How People Change
06/11/11: Have you ever wondered what the stages are of making change in your life? Or do you have someone in your life that is trying to make a change and you wish you could know how to be more helpful? The following post will give a brief overview of the stages of change, give some ideas on what you can do to make changes in your life, and help someone else make change in theirs.
How Do People Change?
At the core, psychotherapy is about creating change, and there have been literally hundreds of theories created over the years to explain how people change. Generally, these range from altering thought patterns, processing emotions, making the unconscious conscious, reinforcing behavior, connecting to our mortality (like having a major health problem), developing new relationships, experiencing major consequences, providing incentives, learning and having new experiences, or connecting to something greater than the self. Unfortunately, during this time in world history, no one really knows for sure yet what the best approach is, but there is evidence that all of these and many more actually work, which is part of why counseling often uses them all.
Despite this range, one thing that we do know is the stages of change that we all move through. With a few exceptions (like when there is an immediate and overwhelming reason to change), this model holds true. This Transtheoretical Model of Change can be applied to almost anything, and it has incredible research support as well. The stages are:
1. Precontemplation: the person is not planning to make a change and is likely unaware that the behavior is problematic
2. Contemplation: the person recognizes that there is a problems and is considering making a change sometime in the future
3. Preparation: the person is planning to make a change in the near future and is starting to take small steps
4. Action: the person is implementing the change
5. Maintenance: the person has stabilized the change and is actively keeping it up
A classic example of this would be someone trying to quit smoking. In precontemplation, the person smokes and is either unaware that this is a health risk or is uninterested in making changes anyway. In contemplation, the person may know that smoking is a health risk and has the idea of wanting to quit in the future, maybe within the next 6mo or a year. In preparation, the person is researching how to quit, may set a quit date, and is ready to make the change happen within the next month or so. In action, the person has begun the process of cutting down or quitting; and in maintenance, the person has held to the change.
If you are looking to make a change in your life, it means you are already at least in contemplation. If you are there, you may start to think about what the next steps are for making the change, or what is preventing you from taking the next step right now. If you are in preparation, maybe this article is giving you more information to do what you are trying to do. A helpful thing in this stage can be setting a timeline for implementation, or accessing more resources to make it happen, like going to counseling.
Can I Change Someone Else?
Questions about how to change someone else are some of the most common things I get asked in therapy. Since relationships are so central to most of our lives, when someone is doing something disruptive, we often wish the person would just change and make everything better. Unfortunately, we are going to go with the bad news first: 90% or more of efforts to change someone else are futile, especially if the person is in precontemplation. Conventional wisdom says that we cannot change others, but we can change our reactions to them. Based on that, I'd encourage you to read these three other articles first instead of this one if you are someone who is often hoping for other people in your life to change: Acceptance Model of Relationship Change; Over-functioning & Under-functioning; Universal Curative Factors.
So if you are still looking to change another person, it can be important to keep the aforementioned stages in mind, and realize that this is a long term process, rather than something that will instantly happen. Otherwise, there are three major approaches to take in trying to change someone else: voicing a concern / making a request, motivational interviewing, and long term conditioning. However, remember that much of this may not be received well by the other person if they feel coerced or if their best interest in not stated well.
1. Voicing Concern / Making a Request: It's amazing how often we skip simply saying that something is hurtful or that we are concerned about the person. If it is done, usually I hear about it being said in frustration or in a heated argument, which is usually not effective. Basically, doing this well can be tricky, so using the model of How to Say Hard Things can be a potential guide for another approach.
2. Motivational Interviewing: The key with this is in helping people to move through the stages of change by directing specific interventions toward them. For someone in precontemplation that would mean providing some information to help the person recognize that there is a problem and there is a need to change. In contemplation it would mean identifying and removing specific barriers to change. In preparation it would mean assisting the person in planning the actual change. In action it would mean supporting and validating the progress. In maintenance it would mean reinforcing and support the change that was made to help the person stay on track. All of these must come in a supportive and compassionate environment to be effective.
3. Long Term Conditioning: The key here is setting up a consistent set of rewards and punishments for certain behaviors that can result in change over longer periods of time. The basics of this are implementing things that will make the target behavior unlikely to happen again, which include positive punishment (adding something unpleasant) or negative punishment (taking away something pleasant). Additionally, things that will make another behavior more likely to happen again include positive reinforcement (adding something pleasant) or negative reinforcement (removing something unpleasant). Over extensive periods of time, if something like this was applied, it would be likely to produce at least some kind of change in someone else, as long as it was consistently applied, the rewards and punishments were sufficient, and tied to the behaviors directly.
Enemies of Change
The enemies of changing yourself or helping someone else change are criticism and impatience. Being critical and judgmental often has the opposite of the hoped for outcome. A lot of people come into my office and describe criticizing someone or voicing concern in a judgmental tone, and they are "shocked" that the response wasn't something like "wow you know... I never saw it that way before. I will change that right away! Thank you for telling me!" Instead they end up receiving defensiveness, a deeper entrenching of the problem, and a more tense relationship. Impatience is equally damaging, since it can take a long time for change to happen. Losing patience can stunt your progress, or that of the other person.
In conclusion, I often think it is more beneficial for people in close relationships or other interpersonal situations to work on acceptance, tolerance, and personal change rather than changing others, but there is occasionally a place for doing some of these things within a supportive and loving relationship. Fortunately, counseling can help you move through these processes or work on acceptance and making the best of what is possible without requiring a change.
