Feature Article

How Change Happens: Turning Good Intentions Into Good Health

Maybe you'd like to finally, really, give up smoking. Or you want to lose the extra weight that's causing your blood sugar and cholesterol to rise. Your problem behavior could be one that's less obvious to others, such as using alcohol, prescription painkillers or illegal drugs to cope with stress, anxiety or depression.

You've waited for the magic moment when you'll be able to change. Wishful thinking hasn't worked. Neither has making a resolution you can't possibly keep ("I'll go to the gym every day"). You may even have decided that you can't change because you're not as capable, deserving or simply lucky as other people.

Well, it's time to give yourself a break. A growing body of scientific research shows that behavior change doesn't just happen by accident or to a special, chosen few.

Instead, change comes through a deliberate process, one that has its own developmental stages. You're more likely to succeed when you complete the elements of each stage in the process. It often takes several attempts. So, if you've tried to make changes before and failed…you're normal!

"It's like building a house. You've got to accomplish each task well enough to support the next step. If you don't get the foundation built well, then it's going to crumble," says Carlo DiClemente, Ph.D., chair of the Department of Psychology at the University of Maryland, Baltimore County, and researcher/co-creator of this scientifically proven system of self-change. In the book Changing for Good: The Revolutionary Program That Explains the Six Stages of Change and Teaches You How to Free Yourself from Bad Habits (William Morrow and Co., 1994), DiClemente and his co-authors use their research findings to show how to move from protecting our unhealthy behaviors to making change really happen.

Consider, then commit
Change isn't easy. The earliest stage in the process, called precontemplation, is a quicksand pit in which we deny or justify our bad habits and resist change. It's a comfortable place to slip back to when things get tough. One study of women who stopped smoking while pregnant showed that those who were only in precontemplation about not smoking after delivery were most likely to start smoking again when their babies were born.

More likely, you're in the contemplation phase--you'd like to change a behavior and are thinking about doing so. This is the time to learn more about your problem, talk about it with others, and examine why you want to change. Look closely at what scares you about changing, such as having a new self-image, experiencing nicotine withdrawal or losing certain friends. Identify both the "pros" your change will create, as well as the many "cons" that may undermine your efforts.

"Part of why it's hard to change is that the unhealthy behaviors we perform, like sitting and watching TV and eating sweet treats, are very rewarding behaviors," says Bess Marcus, Ph.D., professor of psychiatry and human behavior and director of the Physical Activity Research Center at Brown Medical School, Providence, RI. "It is not just that people may have difficulties with starting to exercise or starting to eat a healthier diet, but they have to give up things they like."

Working through the process gradually builds motivation and readiness until you commit to making the change a priority in your life.

How To Get Started: Create a plan, then act
You need to work out, in detail, what actions you'll take. Ask yourself how will you make the change and determine the details:

This preparation stage is the time to tell people about your commitment. Develop a timeline for putting your change plan into action by small steps. "There isn't a single, successful way to do it," says DiClemente. "Building an organized plan that will work for you is really the heart of it." Good preparation is key to realizing your goal.

In the action phase, your plan is tested by real experience. It may work or you may need to deal with problems that arise. That's when having gone through the change process and making a strong commitment really pays off. Instead of giving up, you create an alternate plan and put it into effect.

The long-term maintenance stage can also be challenging, too. Use strategies that help: Stay away from after-work socializing if it threatens maintaining your healthful change. Prepare in advance for what you'll do if your walking buddy moves away and upsets your exercise routine, or a family crisis tempts a return to unhealthy eating, drinking or smoking. Brown Medical School's Marcus suggests you focus on the benefits of your new lifestyle, seek out supportive friends and reward yourself for success.

Remember: Setbacks aren't failures, if you learn from them. "Most people have to go through the process several times until they get it completely right," DiClemente says.

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