Understanding the Role of Stages of Change in Addiction Recovery

It can be confusing to watch an addict make choices that seem self-destructive, continuing in patterns of behavior despite major consequences, unwilling to stop and make a significant change in their lives.

It’s even more bewildering to be in the midst of addiction yourself, facing fluctuating layers of willingness to change within yourself.  Some days you might feel ready to tackle whatever’s necessary to experience freedom from the addiction.  But a few hours later, you might find yourself justifying your behavior and explaining to yourself why it isn’t really that bad.  What gives?

The Transtheoretical (Stages of Change) Model

In 1970s and 1980s, James Prochaska and Carlo DiClemente developed the transtheoretical model to explore the mechanisms of change in problematic behavior patterns, including addictions.  Their model seeks to understand resistance to behavior change in many areas, ranging from eating habits to addictions.

The transtheoretical model has formed the foundation of a new approach to targeting addiction.  Often addicts are aware of a need to change and have begun to confront themselves, which can create shame surrounding their behaviors that backfires. Toxic shame creates lack of motivation and hopelessness.  Motivational interviewing, on the other hand, is a type of therapy that focuses on these mechanisms of change to help an addict in recovery understand how to take steps to move forward.

This shift in strategy involves a more personalized approach in treating addiction.  It helps you understand the effects of the addiction on your personal life and identify what needs to change from that perspective within the context of a vision for the future, rather than just making changes out of shame or a belief that you “should” change.

The Six Stages of Change

The transtheoretical model covers five main stages of change: precontemplation, contemplation, preparation, action, and maintenance.  When discussing addiction, we can add a sixth category, relapse, as an optional stage that often characterizes these attempts to change.  These stages are not necessarily linear, meaning you might jump forward and backward in the progression, but the path to recovery involves working through each to get to a place of long-lasting change.

Precontemplation

In this stage, you do not consider your behavior to be a major problem.  Instead, you are more focused on the benefits that come from engaging in the behavior.  Denial is running the show, characterized by shifting blame for problems onto others.

You are likely resistant to any confrontation or advice about changing your behavior in this stage.  Individuals in court-ordered therapy or rehab recommended by a family member or spouse often begin here.  Usually, an experience of consequences to behavior is what propels someone into the next stage.

Examples of Precontemplation Thoughts:

• “It’s not that big of a deal.  I’m not hurting anyone.  I deserve this.”

• “If my spouse/family member/friend just were more open and let me do my own thing, everything would be fine.”

• You may not notice any thoughts about the behavior at all.

Questions to Ask Yourself in Precontemplation:

• What problems am I experiencing in life?  How might my substance use/problematic behavior be contributing to these problems?

• What are the pros and cons of my behaviors?

• If I’m not experiencing consequences currently, what are possible consequences I could face in the future?

• What long-term negative outcomes could come from this behavior?

Contemplation

In the contemplation stage, you likely have begun to think about changing the behavior.  Usually, this is precipitated by some negative experience, such as consequences (like a DUI or STD diagnosis) or cognitive dissonance about differences between your values and your behaviors.  Ambivalence is a hallmark of this stage: you’re feeling strong desires both toward staying in the problematic pattern and changing the behavior.

Learning, gathering information, and understanding the addictive process are important in contemplation.  To move into the next stage, you need to increase your knowledge about addiction and recovery, even if you aren’t willing to make any major changes yet.  The shift into the next stage occurs when you begin to solidify your vision for the future.

Examples of Contemplation Thoughts:

• “I can see that this is a problem, I’m just not sure I want to change.”

• “Why stop something that feels this good?”

• “I’ll change someday, but I’m not ready to right now.”

Questions to Ask Yourself in Contemplation:

• What personal values am I violating by continuing in this behavior?

• How are the consequences I’m facing now affecting me and my future?

• What am I learning about addiction and recovery that fits with my experience?

• What are the costs and benefits of my behavior?

Preparation

The preparation stage involves planning an approach to change.  You are getting ready to implement the strategies you learned about in the contemplation stage, even though you might still not be ready to act on that plan.  Ambivalence is still present, but you are more willing to consider the work required to make a lasting change.

