Before you begin to make changes in your life, it might be useful to understand the process. The theory called the Stages of Change Model (SCM) describes the mind/body stages we go through when we do change.

James Prochaska, Ph.D and Carlo Diclemente, Ph.D (1982) developed SCM  in the late 1970’s and early 1980’s while at the University of Rhode Island. They were studying how smokers were able to give up their habits. The model has been applied to a broad range of behaviors including weight loss, injury prevention, overcoming alcohol, and drug problems among others.

This a model of change which is unique in many ways. First, it is empirically driven: it is based on the researchers’ scientific investigation of change in humans. Second, the model conceptualizes change as entailing a number of stages which all require alterations in attitude in order to progress. Third, the model depicts change as a cycle, rather than an all or nothing step or series of steps. The authors contend that it is quite normal for people to require several trips through the stages to make lasting change. Additionally, each of us progresses through the stages at our own rate.

One of the reason the SCM is attractive, is that it recognizes change as flexible to individual needs. Some people make lasting change quite rapidly, others require a few times through the stages to acquire more knowledge and build skills. Just as some can master skiing on the first try, others require a couple of seasons to get to the intermediate level.

In this sense relapse can be viewed as a normal part of the change process, as opposed to a complete failure. This does not mean that relapse is desirable or even invariably expected. It simply means that change is difficult, and it is unreasonable to expect everyone to be able to modify a habit perfectly with out any slips. Relapses can vary in severity, as can our reactions to them. Some relapses can be so discouraging that people return to a precontemplative stage for a long time before contemplating change again. Others get right back on track, considering the antecedents to relapse, where they need to put more effort, and swiftly move back into action again.

We enter the stages of change from a state of precontemplation– during which the idea of change is not seriously considered. The cycle begins when we start to contemplate the need for change. Hopefully we will tip the scales in favor of change and become determined to take action. Then specific alterations in thinking and behaving will be initiated. It is hoped that the alterations become accepted and eventually ingrained or automatic. If we are able to maintain our accomplishments, we can exit the cycle entirely.

The Stages of Change

In brief, the stages of change are:

• Precontemplation – Not acknowledging that there is a problem behavior that needs to be changed.
• Contemplation – Acknowledging that there is a problem but not yet wanting to make a change.
• Preparation - Planning to make the changes.
• Action - Actively changing behavior and thoughts.
• Maintenance – Maintaining the behavior change.
• Lapses - Returning to old behaviors and abandoning the new changes. This can happen at any point in the stages.

Stage One: Precontemplation

In the precontemplation stage, people are not thinking seriously about changing and are not interested in any kind of help. People in this stage tend to defend their current bad habit(s) and do not feel it is a problem. They may be defensive in the face of other people’s efforts to pressure them to quit. They do not focus their attention on quitting and tend not to discuss their bad habit with others. It would be easy to call this “denial,” but a much more accurate view would be to describe Precontemplation as a state when a person is “uninformed” in the sense that no personally convincing reason for change has been presented as of yet. In this stage people simply do not yet see themselves as having a problem.

Stage Two: Contemplation

In the contemplation stage, people are more aware of the personal consequences of their habit. They start to think about their problem. Although they are able to consider the possibility of changing, they tend to be ambivalent about it. In this stage, people are weighing the pros and cons of quitting or modifying their behavior. Although they think about the negative aspects of their bad habit and the positives associated with giving it up (or reducing), they may doubt that the long-term benefits associated with quitting will outweigh the short-term costs. It might take as little as a couple weeks or as long as a lifetime to get through the contemplation stage. On the plus side, people are more open to receiving information about their bad habit. They become more likely to use educational interventions and reflect on their own feelings and thoughts concerning their bad habit.

Stage Three: Preparation

People in the preparation/determination are planning to take action and are making the final adjustments before they begin to change their behavior. Their motivation for this change may be reflected by statements such as: “I’ve got to do something about this. What can I do?”

This is sort of a research phase as they start taking steps toward cessation of their behavior. They attempt to gather information about what they will need to do to change their behavior, or seek help to understand how to successfully change. At this stage it is important to gather resources and knowledge that will help with success.

