New Year’s has come and passed. Across America many well intentioned people bought gym memberships, vegetable steamers, yoga mats, and more tools to make this their healthies year ever. However, as we head into mid-February, the classes at the gym are starting to thin and food dehydrators, veggie steamers, and smoothie makers are starting to show up on Craigslist and at Goodwill. As a population we are filled with best intentions, but tend to lack on follow-through. The question is, why isn’t buying new tennis shoes and signing up for a gym membership enough to make a new exercise habit stick?
The million dollar answer is simply that our behaviors do not occur in a vacuum. Our previous experiences, environment, interpersonal relationships, physical ability, and spiritual beliefs each impact our ability to implement a behavior change. In a previous blog, I discussed the 6 dimensions that comprise the human Wellness Continuum. It is important to nourish each of the dimensions of your human spirit in order to have the greatest chance of success for behavior change.
Understanding the Stages of Behavior Change Can Impact Your Likelihood of Success
As you have crossed into the New Year, it is natural to reflect upon your behaviors and experiences of the past. This can often turn into a period of frustration for all that you had previously planned, but did not accomplish. After many years of desiring to make changes, without necessarily following through, it is easy to get lost in the process. However, the beauty of life is that there is always a new day ahead. There is a health behavior theory called the Transtheoretical Stages of Change that describes the processes you move through for behavior change.1 Sometimes recognizing what you are and are not doing is helpful in determining where you need support in order to be successful.
The first stage of the behavior change process is pre-contemplation. During this initial phase, you are not even considering changing your behavior. For example, an overweight person may have tried to lose weight unsuccessfully so many times that they have simply given up. Typically in this stage either you don’t realize you ought to make changes or you don’t want to make changes. However, as soon as you begin to consider if a change should be made, you move into the next stage, Contemplation.
During the contemplation stage, you are evaluating whether a behavior change is something you want to tackle. People may move from precontemplation to contemplation because of a health scare, knowledge of someone else having an issue, or information in the media about the topic. However, during this stage you may find yourself in an internal struggle because giving up a behavior may create a sense of loss, even though you know the result is healthier. Also, during this stage you typically assess the barriers (time, cost, availability, fear, social implications, etc.) as well as the perceived benefits of the new behavior. If the benefits outweigh the barriers, you are likely to move to the next stage of Preparation.
This is the stage that many Americans excel at, as it often involves buying supplies. Preparation is the stage where you are setting yourself up to be able to implement the behavior change. For many this involves buying new workout clothes, a fit bit, cookbooks, supplements, kitchen gadgets, or maybe even a gym membership. The problem lies in the fact that many people struggle with moving beyond this phase. There is a certain adrenaline rush from acquiring the “stuff” needed to implement the change. What happens next is what allows fitness centers to be profitable and turns home treadmills into laundry racks. People often don’t ever start the new behavior or they do it so few times it does not have a chance to become a habit. If all the patrons who owned a gym membership visited it during a 24 hour period, most gyms would exceed facility fire code maximums for the day. However, fitness centers know they can sell hundreds of memberships because most people will never come. The trick is finding ways to prepare yourself for change that aren’t costly, to be sure you are emotionally invested in the behavior, and to get someone else involved. You are more likely to successfully move from preparation to action with a good plan and social support. A great example is deciding to try to get in shape by creating a plan to take a walk each day during your lunch break with a coworker or each evening after dinner with your spouse or neighbor. Once you have your plan, you are ready to get started, which moves you to the stage of Action.
Now that you have the gear, and hopefully an implementation plan and a support system, action is the stage where you are actually enacting the behavior change. This is when you are walking, attending a yoga class, cooking healthier recipes, getting to bed early, watching less television, spending more time outside, etc. The keys to success in the action stage are to:
Choose changes you are likely to enjoy;
- set realistic goals;
- not tackle too many changes at once;
- plan for the unexpected;
- find a support system, through interaction with people or a tracker app; and
- allow yourself the grace to need a day or two off (just be sure you get back at it)
This is the stage where the behavior has become a part of your culture. Sometimes this is easy, and sometimes it can be difficult. For example, if you walk or run outside all summer and enjoy it every day, you are likely to have success with your goal of exercising for at least 30 minutes most days of the week. However, as winter arrives the daylight dwindles and temperatures drop. It may become more difficult to motivate yourself to continue your activity. This is where creativity and flexibility become important. Perhaps you can walk inside at the mall, walk on a treadmill for the winter, join a fitness class for the winter, or find a workout buddy to help you feel safe in the dark and keep you motivated.
People will often cycle from maintenance back to previous stages in the model. The trick is figuring out how to move yourself back to action and then Maintenance as soon as possible.
Termination or Relapse Prevention
The final stage in the model is called Termination because it was originally developed to describe the behaviors of individuals working on smoking cessation. However, a better term for many health behaviors is Relapse Prevention, as you want to implement a positive behavior change and keep doing that new positive behavior, avoiding a relapse back to a time when you were not participating in the positive health behavior. One you have been participating in a health behavior for a significant period of time, you need to give yourself permission to sometimes take a break from the behavior occasionally, but not one so long as to compromise your progress and spin you back to the start. An example would be allowing yourself a few days off from exercise when you are ill or allowing yourself a little leeway on your diet while on vacation.
However, even if relapse does occur, you will have likely learned valuable information in the process. Perhaps you learned that you needed to find an exercise alternative when the seasons changed, or you need to buy little toys or trinkets to give away on Halloween next year instead of having candy in the house, or that binge watching your favorite show leaves you anxious and unable to fall asleep. Whatever the behavior, if you take a moment to self-analyze you will be able to learn valuable information on why you likely relapsed, which you can then apply to a new plan when you decide you are ready to implement the behavior change again.
Pulling It Together
Now that we are a ways into the New Year, take a moment to reassess the behaviors you have been hoping to change, whether it is sleep, brain challenges, nutrition, meditation, exercise, socialization, or all of the above. You have just moved yourself into Contemplation. The next step is to choose one behavior that you can set small, measurable goals for and develop a plan of action, whether that means checking a book out from the library or downloading a free language app to your iPad, you have transitioned to Preparation. This is the crossroads where so many people stall out. If you choose a small and attainable goal, you will have a greater chance of implementing your behavior change. Getting to that next step of Action means you are actually logging into that language app and practicing a new language for 5 or 10 minutes each day or making sure to drink a large glass of water with every meal.
Start small and with skills you are likely to have the greatest likelihood for success. Then, as those behaviors become part of your routine you can try adding in additional behaviors to change. Also, with each health behavior change, after a few weeks, a few months, and hopefully after a few years, you will periodically need to find ways to keep it relevant and fresh, or adjust your goals or schedule to make sure you can keep doing it. Perhaps you want to add an incentive for yourself, like if I walk 20 days each month, then I can go to the movies with a friend. Just find a way to keep yourself excited and engaged so that your behavior change stays in Maintenance. Remember that if you drop back to an earlier stage because of vacation, illnesses, or scheduling changes, don’t give up. Instead reassess the situation and find a new way to implement a similar behavior change that is amenable to your current situation.
Life is a journey with curves in the road. Sometimes we have to amend our travel plans to adapt to a new path that is put in front of us. The RE:mind program we offer identifies the many metabolic and lifestyle factors affecting your cognition and then helps you navigate the process of addressing the recommended changes. Whether you are going it alone or as part of our program, RE:mind yourself that these behavior changes are worth it to preserve your cognition. Your past memories and future plans depend on it. You’ve got this!
- Prochaska JO, Norcross JC, Diclemente CC. Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward. New York: Avon Books; 1994.
Written by Marci L. Hardy, PhD
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