What Do You Want to Change?
Have you ever had a family member or friend who had a glaring problem that you knew they needed to change, but they did nothing about it? Have you struggled with change yourself? We all typically would like to change something about how we manage ourselves or our lives: diet, exercise, finances, time management, unhealthy habits, fear, or anger.
There are usually great tips out there for how to achieve change. The simple formula for weight loss is, “eat less, move more.” To quit smoking, just throw out your cigarettes and use a patch or gum. Balancing your budget? Cut back on non-essentials, work more, and pay down your debt. Have a stubborn fear? Just face your fears and get over it. Find yourself angry often? Just breathe and count to ten. Change seems so easy, but we know the reality is that change is challenging. Even those exciting infomercials that make change look so easy include a disclaimer that the positive results shown are, “not typical.” It is hard for us, and hard to see our love ones struggling with change, especially when an unhealthy habit might lead to serious medical problems or death.
Researchers Carlo DiClemente and James Prochaska originally developed a theory of how people change including stages of change. These will likely resonate with you as you think about times you tried to change something about yourself or you watched someone change or try to change. In the first stage, Pre-Contemplation, a person does not feel they have a problem. Think of a smoker who says, “Smoking doesn’t hurt me! My grandfather smoked his whole life and lived to one hundred!” In the next phase, Contemplation, an individual may begin to consider that they have a problem, like a gambler who sees their losses mounting and their debt climbing.
In the third phase, Preparation, a person takes steps to prepare to change, such as an overweight person who pays for a gym membership and sets an appointment with a dietician. People in the Action phase of change have started acting differently, such as a family that has developed a budget and is sticking to it by tracking their expenses and cutting back on spending. After several months of keeping up a new habit, a person has entered the Maintenance phase, like someone who previously feared elevators but now uses them consistently for several months. This is the kind of story we like to hear, of successful change.
However, we know that many people enter another phase of change called Relapse. Very frequently, with all kinds of behaviors, people “slip” and resort back to unhealthy habits. An example would be an alcoholic who has been sober for two years but after losing his job starts to drink again. Fortunately, the cycle can begin again and that drinker may again start to contemplate that the drinking is not helping, start attending Alcoholics Anonymous, and return to sobriety.
At Apalachee Center, Inc., we understand that our clients are all at different stages of change and use empirically supported therapeutic techniques to help them change, such as Motivational Interviewing that is based in part on the stages of change theory. In the case of severe and persistent mental illness like schizophrenia, bipolar disorder, depression, and substance abuse, issues arise when individuals struggle with recognizing they have a problem, attending appointments, taking medication as prescribed, and refraining from using drugs or alcohol.
However, the reality is that all of us at times may struggle with the same issues. Have you ever skipped a doctor’s appointment? Did you ever stop taking antibiotics before completing the full course, or not follow your prescription fully? Did you ever drink when your medication bottle said not to? People with severe mental illness struggle with the same obstacles to change that we all do. We believe the best response to this struggle is compassion, empathy, support, and encouragement. We encourage you to do the same for yourself and others in your life as we all strive for positive change.
~ Mark Reeves, Ph.D.