It is also important to establish a goal which works with you. A goal which is reasonable for one person, may be unreasonable or inadequate for another. Our goals must be consistent with our capabilities, our values, and our needs. Sometimes, especially by experts in the field of addiction treatment, a successful outcome is mandated as the only realistic goal.

Too often, people skip this stage: they try to move directly from contemplation into action and fail because they haven’t adequately researched or accepted what it is going to take to make this major lifestyle change. For example, many people with intentions for change believe that they must undergo a drastic lifestyle and identity change in order to alter a habit. For example, many recovering substance abusers believe that they must abstain not only from the substance they have abused, but also from all past behaviors, deny all pleasure, and assume a stoic lifestyle. Rarely is this drastic a lifestyle change necessary, or even ideal for lasting change. Often with this “all-or-nothing” approach to change, is that people find that it is virtually impossible to bare, or that they just hate it. They eventually become discouraged and stop the whole change process.

So, at this stage, it is important to examine what specifically you want to modify in your life, and what about your lifestyle is better left unchanged. Understand what you want to change, the motivation for the change, and most importantly, have a destination or way-point defined so that you can recognize the change.

Stage Four: Action

This is the stage where people not only have a desire to change, but also believe they have the ability to change their behavior and are actively involved in taking steps to change their behavior.

The amount of time people spend in action varies: but, in general it lasts about 6 months. This step requires the greatest commitment of time and energy. Mentally, they review their commitment to themselves, practice new skills, and develop plans to deal with both personal and external pressures that may lead to slips. They may use short-term rewards to sustain their motivation, and analyze their behavior change efforts in a way that enhances their self-confidence. People at this stage also tend to be open to receiving help and are also likely to seek support from others: this can be a very important element.

As people make conscience efforts to quit or change the behavior, they are at greatest risk for relapsing to old behaviors. Being mindful of triggers, and the reactions to them, is important. This is where actively building skills, changing thoughts toward the old behavior, and developing alternative coping behaviors comes in to play.

Stage Five: Maintenance

Maintenance involves being able to successfully practicing new skills and avoiding the temptations to return to the old habit. The goal of the maintenance stage is to maintain the new status quo. People in this stage tend to remind themselves of how much progress they have made, while still being cognizant of what it took to make the change.

People in maintenance constantly reformulate the rules of their lives and are acquiring even more skills to deal with life and avoid relapse. They are able to anticipate the situations in which a relapse could occur and prepare coping strategies in advance. They remain aware that what they are striving for is worthwhile and personally meaningful. They are accepting of themselves and recognize that it takes time to let go of old behavior patterns and to become proficient at new ones: realizing that ultimately the new behavior will become as comfortable to live with as the old. Even though they may have thoughts of returning to their old bad habits, they resist the temptation and stay on track.

As you progress through your own stages of change, it can be helpful to re-evaluate your progress in moving through these stages.

Lapses

Along the way to permanent cessation of a habit, many people experience a lapse. These are often accompanied by feelings of discouragement and seeing oneself as a failure.

There is a real risk that people who lapse will experience an immediate sense of failure that can seriously undermine their self-confidence. One of the most significant problems with the 12-step model is the all-or-none manner in which lapses are construed. Regardless of the intensity, slips and lapses have been viewed as failure, time to “start over.”

It is important to remember that experiencing a lapse is common.  In fact, most successful self-changers go through the stages three or four times before they make it through successfully without a lapse. Many will return to the contemplation stage of change; others return to the planning stage to implement what they have learned from the lapse. Consequently, the Stages of Change Model considers a lapse to be normal.

Rather than seeing a failure, analyze how the slip happened and use it as an opportunity to learn how to cope differently. People who lapse may need to learn a more effective ways anticipate high-risk situations, control environmental cues that tempt them to engage in their bad habits,  learn how to handle unexpected episodes of stress, or redefine their personal boundaries. Analyzing what happened gives a stronger sense of self control and the ability to get back on track. In fact, relapses can be important opportunities for learning and becoming stronger.

Transcendence

In addition, there is one more stage that Marc Kern Ph.D., CAS added which is not part of Prochaska-DiClemente original Stages of Change model: Transcendence.

