SNAP!. Gary Small

so she gave up and assumed that no form of psychotherapy would ever help her.

      Often someone’s previous failed attempts at change can reinforce this kind of thinking. Shirley’s first try at therapy failed, so she allowed that to become a barrier against any change at all. Individuals in the considering phase often create imagined barriers that serve as excuses to remain stuck in old, unproductive patterns.

      Transitioning through this stage involves identifying strong motivators as well as pinpointing and overcoming one’s barriers. Some people stay in the considering phase for long periods, remaining ambivalent about whether the effort is worth it to them, and they are not yet motivated enough to try.

      It wasn’t until recently that Shirley’s escalating anxiety symptoms began affecting her health—her asthma was worsening and she was developing irritable bowel syndrome. Her declining health supplied the motivation she needed to make a change. She found a behavioral psychologist who did not delve into her childhood but instead focused on the here and now. This time therapy made Shirley feel better instead of worse, and she was able to discover the root of her anxiety and overcome it.

      Connecting with other people who have made successful changes in their lives can also be very motivating. Many studies have shown that when we spend time with people who engage in healthy behaviors, we are more likely to engage in those behaviors ourselves. If your goal is to become more agreeable, hanging out with other agreeable people will no doubt help you achieve that goal.

      Once my friend Jackson accepted that he needed to change his eating habits and start exercising, he entered the considering phase of change—not quite ready to meet me at the gym, but beginning to formulate a plan to move forward. I advise patients in this phase to begin thinking about small but achievable goals for themselves and to work on understanding the feelings behind their barriers to change.

      Planning

      People in the planning phase have overcome their ambivalence; they know what they want to achieve and are sufficiently motivated. Many in this phase begin experimenting with various strategies, embracing some and discarding others.

      To ensure progress through the planning phase, it’s important to establish a concrete blueprint for change. Brainstorming with a therapist, friend, or family member can be helpful when deciding which strategies to try. Just the process of writing down several possible approaches can accelerate one’s progression.

      Jackson’s busy work schedule made it impossible for him to get to the gym during the week, so he compiled a list of ways to squeeze in some cardiovascular conditioning every day at work. He started by taking the stairs instead of the elevator to his office on the eighth floor. Of course, he wasn’t in good enough shape to climb all eight flights right away, so he began by climbing one flight up each day for the first week, two flights the next week, and so forth.

      Ambivalence may still occur during the planning phase. Reviewing your reasons and motivators for change may assist you in getting to the bottom of your ambivalence and overcoming it. Understanding any lingering feelings that are causing resistance to change can help make your plans more concrete so you can move forward.

      Changing Your Personality Alters Your Brain

      When we alter our personality, we also change our brain. For each phase of change, different brain regions become engaged and work together to solidify our new behaviors and traits. When practicing a new behavior, the prefrontal cortex (the thinking brain) sends signals to the midbrain, which then releases the “feel good” chemical messenger dopamine as a reward for the new, better behavior or personality trait. Another region, the striatum, coordinates these signals, and if the new trait doesn’t pan out, dopamine declines, the behavior is less rewarding, and we are less likely to adopt it. However, if the new behavior or trait is effective in bringing about the desired result, then the brain’s sensorimotor cortex and infralimbic cortex work together to strengthen the neural connections and help transform the new actions into habits so we can sustain them for the long haul.

      Taking Action

      After someone has defined the new behavior they desire and planned how they will achieve it, they enter the acting phase of change. Hopefully, they have prepared themselves to meet reasonable goals along a manageable timeline. However, success may require a willingness to adjust that timeline if necessary. My friend Jackson began taking one flight of stairs up to his office the first week. During the second week of his program, Jackson graduated to two flights each day, but the third week he caught a cold and was too tired to take the stairs, so he had a temporary setback. Once he recovered, he was able to get back to two flights each day without much effort and was encouraged by the endurance he had built up in a relatively short period of time.

      Personality change is challenging for many people, and it is not surprising that lapses and relapses sometimes occur. A lapse is a single slip back to an old behavior, while a relapse is a more significant backslide. Knowing that lapses are common during the acting phase and reframing them as temporary setbacks can help people avoid feeling out of control. If they allow themselves to bounce back to their new behaviors swiftly, they can avoid letting a minor lapse evolve into a relapse.

      Some people find they can gain a greater sense of mastery over their new behavior when they intentionally plan a minilapse—perhaps a day off from their exercise routine or a cheat meal from their diet. They learn that they can return to their new behaviors quickly following a slip and gain confidence that they will be able to bounce back from any future unplanned setbacks. Therapists, supportive friends, wellness coaches, and others can serve as informal cheerleaders to help people stay the course during the acting phase.

      Shirley’s behavior therapist taught her ways to better manage her anxiety and its accompanying symptoms. She started using a guided meditation app on her smartphone that she began using every morning as well as throughout the day when she needed to calm her worries. One morning she couldn’t find her wallet and was late for work, and it threw her into a panic. For the next few days, her meditation app didn’t seem to help. Luckily she had the good sense to call her therapist, who was able to reassure her that her lapse was temporary and she could recover quickly. That brief phone call was enough to get her back on track and make her feel greater control over her anxiety once again.

      Sustaining

      Once our new, improved behaviors and thinking patterns transition into new habits, we move into the sustaining phase. Most of us feel a sense of relief when we make it to this phase, and many begin aiming for new and perhaps loftier goals—this time with the confidence that comes with having achieved their original objectives. Keep in mind, however, that lapses can still occur, so we need to learn strategies for minimizing and rebounding from a slip. Soon enough, our new habits will lead to permanent change and the possibility of a lapse diminishes.

      Reminding ourselves of the values and motivations that first led us to change will help us stay the course and avoid setbacks. Remaining close to others who share our ideals and support our new desired behaviors is important for a successful and sustained personality change.

      Jackson made it to the sustaining phase—he was able to lose 30 pounds with his diet and exercise program, but he wanted to do more. After six months on his program, he finally agreed to join me at the gym and meet my trainer. Jackson began strength training on the weekends, and with the trainer’s encouragement, he increased his cardiovascular workouts as well. Jackson understood that his new diet and active lifestyle would protect his health over the years, and although he no longer was a go-to choice to play Santa Claus, he remained his jolly old self.

      Change Strategies That Work

      No matter what phase you have reached in your quest for change, you will discover that some strategies are more effective for you than others. By experimenting with different approaches, you will find the ones that work best for you. If you encounter