• How We Change
• The Process of Change
• Changing Your Response to Chronic Pain
• Taking Action
• Sources

How We Change

In their book Changing for Good, psychologists Prochaska, Norcross and DiClemente explain that change follows a predictable and controllable course. While you cannot change your pain, you can change your response to pain. It may be helpful to understand the process of change before you begin trying new techniques for managing your pain.

Learning about the change process will help you accomplish the following:

• Be more realistic about how fast you can change
• Be less critical and more understanding of yourself when you are trying to make a change
• Learn how to support the process of change

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The Process of Change

How do we make changes in our lives? It is not that easy! Our behaviors and attitudes can be very hard to change. For instance, our experiences with pain are usually complicated. Our psychological needs and even our relationships with other people can affect our pain. Therefore, making a change in the way we respond to our pain may be challenging. To make such changes, most of us need to spend some time thinking about how to change.

Do not equate change with action!

Prochaska, Norcross and DiClemente outline six separate stages of change:

• Pre-contemplation: In pre-contemplation we aren’t even aware that there is a need for change. For example, you might not be aware that caffeine can interfere with a good night’s sleep. Once you have this information you can decide to ignore the information, remaining in pre-contemplation.
• Contemplation: If you do acknowledge the need for change and begin to think seriously about doing so within the next six months, you have entered the contemplation stage. In this stage you think about the proposed change, debate the pros and cons and then decide whether or not the change is worthwhile. You might decide that a good night’s sleep is important. You may consider finding a substitute for your caffeine drinks.
• Preparation: If you decide to go ahead with the change, you enter the preparation stage. You make plans to start the change within the next month or so. You are still using caffeine, but are now experimenting with different brands of decaffeinated coffee and also trying some herbal teas and other caffeine-free drinks.
• Action: You enter the action stage when you actually make the change. You completely eliminate the caffeine and use the new products you have found.
• Maintenance: In the maintenance stage you struggle with trying to maintain the new behaviors, often finding it difficult to do so. Eventually this change becomes easier and feels more natural to you.
• Termination: If you reach the termination stage, you have complete confidence that you can maintain your new behavior. You are never tempted to go back to the problem behavior you have left behind. For many problem behaviors we never reach the termination phase, but remain in the maintenance stage, always having to work at maintaining the change.
  

Even people who are not ready to act can begin the process of change. Fewer than 20% of problem populations are ready for the "action stage" at any given time.

While all of the stages are important to go through, we sometimes get stuck in a stage. We may need to ask for help in figuring out how to move forward. Sometimes we move backwards to an earlier stage. This is normal. Most successful self-changers go back and forth through the stages of change three or four times before they are finally settled in their new behavior. Successful change takes time and practice!

Only 2% of self-changers follow a linear, step-by-step process of change.

Some basic tips for making a change:

• Allow yourself time to move back and forth through the stages of change.
  
• Appreciate yourself for making the effort.
  
• Look for clues as to what stopped your progress.
  
• Figure out ways to overcome any problems you encountered.
  
• Picture yourself having successfully completed the change and continue to work toward that goal.

Beware of "all-or-nothing" thinking! The "action stage" is not the only time you can make progress.

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Changing to Your Response to Chronic Pain

Use the “Pain Response Worksheet” to think about how you currently respond to your chronic pain and how you manage that pain. Explore how you might be able to change in your daily life to better manage your pain.

DOWNLOAD RESPONSE WORKSHEET-
CHANGING YOUR RESPONSE TO CHRONIC PAIN

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Taking Action

Taking action involves identifying:

• Concrete, feasible, measurable goals
• Barriers to achieving those goals
• Supporting factors
• Strategies for overcoming barriers
• A timeframe for achieving goals

Use the “Action Plan Worksheet” to identify one thing you would like to change about your response to chronic pain or managing your pain and how you will accomplish this change.

Download Action Plan Worksheet

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Sources

This model of self-change is utilized in programs sponsored by the National Cancer Institute and the National Institute for Drug Abuse.

Prochaska, James, Norcross, John, and DiClemente, Carlo. (1994) Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward. New York: Avon Books.

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