Stages of Change: Pre-Contemplation

In the mental health field, we talk ‘Stages of Change’ all the time. For those unfamiliar, the ‘Stages of Change’ model provides an efficient structural model to help describe the stages people go through while changing lifestyle behaviors. This model can be used for any important change that we may face on the path. The key concept of this model is that change does not usually occur in a single, solitary step but through a series of cognitive, behavioral, physical or spiritual actions. The five basic stages of change are as follows: Pre-Contemplation, Contemplation, Preparation, Action and Maintenance. It is too much to give each step it’s appropriate explanation and importance within the space of a single article, so I thought that today we would take a look at the first step in the ‘Stages of Change’ model: Pre-Contemplation.

In denial

People in the Pre-Contemplation stage of change are those that you would label ‘in denial.’ They have a negative behavior that is definitively affecting their ability to thrive, but they refuse to see it. Saying they don’t ‘see it’ may not accurately describe the perception. In some way, most people in this stage probably are aware that the issue exists, but is not in a place to change. They may find a multitude of reasons why they need not change. NOW is not a good time. It would be painful to make this change. If I made this change, I would not be able to do this or that. Making this change could make me sick. The list goes on as long as my arm. Now, I’m sure that many of us have experienced this particular stage with certain changes that we needed (or need) to make to help manage our IBS. Sometimes, there is not even an effort to come up with an excuse. The person may just reason that they just CAN’T DO IT. That is enough to justify the continued negative behavior.

Transition

The transition from the Pre-Contemplation stage to the Contemplation stage (the thought process that begins when the cost/benefit analysis of the change is evaluated) is a slow and sometimes painful one. Trying to get people in the Pre-Contemplation stage to acknowledge the negative behavior and then act on it is a very difficult proposition. People fear change and will probably only begin to consider the beginning steps of change through some kind of catalyst, perhaps a trigger or situation that pushes the person to consider changing. If you are providing support for someone during contemplation (even if it’s yourself), the best way to help is to simply engage in a dialogue about the behavior that is in need of change. Allow the person to make the excuses, deny the problem or express whatever mental contraptions that are keeping that person from action. The dialogue itself may provide the trigger necessary to take the first action. The first ‘action’ is taken during the Pre-Contemplation phase of Change. We will talk more about the Contemplation stage in a future article.