Stages of Change: Maintenance

Maintenance: It's been a week/month, I can do this! I am doing this!

I am going to tell you right now, so you do not feel deceived, that you will probably go through these stages several times before you make it completely through the cycle without a few hiccups. One analogy I heard and still use frequently is this: You have slipped down a few steps. Don't do yourself the disservice of throwing yourself to the bottom of the flight. Just because you slipped down a few steps DOES NOT mean you're back at the bottom starting from Square One. Let me repeat this: YOU DID NOT FAIL. You fell, you did not fail.

Look how far you've come! You've lost 5 lbs, you stopped smoking for 3 months, you take your medications every.single.day, you stopped heroin for 3 weeks, you walk every day! You weren't doing these things before. You are now. Great job!! You have so much knowledge now about yourself, your condition, your environment. You have made great progress. There may be a hiccup, a party or holiday, being in a stressful situation, had a visit with someone unexpected, a death, etc. You will learn to manage and make progress.

How many times have I been though this cycle? More than 10. Each time, I am closer to getting through without having to repeat the whole cycle or some part of it. And, while in maintenance, you may discover other issues that need change- so the cycle will begin again. For example, you've quit smoking! Great! But now you realize that you're addicted to Tic Tacs. Well, this is an improvement, but you've basically just transferred addictions. In time, you will be able to address the emotional connection and overcome this which will then lead to not smoking AND not popping Tic Tacs.

Maintenance looks different to different people, I think. It's a life-long state for me, in a sense. I work through my issues in the cycle, get to a point where I am managing and thriving. I experience a hiccup, re evaluate and begin again, eventually achieving maintenance. You should be maintaining something most of the time. Right?

Life is growth. Development. Self improvement.

Many patients work very hard to achieve a fasting blood sugar (FBS) of less than 140 (for diabetics). Once they ACHIEVE this, they MAINTAIN their regimen. What are they eating? What medications are they taking? How active are they? All questions of behaviors that DIRECTLY contribute to the desired outcome. They MAINTAIN their lifestyle to achieve the desired outcome of a FBS less than 140.


  

Stages of Change: Action

Lights! Camera!

ACTION!!

Are you ready?! Here we go!

Smart Recovery New England defines the action phase of the change process as the stage where people overtly modify their behavior and surroundings, they make the move for which they have been preparing. It requires the greatest commitment of time and energy of all the previous stages.

All the contemplation, preparation, time, and energy are now being put to the test. Will you encounter hiccups? For sure. But, like we discussed last week, if you have prepared, you are decreasing your risk of failing. Does this ensure failure will not occur? No. But, again, you are decreasing your risk.

When someone is dieting, they are often coached on events that may derail them. Parties, holidays, travel, to name a few. The best techniques or practices are now second nature to me, but to newbies, they can be revolutionary. For example, if you tend to overeat at a party, your best bet is to eat a solid meal before you go to the party. The theory is that you won't be hungry and will eat less while at the party. Works for some, not for everyone. Holidays? Bring a dish you know you can eat and enjoy. We brought mashed cauliflower to Thanksgiving one year. We enjoyed it....and had leftovers. I wonder why? :)

These are all actionable behaviors to prepare us and set us up for success. Do I still take mashed cauliflower to Thanksgiving? No, but I make it at home several times a year when I'm craving mashed potatoes. I almost always bring a dish that I enjoy and know is healthy for me to a gathering with other people.

These things take time, but with practice, you build on your past successes and are able to make better choices moving forward.

This is also a good place to mention that I keep a few things sacred. For example, I do enjoy Oreo cookies. I allow myself to have them, usually, whenever I donate blood. It's my after-donation snack to ensure I don't faint. If I stick to the recommended schedule of donation, I get Oreos several times a year! My husband and I enjoy a good cocktail every once in awhile. However, when we're in Hawaii, we only drink Mai-Tai's. What I mean to say is that even though we enjoy Mai-Tai's, we only allow ourselves to drink them while we are in Hawaii. It keeps them special and also limits our intake! We mostly keep to this rule....occasionally we will have a sip here or there. The rum and tropical juices with the little umbrella take me back to a warm beach in the middle of the Pacific....I digress.

Action! Are you ready?! What are your action steps?




 



 

Stages of Change: Preparation

Preparation: I've smoked all my cigarettes, I've removed all lighters and ash trays. Breaks have been rearranged. All the junk food is out of the house. I have a friend lined up to walk with me on Monday. All meals have been prepped. I have a counseling appointment scheduled.

Every single one of these are steps taken in preparation of action.

Who knew change was so laborious?! We're on week 3 and still haven't actually put in any action! There's a reason for this.... Ben Franklin said: By failing to prepare, you are preparing to fail. (Do you know how hard that is to type out!?)

 Good ol' Ben. He was right! So much of our success depends on how prepared we are. Think about it....if you take a road trip you need to get gas, make sure the car is in proper working condition (tires, oil, AC, radio), buy snacks (!), have water and possibly a blanket available. Then, if it's snowy, chains and appropriate clothes. See? That's just a road trip! Why do you think making major life changes would be any different?!

By the time you reach Preparation, you're almost ready. You may still have some ambivalence and anxiety, but you're well on your way towards success! You may already be taking some baby-step actions. Cutting back the cigarettes, walking once a week, buying new workout clothes (Hello!! You gotta look good!), researching counselors, meal planning for a day or two. All great steps leading up to the Big One.

Next week: The Big One: ACTION!

Stages of Change: Contemplation

 

Contemplation: I really should quit. I'm going to quit on Monday. I can still drink my coffee without a cigarette....or maybe I'll quit coffee too?

 

You have acknowledged a problem exists and are now thinking about how to solve it. Smart Recovery of New England says that you know your destination, and how to get there, but you're not ready to go yet. There's still prep work that has to be done.

During this time you may be weighing the pros and cons of change, the risks and benefits and the cost to you. Is there a financial implication? A gross amount of time needed? Appointments such as counseling, training, classes, etc.? The contemplation stage is when this is all evaluated. Obviously you cannot foresee every risk or benefit, but this is the time when a lot of leg work takes place. You may also be experiencing a sense of loss. For smokers, it is often a social activity so the loss of time with a friend, spouse, or co-worker may play a large role in the timing or decision to quit smoking.

The American Academy of Family Physicians offer help to us as we aid patients in change. Questions we can ask of them include: Why do want to change at this time? What are the reasons for not changing? What would keep you from changing at this time? What are the barriers today that keep you from change? What might help you with that aspect? What things (people, programs, and behaviors) have helped in the past? What would help you at that time? And, what do you think you need to learn about changing? It may be helpful to journal about these questions to help you fine tune where you're coming from and what you need.

How do you know you're ready to change? You begin to think about the future more than the past. You anticipate the future. You're active towards change. You may experience anxiety and excitement. You move forward.

 

Next week: Preparation!