The Stages of Change

If not now, when?  — Maimonides



If one were as careful at the end as at the beginning, there would be no failure — Lao Tsu

Evidently, your relationship with an addictive incentive has led you to the point where you are reading about how to get out of it. Coincidentally, the text says that individuals who seek to escape their addictive relationship go through a predictable sequence of stages, which begins with gathering information by reading texts such as this.

Indeed, there is much to learn from observing how addictive relationships play out over time.  The Stages of Change model* emerged from this study.  Individuals who have fallen into an addictive trap tend to cycle through the sequence of stages listed below:

  • Pre-contemplation Stage  – There is no intention to change. It isn’t that they can’t see the solution; it’s that they can’t see the problem. During this stage, incentive use is judged to produce more benefits than costs so there is no motivation to change.

  • Contemplation Stage – The person is now aware of the problem and would like to give up the costs but is reluctant to give up the benefits. This stage of ambivalence may last for a long time; during this time a lot of damage can be done.

  • The Decision– When it is clear that the costs of incentive use far outweigh its benefits, you may decide to change course. The decision is made with the understanding that you may encounter local conditions that would motivate lapsing, and so the intention to adhere to your decision, despite the influence of local factors, is implied.

  • Action Stage – The period of time during which you develop a plan to change the course of your life and begin implementing it.

  • Relapse Prevention Stage – Hopefully you remain in this stage for the rest of your life.  If you relapse, you will have to recycle back to the contemplation stage and go through these stages again.

A Path Through the Stages

The passage from dependence to self-determination is complex. As you progress from one stage to the next you will face a sequence of challenges, each requiring something different of you.  Unlike physical maturity, which unfolds all by itself, the development of psychological maturity requires your active involvement.

The stages of change mark the developmental passage from dependence to self-determination. You play both the role of the agent responsible for planning and executing the change strategy and the recipient of the treatment — the entity who is to change as a result of the change agent's efforts. .

In your role as agent of change, you will have to select the tactics best matched with your current situation.  First some proscriptions:

  1. Do not rely on change processes appropriate for the contemplation stage (e.g., costs-benefits analysis) when you are in fact in the action stage. Trying to modify behaviors by becoming more aware of why you should change is not effective. Insight alone does not bring about behavior change.

  2. Do not rely on change processes appropriate for the action stage until you are genuinely motivated to do what needs to be done. Action without insight produces short-term change.

Recommendations:

  • Contemplation Stage: Most people are vulnerable to local sources of motivation, because they have never decided upon what they really want out of life; or, if they have, they have forgotten what it was. Such individuals are easily corrupted because their motivation is always state-dependent. Since their core motivation is unknown or unavailable to them, there is little to conflict with the motivation for pleasure or relief. .
    The purpose of your life is not ending your relationship with the incentive.  What do you really want for this one precious life you have to live?  If you are unsure about core motivational issues, please work with the contemplation exercises in the next chapter: Contemplation.
  • The Decision: The passage from dependence to self-determination begins with the decision to undertake it. Implied is the understanding that once you make a commitment, your behavior can no longer be dependent on emotional reactions to local conditions . The commitment to quit drinking implies that you will be able to honor it even during moments of great stress or temptation. Be aware that unlike a goal, a commitment is a promise. If you make one and fail to honor it, it would have been better to have declined it rather than to have compromised the integrity of your word. Have respect for the risk associated with making a shallow decision, and invest an appropriate amount of time an energy research the contenders for your core motivation and what you are willing to sacrifice in its service.
    If you are not yet ready to make such a commitment, then return to the contemplation stage exercises. If you are ready to proceed, be aware that whatever you decide during the action stage implies a No Exceptions Clause such as, “I agree to permit no exceptions to my commitment —regardless of how reasonable a violation of its terms may seem at the time.”
  • Action Stage: Once you appreciate your core motivation, you will have to develop a plan and execute it in the objective world.  
    The action stage includes developing your plan and the first few days or weeks of following it. In the beginning, most people are highly motivated to do what it takes to be free of their problem. . The action stage tends to be relatively short and typically lasts until the initial excitement of the new project wears off. Then you will enter what will hopefully be the final stage of this developmental passage.
  • Relapse Prevention Stage: Your task during the Relapse Prevention Stage is to respond as intended during the high-risk situations you encounter until your intended reactions become the default. Ideally, developing good coping skills will be errorless. However, research shows that most people who achieved good long-term outcome did so only after several relapses, each followed by a recycle through the sequence of stages — smokers, for example, relapsed on average seven times before they finally quit. Relapses do not disqualify you from good long-term outcome, but they are very expensive. Relapse prevention is the primary focus of our collaboration.

    The chapters of this section follow the order suggested by the stages of change model, but users are encouraged to focus on the content best matched with their current stage.


* Prochaska, J, DiClemente, Carlo & Norcross, J - In search of  how people change:   Applications to addictive Behavior.   Amer Psychol, 1992,47, 1102- 1114

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