Learn the theory of habit formation to change bad ones, writes JACKY JONES
WE ARE JUST a few days into the year and already many of us will have failed to keep our new year’s resolutions. Recent research shows that only about 12 per cent of people stick to their plans for more than a few weeks, whether they are to lose weight, give up smoking or clear their debts. Some of those people relapse after a few months too. Most people forget them within 48 hours.
To understand why so many people fail, we need to understand the nature of habits. Many scientists and psychologists have developed theories about habit formation. In the 1970s, James Prochaska and Carlo DiClemente developed a behaviour theory called the Stages of Change, which is particularly useful when trying to understand health behaviour habits. Some health professionals apply the theory to help their patients to alter their behaviour. It is not as widely used as it should be, however.
This theory says people go through five cyclical stages when trying to improve their health habits. These are: pre-contemplation, contemplation, preparation, action, and maintenance/ relapse prevention.
When at the pre-contemplation stage, people are not even thinking about changing. They may be in denial or have tried to change a health behaviour so many times they have given up. Those who try to influence someone at this stage are wasting their time and their efforts may even lengthen the time between stages.
In the contemplation stage, people are thinking about changing, but they feel ambivalent about it.
They may see giving up a behaviour they enjoy, such as smoking or overeating, as a loss rather than a gain. They may seek information about their bad habit and begin to weigh up the barriers and benefits of changing. This stage can take many months.
During the preparation stage, people may experiment with small alterations as their determination to transform their behaviour increases. So they may buy low-fat products, for example. Those who are at this stage should make a plan, set goals and decide how to they are going to achieve them, one small step at a time.
Action precedes motivation and not the other way around. So at the action stage, the person makes the change. This action motivates a person to move on to the next step. If the previous stages have been glossed over and no plan has been made, then the action stage is short-lived and many people relapse to the pre-contemplation stage.
The maintenance and preventing relapse stage is crucial; it is when the new habit is formed. This stage involves incorporating the new behaviour until it becomes a habit.
We have to put as much time and effort into forming our good health habits as we did into our bad habits. Often no thought is given to this stage and people assume that it just happens.
Think about how much time we put into our bad health habits. Many smokers put two hours a day into their habit and this does not include time spent thinking about cigarettes.
Hours are spent on poor eating habits: thinking about food, buying it, cooking it, eating it and clearing up after it. This does not include the time spent hating our weight and the poor self-esteem that follows a lifetime of failed diets.
The same effort must be spent on nurturing good health habits, so that they become ingrained in the same way the bad habits did.
If you relapse, just start the cycle all over again and keep going until you succeed. Most go through the stages many times before a new habit becomes established.
Smokers can try many times to quit and go through the five stages several times before they succeed. But it is worth noting that more than 90 per cent of smokers eventually give up on their own. Understanding the stages of change theory may help smokers to quit a few years earlier.
It takes a minimum of seven days for a new habit to form, which is the action stage, but the maintenance and preventing relapse stage can take the rest of your life.
Making a lasting change is not easy and involves a substantial commitment. If you have already failed to keep this year’s resolutions, just start again now or the habits will continue for another 12 months and your resolution list will be the same next January.
Dr Jacky Jones retired recently as regional manager of health promotion at the HSE