Eventually, if you “maintain maintenance” long enough, you will reach a point where you will be able to work with your emotions and understand your own behavior and view it in a new light. This is the stage of “transcendence.” In this stage, not only is your old habit no longer an integral part of your life but to return to it would seem atypical, abnormal, even weird to you. When you reach this point in your process of change, you will know that you have transcended the old habits and that you are truly becoming a new “you”, who no longer needs the old behaviors to sustain yourself.

References

DiClemente, C. C. & Prochaska, J. O. (1982). Self-change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance. Addictive Behaviors, 7, 133-142.

That voice we all hear in our head telling us to engage in destructive behaviors can be very convincing: it will try to rationalization, make up excuses, and lie relentlessly to get its way. So how do we fight giving in? Most people understand how to win an argument with a two-year old: don’t argue. Similarly, the way to fight an urge is to not argue with it. Put your foot down, and say NO to the urge. Instead of arguing with every well rehearsed reason the urge will throw at you, engage in a different conversation with yourself.

DISARM

Destructive Self-talk Awareness and Refusal Method (DISARM) is a tool which exposes the self-talk and images which tell us to use. It challenges those urge-producing thoughts at every opportunity, shooting them down and eventually reducing them to the point of absurdity. All humans, not just humans with substance abuse problems, have thoughts, urges, or other impulses, which, if followed, would harm their long-term interests. Realizing the power to control what we think and believe, especially about our strong urges to use, and understanding how to change the distorted thinking is crucial to success.

“It is a man’s own mind, not his enemy or foe, that lures him to evil ways.” ~Siddhārtha Gautama

We are wise to learn how to make ourselves aware of our destructive self-talk: the thinking that is contrary to our values and long-term interests. Once we recognize it, we can then adamantly refuse to go along with it.

When a strong urge is recognized, ask and answer the following questions:

1. Question: Do I have to give in to the urge because it is intense and hard to resist?
   Answer: No, I don’t have to give in. Because the urge is strong, it would be easy to give in, but I don’t HAVE TO. I have had urges that I did not give in to, therefore it must be possible to resist.
2. Question: Will it be awful to deny myself by not giving into the urge?
   Answer: No, it won’t be awful. It may be quite unpleasant, but unpleasant is not awful, it’s just unpleasant. If I don’t give in to the urge, it will get weaker and come less frequently. If I do give in, the urge will stay strong, be harder to resist next time and show up more frequently.
3. Question: Is it really unbearable not to give into this urge?
   Answer: I don’t like the way it feels to deny my urge, but since it doesn’t kill me not to give in, I can keep on resisting. (Remember, individuals drinking large amounts of alcohol may need to go to a detox center when they first stop because the sudden end of alcohol really could be injurious.)
4. Question: Am I somehow entitled to be able to give up using without strong urges to go back to using?
   Answer: No! I don’t have a note from God, my mother, or anyone else which entitles me not to have strong urges to use. It may be unpleasant to resist some of my urges, but no one gave me a ‘get out of unpleasantness free’ card.

We cannot simply will ourselves to not have certain thoughts and feelings. However, we can learn how to recognize the thoughts driving urges and how to refuse to go along with them: we can learn to DISARM them. We can then walk away from the situation, or get our mind involved with something else, rather than dwelling on the urge to use. DISARM allows the individual experiencing the craving and to carefully and rationally answer a few key questions. The results of using DISARM will help an individual to understand that urges can truly be overcome. As success is experienced, the urges will eventually become less strong and will occur less frequently.

DISARMING the ‘ENEMY’

Some people find it helpful to use a technique to dissociate themselves from the voice inside each of us which says, ‘It’s a good idea to do something self- destructive.’ It is a game you can play with yourself, which might help you to:

1. Identify the specific thoughts which, if followed, would lead to using when you have already decided that, in the long term, this choice is not for you, and
2. Steadfastly refuse to go along with this thinking no matter how attractive it might seem.

Instead of talking yourself into lapsing you can develop powerful countering and coping statements. To do this, it may help to invent and personify an ‘enemy’ who lives in your mind, and whose only purpose is to get you to use. The Enemy (your alter ego) knows you well, and can change form to take advantage of your weakest moments. Name your enemy (i.e., salesman, gangster, diplomat, bad cop). When urges come, ask yourself, ‘What is she/he telling me now? How is she/he trying to trick me?

