Friday, January 25, 2013

The Process of Change

I recently was reading The True Cost of Happiness: The Real Story Behind Managing Your Money by Stacey Tisdale and Paula Boyer Kennedy.  In it I ran across a fabulous outline of the process of change.   While this outline was inserted in a money management book (pp98-120), I could immediately see that the principles were much more generally applicable, so I want to quote it here.  It is applicable for those who wish to change to become more organized and it is applicable all kinds of change.  While it doesn’t necessarily tell you how to change, it can help you understand where you are in the process of changing so that you can retain realistic expectations of what you can accomplish and so that you can know where you can focus your efforts that will bring better success. 

“Changing for Good”

Drs. Prochaska, Norcross, and DiClemente studied thousands of what they call “self-changers” in their efforts to identify what allowed them to successfully change their behavior.  Self-changers are people who have changed without psychotherapy.  Many of them have successfully reversed serious addictions to alcohol, drugs, cigarettes, food, and emotional distress on their own.

The doctors by no means have anything against therapy. Many people need assistance and guidance in order to change. It can be argued, however, that therapy is professionally coached self-change.  Therapy can be a useful step in the change process, but at some point the client has to do the heavy lifting alone.

After years of research, Dr. Prochaska and his colleagues identified six well-defined stages of change in all successful self-changers:

1.     Precontemplation
2.     Contemplation
3.     Preparation
4.     Action
5.     Maintenance
6.     Termination

The key to successful is in knowing where you are in the change process and applying the right technique.  You must be ready….

The Nine Tools for Change

Consciousness Raising.  This is about awareness. You need to be aware that a certain belief or behavior exists. It’s also about becoming aware of the ways in which you use your defenses, resistance, and “mental tricks” to maintain a certain belief or behavior….

Social Liberation. This involves finding external environments where you have more choices and alternatives for your desired behavior. No-smoking areas, for example, provide an alternative for smokers.

Emotional Arousal. This is similar to consciousness raising, but it works on a deeper level.  You may be aware of a spending problem, for example, but that awareness moves to a different level when you realize you don’t have the money to cover the cost of your child’s tuition.

Self-Reevalution.  This involves reappraising your problem and thinking about how your life will be once you’ve conquered it. During this type of reevaluation you can really see and believe that your life will be better without the behavior you want to change. The pros outweigh the cons as well as the costs of what you have to give up.

Commitment. This is an acknowledgement that you are the only one who can act on your behalf—you willingly accept responsibility for the change you want to make and what it will take to make it. The first step involves telling yourself you are ready for change. The second involves going public and telling others that you have made a firm decision to change. Public commitments can be very powerful and effective when it comes to changing behavior!

Countering. This involves substituting healthy responses for [an] unhealthy one….The key is to keep trying until you find countering behaviors that work.

Environmental Control. There are some similarities to the social liberation and countering techniques in environmental control. In environmental control, however, you activevly restructure your environment so that the probability of the problem-causing behavior’s occurring is reduced.  Leaving your credit card at home would be an example of controlling your environment….

Reward. This involves things like self-praise or getting yourself a present when you reach a certain goal. These things can be under your control, or the control of others….One thing to watch out for is that many of us do not believe that we have [the] right to be rewarded when we change or modify a behavior, yet we believe that we deserve to be punished when we fall short of our goals. Dr. Prochaska and his colleagues discovered that punishment is rarely used by successful self-changers.

Helping Relationships.  This involves getting care and support from significant people in your life. Many of us have trouble admitting when we need help, so we limit our opportunities for assistance. In addition, many of the people we care about may be uncomfortable hearing that we’re in trouble. They may find it difficult to provide the support we’re looking for. It’s important to identify the people who can provide the type of support that you need when you employ this technique….

The Six Stages of Change

The Precontemplation Stage of Change

The first stage  of change is called precontemplation. People in this stage usually have no intention of changing their behavior.  Few in this stage think they have a problem at all.  Precontemplation is characterized by resistance, excuses, rationalizations, and denial.

