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Contemplation

In the Contemplation stage of 'the Cycle of Change' a person is thinking about change but they haven't yet made up their mind. Classically, this will be when someone is feeling the physical or psychological after-effect of the behaviour and everything is more difficult or unpleasant than normal. In the midst of the hangover the common cry is ‘never again’ but in just a few hours the temptation arises to have the ‘hair of the dog’ because ‘just a wee one won’t do any more harm.’ The window of opportunity for a change passes as the person goes back into the pub. This will frequently involve both loving and hating the drug (and it is frequently expressed this strongly) and is known as ambivalence. 'I really love smoking and I hate the amount of money I spend on them.'
There is a common popular belief that people have to be really motivated to change and this comes from some kind of 'inner strength.' The assumption is almost that inner strength is something that people either have or do not - almost as if it is something that cab be bought in Boots. The reality is motivation is fluid and susceptible to change. Miller and Rollnick describe two key elements of motivation workers can influence. These are that the person must be both willing and able to make the change.

• ‘willing: the importance of change.’ - the person must want the change. This is made more likely by discrepancy –as long as things are going on OK towards where I want to get then things are OK – when things are off the wall and there is a difference between what I want or believe I am then I must do something about it.
  ▪ ‘able: confidence for change’ – they must believe that the change is achievable and that they are able to achieve it.
  

If it is recognised that a change is necessary but there seems to be no feasible way of bringing it about then the client may make excuses or opt out. Miller and Rollnick citing Anna Freud list four classic strategies to avoid thinking about change.

• Denial – it isn’t so bad
  ▪ Rationalisation – I didn’t want it anyway
  ▪ Projection – it’s not my problem – it’s theirs.
  ▪ Readiness – I want to but not yet.*
  

These insights underpin Motivational Interviewing.

References

Motivational interviewing 2nd ed William Miller and Stephen Rollnick - Guildford press London New York 2002