In preparation, you create a specific, structured plan for how you could change.  Even if you still have misgivings, you are beginning to rehearse in your mind the actions it would take to leave behind your pattern of behavior.  In recovery language, this is where you begin to “trust the process” and learn more about steps involved in recovery.

You might test the waters by attending a 12 Step meeting or support group, purchasing recovery-related books and resources, sharing your desire to change with others, seeking accountability, getting into individual or group therapy, or attending an inpatient or intensive treatment center.

Examples of Preparation Thoughts:

• “I can see that it’s possible to change, and I’m beginning to want it, but I’m not sure yet how I’m going to do it.”

• “I need a plan of action if I’m going to make any lasting change.”

Questions to Ask Yourself in Preparation:

• What kind of change would I like to make?  What are the steps to get there?

• What resources or social supports might I need to help me in this change?

• What are the triggers that influence me to use my substance/engage in my behavior?  How might I need to change behavior to limit these?

Action

Real change begins to happen in the action stage, as you put plans created during preparation into action.  This change may be drastic, or it can involve smaller, incremental changes.  While the first three stages are more internal and often don’t affect external behavior, others can see the change in this stage.

The action stage can be a stressful experience, so preparation must be done beforehand to address triggers with new, healthy coping mechanisms.  There is a distinct shift away from using addiction as a method to cope with stress or pain, instead choosing alternate ways of coping.   

Examples of Action Thoughts:

• “I have a plan, and I’m choosing to move forward even when I don’t feel like it.”

• “I am learning new ways to handle my stress.”

Questions to Ask Yourself in Action:

• What is my relapse prevention plan?

• What are alternate ways I can deal with stress?

• What’s working from my plan, and what do I need to adapt or change in my approach?

• What skills do I need to strengthen to maintain sobriety/change?

Maintenance

The maintenance stage is a continuation of the progress achieved in the action stage: regularly implementing your plans over time to create long-term change.  It requires reflecting back on the two previous stages (preparation and action) to clarify what’s working and what isn’t.  Without maintenance, the likelihood of relapse increases significantly.

Stress can arise in this stage, highlighting the importance of the stress management components of the action stage.  Other challenges come when you’ve had a period of abstinence or moderation of behaviors, as this can put your guard down and lead you to reduce supportive behaviors.  You may begin minimizing the consequences, as the high of the early parts of the action stage has worn off.  Maintaining the behaviors committed to in the action stage is essential for staying sober and committed to recovery without relapse.

Examples of Maintenance Thoughts:

• “One day at a time.”

• “My recovery process works if I work it.”

• “I need to keep moving forward in my plan, even if sometimes I don’t feel like it.”

Questions to Ask Yourself in Maintenance:

• What routine behaviors do I need to keep in place to avoid relapse?

• Where could I be opening myself up to the possibility of relapse, and how can I close those doors?

• How can I stay connected to the original vision for the future that motivated me to change this behavior?

Relapse

Slips and relapses do occur in addiction recovery.  Instead of fearing the possibility of relapse and descending into a spiral of shame if it happens, instead recognize relapse as part of the process of recovery.  At the same time, know that this stage is optional – it does not need to be part of the process if action is maintained through commitment to the maintenance stage.

When relapse occurs, it can propel you back into the precontemplation or contemplation stage of your process of change.  To leverage relapse to benefit your recovery process, use the experience to solidify your understanding of what recovery means and your commitment to the process of change you’d like to make.

Examples of Relapse Thoughts:

• “Yes, I did the behavior I’ve been abstaining from, but was it really that bad?”

• “Acting out felt good, and I’m not sure I want to stop again.”

• “I don’t think this is a problem to do this, as long as I don’t do that.”

• “I can’t believe I did that.”

• “I’m back in my addiction, and I feel hopeless about getting out.”

Questions to Ask Yourself in Relapse:

• What do I need to review from the work in the contemplation, preparation, or action stages to remind myself of my vision for the future?

