“Those of us who have been diagnosed are not objects to be acted upon. We are fully human subjects who can act and in acting, change our situation. We are human beings and we can speak for ourselves. We have become self-determining. We can take a stand toward what is distressing to us and need not be passive victims of an illness. We can become experts in our own journey of recovery. ”

~Recovery is a Journey of the Heart, Conference Talk. 1995. Patricia Deegan Ph.D.~

In my practice as a counselor, I will help you diagnose yourself, and become An Expert In Your Own Journey Of Recovery .

  Your Self Empowerment Is The Goal, Regardless Of Your Initial Situation.

Most people “sneak up” on making big changes in our lives, and all too often, it takes some old fashioned pain to get us even thinking about the change. The chart below is an adaptation from the “Transtheoretical Model of Change”. This model is in very wide use the last few years. I first started using this as a tool about 15 years ago.

Prochaska and DiClemente's Stages of Change Model

Stage of Change	Characteristics	Techniques
Pre-contemplation	Not currently considering change: "Ignorance is bliss"	Validate lack of readiness Clarify: decision is theirs Encourage re-evaluation of current behavior Encourage self-exploration, not action Explain and personalize the risk
Contemplation	Ambivalent about change: "Sitting on the fence" Not considering change within the next month	Validate lack of readiness Clarify: decision is theirs Encourage evaluation of pros and cons of behaviorchange Identify and promote new, positive outcome expectations
Preparation	Some experience with change and are trying to change: "Testing the waters" Planning to act within 1 month	Identify and assist in problem solving re: obstacles Help individual identify social support Verify that individual has underlying skills for behaviorchange Encourage small initial steps
Action	Practicing new behaviorfor 3-6 months	Focus on restructuring cues and social support Bolster self-efficacy for dealing with obstacles Combat feelings of loss and reiterate long-term benefits
Maintenance	Continued commitment to sustaining new behavior Post-6 months to 5 years	Plan for follow-up support Reinforce internal rewards Discuss coping with relapse
Relapse	Resumption of old behaviors"Fall from grace"	Evaluate trigger for relapse Reassess motivation and barriers Plan stronger coping strategies

In the past, counselors, therapists and everyone else tended to look at change as an event, instead of a process. Change takes place over time, not all at once .

Remember, The Very Fact That You Landed On My Site Can Be An Indicator That You Are In One Of The Stages.

To take a closer look at the stages:

PRECONTEMPLATION : No intention of taking action in anytime soon. People in this phase tend to be uninformed or lacking the right information about their substance use. All too often, people in this stage have lost their sense of personal power, and don't feel they can change. Folks in this stage tend to hang out with people who don't talk about their use in realistic terms, or they use alone and isolate themselves from any beneficial influences.

CONTEMPLATION : This is were people intend to make a change within the next 6 months. In this phase there is a lot of “weighing the pros and cons” of using vs not using – but all too often the reasons to continue using override the reasons to stop. This stage can feel like a civil war! There may be an underlying desire to stop using.

PREPARATION : This is where someone is intending to take action over the next month. These folks have a phone number of a counselor but haven't called yet, have been looking around the internet and doing research (a very good thing!), buying self help books. Beginning to imagine yourself as “being there” and maybe starting to get tired of some of your own excuses.

ACTION: A person is has been making changes for about 6 months, and the changes are becoming obvious to those around them. This is where the total abstinence and no “chipping” in going on. This stage is more fragile than some people think, and it's very important to guard against “chipping” and/or relapse. This is where it becomes apparent that one really does have choice whether they use or not! A lot of little victories in coping with daily stress may be experienced at this point.

MAINTENANCE : People in this stage are doing what it takes to prevent relapse, but they don't seem to be working as hard as those in the action stage. They aren't the “eager beavers” they once were in the action stage, but are less tempted and more confident of the ability to stay clean and sober.

RELAPSE : (Not shown in the chart) A relapse back into using can be educational, if it is handled correctly. Most people don't regress all the way to the Precontemplation stage —they usually regress to stage 2 or 3- and this regression can be addressed in treatment as a natural starting point. The truth is, however, that most people don't stay permanently clean and sober in their first attempt. A good example is this: think of the people you know who are addicted to nicotine. Have they tried to quit (many have). Do you know anyone who has quit smoking tobacco? I bet they have made prior attempts to quit- before quitting for good.

(Changing For Good by Prochaska, Norcross and DiClemente 1995)

None of these stages are “good” or “bad”.

You are where you are, well, because that's where you are! The first goal of substance abuse treatment is to meet you where you are, and start from there. .

It' a lot like the process of learning to ride a bike. You see others riding, you contemplate learning to ride, you prepare to learn, you start doing it, then you're riding all over the place just like everybody else!

Stopping using can make you feel
like you have lost a friend.

 

But You Can Do It, With The Right Information,
Skill and Support!

Treatment will help you understand and work through this. This process can occur in stages, and these stages are similar to the stages of Grief and Loss:

•  Denial
•  Anger
•  Bargaining
•  Depression
•  Acceptance

Denial is the “shock absorber of the soul”. It is a built – in mechanism that helps you tolerate intolerable pain. If you are chemically dependent, it can be lethal because it keeps you from seeing your situation for what it is. With people who aren't chemically dependent, it buys time until a person is better equipped to move on. Chemically dependent people prolong their illness with denial by blaming people, places or circumstance while denying responsibility for their own well being. There is usually a lot of excuses (and really good sounding ones!) to justify the use.

Anger kicks in at some point because some part of you feels that you've gotten a bumb - deal, and feel like kicking and squirming. This is often a stage where we feel like climbing up on our high chairs and banging our spoon it because we are uncomfortable and need time and help to assume responsibility .

Bargaining occurs when you are trying to strike a deal with your use, by switching to a different substance, or trying to limit your use in some shape or fashion. We often make promises to “be good” or prove that we can stop using, temporarily.

Depression is where the real grieving is apparent. Often, there is a fine line between clinical depression and the grief process, and some overlap between the two for recovering people. Refer to the outline on grief reactions and depression, below. If you are in counseling, discuss the outline with your counselor.

Common Grief Reaction:

• Don't feel like eating at times, sometimes overeating
• Remembering, imagining or dreaming about using
• Feeling weepy and tearful, feeling of loss or longing
• Feeling overwhelmed or insecure about your capabilities
• Confusion, cant decide what to do next, forgetfulness
• Some difficulty sleeping or oversleeping
• Lack of interest in things that are gratifying to you
• Blaming yourself, anger and self pity

Symptoms of Depression look real similar to the list above, however they tend to persist, and are more intense or severe:

•  Can't function on the job or in your family roles
•  Persistent loss of sleep, multiple awakenings.
•  Can't concentrate and confusion that doesn't subside
•  Loss of interest in friends, family, work, social activities
•  Loss of energy, fatigue
•  Feeling very hopeless, having suicidal thoughts or plans
•  Feelings of panic
•  Depressed mood that doesn't lift
•  Lingering tearfulness and cant feel stable emotionally
•  Loss of weight over short period of time

This Stage, Just Like The Anger Stage, Can Be Understood, Tolerated And Lived Through With Knowledge And Guidance.