In the early 80's, researchers wanted to understand why somewhere between 1-5% of the U.S. population would die of smoking-related diseases. These are an almost uniquely preventable source of death. Just stop smoking. Of course, addiction plays an important role in such a question. But the researchers wanted to know not why so many smokers couldn't quit, but why so many smokers wouldn't even try.
This model is a striking one. Not for its almost trivial description of the stages of change. But because it highlights something fundamental to the human condition---that the window for our openness to change is a very small one indeed.
Stage one: Resistance and denial
The vast majority of the time, humans are resistant to change. Our accumulated years of adapting ourselves to the world around us often makes us unwilling to try risky new ways of being in the world.
And, thus, for many, we occupy the first stage of the model. The 'Precontemplation Stage', as it is called, is characterised by a lack of recognition that there is a need to change. We therefore, often, have any intention of doing so. If we aren't avoiding the subject entirely, we're defending our behaviour and will reject any arguments to the contrary.
For the change-maker---therapists, rehabilitation specialists, 'deprogrammers'---this stage feels the most helpless. Outside of physically eliminating the problem, there isn't much one can do.
Stage two: Recognition
The next stage is one characterised by thought. Called more properly the 'Contemplation' stage, there is a clear cognitive shift in that the need for change is recognised. This recognition may be more or less developed, but one begins here to weigh up whether there is some new way of being in the world worth occupying.
While this new insight may sound like a step forward from the outright denial of our earlier stage, we aren't yet, necessarily, at the point of intervention.
You see, here we are engaging in something like a cost-benefit analysis. Unless we can see that the pros of changing outweigh the cons of remaining the same then nothing will change. It is, therefore, a stage still often characterised by resistance. Overt signs of encouragement to change might be seen as 'pushiness' and the result is often defensiveness.
For the change-maker, the key here is quiet support and agreement, only when our person-in-need indicates that they are contemplating change. Raising issues that they haven't raised often takes us into a space the looks and feels much more like stage one.
Stage three: Preparation
Here, the need for change has been finally been accepted and our person-in-need is starting to make the necessary preparations to enact it. However, there are still large risks lurking. These preparations represent a time of great turmoil as our person-in-need begins to get a sense of the change ahead of them. Under the pressure to change well-trained habits, with a long and difficult road stretching out in front, the idea of creating 'action plans' and meet deadlines can seem stressful and difficult.
In the effort, the key is to provide support in a way that doesn't contribute to a sense of being overwhelmed by the change at hand. The best support comes in the form of helping to sharpen or facilitate plans, and to break problems into smaller, and more manipulable pieces---to help our person-in-need see that the task ahead isn't quite as impossible as it might feel.
Stage four: Action
Now the preparations are complete and the plans have been enacted, but we're not yet out of the woods. While we might feel a great deal of openness to the need and the means of change, the temptation of relapse is quite high. We haven't yet made our new way of being in the world a habit, and slipping into old habits is an ever-present threat.
The hold our old patterns of thinking and behaving have on us is enormous---far more resilient than we might like to admit. This made more difficult by the fact that there may be resistance to change from others around us who have yet to see the need to change.
For change-makers, it is something of a return to helplessness. Encouragement where one can, but a withdrawal from active assistance. If our person-in-need fails to achieve a sense of mastery over their own path to change, the chances of relapse are much higher.
Stage five: Maintenance
The fifth stage is action, but longer. Clinicians normally classify someone as having moved into maintenance after about 6 months. There still may be a chance of relapse, but this risk declines over time. All change-makers can do is continue to encourage, with emphasis on support when our person-in-need expresses fears or temptations to relapse.
Stage six: Relapse
Our old patterns being as powerful as they are, it is very likely that at some point along the path we will experience some form of relapse. Taking on old behaviours, or patterns of thinking to a greater or lesser extent. Such relapse can happen at any time, though the risk declines to the extent we practice our new way of being---with time, with integration, with deliberate engagement.
Yet, relapse isn't always a bad thing. In fact, it's often a moment of important reflection. One can use a relapse to identify where plans were over-ambitious, or where the sticking points exist. It's a setback, but sometimes setbacks are necessary to clear obstacles that we could not recognise.
That said, our person-in-need is not likely to see it this way. Those experiencing a relapse are much more likely to see themselves as failures. This could manifest in a number of ways; dismissal and avoidance of the problem for example; or sadness and guilt.
It's important, therefore, to not feed into these feelings. To help our person-in-need characterise this as a reflective experience---something that will help them do things better next time. We should normalise the experience---relapse is perhaps the most common feature on any pathway to change. It's a part of the process, and we simply must frame it for what it is---an opportunity to improve.
Six stages of change. Humans spend the vast majority of their lives in the first---the stage of change that has almost nothing to do with the change itself. A stage in which the intervention of others, and if the intervention is not drastic and physical, is least influential.
Of the other five stages, there is only one in which the intervention of others weighs heavily---the stage of preparation. Outside of this stage, the lightest of touches is not just encouraged, but often necessary for a change to stick.
The window, therefore, to make change is a small one indeed. More poignantly, outside this window, our well-intentioned advice might not simply fall on deaf ears, it might become an obstacle to the very change it hopes to inspire.
The best change-makers then, are not the ones who beat their drum the loudest. Rather, it is the quiet voice that says to us 'you can try again tomorrow'.