• What recovery-related behaviors do I need to recommit to?

• What wasn’t working about my approach that set me up for a relapse?

• What can I learn for the future as I continue to explore the impact of this behavior on my life?

Sources and More Information on the Transtheoretical Model:

• The Stages of Change Model of Overcoming Addiction - Verywell Mind

• The Stages of Change - Smart Recovery

• Brief Interventions and Brief Therapies for Substance Abuse - SAMHSA

Living Out Your Values in Addiction Recovery

When you first enter recovery, it is often because you’ve come to a crisis point.  You’ve hit rock bottom in your addiction.  You’re forced to face the consequences of your behavior, like a spouse discovering your deception and threatening to divorce.  Intense feelings of depression or anxiety hit you like a wave, and you might even find yourself wanting to take your own life in the depths of your despair.

This initial motivation propelling you into recovery, however, tends to fade over time.  While attempting to stay motivated, many addicts recognize that they don’t have a strong sense of identity.  So much of who you are has been wrapped up in this addiction.  Leisure time has been spent acting out rather than on personal interests and hobbies.  Relationships have been superficial and shallow.  Perhaps your history of past trauma communicates (mostly negative) messages to you about who you are. 

Without that sense of identity, it can be challenging to determine what you value or what is important to you.  Your addiction has distorted what is important and places itself as the highest priority in your life.  When that addiction is removed through sobriety, it can feel like there is now a void in your life.  You might find yourself wondering: what does life look like after addiction?  This question often arises when you’re grieving losses associated with the consequences of your addiction, like loss of relationships, physical health, job, or financial resources.

How do I learn and live out my identity?

Staci Sprout, a fellow Certified Sex Addiction Therapist, shares that the key to developing your recovery for the long-term is identifying your vision and purpose.  The first step requires you to become more familiar with who you are.

It is essential to develop your identity in recovery because it can replace the narrative of shame you’ve lived under for so long.  Many addicts have also experienced abuse, trauma, or neglect in their childhoods that meant they weren’t celebrated for their unique personality and gifts.  If that sounds familiar to you, you may have no idea what your talents and personality are when you enter recovery, and you need to learn and celebrate your qualities that make you who you are.

When you have a more clear sense of your identity, that paves the way for you to connect with a vision for your future and a purpose to your life. 

Vision

Vision involves connecting with your “’why” – why are you committed to recovery?  Why are you making these changes in your life?  If you don’t have a clear picture of your “why,” motivation can wax and wane.

To connect with your vision, ask yourself some of the following questions:

• If you were free from the pull of addiction, what might change in your life?  What would be different?  What would you have more time to do?

• Addiction is often associated with shame and low self-esteem.  If you were free from addiction, how might you feel more confident? What effect might that confidence have on your life?

• Relationships often serve as motivators for change.  What relationships are important to you?  Who do you want to be in those relationships?

• You’re likely seeking out help from a therapist, 12 Step or support group, or even just reading books or articles online.  What do you hope to get out of those support experiences?  How will you know these have been successful for you?  What will change in your life?

• If you’ve completed a three-circle plan, ask yourself why the activities in your outer circle are important to you.  What purpose are they serving?

• What desires or wants do you have for your life?

When you answer these questions, you might begin to see a theme of values you hold.  Values include such things as family, marriage, mental health, career success, authenticity in relationships, service and volunteering, or advocating for causes that are important to you.  This leads well into the next stage, which is looking at purpose.

Purpose

Examining your purpose pushes you into a more existential frame of mind.  It requires you to ask questions like: why am I here?  What is my purpose on this earth?  What am I meant to do with this one life that I have? 

These questions can be challenging for a few reasons.  First, they put your mortality into greater focus, which can stir up challenging emotions.  Also, they are broad topics that can feel overwhelming to tackle.  If you are a person of faith, your Christian faith or other religious practices can inform your purpose, as they lead you to a sense of belonging to something greater than yourself. 

To make your purpose more practical, consider these questions:

• Use the values you identified in the above vision section and broaden then to fit your entire life.  Ask questions like: what might change about my actions if I wanted to live as if this value were my highest priority?  How might my life look different?

