How We Change

1 September 2021

Last week’s blog covered the Cycle of Change, (CoC, Prochaska, DiClemente, and Norcross, 1992) with respect to judgment.  One reader suggested that it might be helpful to discuss the attributes of each stage in the CoC.  The full scheme is illustrated below in Figure 1, The Five+ Stages of Change.

In general, healthy growth occurs with rightward movement through the stages toward the end goal, order.  Consistent leftward movement, toward chaos, is typically unhealthy and self-destructive when dealing with addictive behaviours. However, back and forth movement— through the stages—was noted as early as the 1970s as being typical of the CoC.

Few individuals (or families), affected by addiction, would dispute that active addiction is chaotic.  Without treatment, those with the addictive behaviours—and their loved ones—feel caught in an unending downward spiral that costs increasing amounts of time, money, well-being, and psychic energy. 

Everyone who has tried to implement a new diet or exercise regime knows that changing patterns is hard.  The researchers who created the CoC began their work with cigarette smokers.  What they found, and have had verified, is that few people were able to quit smoking the first time they tried.  From that evidence, they characterized change as cyclical: you take a shot, last a while in the new pattern, fall back, lick your wounds, and try again.  People often succeed after temporary setbacks known as lapses or relapses back into the unwanted pattern.  They also move back and forth between stages.

Again, as many of us know intuitively, we can go on for quite a while believing that we don’t have a problem.  Those ten pounds have always been there!  Even if I smoke, I run twice a week, so how bad can it be?  I don’t drink like my father did—no way, not even close.  What you’re hearing is the voice of denial.  Denial has a bad name.  It’s usually associated with negative judgments.  To be in denial is to have no willpower, backbone, perseverance…

All unhelpful and untrue.  If you’re using denial, you are not ready to move out of precontemplation, the first identified stage in the CoC.  Precontemplation is characterized by denial and an unreadiness to acknowledge that you may have a problem.  Fear, weakness, or bad timing can all be reasons you are remaining in precontemplation.  (It’s called pre-contemplation because it’s the time before you are ready to start considering that the problem may be yours and that it may be real = contemplation.)

Here's the thing.  Fear, weakness, and bad timing are all real.  And they’re experienced, at different times, by every human being on this planet.  That’s why judgment is a waste of time.  Just because your mother wants you to do the dishes doesn’t mean you’re going to do them.  And if yours is a single mother working twelve-hour days to keep your family unit whole, you’ll probably do the dishes.  But—you are not really doing the dishes until you show up on your own steam. At that point, you’re in the stage called preparation.  You’ve decided that you want to change.  And that happens when you start to realize that you are part of something bigger than yourself and that that bigger unit needs helping hands rather than whining complaints.  So, you no longer need to be asked or pressured.  That’s the fourth stage – action. 

And action is probably the coolest stage.  In action, you start to build a sense of self-efficacy.  A Canadian psychologist, Albert Bandura, coined that term and defined it as “...beliefs in one’s capabilities to organize and execute the courses of action required to produce given attainments” (1997, p. 3).  All of which means you start to recognize your own competence to make, act on, and complete the requirements of your own decisions.  And that feels really good. 

You will probably start to see yourself differently as your self-efficacy evolves and develops.  You will begin to trust yourself and so will others.  Which is a serious issue in addictive families.  (And for the record, families with someone who behaves addictively are addictive families.  It's a culture, not an infection.) 

As action and self-efficacy are new patterns for those leaving addiction, such people often (very often) lapse (temporarily slip into old unhealthy behaviours) or relapse (temporarily return to their addictive way of living).  Please repeat this to yourself: lapses and relapses are part of the CoC, they are not disasters or failures, just landmarks on my journey toward recovery. 

If you’ve made it to the action stage, and lapsed or relapsed, think about the effect of feeling judged.  Judgment reduces your sense of self-efficacy, decreases your sense of connection with others, and leaves you feeling weak, vulnerable, and alone.  Perfect conditions to turn a lapse into a relapse.

The final stage of the CoC is maintenance in which you’ve entered a new way of life.  You have sustained healthy values so well and for so long that the thought of returning to addiction seems odd or unreal.  “Why would I do that?” you ask.  “That’s not who I am.”  And you’re right.  You’ve changed.

Dan Chalykoff is working toward an M.Ed. in Counselling Psychology and accreditation in Professional Addiction Studies.  He writes these blogs to increase (and share) his own evolving understandings of ideas.  Since 2017, he has facilitated two voluntary weekly group meetings of SMART Recovery.