Precontemplators rarely want to change themselves, just the people and circumstancees around them. If people around you have been trying to get you to change your lifestyle or certain behaviors, like losing weight, quitting smoking, or eliminating debt, but you think the problem is with them and not you, you’re probably in precontemplation! Movement out of this stage is often unintentional.

“Precontemplators are likely to stay stuck in this stage unless one of two things happens: A crisis occurs, or an event like becoming a parent, turning 50, or some other milestone—situations where your environment no longer supports your lifestyle,” Dr. Prochaska told me.

Defense Machanisms for Precontemplators.  Precontemplators are often demoralized, feeling like a situation is their fate. They don’t want to think or talk about their problem because they feel the situation is hopeless. These feelings of inevitable failure protect them from trying to change.  They give up on themselves, and accept one or more of what Dr. Prochaska and his colleagues have identified as the Four Self-Change Myths.

Myth 1: Self change is simple. It’s simply not!  We shouldn’t become embarrassed or frustrated by our struggles, or feel bad if someone tells us they had an easier time making a change than we did.

Myth 2: It just takes willpower. Willpower doesn’t really come into play until you’re ready to take action. As Dr. Prochaska says, it can seem reasonable to conclude that you don’t have enough willpower if you fail to make a desired change. But failure to change when relying on willpower alone really means that willpower alone was not enough!

Myth 3: I’ve tried everything; nothing works. This goes back to timing—making sure that you’ve used the right process, at the right time, in your change effort.

Myth 4: People don’t really change. Dr. Prochaska and his colleagues have blown this myth out of the water, by interviewing countless numbers of successful self-changers. We’ve all changed. Look at a picture of yourself 10 years ago. Now look in the mirror. Think about how your attitudes, beliefs, and behaviors have also changed over the past decade. Change happens in all of us, whether we want it to or not.

Precontemplation or Lifestyle Choice? It can be difficult to identify whether you are a precontemplator or you’re simply living the life of your choosing. Some people truly believe, for example, that they are okay with debt and overspending. Dr. Prochaska says the following three questions can help distinguish between problem behavior and lifestyle choices:

1.     Do you discuss your behavior pattern? Precontemplators are usually defensive. They tend to tell people to mind their own business. They tend to see feedback as an attempt to control them, rather than a sign of caring. They use their defense mechanisms to avoid an issue.
2.     Are you well informed about your behavior?  Precontemplators tend to avoid learning about their problems. If they see an article or television show about getting out of debt, they would likely turn the page or channel.
3.     Are you willing to take responsibility for the consequences of your behavior?

Successful Change Techniques for Precontemplators. Dr. Prochaska found that precontemplators use three change techniques to move out of this stage: consciousness raising, helping relationships, and social liberation….

Helping Relationships.  Our defenses rarely fool others. Think about someone who cares about you and will “call you out on your stuff!” This person should not rush you toward action before you are ready, but they should help you come up with different ways to look at your problem. Precontemplators rarely change without outside assistance…..

Social Liberation. Self-help groups…are great examples of resources for precontemplators.  Your ability to enjoy non-…destructive behavior will do wonders for your self-esteem.

The Contemplation Stage of Change

As a person moves from the precontemplation stage to the contemplation stuage, he or she starts to seriously consider making a change. Awareness is developed during contemplation—awareness of the consequences of various actions and awareness of the benefits of change.

Contemplators want to change, but this stage is also characterized by resistance, due in large part to a fear of failure. They are also fearful of losing some, or all, of their identity. “I’ve been a shopaholic all of my life. If I give that up, what will I do with my friends on the weekends?”

These fears tend to bring out the procrastinator in the contemplator. In fact, many chronic contemplators substitute thinking for acting. Conflicts and problems hang suspended. Decisions are never finalized. Some in this stage seem to be waiting for some kind of divine intervention to come along and change them.

Contemplators are not ready to prepare for action until they achieve greater understanding of their behavior. This is a positive aspect of the stage. Dr. Prochaska says jumping into action while you’re in this stage will almost surely lead to failure.

