James Prochaska and Carlo Diclemente developed the stages of change model in the 1980s while conducting research about how to help people with alcohol use disorders stop drinking. It identified five clear stages that people go through while altering addictive behavior, and it aims to help treatment providers understand where their clients’ mindsets are and how this relates to their ability to progress through their recovery journey.
Learning about the transtheoretical model, as it’s also known, can help people with substance abuse disorders see where they’re at themselves. Sometimes, it’s hard to recognize behaviors in ourselves, particularly if it shows us in a negative light.
Seeing that there’s a pattern in the thought processes of people with addiction can help you be authentic with yourself and recognize the reality of your situation.
The good news is that everyone has the potential to heal and adopt new behaviors that make drug or alcohol use redundant in their lives. With the help of professional counselors, a strong support network and consistent effort, you can gain control of addiction. Call Calusa Recovery today at 844-254-9664 for more information.
The Five Different Stages of Change
It’s important to note that it’s rare for people to go through these stages in a linear fashion. Often an individual jumps back and forth through each stage several times before reaching maintenance. They might skip a stage or two and return to them later or get stuck in one stage for a while, but in most cases, those who achieve long-term abstinence go through each phase for a period of time. It’s even possible to go through several stages in one day.
A pre-contemplator has no drive to change and doesn’t recognize their position as someone with a disordered way of thinking or lifestyle, even if their physical or mental health is suffering. They often defend their habitual use of substances as nothing to worry about, harmless fun or a necessary part of their daily life. If someone suggests they have a problem or urges them to quit, there’s a strong chance they’ll get defensive or argumentative.
In this stage, substance abuse is a part of the addicted person’s identity, and they’re unwilling to even picture their life without it. They won’t engage with research into addiction and often lie to loved ones about how much they use and how often. In addition to not being honest with others about their substance abuse habits, it’s common for them to deceive themselves, too.
If you’re reading this now, congratulations — you’ve already overcome the pre-contemplation stage. Even if you’re not yet willing to consider attending rehab, the fact that you’ve developed the emotional strength to consider that you might have a problem means you’re at least at the contemplation stage. If you’re reading this while attempting to help a family member or friend, there are steps you can take to gently guide them to the next stage.
At this stage, the individual starts to realize that the negative consequences associated with habitual substance use apply to them. While being able to visualize change is still unlikely, they’ll spend a significant amount of time thinking about the possibility.
In addition to being defensive about substance use, they show signs of considering the idea that change could also have advantages for them.
While in this phase, the person is likely to be open to learning more about substance use disorders. If you know someone who might be contemplating change, helping them get access to credible sources of information online or from a health care professional could inspire progress.
By the time they get to the preparation stage, the individual is committed to wanting to change. The inability to see the seriousness of their affliction dissolves, and the reality of the situation becomes apparent. They start to express their desire to take action to the people around them and begin gathering information about how to go about making alterations to their lifestyle.
People frequently skip this stage and jump straight into action, which can hinder progress because they underestimate how many factors contribute to achieving long-term abstinence. If you learn about addiction, recovery and the array of potential reactions you might have, you’ll be more confident in yourself as you move along the road to recovery.
During the action stage, you start to truly believe in your own ability to drive positive change in your life. You’ll begin to experiment with various techniques to try to tackle the problem and actively seek help from other people, which is vital when identifying this stage. The action stage involves careful planning and an understanding of the fact that you need to have a range of defenses and alternative coping mechanisms in place in case of triggers or stressors.
It’s during this phase that a person is most likely to attend a treatment program, although it’s possible for friends, family or authorities to coerce someone into drug rehab at a prior stage. Even if someone doesn’t enter treatment with the full intention to change, it’s possible for therapists and caregivers to help the individual become more receptive to committing to a new lifestyle.
The maintenance stage usually occurs around six months after the initiation of the action stage, but it can occur much sooner or later. It’s characterized by the ability to remain strong in the face of temptation and continually adopt new approaches and reevaluate the systems in place for maintaining recovery. You’re able to foresee potential issues and establish measures to remain abstinent in advance.
A key feature of this phase is understanding how incredible the progress you’ve made is while simultaneously remaining vigilant about relapse prevention. Complacency has just as much chance of leading to relapse as environmental triggers or exposure.
Relapse and Addiction Recovery
While every effort should go into avoiding relapse, it’s an important part of the addiction recovery process for many people. Individuals who are hard on themselves when they relapse will find it harder to escape the cycle of emotional turmoil that so frequently causes people to turn to substance abuse.