When thoughts are identified:

1. Without debate, ATTACK the enemy with powerful counter statements: ‘Nice try, jerk. You can’t fool me!’ You can be as aggressive or profane as your nature allows with the Enemy – after all, it’s trying to screw up your life.
2. Then quickly FOCUS on some other thoughts, images, or activities which are consistent with what you want in the long run and inconsistent with what the Enemy is saying. The Enemy then looses its perceived power and fades away.

Once the urge has passed, you can submit the Enemy’s tricks to an ABC analysis in order to rationally dispute them. You usually discover irrational themes and patterns to the thoughts and arguments the Enemy throws at you. While the coping statements used in DISARM alone will often work, it is important not to omit disputing. If your coping statements aren’t working, it is because you don’t believe them as strongly as you believe the Enemy. Through disputing we can develop powerful coping statements you fully believe for use in the future. Through actually resisting the Enemy’s suggestions, you become increasingly more skilled at doing it.

Why do we harm our selves by choosing destructive habits? Is it because things like alcohol and drugs have some mysterious power to control us? No. We choose our actions based on our experiences, our habits, and the way we think. If we want to change our destructive behavior we must change; we must learn to choose different solutions to our problems.

“Our liquor was but a symptom. So we had to get down to causes and conditions.” ~William G. Wilson, The Big Book, page 64.

We can simply choose to avoid the substances and experiences that are destructive. I have heard the term “white knuckling it” to describe this solution: it is uncomfortable, difficult, and usually leads back to our destructive behavior as a way to relieve the pain. We must understand that we choose those behaviors because on some level, they work. When we simply stop the behavior without finding a more beneficial alternative, we suffer. Avoidance does not eliminate the underlying thoughts, beliefs, and lack of knowing of alternatives behaviors that drew us to the destructive behavior in the first place.

In this video Sogyal Rinpoche discusses how the mind works to perceive the world around us. As he explains, we must look inward to get to the root of suffering rather than focusing on the external symptoms. We can change to address the causes of our condition, and we can address the real problem we were trying to fix with our destructive behavior.

“All men’s miseries derive from not being able to sit in a quiet room alone.” ~Blaise Pascal

To explain some of the terms used in this video for the non-Buddhists: “Samsara” refers to a general state of overt or subtle sufferings that occur in day to day life. “Nirvana” is the state of being free from that suffering.

Thank you to Darren Littlejohn, The 12-Step Buddhist, for acquainting me with Sogyal Rinpoche’s videos.

Rational thinking presents a vivid contrast to its illogical opposite: It is based on reality – it emphasizes seeing things as they really are, keeping negative events in perspective, tolerating frustration and discomfort, preferring rather than demanding, and self-acceptance. This way of thinking helps you achieve your goals and purposes; It creates emotions you can handle; and It helps you behave in ways which promote your aims and survival.

I’m not talking about so-called “positive thinking”. Rational thinking is realistic thinking. It is concerned with facts – the real world – rather than subjective opinion or wishful thinking.

Realistic thinking leads to realistic emotions. Negative feelings aren’t always bad for you. Neither are all positive feelings beneficial. Feeling happy when someone you love has died, for example, may hinder you from grieving properly. Or to be unconcerned in the face of real danger could put your survival at risk. Realistic thinking avoids exaggeration of both kinds – negative and positive.

In Buddhism, the fist step on the Eight Fold Path is “Right View.” This simply means to see and to understand things as they really are. When our view of the world is clouded by irrational though, we impose our interpretation on the world instead of accepting the reality of how it actually exists: this can cause suffering. Right View is the cognitive aspect of wisdom. Right View is not necessarily an intellectual capacity, just as wisdom is not just a matter of intelligence. Instead, Right View is attained, sustained, and enhanced through all capacities of mind. Since our view of the world forms our thoughts and our actions, Right View yields right thoughts and right actions. This is a skill that with practice, we can mastered. By recognizing our irrational beliefs, and  choosing to changing them, we can start to see and accept the world as it exists.

