I watched “What Not to Wear” (TLC network) last night. I’m on vacation, had a nice dinner at a Mexican restaurant, including Margaritas, sat down in the living room of our rented beach house with my wife, and it was on. The format is that friends and family nominate someone to be on the show because of how badly they look and dress and how much they need a makeover. Last night it was a woman in her late 30s or early 40s (hard to tell) who either wore baggy clothes or party clothes from the 1980s, had frizzy permed hair, and of course no makeup. The male and female co-hosts (who are very hip and very blunt) ridiculed her choices of clothes and style and pointed out that she clearly did not know and/or like her own body. She reluctantly admitted she might need some help “to feel more confident” so agreed to let them destroy her current wardrobe and send her on a $5000 shopping spree in NYC. So far, so good.
As the show progressed, however, the woman became distressed: alternately tearful and angry, expressing doubt as to why she needed to change, longing for the comfort of her old clothes and style, and disliking most of what she was now to wear. The co-hosts made fun of her, pushed her, empathized with her and encouraged her. Finally, after a hair and makeup session, she was re-introduced to her friends and family to applause and much praise, some of which may have been a bit forced. She smiled, said she really liked the “new me” and then confessed she would probably go back “half-way” to her old style. Still, the process jarred her out of her fearful complacency and enabled her to see a lot more possibilities for the future. Watching it, I agreed that she looked much better (younger, happier, more attractive and more likely to be accepted in her profession).
So why am I writing about this? Because it illustrates beautifully the process we go through when we change our behavior. It also demonstrates how persistent, and sometimes aggressive, we might need to be to help someone at least try new behavior.
You didn’t really think I would write a post without including some research, did you? Here is a section from Weight Management for Your Life that talks about the change process, followed by my observations of how the woman in the TV show fits the model:
James Prochaska, Carlo DiClemente, and John Norcross (in a series of articles reporting on their research into how people make important changes in their behavior over time) describe their “Stages of Change Model,” which applies very well to weight management and is especially useful because it predicts and confronts the common problem of early success and later failure. The model covers a time period of many years.
Briefly, the stages are:
• Pre-contemplation. This is the “ignorance is bliss” stage before one is aware change might be needed. One may be aware s/he is overweight, but tend to shrug it off as “genetic” and not think of it as something to actually control.
• Contemplation. This crucial stage may last for years and is characterized by ambivalence. One may think, “I really should lose weight,” and may even read about it and try a few diets in a half-hearted way. Words people use when they are in this stage are “can’t,” “won’t,” “might,” “maybe,” “we’ll see,” “I’ll try,” and, finally, “I want.” A thought, feeling, comment from another, or event may trigger movement toward taking action.
• Preparation. Here is where serious planning begins. There will be more focused education and consideration of many of the issues covered in this book. If special supplies (e.g., notebooks, pedometer) are needed, they will be acquired. Time and space in one’s schedule/environment are arranged. People say, “I’m going to do this!”
• Action. Now the plan is implemented. This stage tends to last from three to six months.
• Maintenance. This is perhaps the most important stage, and the one most often ignored. It consists of a continued commitment to sustaining new behavior, and lasts for many years or a lifetime. Changes in one’s environment and even relationships may be required, so that the positive new behaviors will be encouraged and supported.
• Relapse. Commonly, a person will relapse and resume pre-Action behavior at some point (or points). Relapse, also called “a slip,” can provide valuable information about ways the plan needs modification. After a relapse, a person may need to go back to the contemplation or preparation stage, or, if no major change in plan is indicated, go right back to maintenance.
None of the stages is absolute in any way, and people spiral back and forth from one stage to another as needed. It is important to realize that the self-change stages apply to all sorts of decisions you are trying to implement, and therefore you may be in one stage regarding one decision (e.g., eating less) and another stage regarding any other decision (e.g., exercising more, or reducing family stress). In my experience, teaching people the stages, and helping them assess where they are in the process at any given time, empowers them to keep on track with their decision.
Our “What not to wear” woman went through almost all the stages in a very short time. First she was unaware of any problem with her appearance (pre-contemplation). After her nomination for the show and in the beginning of the show, she began to realize she had a problem, though was not sure quite what it was (contemplation). Then, she agreed to allow the co-hosts to influence her shopping and other decisions (preparation) before becoming an active participant (though still ambivalent) in the change process (action). When she returned home, she saw that her friends and family would be supportive of the new behavior and described how she planned to continue it (maintenance). Finally, she talked about how she might slip back into the old ways (relapse).