’re doing. The brain is trying to learn a new way of being, so we have to be patient with it and support it the best we can during the process.

Give yourself permission to struggle, to be imperfect. It’s typically the most difficult in the beginning. This is why accountability and support are so important.

▶ Begin a habit of daily reflection on your progress. Celebrate the wins, check in on those resentments and fears, track what works and what doesn’t, talk things over with a supportive friend or therapist, practice gratitude, practice forgiveness, stay open and curious about your personal change process.

5. Maintenance

In this stage, new behavior has now come to replace the old, but that doesn't mean we'll never have to think about our behavior again. For most, complacency is the biggest threat once we reach the maintenance stage. To combat this:

▶ Keep doing what works. Sounds obvious, right? Yep. And that's exactly why we often fall out of our new habits. We take for granted the little things that have supported our change journey, making excuses and exceptions that may turn into a slippery slope toward relapse. This doesn't mean you have to be rigid about the change you've made for the rest of your life. It's just wise to be mindful as you transition into the maintenance stage of change. If you want to scale back on the intensity with which you pursue activities related to this new habit, that may be perfectly fine. Just do so mindfully, a little at a time, and assess the effect before making any other adjustments.

▶ Continue connecting with others. Depending on the change you've made, you may find it helpful to continue sharing your story and connecting with others who've had a similar experience. This is common in addiction recovery, but community is a great way to establish and maintain any new routine or habit, no matter how large or small.

▶ Consult your Personal Chaos Index. I borrow this concept from Patrick Carnes, PhD, a renowned addictions therapist, author, and researcher. He developed a tool called the Personal Craziness Index to enhance self-awareness of our daily behaviors as they relate to addiction recovery. With all due respect to Mr. Carnes, I prefer the term chaos—because whether we're talking about addiction recovery or any other significant habit change, it's often the general chaos of life that gets in the way of maintaining our progress, isn't it? My adaptation of this tool focuses on addiction recovery, but is applicable to any sizeable change we want to maintain. Check it out here:

DeeperWellsTherapy-PersonalChaosIndex.pdf

Download PDF • 436KB

In the event of a relapse

Relapse into old habits won't necessarily be a part of your change journey, but it's not uncommon.

Note: If you are in recovery from alcohol or another substance, relapse can be life-threatening. Check out this relapse prevention video on the stages of relapse to hopefully catch it before it happens. If you do relapse, the most important thing you can do is seek support immediately. Don't let shame or fear stand between you and the help that is always available.

Remember the concept of successive approximation and our upward spiral of change. It's okay to feel frustrated by a relapse into the former habit, but try not to get stuck there. Instead:

▶ Revisit your pros and cons. Take another look at what you have to gain by continuing on your change journey.

▶ Reflect on the relapse. Take a hard look at what led up to it. What do you need to be more aware of in terms of triggers, resentments, or fears going forward? Are there behaviors or thought patterns that contributed to the relapse? Are there contingencies you weren't expecting? What were you thinking or feeling immediately prior to the relapse?

▶ Talk to someone. As Brené Brown and others have observed, shame thrives in darkness and secrecy. Find a trusted member of your support system, such as a close friend or therapist who is familiar with the change you're trying to make, and talk about the relapse and how you're feeling about it.

▶ Review your successes. If you've been reflecting regularly during the change process, hopefully you have a sense of what has gone well so far. If you're struggling to come up with things, this can be a sign that you're stuck in shame. This is another moment when a supportive friend or therapist may be able to help you gain some perspective. Remember, you can hold yourself accountable without letting shame consume you.

▶ Explore areas of opportunity. After taking time to reflect using the suggestions above, revisit your plan for going forward. What worked? What didn't work so well? How can you use this to support your brain as you proceed?