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Strategies that keep history from repeating itself by Patrick Mahlen O’Neil, Ph.D. Weight Management Center Here’s a news flash from some well-known psychologists: If you don’t want to make certain changes, or you’re not ready to do so, you may not have much success making those changes.   Admittedly, it’s not much of a surprise when you read it like that, so it’s tempting to wonder why this principle should be cause for attention, much less a self-help book. Begin your wondering with past behavior change attempts that crashed and burned.  You may find if you’re both honest and observant, that most of your failed efforts were efforts that you weren’t ready to take on.   For example, weight loss. Of course you were ready to lose weight each and every time you started a diet. But that wasn’t the question. Were you ready to make the changes required to lose weight? Were you ready to give up high calorie snacks? Were you ready to start and maintain an exercise program? It’s not a moral issue, just one of timing.   In their book “Changing for the Good”, psychologists James Prochaska, John Norcross and Casrlo DiClemente explain for the layman how people go through different stages during the course of deliberately changing behaviors (1994, William Morrow and Co., $22). The volume is not so much a self-help book as it is a self-examination book for people who’ve had trouble making important but difficult changes in behaviors such as eating, smoking, drinking, exercising, etc. Exploring the author’s ideas may help you to keep history from repeating itself.   The authors in their research have noted that there seem to be six sequential “stages of change” that people progress through if they are successful at behavior change. Each stage requires different strategies to get to the next.   The stages apply to an individual with respect to a specific behavior. You can be at different stages for different behaviors. Briefly the stages are: Precontemplation: A generous description for the state of the person who has no intention to change in the near future, little awareness of the need to change, and no interest in examining the need to change. The only change the precontemplater is interested in is getting those naggers off his or her back. Contemplation: The person acknowledges that there is a problem in the need of changing and is seriously considering doing something about it, but not just yet. In contemplation, say the authors, “You know your destination, and even how to get there, but you are not quite ready to go yet.” Preparation: here the person is intending and planning to take action soon and may commit to the change. People who make good use of the preparation stage do just that, take time to prepare their course of action. People who “prepare” endlessly are just stalling. Action: This is where you actually get moving and make changes, where you cut out that nightcap of chocolate cake, throw out the cigarettes and lighter, pour out the booze, or actually take that first walk.   Although this is the stage we associate with change, most people have to go through the previous three stages just to start here. This is also the stage you’re assumed to be in by most diet programs, exercise programs, and diet authors, present company excepted. Maintenance: Here the person is trying to keep those new changes alive, recover from slips and avoid relapse. This is where you realize that it’s not enough to start change; you have to stay changed. Maintenance of course is a particularly challenging stage for people changing behaviors related to weight control. Termination: It’s thought that at this stage the person isn’t even tempted to resume the old behaviors. This is the pot o’ gold at the end of the stages of change, and it probably doesn’t exist for many behaviors, including some necessary weight control. However, many successful changers report that fleeting temptations just don’t pack the wallop that they used to. What keeps all this stage business from being merely academic is that the tools that work best to encourage change are different at each stage. What you should be doing depends on the stage you’re in.   If you’re at the precontemplation stage regarding a weight problem for example, you could be given a dozen diet books, free membership in a weight control program, and fancy exercise togs but it’s still unlikely you’ll put any of it to meaningful use. Exposing yourself to information about problematic consequences of not changing is one of the most productive “processes of change” at the precontemplation stage.   The authors discuss in their book the most productive strategies to employ during each of the other stages, with plenty of examples, and many practical tips including some on using and preserving your relationships while trying to change. There are self-evaluation quizzes to see where you stand.    Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to petersnd@musc.edu or catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Community Press at 849-1778.