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Dr. Steve Frisch, Psy.D. is a clinical psychologist in private practice in
Chicago, Illinois and Northfield, Illinois.

You can contact Dr. Frisch, Psy.D. at
(847) 498-5611.

Learn how to prevent and recover from chemical dependency as well as the aftereffects of chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of Recovery books—From Insanity to Serenity.

What is the Process of Change That Somebody Goes Through In Order to Quit Consuming Alcohol and Other Drugs?

Dear Dr. Steve:

My husband and I have been at odds for the last two years over his drug and alcohol use. He recently got his second DUI. This occurred shortly after he was fired from his job for stealing money. We just took out a second mortgage on our house, one we can’t afford I might add, to pay off his legal bills for the DUI and the trouble he had with his last job. Whereas my kids once idolized their father, they dread the moment that he walks through the front door every night and starts in on them and me. His mood swings are so severe that it seems that there’s never a moment of peace and quiet when he’s around. He steadfastly denies that he has a problem, although the evidence to the contrary is unavoidable. Any time I try to talk to him about his alcohol use, he becomes defensive, changes the subject, and in the end switches the focus to me and my short-comings. I don’t get it, I come from the old school where you pull yourself up by your bootstraps--there’s a problem, you see there’s a problem, you dig in, roll your sleeves up and start working on fixing whatever the problem may be. He should just stop drinking. But that’s not happening here. What will it take for him to see the light and start changing his ways?

In order to best answer your question, let me first present to you a description of the underlying process that people move through in order to change behaviors. This underlying process of change was empirically demonstrated by three very gifted researchers, James Prochaska, John Norcross, and Carlo DiClemente. These researchers developed a paradigm that explains how people change behaviors by moving through an underlying process that has six stages to it. For purposes of our discussion, I will only focus on the first five stages. The six stages are:
1.) precontemplation, 2.) contemplation, 3.) preparation, 4.) action, 5.) maintenance, and 6.) termination.

Precontemplation Stage of Change

People who are in this stage of change are best described by a quote by G.K. Chesterton: It isn’t that they can’t see the solution. It is that they can’t see the problem. Five things can be said for certain about people who are at this stage of change: 1.) they are resistant to change, 2.) they don’t see that any problem exists, 3.) they have no intention of changing their behavior, 4.) they are more intent on changing the behavior of people around them rather than their own behavior, 5.) any help they seek is only because of external pressure applied by their family, friends, boss, spiritual leader, and/or legal system.

Precontemplators are adept at denying that a problem exists. If you talk to a precontemplator about a problem, they’re skilled at shifting the focus of attention to another topic, devaluing your opinion and/or the opinion of others, and assigning blame to others rather than taking ownership of their own behaviors.

Contemplation Stage of Change

In the contemplation stage, people acknowledge that they have a problem and want to do something about the problem. People in this stage often say, “I want to stop feeling so stuck!” The reason that a contemplator feels so stuck is because they are struggling to understand their problem—the cause(s) of their problem, the solution(s) to solve their problem(s), and the technique(s) to execute the solution(s). Although the contemplator may acknowledge that there is a problem and that they are stuck, this does not mean that they are ready to do anything about their problem. Contemplators can spend years stuck in this stage, not because they don’t want to change but because they are afraid to try and perhaps fail. Many contemplators stay stuck in this stage by intellectualizing the problem and the solution. They continue to shop for the best treatment or the best self-help approach without ever taking any action. Once a shift takes place in the contemplator’s focus of their thinking from the problem to the solution and from the past to the future, then and only then will they be ready to move on to the next stage of change.

Preparation Stage of Change

Most people in the preparation stage of change are within a month of taking the necessary actions to start changing their behavior. In this stage of change final adjustments are made prior to actually changing their behavior. As the preparation stage unfolds two things are necessary to take place before the individual moves on to the next step of change. First, the individual must make a public pronouncement of their intent to change—“I will stop smoking next Monday.” The second thing that must take place is the individual must resolve any final residue of ambivalence towards change by convincing themselves that changing their behavior is ultimately what is necessary to solve whatever problem that they’re trying to solve.

Action Stage of Change

This is the stage where the individual most overtly modifies their behavior and their environment. It is during this time that the individual joins a health club, throws their beer down the drain, stops buying cigarettes, or confronts whatever fears that they’ve been avoiding. During the action stage of change, the individual brings together all the preparation and contemplation that they have expended in the earlier stages of change. Although the action stage is the most obvious stage of change to the outside observer, it is not the first stage of change nor the last stage of change. The individual could not have gotten to the action stage of change without first working through the issues associated with the earlier stages of change and will not be able to effect permanent change without going through the following stage of change.

Maintenance Stage of Change

The maintenance stage of change is the stage where the individual consolidates the gains from the precontemplation, contemplation, preparation, and action stages of change. Although from the outside looking in, it may appear as if not much is happening, this is a critical aspect of change without which no change can become internalized in order that the individual is less vulnerable to relapse. It is during this stage that the individual integrates cognitively, emotionally, and behaviorally the changes that they have undergone. During this stage of change the individual shifts the focus of control for the solution to their problems from external sources such as an unreasonable wife just getting off my back, an overbearing therapist finally cutting me some slack, a threatening husband taking anger management classes, a backstabbing boss being fired, a controlling sponsor working his own program, and/or an overzealous legal system finally stops persecuting me to the internal resources of the individual being the sole agent of change. Examples of an individual’s internal resources might be the individual’s own motivation, their ability to manage impulses, and an individual taking ownership of their role in whatever their problem might be as well as their role in what the solution is. Depending on the type of behavior(s) that one is attempting to change, the maintenance stage may last from six months to a lifetime.

From your letter it seems clear that your husband is still stuck in the precontemplation stage of change, yet you are clearly ready for him to change yesterday. But there is still hope for you and your family. You are likely in the preparation stage of change. Apply your old school boot-strap philosophy to yourself and your children. Begin taking action. Attend Al-Anon meetings. See a therapist. Have your children evaluated to best determine what impact your husband’s drinking has had on them. Learn as much as you can about Recovery for family members. Learn how to detach with love. Learn how to stop enabling. Teach your children positive responses to inappropriate behavior. Model for your children what effective self-care is. Just remember, keep the focus on you and your children and off of the behaviors associated with alcoholism.

Learn how to prevent and recover from chemical dependency as well as the aftereffects of chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of Recovery books—From Insanity to Serenity.

Pathfinder’s Checklist
1.) There is an underlying process to changing behaviors that has six stages.

2.) People move at their own pace through these six stages.

3.) People change their behaviors when they’re ready to change not when somebody else is ready for them to change.

4.) Don’t wait for somebody else to change their behavior, focus on moving through the six stages of change and change your own behaviors.



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