Article

We are creatures of habit.  We learn to do things a certain way, and that’s how we do them.  “We’ve always done it like that!” is a common statement of resistance to change.  And most people don’t like change (although some of us do!).  But every so often, there comes a time when you know you have to do something differently, and you are resigned or willing, and able.  Or perhaps you are the one teaching people how to make changes, and want to help them over the hurdles as gently and efficiently as possible.

A few years ago I found a model that describes the steps people go through when making changes.  It is called The TRANSTHEORETICAL MODEL or Stages of Change Model, and it was created by James O. Prochaska, Ph.D., of the Cancer Prevention Research Center at the University of Rhode Island.  It is used a lot by public health educators to monitor and encourage health behavior changes.  I found it a really good tool to help me understand where people are in their efforts to improve their eating regime and their health.  You can use it for yourself or for those you work with, including clients, family and friends, more as a model for your own understanding than to manipulate others.

Prochaska points out a really important detail:  stopping unhealthy behaviors and implementing healthy ones doesn’t happen overnight, it happens one small step at a time. In fact, it happens in clear and distinct stages.[1] The following, then, are the Stages of Change, as I would see them, for example, in a woman who needs to eliminate sugar from her diet.  (I choose this scenario for the practicalities of grammar, but I just as easily could have picked a man with the same problem.)

Stage One:  Precontemplation.  She does not know, nor does she care, that she needs to eliminate sugar from her diet to stop her cravings for sugar.  That is, there is no thought given to the possible change in question.  Even if others (friends, family, nutritionists) make comments or suggestions, she does not hear them, she barely acknowledges them, and has plenty of excuses to ignore the problem.

Stage Two:  Contemplation.   She has decided that she has a problem, and is considering possible ways of dealing with it.  Finally, one of her decisions is to stop eating anything with refined cane or corn sugar in it -- soon.  It may take a month, or six months, but she is actively thinking about the change and making inner preparations to deal with it.  What she is also thinking is about the problems and obstacles in her way to initiate the change: what habits does she need to break?  Her morning doughnut, the candy snacks everyone shares at the office, the two teaspoons of sugar in her coffee,  her pint of ice cream three or four times a week.  Not so easy!  She’s not ready yet.  How will she spend the time with her girlfriends if it is not eating ice cream together while they’re talking about life?  She could not possibly be the only one not partaking!  Would she have to explain what she is doing?  How would they take it, would they laugh, commiserate, get upset?  Not yet.  She does not want to deal with all those issues yet.  This stage could go on for a long time.

Stage Three:  Preparation.   OK, this is it, she has now made the decision to stop eating sugar.  How will she do it, and who will she engage to help her?  She reads books, talks to people, makes a list: where in her diet is the sugar, how to substitute for it.  She decides against artificial sweeteners, there are too many questions about them;  she’s going to go the natural way.  Does she need a counselor, coach, or nutritionist?  She does a little run-through -- one day with no sugar at all.  Oh, that is HARD!  She has to be thinking about it all the time, watching every bite she eats.  Yet, having accomplished one day, she feels encouraged and strengthened.  She makes an appointment with a healthy eating  counselor.

Stage Four:  Action.  The day before she goes to her appointment, she eats a whole pint of vanilla chocolate chip ice cream.  It’s sort of a “loved you - goodby” statement.  She goes to the counselor, who reinforces what she already knows: it’s time to quit sugar.  When she gets home she makes out her plan of action.  First, every day one half-teaspoon less of sugar in her coffee.  Second, replace the doughnut with either hot whole grain cereal (oatmeal is her preferred choice in cool weather), or whole grain bread with almond butter.  Third, instead of ice cream, she buys some nice ripe bananas, peels them, cuts them in chunks, and freezes them in a ziplock bag, so that she can have some if the urge hits.  (Converting her girlfriends is left for another day.)  For the office, she finds some good snacks in the health food store such as pitted dates, Plum Candy and Yinnies (made with grain syrups).   She starts her program, and sticks to it.  Hooray!  She’s off the sugar.  Her energy and moods improve steadily.

Stage Five:  Maintenance.   She’s off, she’s on.  She slips - couldn’t resist on the gabfest with the ice cream - but next day her resolve kicks back in and she remains firm.  After about six months, she notices it takes less and less effort.  Now, instead of having to think about NOT eating something with sugar, she contemplates whether to have it anyway.  And if she has a few sugar days, she notices a distinct change in how she feels, with lower energy and moodier thoughts.  As she has gotten used to feeling great most of the time, that alone is a good prompting to keep her on the sugar-free path.  And as the years go by, it becomes the normal way for her, with less and less lapses because of lack of interest in eating sugared foods.

There is another possible scenario after maintenance, called Termination.  This shows up if she decides the whole thing is not worth the trouble, and she’d rather die young eating ice cream than old without it.

So where are you in your changes?  I can tell you, I am really slow in the contemplation department.  I think it took me about ten years to make up my mind to go for a doctoral degree.  Once I make up my mind I move faster, but I know how hard it is to make real changes in your life.  However, I think changes are good for you, and necessary, otherwise life would be way too boring.  And what I can tell you is that once you start thinking about making some kind of change (a new diet, moving, going to school, getting married, having children, even getting divorced), you better do it sooner or later.  I believe that once you start Stage Two, your bodymind is telling you, this is the way to go.  If you don’t go that way, it will always feel like unfinished business.  It’s more fun to go and then terminate the process if it didn’t work out!

Here is a sugar-free and dairy-free recipe for “ice cream.”

Banana-Apple Ice Cream

1 ripe banana, peeled, sliced, frozen overnight in a ziplock bag

1/2 - 2/3 cup apple juice

1/2 tsp vanilla extract

Put the all ingredients in the blender and blend until creamy, adding apple juice if needed for a soft freeze texture.  Eat immediately.  Makes about 1 cup.

References

[1] . James O. Prochaska and others, “The Transtheoretical Model of Change and HIV Prevention:  A Review,” Health Education Quarterly 21, no. 4 (Winter) (1994): 471-486.

© 2001 by Annemarie Colbin