This excerpt from chapter 5 of “Powerless No Longer” covers the next two stages of change, the Preparation and Action phases. Both will be discussed more fully in subsequent chapters.
Preparation – making plans to change and deciding upon the method
Entering this stage, you have done your CBA and decided that the benefits of making a change outweigh those of continuing the way you were headed. You have taken care of the “why,” and are now considering the “how.” The good news is, there are many choices available, and, if you are really convinced that you want to change, many, if not most of them will work just fine for you. The bad news is that if you are still wrestling with the decision to quit, and many still are at this stage, some of the available choices may do you more harm than good. As I mentioned earlier, these stages are not cast in concrete, and people often drift back-and-forth between them, they are only a framework we use as a starting point so we can have a discussion about a difficult and complex subject. At this point, you are experimenting with taking control of your own life, and for some of you, this is a new and frightening experience.
During this phase, you will be deciding which of the available change methods you will choose to begin the process, but don’t think that any decision you make here is irrevocable, you can always revisit it depending upon how well your chosen method is working out for you. We will spend a lot of time on the criteria you should consider in choosing your pathway to change in the next chapter, for now, just realize that the decision you make should be based upon a critical and sometimes painful self-evaluation of not only your degree of dependency, but how you as a person will respond to the different change methods.
For instance, if you are consider yourself a person of “faith,” one of the spirituality-based programs might be a choice for you. On the other hand, if you are the kind of person who is more likely to respond to a rational, cognitive approach, more science and evidence than spirituality-based, there are several good choices for you, as well. There are also paths between the two where you can mix-and-match spirituality, fellowship, and faith with reason, science, and proven cognitive tools, and custom-design your own recovery program.
The first choice you must make in this stage is between the three major categories of change methods, each of which contains various sub-categories. I will do no more than list them with their associated subcategories here, and I will cover each of them in detail in chapter 6:
Primary change methods
1. Without any help, or with informal help
a. White knuckle, just resist urges
b. Engage in alternative activities
c. Avoid temptation
d. Talk with trusted friends
e. Help from parents/family
f. Motivational Enhancement
g. Read and study how others have changed
2. Self-help groups
a. Alcoholics Anonymous
b. S.M.A.R.T. Recovery®/Rational Recovery
c. Moderation Management
d. Other self-help groups
3. Professional help
a. 12-step substance abuse program or treatment center
b. Other orientation substance abuse program
c. Substance abuse counselor
d. Private professional
The overwhelming majority of self-changers, who remitted without formal help or self-help groups, used informal help of some kind. What method you end up trying is going to depend, a great deal upon your assessment of your own condition, and how you think you may respond to the various methods open to you. Although I will touch upon all of the various options in chapter 6, I will concentrate primarily on four of them in chapter 7:
1. Informal help – reading and studying how others have changed, help and support from family and friends, and Motivational Enhancement. From the results of the studies in the last chapter, and an analysis of some other recent studies, I will discuss some simple tools that have worked for the vast majority of those who have overcome substance dependence.
2. Alcoholics anonymous, 12-step recovery. By far the most widely-used of the treatment methods, but it doesn’t seem to work for most people, given its fairly low success rate. We will examine why that is, whether it’s a method you should consider, and if not, are there any portions of it that can be adapted into your own recovery program.
3. SMART Recovery® . Self Management and Recovery Training (SMART) is a four-point program based upon scientifically-proven tools, with both face-to-face and online self-help meetings available all over the world.
4. Moderation Management. A self-help group with on-line and face-to-face meetings working with those whose goal is to moderate their drinking rather than abstain completely.
This book is about what works for most people. It’s designed to help you find the best pathway to recovery for you! The easiest choices, the ones that make the most promises are often not the best ones, so keep that in mind as you examine the alternatives.
Action – now you go to work!
Congratulations, you have made your choice, and don’t ever let anyone ever tell you it wasn’t hard and a bit painful getting here, but now that you have made your decision, not only to make a change, but how you are going to do it, you should feel a bit of relief. A weight has been lifted from your shoulders, and you feel free to move ahead. Of course, apprehension and a touch of fear are entirely normal at this stage, after all, you have not only made a decision to leave your “lover,” but you have purchased the tickets and are at the airport about to leave!
For some, the last few stages are a complete blur, as they pass from precontemplation to action seemingly in a very short time. When I left for work the day I quit, my wife had no inkling that I was going to come home and tell her I was through drinking, but that’s what happened. Of course, the idea had been rattling around up there somewhere for months; I just never said anything to anyone about it.
For the majority of those who quit various substances totally on their own, the action stage initially consisted of a strong resolution to stop using, followed by self-discovery of methods of change that worked for them. These may or may not have included one or more of the following:
- Changes in daily routine
- Engagement in new activities
- Changes in work environment
- Avoidance of situations that created temptation
- A “self-identity” change, that is, they began to see themselves as a non-user
- Stopped seeing former “using buddies,” and replaced them with non-using new friends
- Terminated unhealthy relationships
- Found and nurtured a new “self-awareness” either through spiritual or cognitive means
- Concentrated upon long-term goals rather then short-term gratification
I have already related my own experience with quitting a two-pack-a-day smoking habit, and, as I was extremely well-motivated, and already recovered from another addiction, there weren’t too many changes I had to make, but there were a few worth mentioning. I changed my morning routine, as avoiding that “first cigarette” is really the key to the whole day. I simply read my paper inside, on the couch (I never smoked in the house), instead of outside on the “smoking porch.” I adapted a mental image of myself as a non-smoker. We act as we believe, and we believe as we think. Think of yourself as a non-smoker and you will act as a non-smoker.
The rest was dealing with urges, which were strong at the beginning, and gradually got weaker and further apart as time went on. They were much stronger with nicotine then I remember with alcohol and the best technique I developed for dealing with them was to realize that they were always of short duration, a minute or two at most, and then they would dissipate. It helped to keep in mind that the consequences of smoking far outweighed the short-term “pleasure” that giving in to the “gotta have it” primal scream from my reptile brain would bring.
Most of the recovery programs and self-help groups above use many of the techniques I just mentioned, some more than others. Although I’ll talk in great detail about criteria you might consider when choosing an action method, I suggest you might consider what has worked for those who have quit on their own, as they represent the large majority of those who have successfully recovered from drug or alcohol dependency. According to study and survey data, they all used some form or degree of the following:
- They made a conscious decision that the benefits of not using outweighed the costs (physical, emotional, financial, etc.) of using, thereby gaining the motivation to quit.
- They had to deal with the urges associated with stopping any drug, the “gotta have its’.”
- They had to learn, some of them for the first time, how to get along on a day-to-day basis without resorting to drugs they were using to deal with stress, kill pain, and alter reality, while facing the same problems we all face.
- They had to learn to balance short and long-term goals, achieve a happy lifestyle, get along with others, in short, learn how to live.
All of these factors are important, overlooking any of them could, and usually does, result in relapse, and multiple studies have shown that each time an addict relapses, it becomes more difficult to successfully recover. We will delve much more deeply into these four factors later on, and talk about specific tools to help you deal with the challenges they pose.