• If you’re involved in a 12 Step or support group, you may appreciate how others have helped you along in your recovery.  How might you want to give back?  How can your story of walking through recovery serve or help others?

• For those in middle-age or older, generativity is a major life goal – passing along the knowledge and wisdom you’ve gained.  How might you pass along this insight and wisdom to others?  How could you mentor younger adults in a similar career field, through their recovery journeys, or in their faith?

• For those who haven’t hit that generativity milestone, what life dreams have you considered or hoped for that you haven’t accomplished yet?  What might you still be able to do with the time you have left?

• What do you want others to stay about you after you’ve passed away?  What legacy do you want to leave?  How would you like to be described in a eulogy?

Exploring these questions related to life purpose can help you recognize the end goal of your sobriety and recovery work. Ultimately, your work isn’t only for you, but it is for those who will benefit after you.  By clarifying your vision and purpose for yourself, you’ll have a more clear path forward whether you are dealing with discouragement in your recovery journey or if you’ve hit a major milestone of sobriety and are looking for what’s next.

Willingness in Recovery: What To Do When You Don’t Want to Stop Acting Out in Sex and Love Addiction

In recovery circles, willingness to change is a necessary part of leaving behind destructive patterns of sex and love addiction to experience freedom.  Sometimes willingness comes easily.  For example, if you are married and your spouse discovers your addiction, that often creates a push to change as you work to heal your relationship.  You may be experiencing real consequences of your addiction, like an arrest or the dissolution of friendships.  Or you’re early in the process of recovery and motivated to put in the hard work of change.

But as time goes on, you might notice your willingness fading.  You might miss the dopamine rush you got when you were acting out.  Or you’ve ended your relationship with your partner, which removes that motivation to change.  Perhaps you’re feeling shame about your behaviors, and the easiest way you know how to self-medicate shame is with more acting out.

Maybe you relapse, getting caught back up in the cycle of acting out.  Perhaps the boundaries you know you need to put in place to help you along the path to recovery seem way too hard to implement. 

You could be struggling with the cost of recovery, recognizing the extent to which your life may have to change.  Sometimes the work involved in the process recovery leads to a feeling of weariness and a desire to just give up. 

Regardless of reason, it is common to see willingness ebb and flow in the process of recovery.  Instead of viewing your lack of willingness or motivation to change as a death knell to your recovery work, use this opportunity to learn more about yourself and lean in to practices that will help you stick with recovery even when it becomes challenging.

As a note: these recommendations are specific to sex and love addiction.  There are likely different, more targeted recommendations for addictions that involve a substance, such as alcohol or drugs.  If you are dealing with those addictions, reach out to 12 Step resources and specialized counseling or treatment centers to get guidance on how to address willingness in that area. 

What to Do

Remind yourself of your vision for your future.

It can be a challenge to find hope when you’re stuck in the (often devastating) consequences of your acting out behaviors.  Define for yourself what a recovered life could look like.  Even if you never achieve this, what would be the ideal?  Why did you choose recovery in the first place?  What could life be like when you are free of your addictive behaviors? 

Use this vision to help you identify what you’d like your life to look like in 10 years, 5 years, and 1 year.  Breaking down those goals into more manageable time frames can help you make concrete goals or plans for what’s right in front of you.

Target your denial.

Your unwillingness to change often finds support from denying the impact of your behaviors.  This denial often comes in the form of distorted thinking patterns.  I often call this process “addict thinking” versus “rational thinking.”  When you’re acting out in addiction, the rational, healthy component of your brain goes offline. Instead, the addict part of you is at work trying to persuade you that your addictive behaviors are not only okay, but good for you.

Identify the “voice” of your addict part of yourself by writing down the statements of denial that are most common for you.  They might include words such as:

• “It’s not hurting anyone.”

• “I only do it because my spouse isn’t meeting my sexual needs.”

• “I deserve this.”

