Perhaps they will say I’m afraid to drink, I’m less social, I’m “different”
The positive and negative aspects of changing a problem behavior can be listed next to each of these four categories, as illustrated in Table 8, which provides a sample decisional balance scale that was completed by a woman who considered quitting drinking. Completing such a scale is an individualized matter requiring considerable self-examination and honesty.
In Table 8, Jane is considering how quitting drinking would bring greater health, happiness, and success, and how it could provide her with freedom and some self-esteem. At the same time, she is considering the positive impact it would have on her children, husband, and boss. The possibility of freeing her family from her alcoholism is a major positive consideration for Jane as she contemplates quitting drinking.
But Jane’s negative considerations are also substantial. The loss of certain friends, the loss of the social ease she experiences with her hard-drinking extended family, and the looming search for new things to do all factor against her decision to quit. And although the future happiness of her husband and children are positive elements, the reality of their having to deal with her mood swings may tip the balance against Jane’s taking action at this time.
Some decisions follow the evidence and logic revealed by consciousness-raising; the decisional balance scale makes the right choice clear. Deciding to get divorced, for example, is not the correct choice for everyone who makes it to the contemplation stage, but quitting smoking is, and action is almost inevitable. The decision to take action can be made at this point (although this doesn’t necessarily mean that it is the next logical step; commitment is still part of the process).
The decisional balance scale should be as comprehensive as possible. Avoid the mistake of focusing only on the negative side of things. Any problem has its positive aspects. If it had no benefits you would have abandoned it long ago. If you deny or fail to acknowledge these aspects, you will attempt an ill-timed or ill-prepared change. In the long run, you do not have to give up the ultimate rewards of a bad habit. Most problem behaviors represent elaborate and indirect means of achieving relaxation and assertion. During the action and maintenance stages you will learn how to substitute alternative, healthier ways of deriving the same benefits.
After you complete the decisional balance scale, weigh and reevaluate the assets and liabilities of your problem behavior. If the pros seem stronger than the cons, you are probably not ready to move to the preparation stage. Spend some time gathering more information and focusing on the cons of your problem behavior. The best position for preparing for action is to have the pros of changing slightly higher than the cons of changing. This tips the decision making toward action and readies you for commitment.
Self-reevaluation self-assessment
Here is a brief self-assessment to check your progress. Again, be honest and realistic. Fill in the number that most closely reflects how frequently you have used self-reevaluation in the past week to combat your problem.
1 = Never, 2 = Seldom, 3 = Occasionally, 4 = Often, 5 = Repeatedly
FREQUENCY:
_____ I consider that my family and friends would be better off without my problem behavior.
_____ My tendency to give in to my problem makes me feel disappointed in myself.
_____ I reassess the fact that being content with myself includes changing my problem behavior.
_____ I get upset when I think about giving in to my problem.
_____ = Score
Scores of 14 and higher indicate you have made sufficient use of self-reevaluation to be able to move from the contemplation stage to the preparation stage. Scores below 13 strongly suggest a need for a more cognitive and emotional reappraisal of your self in relation to your problem. If you attempt to continue on in the cycle of change without such a reappraisal, our research indicates that you are likely to relapse. Why not do your reappraisal now, instead of the second or third time you pass through this stage?
GAIL, THE DIET EXPERT
When Gail began to consider the pros and cons of losing weight, she was forty-six pounds overweight, and her thirtieth high school reunion was less than six months away. Hers is a story, like George’s, which we will follow through several chapters. Facing fifty, this successful executive was convinced that she was doomed to follow her mother’s example: Trim and attractive until Gail was born, her mother afterward fought the battle of the bulge for thirty years until she ended up defeated, depressed, and obese.
Gail had already attended two of the top commercial weight-control programs that “guaranteed” permanent weight loss. After five cycles of weight loss followed immediately by weight gain (she lost more than 220 pounds and gained back 240), she doubted whether the benefits of losing weight were worth the costs. She could appreciate why her mother had given up.
On the other hand, Gail knew she had a lot more going for her. She had a rewarding career as a vice president in a communications company, while her mother had been a housewife with little to do once the children were off to college. Gail was a good athlete, like her mother before her—both swam, skied, and played golf and tennis. But unlike her mother, Gail continued to pursue sports even while her two children were in school. Fortunately Dan, Gail’s husband, proved to be a much more active partner in raising the children than her father had been.
Besides obesity, age brought Gail’s mother menopause, the empty-nest syndrome, feelings of inadequacy, and a declining future. However, a fuller future was in store for Gail. She could become president of her company; she would certainly travel, for business and pleasure; she could look forward to years more of competitive tennis; she had a happy marriage, and lovely children with exciting futures.
She wished it were possible not to worry about her weight. Although she hadn’t been overweight until she reached her thirties, she had been acutely sensitive to weight issues all her life. Growing up, she saw how poorly fat kids were regarded by other girls. She also knew that heavy girls were not popular with the boys. And her mother, because of her own problems, was painfully observant of the changes Gail’s body underwent during puberty, during menstrual periods, and even during pregnancy.
