Why do people seek help from a psychotherapist? Psychotherapy helps people in many ways. For some, it is a way to understand themselves better. For others, it helps to find meaning in their lives. Some have a definite problem they want to address, like, is my job right of me, while others have a specific conflict that appears repeatedly in their lives. For example, “why do I always end up in fights with the people I am closest to?” Some may want an objective listener who will always look out for their best interests. A large number of people, however, seek therapy in order to come to terms with self-defeating behavior that they know they must change because it is jeopardizing their health, their future plans, or their relationships with friends and family. They want to make life changes.
The list of self-defeating behaviors is endless. People want to quit smoking or abusing alcohol and other drugs. They want to control their weight, exercise more, be more optimistic, and quit gambling or watching television so much. They want less conflict with family members and friends. They hope to get their anger, anxiety, or sexual behavior under control, quit procrastinating, stop trying to control other people or letting others control them. They want to stop spending so much money or so much time online, so they seek help from a psychotherapist.
Fortunately therapy can help people address these problems, but only if the person is ready to make the lifestyle changes required to bring the self-defeating behavior under control. Making life changes is easy for some people. For others, the changes seem enormous and the person goes into relapse repeatedly. Think of the number of smokers you know and the number of times they have tried to quit. Think of the number of friends you know who have tried repeatedly to diet, only to gain all the weight back within a year.
Change can happen when the person is ready to change. A psychotherapist can help people identify their readiness to change and move toward the stage of taking action to make the changes occur. A major emphasis in therapy is examining why change may be difficult and understanding how to get past the roadblocks that stand in the way of change.
Research has identified six major stages in the change process. A key to successful psychotherapy is knowing the stage you are in for the problem you are working on. While these are identified as stages, it is important to remember that it is common for a person to move back and forth between stages in terms of their needs at various times. It is not a failure when you need to go back to a previous stage and, in fact, you may have to go backward before you can go forward again.
The first of the six stages is pre-contemplation. In this stage, while others, friends, family, medical professionals, can see the problem, pre-contemplators fail to see the problem and see no need to make changes. The main defense is denial. They tend to blame outside factors for their problematic behavior and claim that they have no control over it.
Next is the contemplation stage. The contemplator is tired of feeling trapped by the self-defeating behavior. People at this stage feel that they can start making changes within perhaps the next six months or so. They admit that there is a problem in their way of living and start thinking about ways to come to terms with it. They are open to raising their consciousness about the problem at hand.
Preparation is the next stage and those in this stage are planning to take action within the next month. They have made commitment to change their problematic behavior in the near future; however they may still have some ambivalence about starting the change process. They are now aware of the problem and anticipate what life will be like once the self-defeating behavior has ended.
The action stage is the one that is most visible to other people. This is the stage where most of the change activity takes place and it is the stage where the greatest degree of commitment is needed. This stage takes real work, but if the previous stages have been addressed adequately, then this stage has a higher probability of success. It helps at this point to engage in healthy self-soothing behavior to replace the loss of the old self-defeating behavior.
Maintaining the changed behavior requires a long-term effort and a revised lifestyle. The maintenance phase is a time to consolidate the changes and to make them part of everyday life.
The termination stage is the victory over the old self-defeating patterns. The lifestyle change has taken hold and the old behavior will never return. The temptations have disappeared. The person can now go on living with fear that a relapse will occur. A brand new day has begun.