Then, when you have some space from your acting out behaviors, sit down and write responses from the point of view of your rational brain to address those denial statements with facts.  Come back to these responses when you’re tempted to act out and remind yourself of truth about your behaviors.  To the above comments, you might respond:

• “Addiction hurts my spouse, my children, and most importantly, myself.  I lose control over myself and expose myself to further and more dangerous consequences.”

• “My addiction is how I shortcut my way to a dissatisfying false intimacy instead of pursuing true intimacy with my spouse.”

• “I am not entitled to harm myself or others by my actions.  My behavior promises that it will feel good, but I consistently end up feeling miserable afterward.”

Be patient with yourself.

Acknowledge that this process takes time.  Consider climbing a mountain: when you begin at the bottom, it is obvious that you have a long way to go to get to the top.  As you climb and begin to grow weary, it can be easy to get distracted by how much further you have to go.  You might look up at the summit and get discouraged by the time it will take you to reach the top.  Instead, focus on the step right in front of you.  In 12 Step terminology, this is taking “one day at a time.”

Recognize that recovery is a lifestyle change, not a one-time experience; a marathon, not a sprint. But the rewards of a recovered life will make every step worth it.

Stay committed to your recovery plan.

If you’ve been in recovery for any length of time, you probably have been participating in some recovery-related activities and have potentially even made a plan for how to best address your addiction.  Even if you’re currently acting out, continue to engage in these recovery behaviors. 

If your plan was to go to 12 Step meetings regularly, keep going to your meetings.  Meet with your sponsor.  Make calls to others in recovery.  Keep attending therapy or support group.  Use the principle of “fake it til you make it” until your recovery behaviors begin to shape and mold your thoughts and emotions.  This will eventually create motivation to change if you give it time.

Do the bare minimum.

If you’ve already gotten out of the routine of your recovery plan, it might seem challenging to get back into the habit.  When commitment to recovery feels overwhelming and too much, focus instead on one practical step you can take right now.  (Remember the mountain metaphor.) 

Make one call to a supportive friend.  Schedule an appointment with your therapist or sponsor.  Read a chapter in a recovery-related book.  Practice a small act of self-care – eating a healthy meal, going to sleep early, getting outside for a walk.  Any of these small steps can have a huge impact over the long haul. 

Focus on recovery, not sobriety.

It’s common early in recovery to find yourself focusing only on sobriety and “white-knuckling”, attempting to force yourself to stop by your own willpower.  This usually is accompanied by a lack of commitment to the whole-life change required in recovery.

What’s the difference?  Recovery is a holistic process - much of your life must change.  Sobriety is one part of that, but it is not all of it.  Attempting to keep your life exactly the same and get sober is a recipe for failure, because likely some of what you were doing in daily life contributed to your desire to act out.  Focusing on sobriety involves only focusing on what you can’t do, while recovery shifts that focus to what you can do. 

Focusing only on sobriety leads to beating yourself up about failing when you inevitably slip or relapse.  Rather than placing so much of your identity and hope on sobriety, place that relapse or slip under the context of recovery and see what you can learn from it.  Sobriety is categorized by shame; recovery is categorized by hope.

Ask God for willingness.

The 12 Steps are built around reliance on a Higher Power to do the work of creating change in you, recognizing you are incapable of creating that willingness to change on your own.  Speaking from a Christian worldview, we are told in the Bible that it is God who works in us to will and act in order to fulfill his good purpose (Philippians 2:13).  Ask God to help you with this process. Invite the Holy Spirit to do a transforming work in your heart.

Remember the message of grace here: that if you are in Christ, you are no longer condemned (Romans 8:1) and you are set free (Galatians 5:1), and if you invite God in, He will do a healing work in you and transform your willingness.

Know that you can’t do this alone.

In addition to having the support and help of God, it is essential to have the support of other people to help you make these changes.  Social support is one of the most important factors in any addiction recovery.

Reach out to the people you know who are in recovery circles or who you trust are safe for you.  If you don’t know who those people are, now is a good time to find them.  Start by attending a 12 Step meeting, support group, or counseling session and connect with supportive people who can help you along your path to recovery.