In Rational Emotive Behavioral Therapy (REBT) certain core self-defeating and irrational beliefs, which have been clinically observed, are understood as the root of most disturbances in our life.

Below are twelve examples of common irrational beliefs, and contrasting rational thoughts.

The ABC Exercise is from Rational Emotive Therapy (REBT). The ABC Exercise is a simple and effective tool that can be used by anybody, and most importantly – it works. This exercise helps an individual examine irrational thought processes, and stop being victimized by their irrational thinking. Often when we feel an emotion, or a thought comes into our awareness, we think that it just happens: In fact, these thoughts and emotions are a result of our observations and our beliefs regarding those observations. We choose our reactions, and our emotions: they are not forced upon us. Though, we are often unaware of the underlying beliefs that cause our reactions. Taking the time to slow this habitual thought process using the ABC Exercise allows us to examine why we think or feel a certain way, and create new healthier thoughts and emotions in reaction to the world around us.

A common example used in the ABC Exercise is that someone else’s behavior is “making us angry.”  This is a very common expression and we hear it often. In fact, rationally, this is a distortion of the situation it attempts to describe. A more accurate description of “someone making me angry” is to say “I feel angry about someone’s behavior.” They are not making me anything – they are simply behaving in a way that I am getting angry about. I notice their behavior and then I become angry. The responsibility for feeling anger is mine, not theirs. This may sound strange at first, but dealing with anger and frustration this way works to have a healthier and more realistic view of the world. The REBT theory says that it is generally irrational and self-defeating to get all worked up about someone else’s behavior.

Think about anger for a moment.  Someone does something you do not like.  You do have a “right” not to like it.  You even have a “right” to share your dislike with them.  But where does it follow that because you do not like it, they therefore SHOULD not do it?  Do you own them, control them, are they your possession? You may have a very rational preference that they change their behavior. However, when you then take this preference and escalate it to a DEMAND, as if you were granted supreme power, it becomes irrational. In addition, their behavior is governed by how they think and feel at that time and is consistent with their thoughts.  In fact, their behavior at that moment cannot be anything different than it is (this is reality based thinking).  You don’t like it, and you wish it were different, but their behavior is consistent with their thinking.  You may still be left with a practical problem, “how do I get them to change their behavior?”  But then you become focused on problem solving instead of simply focusing on the problem.

The result of this change in thought process means you may still feel annoyed or irritated about their behavior, but not angry or enraged.  You changed your very irrational DEMAND to a very rational Preference.  Once you downgrade the DEMAND to a PREFERENCE, the heat is turned down and you can function again. The less intense emotion will allow you to become much more creative in trying to convey your feelings to the other person with an attempt to get them to change.

REBT has a simple exercise to help us make the adjustment from reactionary habitual thinking to more useful rational thoughts: it is the ABC Exercise.   It is used to analyze our thoughts, emotions, and beliefs about a situation. We can then change what happens within us so that we can feel better about the situation. That isn’t to say that we shouldn’t try to change the external reality: sometimes changing the reality is appropriate. By taking the time to rationally examining a situation and how we think and feel about it, instead of simply reacting, we are able to choose an appropriate and effective response.

To use the ABC Exercise for yourself, pick any situation where you were angry about someone’s behavior and examine what it is you are thinking: Is it DEMAND-ing and irrational? Try to change those thoughts into something more rational – a PREFERENCE.

Here is an example using drunken people making a lot of noise late at night as they pass by outside where I live.

• A. (Activating event)
  Drunk people outside, making some noise.

• B. (irrational Belief (iB) I have about A)
  They MUST NOT make any noise.

• C. (Consequences of having those beliefs about A)
  When noisy drunk people pass by in the street outside late at night and wake me up, I feel angry. It feels bad. I lie awake feeling angry and upset and don’t get back to sleep for a long time.

• D. (Dispute the irrational Beliefs (iB’s) in B
  by turning them into questions and answers)
  WHY shouldn’t they make any noise? Where is that commandment written in stone? Where is the evidence?  Again, who made you Supreme Ruler of the Universe dictating how people Should or Must act?

