Change isn't easy


  • Health
  • Sunday, 12 Jan 2003

By ERIKA NIEDOWSKI

THE philosopher and psychologist William James once said: “We are stereotyped creatures, imitators and copiers of our past selves.”  

Millions of people prove him right every year when they sit down and make their list of New Year’s resolutions, then come up miserably short of fulfilling any of them.  

Why is it so hard to change?  

Because we’re basically programmed – by our brains, our bodies and the environment in which we live – to do things the way we did them yesterday. And the day before that.  

“The issue about New Year’s resolutions is that there is very little correspondence between what people say and what they do,” says Ellen Ostrow, a Silver Spring, Maryland-based psychologist and professional coach who helps people change behaviours and reach goals.  

UP IN SMOKE: Between 10% and 15% of smokers who try to quit on their own are still cigarette-free a year later.

“Our behaviour is far more regulated by habit and the environment. So we can have the clearest intentions, but after making those (resolutions), without a very, very specific implementation plan, the odds of us following through are minimal.”  

Studies show that the vast majority of people who make New Year’s resolutions break them by the third week of January, says Robert R. Butterworth, a psychologist in Los Angeles who makes resolutions himself but does so “quietly” to lessen the pressure.  

One problem, he says, is that people resolve to do too much: start exercising, stop smoking, lose weight and be nicer to people. “Yeah, right,” says Butterworth. “Try one of those.” 

Another issue, he says, is timing. People are usually exhausted after the holidays and, thus, not well-equipped to make big life changes (Butterworth starts in on his resolutions about the time everyone else is giving up on theirs).  

Many people also decide to make changes for the wrong reasons.  

“In a sense, there’s a lot of pressure to make (a New Year’s resolution) because everyone’s making one. ‘I’ll tell you yours if you tell me mine,’” Butterworth says.  

Twenty years ago, researchers James O. Prochaska and Carlo C. DiClemente developed a model that is widely used by psychologists and clinicians today and which outlines the various stages of behavioural change.  

Though much of their work has been in the field of substance abuse, the “Transtheoretical Model” can be applied to most types of behaviour modification – from shedding pounds to getting more organised.  

“Some require starting a new behaviour. Some require modifying a current behaviour. Others require stopping a problematic or risky behaviour,” says DiClemente, who is chairman of the psychology department at the University of Maryland, Baltimore County.  

He and Prochaska, a professor of clinical and health psychology at the University of Rhode Island and director of the Cancer Research Prevention Centre there, came up with five stages of change: precontemplation, contemplation, preparation, action and maintenance.  

Take someone who wants to quit smoking. In the precontemplation stage, it hasn’t even occurred to him that he should stop. Once he starts thinking about the risks of his habit and why it might be a good idea to quit, he’s moved into contemplation.  

In the preparation stage, he builds up his commitment to stop and creates a plan for doing it – like getting rid of the cigarettes in his house.  

Then he actually does it. That’s the action stage.  

DiClemente says a person has to be in the action stage for at least three to six months before he reaches maintenance.  

There is always the danger, of course, of relapsing into old behaviours. A natural part of the process of breaking habits is stumbling along the way.  

Between 10% and 15% of smokers who try to quit on their own are still cigarette-free a year later. Among those receiving more formal treatment for a range of addictive behaviours, including smoking and using drugs, about 25% to 30% are substance-free after a year, DiClemente says.  

“Relapse has always been seen as failure,” he explains. “But if you recast relapse into a learning experience, then what you can do is kind of help people to say, ‘You didn’t make it, but let’s go forward and see what we need to do (differently). What went wrong?’”  

Though change is almost never easy, it’s most likely to happen when it is intentional, not imposed.  

Steven R. Herr, director of the division of alcohol and drug abuse at the University of Maryland Medical Centre, says wanting to change in response to external influences is the wrong reason. Rather, you have to understand your “sense of self”, your emotions and what is triggering your behaviours in the first place.  

“Behaviour oftentimes is the direct result of emotions,” he says. “You can’t make a change on something if you can’t define it emotionally.” 

Behaviour is also dictated in part by biology, especially in the case of addiction, since using drugs can actually modify the chemical make-up of the brain and how it works. In fact, many scientists now consider addiction a brain disease.  

Dr Alan I. Leshner, head of the American Association for the Advancement of Science and former director of the National Institute on Drug Abuse at the National Institutes of Health, calls addiction the “quintessential biobehavioural disorder”. 

“Modern science has taught that it is much too simplistic to set biology in opposition to behaviou or to pit willpower against brain chemistry,” he wrote in the journal Issues in Science and Technology last year. “Addiction involves inseparable biological and behavioural components.” – LAT-WP  

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