James Prochaska, a psychologist, could not understand why psychotherapy did not help his father, who died from alcoholism and depression. His father’s death made him wonder how some people managed to overcome addiction while others didn’t. He decided to find out. He interviewed thousands of smokers and alcoholics who had kicked their addictions; some with the help of psychotherapy and some who quit on their own. He also interviewed people who relapsed; often numerous times.
He asked what helped and what didn’t. He studied various theories of psychotherapy to determine which therapeutic processes foster behavioral change. He compared the theories to the information he obtained from his many interviews.
In 1979, he introduced his theory, which states that overcoming an addiction happens gradually, in six stages. He stated that some therapeutic processes are helpful at specific stages and not helpful at other stages. When people skip any stage, or when they don’t complete a stage, they usually remain addicted. Prochaska and his colleagues tested the model in numerous clinical settings, with great success. In 1994, they published Changing for Good, making the findings available to the general public.
The Stages of Addiction Recovery
Below are Prochaska’s six stages of recovery. For each stage, I’ve listed specific tasks that will help you to complete each stage successfully. Follow these stages and you’ll begin to understand that freeing yourself from addiction is a process that takes time, effort, and accommodation to setbacks.
Stage 1 – Precontemplation: You have no intention to end your addiction. You might deny that you have an addiction. Even if you admit you have an addiction, you tell people you are happy with yourself just the way you are. You might join a rehab program, but you won’t participate wholeheartedly and you won’t get lasting results. You say, “Those things don’t work for me.�? You might resent it when other people express concern about your addiction. You aren’t interested in information on the risks to your health. You might believe that you cannot be helped or that your situation is hopeless.
Your task: Confront feelings of hopelessness and denial. Make a realistic assessment of the short-term and long-term consequences of your current behavior. Find one person who will give you honest feedback about how it feels to see you in the throes of destructive habits. Listen carefully and see yourself through the eyes of another. In order to advance to the next stage, you must do three things:
- Decide that the consequences of your addiction outweigh the pleasures.
- Commit to taking full responsibility for your health and safety and for overcoming your addiction.
- Surround yourself with people who will support in your behavioral changes. You cannot conquer an addiction alone.
Stage 2 – Contemplation: You admit your addiction is a serious problem, and at some point, you intend to resolve it. Still, you might feel ambivalent about making behavioral changes and unsure about where to start. You’d like to pursue action, but you focus on the many inconveniences and disadvantages involved. So you feel stuck. Sometimes it takes a life-changing event to propel people out of the inertia of this stage.
Your task: Educate yourself. Find out what you need to do to replace addictive behaviors with healthy behaviors. Consult expert sources. Get a physical exam and ask for your doctor’s recommendations. Find out what support mechanisms are available online and in your community. Find examples of people who have successfully changed their lifestyle and feel inspired by their stories.
Stage 3 – Preparation: You focus on the advantages of conquering your addiction. You feel motivated. You formulate a plan.
Your task: Decide on your result – how will you know you have succeeded? Make a list of action steps and decide how to achieve each one. Your outcomes might include any or all of the following:
- Assemble a support circle of friends and family members.
- Eat for balanced nutrition.
- Start taking supplements.
- Manage your environment by removing temptations and relapse triggers.
- Go with technology: Check out fitness devices and apps that can help you reach your goals.
- Arrange to get adequate sleep.
- Decide on a suitable form of moderate exercise.
- Resolve any unfinished business that may present an obstacle to achieving your goals.
- Get into treatment with a therapist, class, program, or support group.
Stage 4 – Action: At this phase, you are taking action, following your plan. You are replacing addictive behaviors with new behaviors. You are making better choices and getting positive results. These changes might initially seem awkward, time-consuming and difficult
Your task: Follow the steps in your plan. The challenge is to circumvent temptation, bear with disappointment, and develop consistency in new behaviors. Avoid high-risk circumstances whenever possible.
If you are participating in a program, class, or group, attend regularly for the support and energy you get from people engaged in a mutual endeavor. Keep reading, watching, and listening to books, videos, TED Talks, webinars, and whatever inspires you with hope, examples, and encouragement. Others have overcome addiction and so can you.
Don’t expect everyone to understand the tenacity your commitment requires. Negotiate with friends and family: tell them specifically what you want them to do to support your new behaviors. If they don’t cooperate, don’t argue or defend yourself. Instead, politely insist that this is a promise you made to yourself and you intend to keep it. Get support from those who understand what you need.
Stage 5 – Maintenance: You maintain behavioral change through conscious effort and diligence. Maintenance can last anywhere from a few weeks to several years. The challenge is to prevent relapse. In Maintenance, you can consolidate your successes or you can backslide. Know your weaknesses and respect them. Avoid high-risk situations. The most common threats to maintenance are:
- Social pressure: Your friends and family coax you to relax your discipline. They divert you from your plan. The solution is to maintain your support network. Tell your family how they can support you.
- Overconfidence: You think you can handle a small indulgence or take a “day off�? now and then…and the “now and then�? becomes more frequent. The solution is to get specific with your goals: How often, when, and where, and for how long will you exercise, or meditate, or attend your support group? If you decide you can handle an indulgence, then what are the limitations – how much, how often?
- Stress: An unexpected calamity throws off your routine and you default to old habits. It may be time to improve your coping skills.
- Forgetting: You forget how miserable you felt when you were addicted. You forget how much discipline and effort it has taken to get clean. Forgetting leads to complacency. Most dieters regain all the weight they’ve lost because they think of their behavioral changes as temporary. They think, “As soon as I’ve lost this weight, I can go back to eating what I want to.�? That’s the thinking behind relapse. You must continue to renew and maintain your commitment, even when you veer away from your plan. The foundation of success is not perfection; it’s persistence. Maintenance must be a priority
If you need help with maintenance, hire a counselor, social worker, or psychologist who can help you cope with setbacks, recognize your blind spots, plan for challenges, set up behavioral contracts, and hold you accountable for your progress. Choose someone with competence and experience in treating people with your type of problem. Look for someone with a good professional reputation, warmth, caring, and openness.
Many people do relapse in Maintenance and recycle through the stages a few times before making a permanent change. Guilt and self-blame will not help. Relapse is an opportunity to learn what went wrong and to make corrections the next time around.
Prochaska wrote that action followed by relapse is better than no action at all. People who take action, and then fail, are twice as likely to ultimately succeed, as compared to people who take no action at all.
Stage 6 – Termination: The addiction is finally at an end. Relapse is not a possibility. You have a healthy lifestyle and the old temptations no longer pose a challenge. You have a healthier, more confident self-image.
Recovery is an ongoing endeavor, with setbacks, stalls, and pitfalls. It is rarely straightforward. While it is possible to advance through the stages in a linear manner, many people will move forward, double back, and move forward again. Recovery takes time, tenacity, patience, and the ability to bear with your mistakes along the way. You might give in from time to time, but whatever you do, don’t give up.
For more information on how to end bad habits and improve your coping skills buy my book: Why Do I Keep Doing This?!! End Stress, Bad Habits, and Negativity with Self-hypnosis and NLP
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