Women’s health articles
How to make life changes — becoming the person you want to be
by Marcy Holmes, Women’s Health NP
“If we don’t change, we don’t grow. If we don’t grow, we
aren’t really living.”
— Gail Sheehy
Patients frequently tell us they want to change something in their lives. Maybe
they have gained a lot of weight, or have been struggling with a bad habit like
smoking. Others are fed up with certain relationships that have become toxic, or
they have emotional issues that have made them miserable for years.
Common changes women want to make:
- Lose weight
- Eat healthier foods
- Exercise regularly
- Quit smoking
- Improve emotional wellness
- >End “toxic” relationships
So if we want to change our lives so badly, why can’t we just do it, and morph
into the person we want to be?
The fact is that lasting change is possible, when we understand the emotional, mental,
and physical steps we will need to take. We still need to commit to the idea of
changing, and follow through with our efforts, knowing that it will be better for
our overall health and wellness. But if we get the lay of the land before starting
our journey toward change, it multiplies our chances for success.
Naturally, there will be barriers to overcome before you embark on the change process.
As adults, many of us fear life changes and the uncertainty it brings. But understanding
and analyzing fear is the first step towards dissolving it. When you aren’t
scared anymore, the idea of changing suddenly becomes much more appealing.
Often, people find that problem behaviors are rooted in parental messages from childhood.
Our patterns are remnants of old coping mechanisms that served us well as children,
but in adulthood, they’ve turned into an endless loop of negative self-talk:
I’m too weak to quit smoking, or, I’m already so unattractive, what’s
the point of trying to lose weight?
Which person is ready to change?
Mary B. told us she plans to change her eating habits. She says that she eats too
many sweets and drinks soda non-stop, but she is stressed out about her job. Mary
says that as soon as she gets a new job, she’ll change her diet.
Rebecca H. worries that her lack of exercise and poor diet choices over the years
put her at risk for type 2 diabetes, like her sister. She knows it could be the
beginning of serious health problems, and it scares her. Today she walked up the
stairs to work, instead of taking the elevator.
Rebecca has already begun her journey, but Mary is not ready. She is still just
thinking about it.
Sometimes people feel trapped in a cycle of behavior, perhaps with a spouse who
is resistant to the idea. Or maybe it’s just hard to picture ourselves without
the problem behavior. I tell my patients who feel hopeless about changing, that
they can do it — when they are ready to commit and do the work to prepare
for the obstacles they will encounter along the way.
When “failing” is a good thing
On New Year’s Day, thousands of people resolve to change something about their
lives. They start off strong, but as February approaches, many begin to lose steam,
quietly dismissing their well-intentioned resolutions. This happens a lot when people
try to quit smoking — which isn’t just a bad behavior, but also an addiction.
Smokers want to stop, but they often fall off the wagon quickly and feel
like giving up altogether.
But surprisingly, the most successful changers are the people who have already “failed”
several times. The willingness to keep trying — persistence — is a common
trait of successful changers. At Women to Women, we know this is true because of
our experience helping women through important changes in their lives.
Some women think that all they need to do is to muster enough willpower to change.
In reality, at any given time, only 20 percent of us are truly prepared to take
action toward changing. And no amount of willpower can help if you’re not
genuinely ready to change.
Another key element for success is staying optimistic which can be hard —
or even impossible — to do unless you have support. Support is certainly one
of the “secrets” of success, and research bears this out. For example,
if a hundred people try to quit smoking, only five will succeed if they quit alone,
cold turkey. But that number jumps to 20, if the quitters have someone to counsel
them and offer additional support strategies.
Reality check: a sense of urgency to make a change
After living with a problem behavior, it’s easy to become complacent about
it. We might think, What’s the big deal? Everything’s fine just like
it is. And you can go on thinking that way for a long time — until
a major event forces you out of your comfort zone. If you want to lose weight, it
may be a health scare that gets your attention, or the realization that you can’t
walk up a flight of stairs without being short of breath.
I know someone who recently quit smoking after many years. Louise had known about
smoking’s health risks, but the “sudden” decision to quit finally
came when Louise sat by her mother’s bedside, watching her die of lung cancer.
For Louise, that was the end of smoking cigarettes.
You too may experience a “last straw” event that propels you into taking
the first tentative baby steps toward change.