How Do People Change?
At the core, psychotherapy is about creating change, and there have been literally hundreds of theories created over the years to explain how people change. Generally, these range from altering thought patterns, processing emotions, making the unconscious conscious, reinforcing behavior, connecting to our mortality (like having a major health problem), developing new relationships, experiencing major consequences, providing incentives, learning and having new experiences, or connecting to something greater than the self. Unfortunately, during this time in world history, no one really knows for sure yet what the best approach is, but there is evidence that all of these and many more actually work, which is part of why counseling often uses them all.
Despite this range, one thing that we do know is the stages of change that we all move through. With a few exceptions (like when there is an immediate and overwhelming reason to change), this model holds true. This Transtheoretical Model of Change can be applied to almost anything, and it has incredible research support as well. The stages are:
1. Precontemplation: the person is not planning to make a change and is likely unaware that the behavior is problematic
2. Contemplation: the person recognizes that there is a problems and is considering making a change sometime in the future
3. Preparation: the person is planning to make a change in the near future and is starting to take small steps
4. Action: the person is implementing the change
5. Maintenance: the person has stabilized the change and is actively keeping it up
A classic example of this would be someone trying to quit smoking. In precontemplation, the person smokes and is either unaware that this is a health risk or is uninterested in making changes anyway. In contemplation, the person may know that smoking is a health risk and has the idea of wanting to quit in the future, maybe within the next 6mo or a year. In preparation, the person is researching how to quit, may set a quit date, and is ready to make the change happen within the next month or so. In action, the person has begun the process of cutting down or quitting; and in maintenance, the person has held to the change.
If you are looking to make a change in your life, it means you are already at least in contemplation. If you are there, you may start to think about what the next steps are for making the change, or what is preventing you from taking the next step right now. If you are in preparation, maybe this article is giving you more information to do what you are trying to do. A helpful thing in this stage can be setting a timeline for implementation, or accessing more resources to make it happen, like going to counseling.
Can I Change Someone Else?
Questions about how to change someone else are some of the most common things I get asked in therapy. Since relationships are so central to most of our lives, when someone is doing something disruptive, we often wish the person would just change and make everything better. Unfortunately, we are going to go with the bad news first: 90% or more of efforts to change someone else are futile, especially if the person is in precontemplation. Conventional wisdom says that we cannot change others, but we can change our reactions to them. Based on that, I'd encourage you to read these three other articles first instead of this one if you are someone who is often hoping for other people in your life to change: Acceptance Model of Relationship Change; Over-functioning & Under-functioning; Universal Curative Factors.
So if you are still looking to change another person, it can be important to keep the aforementioned stages in mind, and realize that this is a long term process, rather than something that will instantly happen. Otherwise, there are three major approaches to take in trying to change someone else: voicing a concern / making a request, motivational interviewing, and long term conditioning. However, remember that much of this may not be received well by the other person if they feel coerced or if their best interest in not stated well.
1. Voicing Concern / Making a Request: It's amazing how often we skip simply saying that something is hurtful or that we are concerned about the person. If it is done, usually I hear about it being said in frustration or in a heated argument, which is usually not effective. Basically, doing this well can be tricky, so using the model of How to Say Hard Things can be a potential guide for another approach.
2. Motivational Interviewing: The key with this is in helping people to move through the stages of change by directing specific interventions toward them. For someone in precontemplation that would mean providing some information to help the person recognize that there is a problem and there is a need to change. In contemplation it would mean identifying and removing specific barriers to change. In preparation it would mean assisting the person in planning the actual change. In action it would mean supporting and validating the progress. In maintenance it would mean reinforcing and support the change that was made to help the person stay on track. All of these must come in a supportive and compassionate environment to be effective.
3. Long Term Conditioning: The key here is setting up a consistent set of rewards and punishments for certain behaviors that can result in change over longer periods of time. The basics of this are implementing things that will make the target behavior unlikely to happen again, which include positive punishment (adding something unpleasant) or negative punishment (taking away something pleasant). Additionally, things that will make another behavior more likely to happen again include positive reinforcement (adding something pleasant) or negative reinforcement (removing something unpleasant). Over extensive periods of time, if something like this was applied, it would be likely to produce at least some kind of change in someone else, as long as it was consistently applied, the rewards and punishments were sufficient, and tied to the behaviors directly.
Enemies of Change
The enemies of changing yourself or helping someone else change are criticism and impatience. Being critical and judgmental often has the opposite of the hoped for outcome. A lot of people come into my office and describe criticizing someone or voicing concern in a judgmental tone, and they are "shocked" that the response wasn't something like "wow you know... I never saw it that way before. I will change that right away! Thank you for telling me!" Instead they end up receiving defensiveness, a deeper entrenching of the problem, and a more tense relationship. Impatience is equally damaging, since it can take a long time for change to happen. Losing patience can stunt your progress, or that of the other person.
In conclusion, I often think it is more beneficial for people in close relationships or other interpersonal situations to work on acceptance, tolerance, and personal change rather than changing others, but there is occasionally a place for doing some of these things within a supportive and loving relationship. Fortunately, counseling can help you move through these processes or work on acceptance and making the best of what is possible without requiring a change.
