5.0: The Stages of Change

Evidently, your relationship with the incentive has led you to
the point where you are reading about how to change it.
Coincidently, the text says that individuals who have developed
an addictive relationship go through a predictable sequence of
stages, including one in which they gather information about
how to change by reading texts such as this.
In fact, much can be learned by observing what happens when
people attempt to end or control their relationship with an
addictive incentive. The Stages of Change model1 emerged from
researching how addictive relationships unfold over time. The
typical sequence of stages is listed below. As you review them,
see if you can identify your current position within this
developmental passage.
Pre-contemplation – Stage at which there is no intention to
change. You are unaware or under-aware of the problem. It isn’t
that you can’t see the solution; it’s that you can’t see the problem.

Contemplation – Stage of ambivalence; you are aware of the
problem and would like to give up the costs but are reluctant to
give up the benefits of incentive use.
The Decision – When it is clear that the costs of incentive use
far outweigh the benefits, you may decide to do what it takes to
change course. You make the decision with the understanding
that you may encounter local conditions that would motivate
lapsing, and so the promise that you will do what you said you
would do despite the influence of local factors is implied.
Action – Stage at which you develop the plan to change your
life’s course and begin to implement it.
Relapse Prevention – During this stage, which hopefully lasts
the rest of your life, you do what it takes to prevent relapse. If
you do relapse, you will cycle back to the contemplation stage
and at some point in the future go through these stages again.
Because it is both painful and hard to escape, an addictive
relationship condemns you to continue to cycle through these
stages until you achieve irreversible change, one way or another.
Like the passage from childhood to adulthood, the passage from
dependence to self-determination is complex and takes time.
During different stages you will face different challenges that
require different tactics. Tools well matched for particular stages
are described later in this chapter.
This model is useful because it suggests that the different stages
of this passage require different ways of coping. Because you
will be developing your own plan, you have the opportunity to
match your methods with the stage of change that best matches
where you are at now. Some rules of thumb:

• Do not rely on change processes appropriate for the
contemplation stage (e.g., costs-benefits analysis) when you
are in fact in the action stage. Trying to modify behaviors by
becoming more aware of why you should change is not
effective. Insight alone does not bring about behavior change.
• Do not rely on change processes appropriate for the action
stage until you are genuinely motivated to do what needs to
be done. Action without insight produces short-term change.
Recommendations for each stage:
Contemplation Stage: Most people are vulnerable to local
sources of motivation, because they have never developed a
core motivation, or if they have, they have forgotten it. Such
individuals are easily corrupted because their motivation is
always state-dependent—that is, there is no
core motivation to compete with local sources
of motivation.
The purpose of your life is not ending your
relationship with the incentive; rather it is to
be free of dependence on the incentive so you
can behave in accord with your principles and
interests—your core motivation. If you are
unsure about core motivational issues—such as: What do you
really want? What is meaningful to you? What do you stand
for?—please engage the contemplation exercises in Chapter 5.1.
Once you appreciate your core motivation, you can perform a
realistic costs-benefits analysis regarding incentive use by
completing the Decision Matrix, which follows these exercises.
The contemplation stage is completed when you have resolved
your ambivalence so you can make an incorruptible decision.

Decision Matrix to be a useful tool later when you are in the
action stage.
The Decision: The climax of your relationship with the
addictive incentive is your decision to change it. You must
appreciate that the decision requires that your behavior can no
longer be state-dependent. If you decide to quit drinking, you
cannot then have a drink just because you feel like it at the
moment. You accept the commitment with the understanding
that you will go to any lengths to adhere to its terms. Be aware
that unlike a goal, a commitment is a promise. If you make one
and fail to honor it, it would have been better to have declined
it and avoided the violation of your vow. So, if you are not yet
ready to make such a commitment then
return to the contemplation stage
exercises. If you are ready to proceed,
be aware that whatever you decide
during the action stage implies a No
Exceptions Clause such as, “I agree to
permit no exceptions to the
contingencies stated here—regardless of
how reasonable a momentary lapse may
seem at the time.”
Action Stage: Once you appreciate your core motivation, and
have decided upon your intentions, you will have to act. This is
a major undertaking and you will have to pay attention to
following your intended course for quite some time, so you will
need a plan. The action stage includes developing your plan
and the first few days or weeks of following it, and lasts until
the initial excitment of the new project wears off. Then the
most important stage begins.
Relapse Prevention Stage: Research shows that most people
who achieved good long-term outcome did so only after several
trips through the sequence of stages. Don’t be discouraged if