Making life changes: getting started
In life, we learn that change is inevitable. But the real revelation comes when
we are able to embrace change — instead of resisting it, which helps ease
the transition into a new behavior. Making a change is often a courageous act, especially
if it affects others, perhaps family members or coworkers. But just knowing you
need to change is actually the first step.
Big life changes occur in stages, over time, as part of an ongoing process that
can ebb and flow like life itself. Change is a nonlinear process that sometimes
requires us to take a step back before we move forward.
Change also involves us totally which is why planning for change can help push us
through the rough spots as we evolve into the person we hope to become.
Just as Elizabeth Kübler-Ross defined the classic stages of grief (denial, anger,
acceptance, hope), so can the stages of change be identified. These phases are not
consciously chosen but occur naturally, sometimes at an unpredictable pace or sequence.
Just being aware of how the change process works — and then preparing for
its stages — is critically important for success.
Prochaska’s six stages of change
In their pioneering book, Changing for Good, James Prochaska,
PhD and colleagues report on the experiences of successful self-changers. They found
that the stages of change are universal and quite clear, but that you cannot control
how quickly you move through the stages, nor can you skip any of them.
At Women to Women, we often use this change model, both at the Clinic and during
our support calls for the Personal Program.
Learning how to recognize the stages of change helps women make plans that help
overcome difficulties along the way.
The six stages of change
1. Precontemplation: Problem? What problem?
You are still resistant to the concept of changing, and could be deeply in denial,
even as those around you are able to see your problem easily. It’s common
for people to stay in this stage for long periods.
Maryann: “Since I was diagnosed with multiple sclerosis, I’ve thought
about trying some small things to see if it might help. For months I argued with
myself about how nothing could possibly work. Then I said, okay. I’ll change
my diet for a week and see how it goes. Well, one week turned into two, and I started
to feel better and more alert. That gave me the faith to keep going. I still have
MS but I feel a lot better.”
2. Contemplation: Thinking it over.
You begin to acknowledge the problem and accept that change is in your future, perhaps
prodded by another person.
My patient, Liz, refused to admit she had diabetes. She had very poor nutrition
and her blood sugar levels were scarily unstable. Liz had several close calls, which
she had told me about. Finally, she came in one day and said that because I had
nagged her so much, she had bought a glucometer to measure her blood sugar. This
was a major contemplation step for her.
I frequently see people “dance” back and forth between precontemplation
and contemplation. It can be an integral part of the process as you get ready to
take on the responsibility for changing.
3. Preparation: Putting your ducks in a row
You begin to widen your thinking about all the things you need to do to make your
change. If you are going to quit smoking, perhaps you “go public” with
your goal and throw away your secret stash of cigarettes.
Margaret: “I smoked on and off for about 20 years. I knew I should quit for
good, but I didn’t really want to. But then one day my 3 year old son asked
me if smoking cigarettes kills you and I had to answer ‘yes.’ I was at a party
a few days later and told my friends about it. I told them it was to going to be
hard, but that I really wanted to quit for my son. It wasn’t long after that
I officially stopped smoking.”
4. Action: Diving in
This is the most exciting stage, though you may be nervous about moving forward.
Action is often confused with actual change — which, surprisingly, comes much
later. I find that it takes about 45 days to change a habit so I always tell people
to start by working on one or two things at a time, so you don’t get overwhelmed.
As time passes, it gets easier and that gives you more confidence to keep going.
Barb: “At first it felt really great. I was proud of myself for making the
commitment to eating differently and remembering to take my vitamins. Then the novelty
sort of wore off and I was so distracted one day that I impulsively ate a cupcake
and thought that I had destroyed all my good work up ‘til then. But my friend said,
‘Barb, it isn’t the end of the world. It’s just a cupcake! You can get
back on track right now.’ And I did.”
5. Maintenance: Living with change indefinitely
This stage is commonly overlooked, and that’s a mistake. Maintenance is the
act of living with your change and practicing your new behavior day after day. You
will hit some rough spots that may last for days, weeks, or months — or even
longer. But with support, you can avoid reverting to your old ways.
“Getting started, keeping going, getting started again — in art and
in life, it seems to me this is the essential rhythm not only of achievement but
— Seamus Heaney, poet
Jennifer: “When I was preparing for a new weight loss program, my husband
took a “before picture” but I filed it away and forgot about it. A few
months later, I got really frustrated and my husband brought out that “before”
picture. I was so shocked to see how much I had already changed that it helped get
me over the hump. Now I keep that picture where I can see it to remind me of how
far I have come.”