Defense Mechanisms for Contemplators.  Dr. Prochaska and his colleagues have identified these common traps that contemplators can fall into:

·      The search for absolute certainty. People who are stuck in contemplation may tend to spend their time analyzing, thinking, and worrying, instead of taking action. Some people, for example, will spend decades in therapy, exploring every aspect of various issues, without taking actual steps to change their situation. They seem to harbor the belief that if they get enough information, change will be easy or the problem will go away.
·      Waiting for the magic moment. Someday….I’ll quit smoking.  Someday, I’ll get out of this unhealthy relationship. Most of us are familiar with the concept of waiting for the perfect time for change. It’s driven by a belief that there will be a magic moment when change will just happen or, at least, be easy. When the kids grow up. When things slow down. Things, of course, never slow down.
·      Wishful thinking. It’s much easier to wish for change than to work towards it. The problem is that wishing rarely works….
·      Premature action. Trying to take an action before you’re ready can serve as a conscious or an unconscious way out.  Dr. Prochaska is quick to point out that a period of contemplation prior to taking action is essential for lasting change. Premature action can also come as a result of being nagged or threatened by an outside party. When failure comes, the contemplator can now say, “See, I tried. I knew I couldn’t do it. Get off my back.” Now they can justify putting off future attempts to change.

Successful Change Techniques for Contemplators.  Dr. Prochaska and his colleagues found that contemplators use four change techniques to more out of this stage: emotional arousal, consciousness raising, self-reevaluation, and helping relationships.

Emotional Arousal.  As we discussed emotional arousal happens on a deeper level than simply becoming aware of your problem behavior and its consequences. Losing a business, a job, or a relationship over financial issues; an illness; or other life-changing events can provide the kind of emotional charge that is needed to make the decision to change a behavior.

Dr. Prochaska says we can also emotionally arouse ourselves. He says movies that focus on our specific problem are wonderful ways to rouse emotions. He cites Jack Lemmon’s portrayal of an alcoholic in the movie Save the Tiger as a motivating event for many alcoholics. Creating your own stimulus can also be helpful. Overweight people, for example may want to use mirrors to encourage them to change….

Your imagination can be a great tool as well. Think about your problem behavior and imagine the distressing scenarios it could lead to. Think about the people it is affecting and the consequences to your lifestyle. Imagine how this behavior will play out 5, 10, or 20 years down the road.

Consciousness Raising. If you’re in the contemplation stage of change, you’re probably more open to hearing information about your problem than someone still in precontemplation.  Use this as an opportunity to gather information that can motivate you to change your behavior.

Come up with questions that will raise your level of consciousness about your problem, such as:

·      What do my finances have to look like in order for me to retire in 10 years?
·      How long will it take me to pay off my credit card debt if I pay only the minimum?
·      What are my triggers for overspending?
·      What am I thinking and feeling before I make a purchase that works against my goals?....

Self-reevaluation.  Take the information you learned about a behavior and its consequences through consciousness raising and put some well-informed though into how you’ll feel if you continue to act in the same way.  How will I feel about myself if I continue to stick my head in the sand...?  In addition to asking the “tough questions,” Dr. Prochaska and his colleagues noticed that contemplators getting ready to move out of this stage begin to think before they act.  Pausing and thinking before you make a purchase or a financial decision can do wonders for your financial stability.

Contemplators also create a new self-image for themselves. “If I move past this behavior, how will I feel?  How will others think of me?  What types of things will I be saying and doing?”  They begin to act according to their new image.  Contemplators also make a decision to take action, sooner rather than later, after weighing the consequences of change to themselves and others around them.

Helping relationships. Contemplators benefit a great deal from empathy—someone who’s able to see his or her perspective. Unconditional support and warmth is also critical during the contemplation phase. No insults threats, “I told you so,” or false praise. Dr. Prochaska says it’s wise to remember that “warmth begets warmth.” The best way to ignite warmth and compassion from your helpers is to extend it. Helpers can also offer assistance with gathering information that could be helpful during self-reevaluation and consciousness raising.

The Preparation Stage of Change

People in this stage are usually planning to take action within the next month and are making the necessary adjustments before they begin to change their behavior.

“They are preparing for how hard taking action is really going to be. They are creating a plan to deal with the expected and unexpected challenges that are to come, because their realization of the benefits of change have gone up,” Dr. Prochaska told me.

