The cycle of change
STAGES OF CHANGE
Getting from point A to point B in quitting a compulsive habit can be easier for some and harder for others. For some just realizing that the habit has brought on unexpected problems is enough for them to merely stop doing it any more. These are usually people who have a fairly strong sense of their own worth and value as an individual and as a human being. They easily see the long range value of quitting. But for many it is much more difficult to turn away from a habit that has been a satisfaction and substitute for something that seems to be missing and which gives a sense of relaxation and a feeling of “completeness”.
When that is the case, the road to sobriety is a succession of efforts. Putting those efforts in a sensible order will greatly enhance its success. In the book, Changing For Good, James Prochaska outlines six stages of change. Here they are:
Pre-contemplation, (What problem? Don’t bug me!) People don’t want to admit that they have a problem and avoid any consideration of the subject. Some people stay in this stage of change for a long time and often experience growing problems. This difficult stage is often called “denial”.
Contemplation, (I want to change . . but then, I don’t) This is probably where you are if you have read this far. You may well have mixed emotions about either quitting or just letting it all hang out and doing nothing about the problem. Here you at least become aware of your problems, struggle to understand them and even may think seriously about solving them.
Preparation, (I know I have to, but how?) Here is where you start to make decisions. While some people become chronic contemplators and substitute more and more analysis for action, the successful person will make decisions and prepare for them. At this stage, your personal outlook will start to reach more toward your future and less toward your past.
Action, (Now I’ve got the bull by the horns!) OK, this is where you take the plunge! But there is no “magic bullet”, and there is no cheap change. At this point you are very much on your own. You need all the helping relationships you can get and so you let your commitment be known to others, but you are doing this just for yourself. Be prepared, you may even get some disapproval of others, and experience some anxiety and anger. However these things will be temporary. Just review all the things you have established in your contemplation and preparation stages and stick to them.
Maintenance, (Gotta stay with it!) This is the great drama of quitting an addiction. You have considered and planned and decided to change your life and leave part of it behind with good riddance. But the bugaboo of temptation and lapse are always present. Therefore this stage needs plans and goals like all the others, you treat a lapse as just a temporary delay in forward progress and something that you can learn from. And you have the anchor of all your well-planned contemplation and preparation to rely on.
Termination, One day you will be able to look back and feel very good about your courage and determination in doing these right things in your life.
ENHANCING THE STAGES OF CHANGE
The Six Stages of Change are enhanced by the 9 Processes and Techniques.
From the book Changing for Good by James Prochaska.
“Processes” are selected activities that are regularly initiated to effect change. There are nine important ones chosen by the authors as distinct areas of consideration and useful “tools” in Changing for Good. They are:
1. Consciousness-raising: Increasing knowledge about yourself and your problem.
2. Social liberation: Considerations in the external environment that can contribute to helping change, ie: no smoking areas, lo-cal menu items, advocacy groups.
3. Emotional arousal: Increased awareness through depth of feeling from natural events or dramatic intervention, psychodrama.
4, Self-reevaluation: A thoughtful and emotional reappraisal of yourself as regards your problem, weighing the pros and cons of changing.
5. Commitment: Acknowledging that you are the only one who can respond, speak and act for yourself.
6. Countering: Planning for and substituting healthy responses for unhealthy ones, action oriented.
7. Environmental control: Restructuring your personal environment so that the probability of a problem-causing event is reduced.
8. Rewards: Affirmation of desirable behavior by self or others as contrasted with and better than any type of punishment for problem behavior.
9. Helping relationships: Receiving care, support and assistance from significant people in your life.
The 9 Processes are broad areas which are applied during different stages of change.
Within each process there are usually a number of Techniques that can be applied to further the effect. The few examples given with Social liberation above are examples of techniques.
Another illustration of this would be in countering urges. One person might substitute chewing gum as an alternative to having a cigarette, while another might distract himself by running around the block.
THE STAGES OF CHANGE
“It isn’t that we cannot see the solution. It’s that we cannot see the problem.”
Precontemplators usually show up in therapy because of pressures from others… spouses, employers, parents, and courts… Resist change. When their problem comes up, they change the topic of conversation. They place responsibility for their problems on factors such as genetic makeup, addition, family, society, destiny, the police, etc. They feel the situation is HOPELESS.
2) CONTEMPLATION STAGE
“I want to stop feeling so stuck!”
Contemplators acknowledge that they have a problem and begin to think about solving it. Contemplators struggle to understand their problems, to see its causes, and wonder about possible solutions. Many contemplators have indefinite plans to take action within the next few months.
“You know your destination, and even how to get there, but you’re not ready to go.”
It is not uncommon for contemplators to tell themselves that some day they are going to change. When contemplators transition to the preparation stage of change, their thinking is clearly marked by two changes. First, they begin to think more about the future than the past.
The end of contemplation stage is a time of ANTICIPATION, ACTIVITY, ANXIETY, and EXCITEMENT.
3) PREPARATION STAGE
Most people in the preparation stage are planning to take action and are making the final adjustments before they begin to change their behavior. Have not yet resolved their AMBIVALENCE. Still need a little convincing.
4) ACTION STAGE
Stage where people overtly modify their behavior and their surroundings. Make the move for which they have been preparing. Requires the greatest commitment of time and energy.
CHANGE IS MORE VISIBLE TO OTHERS.
5) MAINTENANCE STAGE
Change never ends with action. Without a strong commitment to maintenance, there will surely be relapse, usually to precontemplation or contemplation stage.
Most successful self-changers go through the stages three or four times before they make it through the cycle of change without at least one slip. Most will return to the contemplation stage of change. Slips give us the opportunity to learn.
The process of change cNan be scary but sometimes remaining the same and not changing ends up a scarier prospect than jumping into the unknown.