Choose helpers who are consistent and strong, but don’t push you, nag you,
or enable you as you work through the stages. The most important qualities for helpers
are empathy and warmth.
6. Recycling: Staying aware
At this point, you are free and clear of your old behavior, and never find yourself
tempted to revert. Fair warning: for many, this stage never really arrives, and
they stay in maintenance. Some people relapse years later. You need to keep nurturing
the delicate balance you’ve created. This is real change, however tentative
it might feel.
I tell my patients that relapsing is the rule, not the exception. Your old behavior
will continue to entice you for a while. Even if you relapse, it’s just a
matter of returning to your new “normal” after a setback.
Techniques for each stage of change
James Prochaska and his associates determined that self-changers rely on many proven
techniques that support them through the stages of change. Many are well-established
methods used by therapists and psychologists, but self-changers often employ them
You may use consciousness-raising to expand your understanding of the behavior you’re
trying to change. Social liberation helps you create genuine choices, perhaps by
joining a support group, or frequenting nonsmoking areas.
Emotional arousal is found in a cathartic event that generates a sudden
realization about the seriousness of a behavior. For example, a popular Australian
internet blogger says that she knew she was ready to lose weight when she saw her
“enormous white knickers” billowing on the clothesline next to her sister’s
“impossibly teeny pair.”
Self-reevaluation can help you picture who you will be when you change.
Commitment shows that you — and only you — are responsible
for your change. Countering replaces the negative behavior with something
positive. Environment control happens when you take steps to remove temptations
from your daily life.
Reward is patting yourself on the back for incremental changes. (I recommend using
this strategy a lot!) And helping relationships are the buddy systems we
form to help us through each stage. At Women to Women, we recommend putting the
helping relationship strategy in place as early as possible.
Using the right strategy at the right time increases your ability to affect change,
though it is common to toggle back and forth between techniques as you negotiate
your way through each stage. The change process is fluid, and your forward motion
may have a few fits and starts, but there will be smooth sailing as well.
Clearing your path to change
The path to change is individual, and can be peppered with obstacles and detours.
At the Clinic, we listen to each woman’s story so we can understand how her
life and history influence her journey towards change.
From these experiences, I’ve created a “tip sheet” to help you
start down your path to change.
Marcy’s Tip Sheet
- Become an observer…of yourself
Take the view from 10,000 feet as you analyze your behavior. Start by noticing how
you go through your day so you can define what you want to change and be precise
- Measure your “decisional balance” honestly
Examine what you like about your behavior, and what you don’t. If you smoke,
you might like the people you smoke with, but you might not like how it makes your
clothes smell. Over time, the things you dislike about your habit will outnumber
those you do.
- Rephrase the question
If you are stuck, look at the situation from another perspective. Rephrase the question,
“Why can’t I stop eating junk food?” to be, “What do I feel
like inside when I eat junk food?” The answer to the new question can help
you see the ramifications of your behavior and how its consequences shape your efforts
- Use diversionary tactics
To keep your momentum in the action stage, fill your day with active pastimes. This
“keep-busy” doctrine can help you get through each day. But make sure
the new activity is lively, involving, or physical, and not watching TV.
Believing in change
Envisioning yourself as the person you want to be can be very powerful. This method
is used by elite athletes who create vivid mental images of themselves accomplishing
their goals. As they do this over and over, the picture sinks in and eventually
they believe their goals are possible, perhaps even probable.
Consider one other idea when you are beginning the change process: loving kindness.
Treat yourself gently and lovingly, rewarding your victories, and comforting
yourself when you have setbacks. This practice can help you finally become the woman
you want to be.
Our Personal Program is a great place to start
The Personal Program promotes natural hormonal balance with nutritional supplements,
our exclusive endocrine support formula, dietary and lifestyle guidance, and optional
phone consultations with our Nurse–Educators. It is a convenient, at-home
version of what we recommend to all our patients at the clinic.
If you have questions, don't hesitate to call us toll-free at
1-800-798-7902. We're here to listen and help.
Related to this article:
References & further
reading on how to make life changes
Last Modified Date: 06/02/2011
Principal Author: Marcy Holmes, Women’s Health NP