See it as a learning experience, and mindfully recognize what happens throughout the process, from the initial thoughts that led you there to the feelings of guilt and shame upon the come-down. As you bring greater awareness to your actions, you’ll gain more control over them. Relapse doesn’t mean you’re incapable of achieving sobriety, but it means you need to adapt your approach in some way.
The team at an addiction treatment center can help you identify where you went wrong and guide you toward taking the necessary steps to prevent it from happening again.
Why Is Behavioral Change So Hard?
What seems like healthy behavior to someone who’s struggling with a substance use disorder is often quite different compared to those with a non-addicted mindset. This is the essence of why it’s so hard to change — denial and rewired brain chemistry convince the sufferer that their substance of choice is of the utmost importance to their fundamental existence.
When you believe substance abuse is working in your favor, it’s hard to drum up the motivation necessary to overcome it. Not only that, but the underlying emotional issues that drive you to try to control your feelings synthetically are often the result of thought patterns and beliefs that you’ve developed over the course of your entire lifespan.
Habitual thinking and behavior is beyond our conscious control, so rationalizing alone can’t inspire change. The way our brains are wired means implementing a new behavior requires you to attach a strong emotional connection to making the change and then repeat that behavior, even when it’s hard. Habits are deeply ingrained into your brain’s chemistry, and the only way to make the necessary changes is to create completely new neural pathways and strengthen them.
Recovery is possible for everyone. Scientific research into neuroplasticity is highlighting the potential for change that people have at all ages. Therapeutic modalities like cognitive behavioral therapy, contingency management and motivational interviewing all help the client replace unhelpful habits with new, healthier ones using evidence-based techniques based in neuroscience.
To truly understand why change can be so challenging, you must first understand how deeply ingrained the reasons people develop substance use disorders are.
What Is Addiction?
Addiction is defined as the repeated use of harmful psychoactive substances in spite of negative consequences. This definition alone shows how complex the condition is, because the person continues to repeat an unhelpful behavior in spite of damage that seems obvious to the outside world. From the addicted person’s perspective, they’re doing something helpful and the benefits outweigh the consequences, no matter how illogical that might seem.
Helping someone see that their behavior is holding them back is one of the most challenging things for friends and family. In general, a loving and supportive approach that kindly encourages research into the science of addiction and the benefits of recovery is more effective than a harsh approach of assigning blame or getting angry.
While remaining patient is hard for loved ones, learning about the different factors that contribute to addiction can help you understand addiction as a disease. It’s easy to take the unpredictable behavior of someone personally, but it’s the result of a complex mix of causes. The better armed family members are with information about addiction, the easier it is to help someone caught up in the cycle of drug abuse.
Genes and Environment
Genetics play a significant role in addiction, although environment has the potential to alter genetic predispositions entirely. Scientists have discovered specific genes that are associated with a person’s potential to get addicted to specific substances, but there’s no single gene that dictates whether it’ll happen to you.
If a person has a parent with an SUD, they’re significantly more likely to develop addiction. This is particularly true if that individual experienced a lack of supervision during adolescence and picked up habits like smoking or drinking at a young age. Not everyone who has these experiences will get addicted later in life, and some people develop addictive behaviors solely because of peer pressure, boredom or repeat exposure.
Trauma and Substance Use Disorders
Experiences in childhood have a huge impact on your emotional reactions in later life, and early trauma has been shown to play a major role in the onset of alcohol and drug use disorders. Research into adverse childhood experiences shows that more than six of the following childhood incidents (including secondary exposure) strongly correlate with addiction in later life:
- Parental separation
- A family member who’s addicted to alcohol or drugs
- An incarcerated family member
- Mental illness within the family
- Witnessing violence
- Physical or emotional neglect
- Verbal abuse
- Sexual abuse
- Physical abuse
Mental Health and Addiction
The link between mental health and addiction is evident, with people who struggle with a mental illness at an increased risk of developing an SUD. Anxiety disorders, mood disorders like bipolar and psychotic disorders like schizophrenia all increase a person’s likelihood of falling victim to harmful substance use.
It’s important for someone with a dual diagnosis to be diagnosed by a medical professional to ensure they get the treatment they need. Many individuals who struggle with repeated relapse do so because of an undetected mental health condition.
Small, Consistent Steps Take You a Long Way
Picking up the phone and inquiring at an addiction treatment center is a small step that can lead to big changes in your life. Recovery is about understanding that behavior change takes time, patience and a lot of hard work. Most importantly, you need to believe in yourself and keep picking yourself up, even when the going gets tough. Don’t worry, though; you don’t have to do it alone.