Preparation is the cornerstone of effective action.  When it comes to financial behavior, preparation could include things like setting up accounts to have money automatically allocated toward your goals….

In this stage, the focus has shifted to what life will be like once you have changed your behavior.  Dr. Prochaska gives the example of a therapy group for people addicted to cocaine.  Those who were in the contemplating stage delighted in talking about their war stories—the crazy things they did to get cocaine, the crazy things it did to them  This was appropriate because they were still in the decision-making stage.  Those in the preparation stage found these stories to be distracting.  They talked about how their lives and relationships would change for the better without cocaine.

Dr. Prochaska and his colleagues found that people who rushed into action without preparation usually failed to make the changes they desired.

Successful Change Techniques for Those in the Preparation Stage.  People in the preparation stage use three techniques to move forward: self-reevaluation, helping relationships, and commitment.

Self-Reevaluation.  Using self-reevaluation to create a new image absent your destructive behavior will help you let go of the past.  Ask yourself: What is my potential if I change?  What will it free me up to become?  How will my life be enhanced?  This type of forward-looking self-inquiry allows people in this stage to turn away from old behavior.  It can be scary and downright hard to let go of habits and patterns, but “your new self will be there to greet you.”  In addition, people in the preparatory stage can use self-reevaluation to help them make change a priority.  As you plan for your life without the…behaviors you want to change, what do you need to do?

Helping Relationships.  The preparation stage usually involves notice-able changes that may affect the people around you.  If you haven’t enlisted their help, this is a good time to do so.  In addition, it can be quite tempting and easy to give up in the first days and weeks of your new behaviors.  You may need the support of helping relationships now more than ever.

Dr. Prochaska says it’s important to let people know the best ways to help you.  Tell them, for example:

  • “Don’t keep asking how I’m doing.”
  • “Lend a helping hand when you see that I’m overwhelmed.”
  • “Tell me how proud you are that I’m doing this.”

Commitment.  While commitment involves a willingness to act and focus on the ways in which you want to change, the spark that really ignites its force is your belief in your ability to change.  Believing in how you’ve assessed yourself and your problem during self-reevaluation will help build your will and your confidence.  Still, Dr. Prochaska says, at some point you’re just going to have to make tough choices when you are committed to change, and throw yourself into a new way of behaving.  Even the strongest commitment and intention, however, can be overwhelmed by fear of failure.  There are no guarantees that change will be successful.  Dr. Prochaska says we must learn to accept the anxiety that comes with this fear.  He offers these five commitment techniques to help combat that stress:

  1. Take small steps.  Gathering the emotional and physical supplies you need to prepare for action should not be underestimated or rushed.  Cut up your credit cards, for example, before you take more aggressive steps to get out of debt.
  2. Set a date.  Choosing a date can help prevent premature action and prolonged procrastination.  The date should be realistic, but as soon as possible, so that you can capitalize on the momentum you’ve built to make this change.
  3. Go public. Going public with your intended change not only enlists the support of people who care about you, but also gives you a fear of embarrassment if you fail.  Both can be a major motivator when it comes to staying committed.
  4. Prepare for a major operation.  If you were having a major operation, you would plan for it and your recovery. Do the same for the behavior you want to overcome. Put the “surgery” first.  That means your relationships, moods, and other areas of your life will change accordingly. Also, plan to take as much time as you need to recover, just as you would after a physical surgery.
  5. Create your own plan of action.  Knowing yourself and what works for you is critical when it comes to creating a specific plan of action. Your plan should list a variety of techniques for coping with expected barriers. Spending one day a month versus one day a week with your neighbor who pushes the “keep up with the Gateses” button, for example. Reviewing your previous attempts to change may also hold valuable information about your barriers.