Gail often felt that her preoccupation with her excess weight was self-centered—she called it “the vanity factor.” But as a young woman she had taken pride in her lean legs and her trim torso (as had her husband). She used to say, “If you can’t look yourself in the stomach, you’re not living right.”
Now her words returned to haunt her, and her high school reunion was approaching. Gail began thinking seriously about doing something dramatic to lose those extra pounds. She thought the fasting program at her local hospital might help. Gail charted the pros and cons of the program (Table 9); the results once again left her dejected.
Normally Gail was a positive person; it shocked her to see that her list of cons was twice as long as her list of pros. No wonder she didn’t feel motivated to move ahead. Her decisional balance underscored her doubts about taking dramatic action to lose weight. Why not be a feminist and reject the anorexic ideal that advertising campaigns had foisted upon her? Why not face fifty by accepting the fact that her fat was a permanent part of her life? Why fight biology, and risk her health, by undergoing still another episode of drastically and uselessly cutting calories?
At this point, to raise her consciousness, Gail read several articles that I had written. She discovered that weight loss is not a behavior, it is an outcome. Counting calories and cutting calories are behaviors, and it is questionable whether their consequences are healthy or not. But there was a possible “no lose” solution open to Gail, if she worried less about the final outcome, and concentrated instead on choosing alternative behaviors that were unquestionably healthier than either unrelieved feasting or periodic fasting.
TABLE 9. GAIL’S FIRST DECISIONAL BALANCE SCALE
Consequences to self
Pros: 1. The vanity factor will finally be satisfied!
Pros: 2. My health will be improved.
Cons: 2. This new diet will be costly.
Cons: 3. I can’t fast forever.
Consequences to others
Cons: 4. Can’t eat out with others.
Reactions of self
Pros: 3. I’ll feel better about myself.
Cons: 5. I’ll be embarrassed if I fail.
Cons: 6. I’m not really sure my weight is a health problem—maybe it’s genetic?
Cons: 7. I’ll feel like a slave to the fashion media.
Reactions of others
Pros: 4. Children won’t have to be embarrassed of me.
Cons: 8. Feminists won’t approve.
Pros: 5. Husband will think I’m sexier.
Cons: 9. Family says they love me however I am.
Cons: 10. Husband isn’t willing to fast with me to get rid of his own tummy.
There is a clear consensus that certain behaviors are good for one’s body. By committing herself to following a low-fat diet, a consistent exercise program, and to giving up binge eating, Gail was unlikely to start any fights with feminists. Besides, she would suffer no doubts about the health benefits, no preoccupation with calorie count, and no need to feel guilt about personal vanity.
TABLE 10. GAIL’S SECOND DECISIONAL BALANCE SCALE
Consequences to self
Pros of a Low-Fat Diet: 1. Prevent breast cancer.
Cons of a Low-Fat Diet: 1. Must give up some favorite foods.
Pros of a Low-Fat Diet: 2. Prevent colon cancer.
Cons of a Low-Fat Diet: 2. Extra food preparation, for husband’s meals.
Pros of a Low-Fat Diet: 3. Prevent osteoporosis.
Pros of a Low-Fat Diet: 4. Prevent heart attack.
Pros of a Low-Fat Diet: 5. Prevent strokes.
Pros of a Low-Fat Diet: 6. Lower cholesterol.
Pros of a Low-Fat Diet: 7. Lose weight.
Pros of a Low-Fat Diet: 8. Increase fiber.
Consequences to others
Pros of a Low-Fat Diet: 9. Can dine out with others.
Pros of a Low-Fat Diet: 10. Be more responsible.
Reactions of self
Pros of a Low-Fat Diet: 11. Feel less sluggish.
Cons of a Low-Fat Diet: 3. I’ll be embarrassed if I fail.
Pros of a Low-Fat Diet: 12. Feel more modern.
Reactions of others
Pros of a Low-Fat Diet: 13. Husband will be happy I’ll be able to eat with him.
Consequences to self
Pros of Exercising: 1. Play better tennis.
Cons of Exercising: 1. Takes time.
Pros of Exercising: 2. Have more energy.
Cons of Exercising: 2. Health club is costly.
Pros of Exercising: 3. Have better moods.
Pros of Exercising: 4. Prevent cardiovascular disease.
Pros of Exercising: 5. Prevent cancer.
Pros of Exercising: 6. Lose weight.
Pros of Exercising: 7. Maintain muscle mass.
Consequences to others
Pros of Exercising: 8. I’ll be more responsible.
Reactions of self
Pros of Exercising: 9. Increased self-esteem.
Cons of Exercising: 3. I’ll be embarrassed if I fail.
Pros of Exercising: 10. I’ll feel younger.
Pros of Exercising: 11. I’ll have lower stress.
