"You have to really want to do what you set out to do," he says. He speaks from experience: In 1964, Tritsch quit a nearly pack-a-day cigarette habit cold turkey.
Research shows most people attempt change many times before succeeding. Did you make New Year's resolutions a few weeks ago? How are you doing? Most resolvers — about 60 percent — fail on the first attempt, studies show.
So how do we get motivated? And make it stick? How do we get "finally ready"?
Skip the guilt
First off, guilt doesn't work.
It's "tremendously unhelpful" to view health behavior as a moral issue, says Dr. Greg Simon, a psychiatrist at Group Health.
People change when "they're able to see some discrepancy between their behavior and one of their core values or something that's important to them."
Sometimes resolve emerges from a defining event — a drunken-driving arrest or a cancer diagnosis.
Sabrena Harris, a 49-year-old from Kirkland, lost 125 pounds between September 2002 and mid-2004. After getting cancer twice, then undergoing a bilateral mastectomy, she learned that obesity may have been a contributing factor to her illnesses.
"It hit me like a rock," said Harris, a receptionist at Microsoft. "I thought: Oh, my gosh. I may have had a hand in creating this myself. I gotta do something."
Harris had lost and regained weight before. This time she joined a respected diet program and followed it "to a T." Now she hikes, participates on a Dragon Boat paddling team and tries not to look back.
If her weight creeps up, as it did over the holidays, she resumes measuring and weighing her food.
For many people, getting to "finally ready" can take a long time.
"Changing health behaviors is much more like a marathon than a sprint," says James Prochaska, director of the Cancer Prevention Research Center at the University of Rhode Island.
Twenty years ago, Prochaska and colleagues developed one of most widely used and best substantiated theories about how people change their health behavior.
The theory is described in a book he wrote with others called "Changing for Good" (William Morrow and Co., 1994).
People who make a change, Prochaska found, typically progress through six stages:
Pre-contemplation
At first, you may not see a problem. You may be ignorant of negative health behaviors or avoid information. You can be stuck in this stage for a long time, says Prochaska. The seed of change comes when you acknowledge the problem either on your own or because of a crisis. Then you start seeing reasons for fixing it.
Contemplation
This is the time for building motivation. As you grow more aware of the arguments for and against change, you may feel ambivalent.
You might say: "I'm still not motivated. What the devil am I going to do about that?"
Don't worry about motivation, Prochaska counsels, rather, "Commit oneself to become better prepared for change." Keep building the pros and decreasing the cons.
Take the resolution to exercise more. What if you can only think of three reasons to start? "Forget taking action," advises Prochaska. Instead, "Grow your pros."
Think of exercise as the "bargain basement of behaviors," he suggests. What else can you do in the same amount of time that reaps as many rewards — better health, better mood, better sex?
Preparation
In this phase, you make the behavior change a top priority and get mentally ready for at least six months of considerable effort.
You can tell people you'll need more support during this time and may not be at your best.
Consider going public to boost your willpower.
Experts suggest setting small, very specific goals.
Don't say "I need to get back in shape." Say: "I will try to walk 20 minutes three times a week starting at 5 p.m." suggests Simon.
Joann Sampson, a 41-year-old Seattle single mom with four children, one with severe disabilities, has big goals. She wants to be more positive and outgoing, lose weight and eat better.
But she has no free time. Her first small steps have been to skip her breakfast doughnut and to take a weekly bubble bath in candlelight after the kids are in bed.
"It doesn't cost anything and it really helps."
Sampson figures if she can get some peace of mind, she'll be able to eat and think better.
Her next step? To exercise on the treadmill twice a week. And she'll continue to eat right.
Focus on the end result
"Most of the benefits of positive behavior change are slow, while the costs you have to pay are pretty immediate," says Simon.
During this difficult phase, mark your progress with small rewards to remind yourself of the good things that will eventually result from the effort.
In some cases, though, benefits materialize quickly.
"If I start exercising there's a good chance I'm going to feel better about myself right away," says Prochaska.
He suggests applying the list of pros in the action stage. Take walking. Think about a new pro each week: walking for my heart, walking for my weight, walking for my mood.
Success is more likely if you've got support from a program or friends.
Dick Newcomb, 65, of Seattle always considered himself athletically challenged, a person who would rather read than sweat.
"I had good intentions. I tried to start on exercise programs. But basically I haven't done very much — except for walking."
That's a big reason he retired early as an academic counselor from the UW three years ago — to spend more time taking care of himself. Now he's physically active five days a week either with a friend or in a group. He works out with weights and machines, takes exercise and yoga classes and walks around Green Lake.
"It's still becoming more a part of my life." says Newcomb. "I'm beginning to see that exercise in itself feels good."
Maintenance
This is where you strive to hang on to what you've accomplished, a stage that can last from six months to a lifetime.
The most common reason for relapse is distress, says Prochaska. Depression, loneliness, boredom, anger, even happiness can knock us off balance.
Strategize how you'll stay on track during those times, he says.
Sometimes, we backslide, much as Harris did with her weight over the holidays. The trick is to get back up and keep going.
"The only serious mistake we can make is to give up on ourselves and our ability to change," says Prochaska.
Termination
You finally have it nailed. Prochaska calls this "termination." There's zero temptation. You're so confident of the change, it's no effort any more. Some never reach this point.
Beth Cook is convinced she's at this stage in beating her smoking habit, even though smoking is a big part of college social life.
She no longer even wants a cigarette.
"I have a lot of motivation. I see what it did to my grandparents and what it's doing to my parents. I just have no desire to go that route. It's, you know, going to make them die, to put it bluntly." |