The Action Stage of Change

When you are prepared to make the changes you desire, and you’ve planned for them, action can come naturally.  You’re committed and you’re motivated. Now you can act…. Taking action also involves making the difficult changes in your life that will allow you to alter your behavior  This could mean avoiding certain places and people or getting rid of things in your everyday environment so that you can stay focused.  Being aware of the pitfalls during this stage greatly improves your chances for success.  Dr. Prochaska and his colleagues identified these four danger zones:

  1. Taking preparation too lightly. More often than not, action without preparation will not last for very long.  Without the necessary preparation and plan for temptation, the inclination to return to the problem behavior is too strong.
  2. Cheap change.  Change requires work, effort, enormous energy, and standing up to the efforts by others to hold onto the old you. Your best friend may try to talk you back into your old spending patterns to assuage her own guilt.  Standing up to this pressure is extremely difficult, but there’s nothing cheap or easy about change.
  3. The myth of the magic bullet.  Many of us believe that there is one magic way to bring about successful change.  Dr. Prochaska says some people are attracted to his work because they believe it provides some miracle cure. Relying on a single technique will likely lead to failure. Try different techniques in different doses until you find one that works for you.
  4. More of the same. Many of us have a tendency to cling to old techniques that are bringing partial success or no success at all.  By holding onto old methods, we don’t allow room for change, and we don’t give ourselves opportunities to recognize that other, perhaps better, techniques and variations exist. Combining a variety of techniques at the right time is the best way to get your desired results.

Successful Change Techniques for People in the Action Stage. Dr. Prochaska and his colleagues found that people who successfully moved through the action stage of change used four techniques: countering, environmental control, rewards, and helping relationships.

Countering.  This involves finding a healthy substitute for the behaviors you want to change.  This eliminates much of the risk of the old habits returning.

I once interviewed Dr. Bernard Arons about behavior substitutions for people with addictions.  Dr. Arons is the executive director and CEO of the National Development and Research Institutes, which does scientific research on substance abuse and other health concerns.  He has served in a number of positions, including mental health and substance abuse adviser to Tipper Gore during the Clinton administration in the early 1990s.  During our interview, he pointed out that when we engage in a behavior that we know is self-sabotaging (e.g. reckless spending), we experience some form of gratification.  Perhaps shopping gives a sense of control to someone who feels that his or her life is in chaos. He says it is important to find an alternative nondestructive way to achieve that same effect.  This can be very helpful when it comes to finding effective countering techniques.

Dr. Prochaska and his colleagues identify these effective countering techniques:

·      Active diversion.  Keep busy.  Find an activity to preclude problem behavior.  This could be anything—reading a book, calling a friend, walking…--anything that refocuses your energy.
·      Exercise.  This is one of the most beneficial substitutes for problem behavior.  Dr. Prochaska says omitting exercise from a self-change plan is like fighting a foe with one hand tied behind your back. Exercise prepares you mentally and physically for change and reduces your stress levels.
·      Relaxation.  Research has shown that 10 to 20 minutes of daily deep relaxation can bring lasting improvement to your physical and mental health. You will experience an increase in energy, which is needed to take action. Decreased anxiety, improved sleep, and improved concentration are other positive effects.  Yoga, meditation, prayer, and progressive muscle relaxation (systematically relaxing every part of your body) are some of the relaxation techniques successful self-changers use.
·      Counterthinking.  We’ve had much discussion about the importance of “rewriting your scripts”….Counterthinking is quick, takes little energy, and can be used anytime, anywhere.  When a negative thought is getting the better of you, give it a reality check.  What are you telling yourself that’s making you so upset?  Is it the truth?  Are there more rational assessments of the situation?  Absolutes are a good indication that you should come up with a new thought: “I must buy this car,” “I am bad at saving money”—anything that doesn’t leave room for discussion.  What new tune are you going to play when that old song comes up?  How are you going to rewrite scripts that don’t serve your best interests?....
·      Assertiveness.  Trying to overcome problem behavior can result in feelings of weakness and helplessness, especially if there are people or other outside influences that resist or are threatened by the changes you want to make.  Exercising your right to be heard can build confidence.  In addition, don’t forget your right to make mistakes, change your mind, and resist other people’s judgments, as well as your right to not have to justify yourself.  Assertion crosses the line into aggression, however, when your assertiveness comes at the expense of others.

….Think about what it is in that behavior that you find gratifying.  A sense of control?  A distraction from boredom or depression?  Come up with some countering techniques for your behavior.  Be specific about how and when you can apply them.  Don’t forget that you’ll probably have to be flexible and try new techniques until you find the right solution.

