walkitout (walkitout) wrote,

_Changing for Good_, Prochaska, Norcross and DiClemente (kindle)

Subtitled: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward

It's not clear exactly when the last substantive revision of this kindle edition occurred. No OCR problems, typos, grammar issues, wtf were apparent in the course of a single read-through. Because the original book dated from the 1990s, the contents are somewhat, er, dated. For example, we have made much more progress towards what they call "social liberation" with respect to smoking, and to a lesser degree with respect to drinking. For example, most indoor and some outdoor public places in the US and many other developed nations are now, by law, smoke-free. Far more people have quit smoking since this book was written, and the phenomenon they describe (of smoking becoming increasingly covert, hidden even from family members) has progressed even further, albeit electronic cigarettes have produced a new wrinkle. Because I've been paying a lot of attention to alcohol portion sizes, the text has a single-alcoholic-serving as 12 oz beer, shot (1.5 oz) serving of spirits (both the same as now) or a 4 oz glass of wine.

Before anyone goes, OMG, do you drink/smoke/have a whatever problem, the answer is, of course I have a whatever problem. Almost everyone has a whatever problem. And this is a systematic way of thinking about whatever problems and what people do about them without involving professional assistance and when that works and, when it doesn't, why. Their theory, the TransTheoretical Model of Change (TTM) is a very 90s, pre-CBT approach to Helping People Help Themselves. Starting from then-current research that indicated that virtually all theoretical approaches in the helping professions (he calls them psychoanalytical theories, and quotes Freud without apology, altho fortunately not often) were roughly equally efficacious. Not too long after the TTM model was devised as a way to map approach to "stage" in the progression of change, the helping professions in general explored and adopted a bunch of Brief/Quick/client-centered approaches to helping -- they are now more or less lumped together as cognitive-behavioral therapies.

In any event, a bunch of people and organizations have adopted TTM as a way to better match therapeutic tools (whether that is consciousness raising or putting together a plan of what to do instead of whatever, or rallying one’s social network to provide support or any number of other things) to where in the change process the complainant/client/patient/addict/etc. is. In general, matching the appropriate tool to the person is a Good Thing; one of the major complaints about TTM is that 6 months out, a lot of people need a fairly significant Readjustment (whether that’s a relapse, or a secondary problem that was why the person had the bad habit in the first place, or one of their coping strategies has gotten out of hand, etc.). TTM is pretty much just like everything else in that respect, offering little more than platitudes about Hey, Lather, Rinse, Repeat.

Many brief, quick, CBT type therapies, however, address the readiness for action problem very differently. If someone is sitting in front of a professional, they are ready for _some_ kind of action; these therapies are much more rigorous about having the client define the goal state. Prochaska et al are here to tell you what your goal state should be, and thus they generate a lot more classic therapeutic resistance. They are _smarter_ about responding to that resistance, but they still generate resistance.

Prochaska et al also stumbled across some perceptual things (like how bad punishment is, how good praise is, ratios of positive to negative statements to be perceived as balancing out as positive, the importance of making a goal more attractive vs. the current state of being less attractive, and having some numbers on that) that are pretty widely recognized by NLP types. In good news, this group of authors is considerably less cult-y than some NLP outfits. In bad news, their therapeutic tricks are a lot sloppier and thus take longer and don’t necessarily “stick” as well.

But if you are looking for a theory of habit change, this is a good one. While the primary focus is on smoking, drinking problems, anger management, exercise/diet/weight control and other health interventions and so forth, you could kind of use it for almost anything. One of the most consistently wonderful things about this book is its honesty about the crankiness of people who are in the process of major self-change, and how a lot of bad habits are the result of people trying to suppress negative emotions or avoid enforcing boundaries, and other things that cause social conflict. They emphasize the importance of developing assertiveness, and recognize that some relationships may need to end (temporarily or permanently) if they are getting in the way of necessary changes.

They do devote a chapter to exploring how to tell when it is time to involve a professional in the change process.

However, I’m going to look around and see if there is anything better out there.
Tags: book review, non-fiction, psychologist
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