Joanna is a Clinical Psychologist with over 25 years of experience working in the NHS and privately, and now runs a thriving private practice, Key Psychology Services, online and in-person. She is passionate about helping people make changes to both their physical and mental well-being using evidence-based approaches.
What is the psychology of change that lasts, enabling us to make lasting transformations? I often use the analogy of a snakes-and-ladders board. We climb the ladders on the board, but we slip down a snake. We start again and again, climbing the ladders until we reach the desired goal. Do you recognize this game in your own life, or do you often slip back down to the beginning, never reaching the end goal?
The key to reaching and maintaining change involves more than just a decision or resolution. Background preparation, along with significant mental and physical effort, is essential for lasting change and its maintenance.
Let’s explore concepts like motivational interviewing, pros and cons lists (which many of you may already be familiar with), attitude shifts, the cycle of change, and the difference between relapse and lapse. The game-changer is maintenance, which only a select few in this arena of lasting change manage to achieve. I’ll share some tips with you so that the changes you decide to make for 2025 actually last into 2026 and hopefully much longer.
1. Pros and cons and motivational interviewing
A common technique we are all familiar with when trying to make a change, particularly giving up a habit or behaviour is a pros and cons list. What will be the benefits of giving something up, and what will you lose out on? What are the benefits of starting something like a diet or going to the gym, and what are the cons?
Miller and Rollnick (1995) use this as part of their motivational interviewing technique to help people move from resistance to ambivalence. Giving up smoking has its losses, such as stress relief and social aspects, but the pros are huge, mostly health benefits. So why do people continue? Giving up eating large amounts and going on a diet has many pros, but the cons are also in abundance. Enjoyment, stress relief and comfort are often the reasons stated for snacking and bingeing. Stopping these behaviours removes the associated perceived pleasures.
2. Attitude shifts before behavior change
An attitude shift is needed to maintain a behavior change. For example, if you want to stop smoking, you may only have success when you really believe it is for your health. You may have someone close to you who you have lost, which leads to the change. Sometimes, if you have a health scare from the doctor, then this will shift behavior as the attitude has shifted.
Is the incentive of good health enough? Clearly not, as most people relapse within a month of trying to make healthy changes, whether that is giving up smoking, starting a diet or healthy eating plan, or going to the gym. Temptation and instant gratification are too easy when offered a cigarette, a bar of chocolate, or the chance to stay in on a cold night rather than venture to the gym.
Excuses and cognitive dissonance are in abundance when convincing oneself of the thing you are not supposed to do. ‘Oh well, I may get run over by a bus, so I may as well smoke another cigarette.’ This is cognitive dissonance in its glory. Or, ‘I’ll start my diet on Monday. Another chocolate won’t matter.’
If health is stated as a reason, then a major attitude shift is needed. This may involve a lot of deep psychological work, a level of willpower, a huge incentive, or all three.
3. Ambivalence and cycle of change
When making changes, there is often a lot of ambivalence before even starting the cycle of change. Prochaska and DiClemente (1983) describe this well with their Cycle of Change model. Starting with the pre-contemplation stage, usually, there is unawareness of needing to make a change. The Contemplation stage is when an individual knows they ‘should’ make a change but are usually not very motivated. The next stage, Preparation, is when making changes is really thought about in more detail, such as planning the start date for a diet or stopping smoking. Pros and cons lists are drawn up, and the game is ready to begin. Action is the third stage, when cigarettes have been smoked, chocolates eaten, and nicotine chewing gum or vapes are used as replacements, along with healthy chopped fruit and salad for dieters. This continues until something causes the slippery slope down the snake on the snakes and ladders board, back to the beginning. A night out leads to smoking a cigarette socially, or a meal out leads to eating the wrong foods. This is known as the Relapse stage.
4. Lapse vs. relapse
Knowing the difference between a lapse and a relapse can be the ingredient/piece of the puzzle that consolidates change. Often, when you lapse, change is halted. For example, a lapse in a diet may lead to eating unhealthily, and you decide your diet is over and there is no point in continuing. Likewise, if you stop smoking and then smoke a cigarette, believe that change has been ruined, and you start smoking again.
If a relapse can be viewed as a lapse, then change allows for weak moments where unhealthy food can’t be resisted, or the very occasional cigarette is smoked. Going ‘cold turkey’ as often happens after the turkey season, doesn’t always work and, in fact, can have the opposite effect. Along with this, taking a cognitive behavioral approach (CBT), which looks at behavioral changes and the associated thought processes, can also help with change.
5. The game changer: Maintenance
Going round the cycle many times, like the monopoly board, is the game changer. Keep going. You may go back to the beginning, slip back, lapse, or relapse, but get back in the game. Eventually, you will get there, but you need the longer-term goal and focus, not instant gratification. Watch your self-talk and introduce distraction strategies to manage temptation and enhance willpower. Whatever works, do it more, but watch out for excuses, cognitive dissonance, and the lies we tell ourselves, as Steven Bartlett mentioned in one of his recent motivational talks!
6. Seeking professional help
If you want help with making last changes and changes that last, then CBT coaching and Psychological therapy could be your game changer, online and in-person.
Visit my website for more info!
Read more from Dr. Joanna Livingstone
Dr. Joanna Livingstone, Clinical Psychologist
Joanna is a Clinical Psychologist, Coach and NIA Wellbeing Movement Practitioner. Her interest and passion for helping people make lasting changes both to their physical and mental well-being is at the heart of her work. With her 25 years of experience working in the field, she has assessed and treated individuals with a range of conditions. Her particular interests are in workplace wellbeing, ADHD coaching, maternal wellbeing, boosting brain chemistry through psychological techniques, and trauma-based medico-legal work. She has also combined her passions for psychology and wellbeing dance to provide Wellbeing in Motion workshops and retreats, which she offers locally and internationally.