you have relapsed in the past; instead, learn from your experience
in order to discover what it will take to prevent relapse. In the
beginning, most people are highly motivated to do what it takes
to be free of their problem. After this initial “whoopie effect”
has past, the real battle begins. As long as you perform well,
time is on your side, and you will get better with practice.
However, as you might suspect, some people become sloppy as
the salience of their original commitment dissipates with the
passage of time. Good outcome requires that your motivation
to adhere to your plan is always greater than the forces that
would pull you into relapse. Your task during the Relapse
Prevention Stage is to respond as intended during the high-risk
situations that lie ahead until your intended reactions become
the default.2
The chapters of this section are presented in the order suggested
by the stages of change mode, but users are encouraged to focus
on the content best matched with their current stage.
2. The “rule of three” provides a rough guide to the creation of an intended
default path: If you adhere to your plan for 3 days that means you have gone
beyond merely thinking about it and have begun to engage the challenge; if
you adhere for 3 weeks you may notice it takes less cognitive energy to cope
successfully with many of the high-risk situations you encounter; by 3 months
successful coping reactions become habitual and often occur without conscious
effort; and by three years the intended action patterns have become autonomous
and your path of greatest advantage has become the default path.

4.4: Invitation to the Trance

Covert experience is cheap. Imagining what would happen if you take a curve too quickly on a slick road is less costly than learning from direct experience. Taking the time to purposely engage your mental faculties, including rational analysis and creative imagination can prepare you to cope with the unavoidable crises that await you on your journey ahead. The exercises in this chapter will give you the opportunity to explore and develop your cognitive resources.

The Exercise of Will
During the early phases of behavior change you will encounter many autonomous paths that lead to relapse, and so you will have to be vigilant for the early warning signals of state-dependent biases the would promote relapse. These are your signals to switch to a meta-cognitive perspective and dissociate from your current state. A recommended tactic is to use this moment of dissociation to ask Will’s Question: “What is the best use of my attention right now?” The answer to this question may then be used as the target stimulus to achieve Intentional Trance Formation. The objective of this tactic is for you to get yourself focused on thoughts or activities that promote good outcome as you define it, rather than to allow yourself to get sucked into the emotional states and the autonomous behavioral sequences they evoke.

Contemplation
To understand what good outcome means to you, invest 20 minutes of your attention to contemplate questions such as: “What do I really want for this one life I have to live?” Engaging such issues with your full cognitive powers can produce more interesting adventures and a higher quality of life than mindlessly following the path of least resistance. There are many methods to facilitate the contemplative process; the attached CD-ROM includes:

· Ask Alice
· Short Harmony

Other Transformative Tools
Intentional Trance Formation refers to a range of covert tactics that can help you intentionally change your life’s course. The attached CD-ROM contains hypnotherapy audio files (in MP3 format) including inductions and scripts that address specific addictive relationships. These may be copied to a format that will be convenient for you to play in an environment appropriate for the purpose of the exercise.

· Hypnotic Induction: This is a general hypnotic induction.

· Suggestion: An exercise to enhance your ability to use your imagination to influence your subjective reality.

· The audio files below are designed for specific addictive disorders. See Psychological ARTS' web site to register and download the appropriate files.

o Nicotine
o Substance Use
o Overeating
o Impulse Control – e.g. gambling, pornography, computer use, etc.