Environmental Control.  While countering involves changing your responses, environmental control involves changing the situation itself.  It involves changing your environment in a way that reduces temptation.  An alcoholic, for example, has a better chance of success if he doesn’t keep alcohol in his house.  Controlling your environment is not a sign that you are too weak to be tempted.  It shows that you are strong enough to put yourself in the best possible situation to achieve success.

While avoidance is very effective when it comes to controlling your behavior, it’s not always a permanent solution.  Other techniques Dr. Prochaska and his colleagues suggest include:

  • Cues.  Eventually you will be faced with a cue that triggers your problem behavior.  I once met a woman who felt the need to go on a shopping spree and get a makeover every time she saw well-dressed celebrities on award shows like the Oscars.  Dr. Prochaska recommends using your imagination to confront and plan for cues. Perhaps this woman could conjure up that anxious feeling she gets from watching the award shows.  She could remind herself that her family and friends love her for who she is, not for what she wears, until the feeling subsides. She could also tell one of her friends she has identified as a helping relationship that she will plan to call them for a “pat on the back” when the Golden Globe Awards come on.
  • Reminders. Reminders are very effective during the action stage.  Putting a picture of your dream house where you keep your credit card, for example, will stop you from rushing full steam ahead into a purchase that is not high on your priority list.  “To do” lists are also effective.  Put your countering techniques near the top—things like counterthinking, Relaxing, and Exercise.

Rewards.  Many people do not believe they should be rewarded for changing problem behavior. Failing to reinforce positive self-change efforts, however, is essentially punishing yourself. Many psychologists say that punishment only temporarily suppresses troubled behavior. Dr. Prochaska and his colleagues found that successful changers rewarded and praised themselves for their efforts.  Many used these three techniques:

1.     Covert management.  If you choose to take a deep breath and relax until the urge to spend passes, congratulate yourself.  Telling yourself, “Nice job, it feels good to be in control,” is a much more effective tool for change than beating yourself up for having the urge in the first place.  The latter breaks down self-esteem, whereas a “pat on the back” reinforces your effort and makes you feel good about success you’re having in the change process.
2.     Contracting.  Many successful changers make contracts with themselves during the action stage.  Written contracts are even more powerful than spoken ones.  “Every time I put $200 into my child’s college fund, I will take the two of us to the movies.”  Tapping into helping relationships when using this technique can make your contracts more binding.
3.     Shaping up. By this Dr. Prochaska and his colleagues mean taking small steps to gradually reshape your behavior.  Well-practiced well-rewarded moves to put $25 a month into an investment account, for example, can lay a strong foundation for the time when you want to make the larger investments needed to attain your goals.  Gradually reshaping your behavior builds your resolve….

Helping Relationships.  You’ll rely on your helping relationships more in the action stage than you have in the previous stages.  It’s important  that your helpers are clear on your intentions, and the kind of support you need from them. You should ask for their help with your countering techniques.  You could ask a friend to exercise with you, and ask him or her to help you change your environment so that you can avoid tempting cues. As we discussed earlier, helping relationships are also very useful when it comes to sticking to contracts. In addition, praise and reward from those close to you goes a long way in helping you feel good about the changes you’ve made.

Think of the best people to provide you with the support you need during the action stage of change. Who will help you with the ways in which you are trying to counter your behavior? Who will help you stick to your contract? How can they be of the most help?....

The Maintenance Stage of Change

Successful change is not measured by action alone. It means you must sustain your new behavior for years, decades, or a lifetime. Sound challenging?  It is.  In addition, you won’t get that confidence boost from seeing the immediate results of taking action or the praise from people who see your dramatic changes. The new you is old news.  Dr. Prochaska and his colleagues define the maintenance stage as a busy, active period of change that requires you to learn new coping methods.  They say sustained, long-term effort and a revised lifestyle are the key ingredients to successfully maintaining the changes in your behavior.

As we discussed, there was something about your problem behavior that brought you some kind of gratification. That attraction will still be there long after the habit is broken. It is important to acknowledge that you are still vulnerable to the problem, even though you see it has no value.

