In my last post I made a case for change as a process. I outlined the Transtheoretical Model’s Stages Of Change which describes the evolution of “readiness thinking” that is necessary to put change into action. This week I’m starting with Stage 1, Precontemplation, and highlighting what the characteristics of this stage are and how to help yourself or someone you care about with the particular tasks of this stage. In Precontemplation, just as it sounds, change is not even in the realm of possibility yet. People in this stage have no plans for change, even if they wish for it. In other words, Precontemplation is the very beginning. But just like a seed hidden in the ground during winter, although you can’t see it yet, the potential for a flower is there.

In Precontemplation, a person completely lacks motivation or confidence (or both) to change. People may not be fully aware of the potential benefits of a change, or they may be demoralized from failures in the past. Generally, the hallmark of this stage is a general lack of awareness and/or an annoyance or avoidance of the need for change. According to Dr. Prochaska, who developed the model, “In Precontemplation, people underestimate the benefits of changing and overestimate the costs or cons. But they’re not particularly concious of that, so it’s not a focused rational decision making process.”

So how do I know if I’m in this stage if it’s not conscious?  Chances are you’re a Precontemplator if you’ve heard plenty of times from your partner, your doctor, your friends, or your own conscience that you should make a change.  And when these people, including yourself, try to talk to you about it, you tune out, shut down, withdraw, or change the subject.  You may even find yourself annoyed and wishing they would mind their own business.  Precontemplators often are represented by the four “Rs.”  Reluctant precontemplators lack knowledge or inertia to consider change.  The impact of the problem hasn’t become fully conscious.  Rebellious precontemplators have a heavy investment in their current behavior and in making their own decisions.  They’re resistant to being told what to do.  Resigned precontemplators have given up hope about the possibility of change and are overwhelmed, perhaps having failed before.  And finally, rationalizing precontemplators have all the answers. They have plenty of reasons why they have no problem and or why the problem is a problem for others but not for them.

Supporting a person to move through Precontemplation involves mostly increasing their tolerance for awareness (it’s painful to think you need to change!).  Therefore, it’s so important to approach the issue in a way that is as collaborative as possible, showing love and compassion, even within yourself.  Often out of frustration, we lecture, nag, or confront in a way that may actually increase resistance.  Often it’s out of shame and embarrassment that a person avoids a topic and becomes irritated when the subject is even mentioned.  It’s important to remember that we can’t make anyone change and that the best way to support change is to allow the person to take responsibility in whatever way they feel possible.  Oftentimes it takes a scary test result, a major life event (such as the birth of a child, the death of a loved one) or a health crisis that opens the door for people to get motivated.  

It’s also important to remember that even just thinking about change is in fact a change in and of itself and is the first necessary step.  According to Dr. Lickerman at the University of Chicago, “thinking about making a change is what gets people used to the idea of actually making it.”  Some tools for addressing the Precontemplative dilemma are to ask permission to address the topic with someone and be flexible to what is a good time and place for the discussion.  It’s also good to acknowledge and commend the person to being open to the conversation and be a good listener.  It’s usually more helpful to ask questions than to provide answers.  Check in with the person during the conversation and when you are finished, be open to feedback.  Watch for body language that indicates someone is overwhelmed and/or feeling shame.  

Power struggles can be strong barriers to change, even within yourself.  Compassion and curiosity are truly the best tools you can acquire for the process of change.  Remember, the seeds of change need nurturing. You can’t make a flower bloom by demanding that it does or assuming it doesn’t love you if it doesn’t.  

Stage 1: Precontemplation – Not yet considering change or unwilling or unable to change. Primary Task:  Raising Awareness