Reactions of others
Pros of Exercising: 12. They’ll see me as healthier.
The pros on Gail’s list grew longer and healthier, as shown on Table 10.
It became obvious that her decisional balance had shifted dramatically, from two to one against fasting, to four to one in favor of a low-fat diet and aerobic exercise. Gail had overcome her demoralization and doubts about the pros and cons of dieting. She was convinced that she was developing a “no lose” plan; although weight loss would not be a primary goal (indeed it accounted for only two of the twenty-four pros of her plan), she had good reason to hope that a healthier, happier self would lead to a trimmer self.
Gail imagined that aerobic exercise would reaffirm her active and athletic self. She would not end up a passive person like her mother. She was a modern woman, eating a contemporary diet. Eating too much fat has become the equivalent of smoking cigarettes: Experts unanimously agree that it is bad for you. Fat clogs your arteries, and causes cancer, cardiovascular disease, and other chronic conditions.
The more Gail read the more she liked what she contemplated becoming. She would end up more fit, with less fat in her body. Being active physically and socially is the best way for the elderly to maintain physical and mental health. Plus, physically active women stay more sexually active. The pros were winning so decisively that Gail felt ready to forge ahead and prepare for taking action.
HELPING RELATIONSHIPS DURING CONTEMPLATION
Successful self-changers report that they value their helping relationships most during the stages of contemplation, preparation, and action. The first two techniques given here, especially valuable during contemplation, were originally described by the renowned psychologist Carl Rogers, who dedicated much of his life to studying the interpersonal strategies of helping relationships.
Empathy This is the ability to take another person’s place emotionally and cognitively, to walk in his or her shoes. Most contemplators actively seek and readily accept this special understanding, and welcome the knowledge that others have experienced concerns similar to their own. It is especially valuable to know that ambivalence need not lead to paralysis, that one can simultaneously feel positive and negative about changing a problem, and that it is possible to move forward to action despite self-doubt.
To maximize the empathy you receive from helpers, it is important to let helpers know where you are in the change process. Although you have achieved heightened awareness and have moved past the precontemplation stage, helpers must be aware that you are not ready for action. They should also know that change and action are not synonymous, and that you are changing in your own way and at your own pace. Don’t let overzealous helpers push you into premature action.
In addition, as in any relationship, it is your responsibility to inform helpers of your specific needs. Contemplators typically need support, listening, and feedback. Many helpers, however, are more apt to offer glib answers and quick solutions. It might, therefore, be necessary to tell helpers that you seek understanding and support, but not advice, at this time. Statements such as “I’d like someone to just listen now; I might benefit from your own change techniques in a few weeks, but first I’d like to understand myself and the problem,” will guide your friends and family toward the type of support you need rather than the type they might automatically offer.
Warmth Another relevant strategy for enhancing change is warmth, defined by Rogers as a nonpossessive caring and prizing of another person without imposing conditions. The lack of conditions is tricky, since we frequently tend to attach strings to our kindnesses. “I’d like to help you change, but I’m going to leave you if you don’t,” and “I’ll help you after you stop [drinking, eating, smoking, arguing],” are two examples of conditional “support” that encourage premature action and discourage sensible change.
How does one ignite the real warmth of helpers during contemplation? Start by being as caring and warm as you can be: Warmth begets warmth. And since no one profits from insults and threats, ask your significant others to express their concerns as observations, rather than as confrontations. Instead of saying, “You’re doing it again—you know I can’t stand that,” concern can be presented in a caring manner: “I know how hard it can be to alter your behavior immediately.” We all respond more positively to the second kind of feedback.
Warmth should not manifest itself as uncritical praise or incessant compliments—phony platitudes are counterproductive. Instead, it should represent a genuine attitude of acceptance and caring. An early study
on coping with stress found that the most supportive statements are along the lines of “I know you’ll do the best you can. I’ll like you no matter how well you do.” By contrast, the most unhelpful statements indicated false confidence—“Of course you’ll do it!”—which implies conditions of worth and creates performance anxiety.*
Solicit input One of the central tasks of precontemplation was recognizing and overcoming maladaptive defenses; you asked others to point out your self-defeating defenses. During contemplation, you should ask helpers to assist you in your quest for more information, more awareness, and more self-motivation.
Loved ones can dramatically increase your self-knowledge by calmly reporting their observations, their personal experiences, and any information about your problem that they have gathered through reading, television programs, and so on. Family members are often able to report with great accuracy just what precedes and follows a problem. For example, John Norcross, who is battling a weight problem, is frequently asked by his wife to evaluate why he is overeating in order to have him think before he acts.
Although other people can be of great help in our becoming conscious of the causes and consequences of our problems, few of us are secure and open enough to solicit their input. Take the risk with your loved ones. The resulting awareness will help you to make the transition into the preparation stage, an exciting time filled with positive anticipation.
Changing for Good Page 12
