don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

I'm often asked this question, particularly by a spouse concerning some particularly undesirable habit of his or her mate. Just yesterday, I got the following post from a friend, and a person I know to be a genuine wellness enthusiast: "Don-- I (like many other people) love a person who still smokes. He knows it's wrong and that he should quit. But he doesn't. How about an essay for people like me who want to help without nagging...What's a person to do in a situation like this, Dr. Don?"

It pains me to have to break the news to nice people like the good woman who asked this question, but somebody's got to do it. Here is what I wrote: "Other than to make your wishes known to the loved one in a supportive fashion (in other words, without unpleasantries), there is little to be done to bring about changes in another that the other does not desire. Substitute a wide range of "offenses" against your sensibilities and assess what YOU would do if these behaviors were practiced. At what point would YOU make changes, as opposed to hoping for changes in someone else? How about if the loved one were an alcoholic? How much of that would YOU endure before leaving the situation? How bad would it have to get? Ask the same for all manner of horrors (violence, enthusiasm for the Republican ticket, etc.) and pay attention to YOUR responses. Forget about changing someone else."

This is not to argue that such attempts do not occasionally succeed (they do) or that it's not a good thing for the professional class (health educators, doctors, counselors, etc.) to promote change in general (through lectures, books and so on) and in interpersonal encounters, especially when there is an INTEREST in changing on the part of others. However, on a personal level (spouse, friend, etc.), the price in resentment as well as recidivism is usually high. Most of the time, however, attempts to change someone else before he/she is ready to make changes are doomed. The energy and other costs required are out of proportion to the success rate for such unpromising campaigns.

Health educators, especially academics, love to theorize about change. They have promoted a number of popular constructs for change, the best known of which is Prochaska's "Stages of Change" model. This concept views change as a gradual process, progressing from disinterest ("I like to smoke!") to an unwillingness to change ("Back off, woman!") to precontemplation ("Well, I might consider it at a later time--MUCH later!") to a genuine period of contemplation of change ("Hmmm, I suppose the house WOULD smell better!") to deciding and preparing to make a change ("You know, Honey, you may right about this-it would improve MY life, too!"). The final steps are the action ("I've smoked my last cigarette-that's it!") and the maintenance/relapse prevention stages ("Yes, I'm a backslider, but I mean it this time, really!). I have often heard the statistic that those who quit smoking for good do so on their 17th attempt to quit. If true, and I have not been able to find evidence to support this popular assertion, it would suggest that previous "failures" were not really failures at all, but rather necessary stages to gaining the self-knowledge and resolute determination to quit for good. In any event, Prochaska believes people recycle through the stages of change several times ("relapsing") before success is finally achieved.

The bottom line: Don't play health educator with a spouse, close friend or family member whose good will and love you wish to maintain-even if you are a health educator. People will change when they are ready, and there may be some stages to undergo before that time will come to pass. If you really can't resist trying to change someone else, pick someone who is not so important in your life, preferably a total stranger you are not likely to see again!

If changing others were so easy, would about 20 percent of adult Americans still be smoking? Would 64 percent of the population be overweight or obese, out of shape, overstressed and looking for every opportunity to elude self-responsibility by finding cures in prescription drugs and other medications, including alcohol? I'll let you guess what I think about that--it won't be hard! What YOU think about it is what really matters.

I asked my good friend Bob Ludlow, former editor of a major health magazine and, more important, a true critical thinker who knows a great deal about behavior change, what he thought of my advice to the lady who loves a smoker. You might enjoy his comments as much as I did, so here they are.

I like this good, sensible advice. Only comment is I am very suspicious about so-called "stages." You know, even when presumed stages are based on good data, we're talking about averages that may or may not apply to any given individual. Hell, sometimes the average doesn't apply to ANYONE. And we all know each individual situation is unique. In this case, "He knows it's wrong and that he should quit but he doesn't," is the key. If this were my spouse, I would be sure she knew how important the issue was to me and ask if she would think about seeking assistance from a qualified professional. You never know what might work for any given individual. That's why I'm so skeptical about stages that seem to imply a kind of inexorable, uniform process that everyone goes through. I know I'm right when I assert that that is BULL.

There you have it. Besides Ludlow, the only other notable I want to cite on this topic is Aldous Huxley, who said, "I wanted to change the world. But I have found that the only thing one can be sure of changing is oneself."

Good luck, be well and always look on the bright side of life.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of appearance and aging. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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