• E. (Effective new thinking- substitute something rational instead of B)
  Drunk people are often noisy, but really it’s no BIG deal. I don’t like it, but I am able to deal with what I don’t like.  Maybe I will touch base with them in the morning (when they are sober).  I will CHOOSE to not upset myself about this, and I may even stop even noticing it because I am no longer demanding it be different than it obviously is (Reality Based).
  When this happens I will say “Ah, the drunk people who pass in the night” and maybe go back to sleep.

You can make an ABC exercise really short:

• A. (Activating situation)
  Drunks walking past outside, making some noise.

• B. (irrational Belief (or IB)I have about A)
  They SHOULDN’T make any noise.

• C. (Consequences of having those beliefs about A)
  I feel angry, etc.

• D. (Dispute the irrational Belief/s in B)
  WHY shouldn’t they make any noise?

• E. (Effective new thinking)
  Drunk people do make noise, it’s what they do.  It’s like a natural talent for them. I will CHOOSE to not upset myself about this.

That’s it. That is how to do an ABC Exercise. Try this technique with something that is bothering you. Try to keep it as simple as you can while you get used to the ideas involved.

Please note; this is a tool not just a theory: success with this (and other) cognitive techniques is dependent on you writing out your own examples and making it part of the way you think. Try to find some Activating situations, iB’s and Consequences of your own and do this exercise with them. Use this MS Word Document (ABC Worksheet) to write down the exercise.

Whenever you feel upset it can be a useful exercise to see if an ABC can be done on the situation and your thinking about it. You never know, you might just feel better. Get into the habit of doing this regularly and you might feel a lot better overall.

More In-depth Explanation of the ABC Exercise Steps:

NOTE: It is often is easier to start with the Consequences you are unhappy with, then work back to the A and B understand what they were.

• What is an “A”?
  (Activating Event)
  Something has disturbed you. This disturbance could be from the past, present, or thoughts about the future. These disturbances could be internal or external, real or imagined. It is important to know what actually happened to you, and what you truly observed.

• What is a “B”?
  (Your beliefs about “A”)
  Our beliefs can be helpful or unhelpful, self-enhancing or self-defeating, rational or irrational. This part of the exercise asks you to look closely at your beliefs, and carefully judge them as rational or irrational, helpful or unhelpful. This can be done by understanding some of the common distortions or irrational beliefs many of us have when we’re upset. Here are some irrational “core beliefs” with examples:
  • Awfulizing: “This is as bad as it can be!” Or having the belief that the worst has happened, or that one event will “automatically” lead to total despair.
  • Frustration Intolerance: “I just can’t stand this!” Easily frustrated by common disturbances, when we know that it really won’t kill us.
  • Demandingness: “All of this must go my way!” Having an expectation of absolute control.
  • Person Rating: “You’re no good, I’m better than you!” Judging others without cause; judging the entire person based on one action.
  • Entitlement: “I deserve this, the world owes me!” Expecting or demanding special treatment.
  • There are other common distortions that can disturb our ability to reason things out, but these are the five core irrational beliefs that stand in the way of our ability to make sense of our problems.

• What is a “C”?
  (Consequences of “B”)
  Some consequences of our irrational beliefs can appear as rage, anxiety, depression, or some other strong negative emotion. Consequences can also appear as inappropriate behavior such as drug and alcohol misuse; gambling, sexual, or food addictions; or physical and emotional violence. These emotions and behaviors are the consequences of holding on to our irrational beliefs and acting upon them.

• What is a “D”?
  (Disputing the irrational beliefs, and adopting more helpful “B’s”)
  Here are some important questions to ask yourself when examining your irrational beliefs:
  • “What is the evidence that my belief is true?”
  • “Could there be other explanations for what occurred?”
  • “In what ways are my beliefs helpful or unhelpful?”
  • “What harm could come from examining other ideas and options?”
  • “If someone close to me were experiencing this event, what would I tell them to do?”

• What is an “E”?
  (A new effect, or effective behavior based on your rational beliefs)
  Calmly make the effort to change your irrational beliefs about any disturbing events so that you can develop a more rational response to them. If you are successful at examining how you respond to the events that occur in your life, you can reduce the stress and anxiety that results from reacting to events with negative responses and enjoy a more positive relationship with yourself and others.