Recognition Is the First Step to Change

Previous articles have described the stages that people undergo on the path toward achieving a sustainable change goal.(1) The stages:

• Precontemplation: There is no intention to change; the individual is unaware or not fully aware of the need for change.

• Contemplation: The person is aware that a problem exists and is thinking about changing but has not yet made a commitment to action.

• Preparation: The individual intends to take action in the immediate future or may even begin taking small steps toward the change goal.

• Action: The person is fully involved in making a change as seen in a commitment of time and energy.

• Maintenance: The person has consolidated the gains attained during the action stage, and the change is considered stable.

Moving from one stage to the next is not always easy. People often get stuck in a stage, and it is a coach’s job to help them take the next step.

The first obstacle to facilitating change is when people are in the “precontemplation” stage because they are unaware or unconvinced of the need to change. Here’s an example:

Cardiologist: I am thinking about applying for the chief’s position, but I’m not sure what the situation is over there or what they’re looking for, and I have some concerns. Do you think it’s something I should do?

Dr. Ross: I’ll be glad to help, but first tell me more about your concerns.

Cardiologist: Well, my foremost concern is whether they will be open to my leadership.

Dr. Ross: I see. Well, in my opinion, the most immediate challenge will be coming to terms with Dr. Smith, chief of cardiac surgery. He’s been in that role for a long time and, as you know, he’s very opinionated. He really doesn’t listen to anyone’s ideas except his own and can be challenging to deal with. He’ll be retiring next year, though, so you’ll only have to work with him — or around him — for a few months. Given your style, how do you see that working out?

Cardiologist: I don’t see a problem. He’s very assertive, but I can stand up to him. They’ve needed strong leadership over there for some time.

Dr. Ross: True, but is it possible that you may also come across too intense or strong at times?

Cardiologist: I guess I am a little outspoken, but it’s nothing that causes me problems. Frankly, that’s the problem around here; people don’t speak their mind.

Ross has a challenge: He knows that his cardiologist colleague has a reputation for being brash and even aggressive in conversations with others. He also knows that the cardiologist must change his style to be successful in the position for which he is applying.

However, it is evident that the cardiologist does not realize the magnitude of his problem. In other words, he may understand that “something” is there, but thinks it’s not a big-enough issue for him to think about changing. In short, he is *under*aware of the problem, and he is fixed in the “precontemplation” stage. When people are in that stage, it is impossible to help them change.

Research has shown that precontemplators devote less time and energy to re-evaluating themselves and the effect of problem behavior.(2) As a result, they experience fewer emotional reactions to the negative aspects of their problems. Therefore, when attempting to shift a person who is either unaware or underaware of problem behavior, you will likely encounter resistance. To detect resistance, listen for “resistance talk.”

Resistance Talk

Resistance talk is easy to identify. It is speech that signals movement away from a particular kind of change.(3) It is present when the person speaks about:

• Contentment with the status quo. The person does not want to change. “I’m satisfied where I am in my career, right now.”

• Reasons for sustaining the status quo and/or the disadvantages of change. “If I take a leadership position it will inhibit my clinical work, which I love.”

• Need for the status quo. The person believes he or she must stay, with no viable choice. “I have to take on the extra assignments; nobody else will do it.”

• Commitment to the status quo. The person is not going to change. “I’m not as insensitive as some people think” or “I’m not going to start delegating more because I don’t think they will do as good a job as I will.”

When the cardiologist tells Ross that “I guess I am a little outspoken, but it’s nothing that causes me problems. Frankly, that’s the problem around here; people don’t speak their mind,” he is engaged in resistance talk by indirectly expressing a commitment to the status quo.

Resistance talk is a sign, an indication that, as a coach, you need to slow down, proceed with caution and be patient with where the other person is coming from. However, this is often easier said than done, especially if you have a strong desire or investment in the person changing in some way.

If you advocate too strongly for change because it is clear to you that change is needed, you might unintentionally intensify a person’s resistance. It’s a variation of Newton’s third law: For every action, there is an equal and opposite reaction. In other words, the more you push, the more people resist unless they have come to their own conclusion that change is needed. In an upcoming article, we will discuss how to deal with resistance productively.

Summary

Change is not easy regardless of the stage a person is in, but it is impossible when the person is stuck in the precontemplative stage. The possibility of change only becomes real when a person has moved into the “contemplation” stage.

Resistance talk is a clear sign that the person is in the precontemplation stage. Forcing the person to accept the need to change will most likely fail. When you hear resistance talk, combat your need to “make it happen.” This is a case where you have to go slow to go fast. We’ll soon discuss techniques for doing this.

References

1. Prochaska JO, Redding CA, Evers KE. The transtheoretical model and stages of change. In: Glanz K, Rimer BK and Viswanath K. (eds.) Health Behavior and Health Education. 4th ed. San Francisco: Jossey-Bass, 2008

2. Prochaska JO, Norcross JC, DiClemente CC “Stages of change: prescriptive guidelines.” In Koocher GP, Norcross JC and Hill III SS (eds.), Psychologists’ Desk Reference, 2nd ed. New York, NY: Oxford University Press, 2005, pp. 226-31.

3. Miller WR, Rollnick S Motivational Interviewing: Preparing People for Change (2nd Ed.). New York, NY: Guilford Press, 2002.