Dr. Prochaska and his group identified three common threats to successfully maintaining your new behavior:

1.     Social pressures.  These come from those around you.  They may engage in the behavior you’re trying to change without realizing their actions are having an impact on you.
2.     Internal challenges.  These usually result from overconfidence or other forms of defective thinking. “I’ve been able to stop using my credit card for six months.  This one purchase won’t make a difference.” 
3.     Special situations.  The desire to “keep away from the Joneses and Gateses” and not buy cars that take up 30 percent of your income might be greatly challenged if you get a big bonus.

It is difficult to prepare for these challenges because they are usually unexpected.  Daily temptation and self-blame when urges or relapses hit were prevalent in people who failed to make lasting change.

Successful Change Techniques for People in the Maintenance Stage. People who successfully maintained behavioral change continued to use the change techniques that worked for them.  These brought them success:

Commitment.   Once you’ve changed your lifestyle and moved into maintenance, the threats to your new behavior are fewer and far between. You’ve controlled your environment, developed countering measures, and enlisted support.  That can make it easy to become complacent. Watch for signs like these that show that you have lessened your commitment: “I’ll skip my credit card payment just this month,” “I’ll start saving again next month; I already know that I can.”  Also, always remember to be patient with yourself, and keep your eye on the long-term benefits of your change.

 Reward. Take credit and responsibility for your accomplishments.  Remembering how far you’ve come and praising yourself for it can help keep you connected to how much you’ve already committed yourself.  This can be a great motivator when it comes to sustaining that commitment.

Helping Relationships. Give your helper permission to confront you if you start reverting to old behavior, express overconfidence, expose yourself to tempting situations, or break your contracts.  Also, let your helper know that he or she is “on call.”

Dr. Prochaska suggests making a crisis card for your wallet or pocketbook that also includes a set of instructions to follow if you slip:

1.     Review the problem.
2.     Substitute positive for negative thinking.
3.     Remember the benefits of change.
4.     Engage in rigorous distraction or exercise.
5.     Call my helper. Being a helper to someone with a similar problem is also helpful during the maintenance stage.

Environmental Controls.  Environmental controls are also a key ingredient when it comes to successfully maintaining change.  As your confidence grows, you’ll become more comfortable in the presence of certain temptations, but you may not be totally immune to them.  Continue to avoid people, places, and things that could compromise your change efforts, especially in the early months of maintenance.

Countering.  Dr. Prochaska says that working to create alternative behaviors is one of the most important parts of maintenance.  Make time for something that you’ve always wanted to do.  Countering negative thinking is equally as important.  Plan time to step back, check your thinking, and give yourself a reality check, so that you can keep negative thoughts from gaining a foothold….

The Termination Stage of Change

Termination is the final stage of change.  There is a great deal of debate over whether a behavior is ever truly terminated, or if people spend their lives in the maintenance stage.  Age seems to be a factor.  The older we get, the more likely we are to simply lose our appetite for some of our old behaviors.  Dr. Prochaska and his colleagues did find that some tendencies and behaviors could be terminated.  They identified these four criteria in people who had changed their behavior for good:

1.     A new self-image.  If a major revision in your attitude and self-image takes place during maintenance, there is a good [chance] you will reach termination.
2.     No temptation in any situation.  People who reached the termination stage felt no temptation to return to their old behavior, regardless of the situation. It wasn’t even a thought.
3.     Solid self-efficacy.  People who move from recovering to recovered are convinced that they can function well without ever engaging in their former behavior, no matter what the situation.  This is not false bravado; it’s a genuine self-confidence.  Their focus is on themselves, not their problems.
4.     A healthier lifestyle. People modify parts of their lives during maintenance.  They control their environment, change their social contacts, and counter old behaviors with new healthier ones. When a behavior is terminated, a healthier lifestyle becomes their way of life, without struggle.
Precontemplators don’t enjoy thinking about the consequences of their actions. Ask them to think about how a behavior will play out 5, 10, or 15 years down the road, and they are likely to become defensive and avoid answering the question.

Imagine yourself once you’ve terminated the behavior you want to change. How will you think, feel, and act? How will your thoughts be different?  How will your lifestyle be different?

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