By David Joel Miller.
How do you stay changed?
How can maintenance be a part of change? Isn’t maintenance what you do, as needed after the successful results of change are obvious? No, not at all. Not including maintenance as a step in the change process is where many improvement projects, public and private get themselves into trouble. Let me give you a more visual example.
The other day I drove through an older part of town. This part of town, built throughout the Victorian era to the turn of the century was really something once. Today this part of town is a poor neighborhood. While there are still a few houses that reflect the old glory days most of them are getting run down now. A couple of houses are slated for demolition. What happened to those grand old houses? There was no earthquake or fire, nothing dramatic, just the slow process of decomposition.
A roof was torn off, the owner had not bothered to get it fixed and the rain had rotted out the lumber. Another has a porch that has fallen down. Lots of homes have not been painted in a while, broken windows are covered with cardboard, and sometimes there is an old blue tarp over the destruction. Realtors describe these homes as having “deferred maintenance.” Last time I talked with you about relapse as the result of the failure to do a maintenance step. Relapse is a sort of deferred maintenance.
What do we hear from people who relapsed on substances? You hear the story so often it starts to sound like a well-rehearsed poem. The recovering person says they, stopped going to meetings, stopped calling their sponsor and started hanging out at the old spots. The dieter gets the goal pounds off and then eases up on the diet. The change has been a short-term project and now the deferral of maintenance starts. Eventually, when the change is completely reversed by the relapse the person starts to wonder when they tried to make that change in the first place.
We tell recovering people that whatever you did to get better, you need to keep doing it to stay recovered. Most people don’t want to accept the idea that what was needed was not a quick repair but an ongoing plan of preventative maintenance.
One important component of that relapse prevention plan is learning to provide good self-care. Having a good support system is also vital. People who have positive people in their life, people that want them to do well, are more likely to succeed. Never get to busy to call your support system. One study found that schizophrenics with a warm supportive person in the home with them cut their risk of ending up in a psychiatric hospital by almost 50%. People who attend AA drink less even if they don’t stop altogether. Many weight loss programs include a group component. Being surrounded by others who are also working on their own recovery is likely to strengthen your recovery.
Real lasting change has to include a commitment to a different lifestyle. This does not mean that every self-improvement plan needs to take over your life. If the changes you make are hard to do the chances are that you will stop doing them when the urgency is gone. Urgency is an often overlooked factor. If your doctor tells you to lose twenty pounds or he can’t do a life-saving surgery, that is motivation. If the judge says to stay off drugs or you will go back to prison that is motivation. But if the diet is a lot of work to keep up it will probably be forgotten way too soon.
The end of this tale is that whatever got you better, diet, meetings, a religious practice or time with friends, keep doing them. Don’t give up these positive things as you see results from your change efforts.
That is the story of my understanding of stages of change. In future blog posts, I want to talk more about relapse prevention and triggers. We should also talk more about the connection between depression, bipolar and abuse of a couple of substances. There is a huge connection between mood disorders and substances and not always in the direction you might think. I also want to talk about why it seems there is so much controversy, especially among professionals about the diagnosis of bipolar disorder.
I read your comments and appreciate them. I also try to read as many blogs as I can that are written by recovering people of all types. The things you say remind me of things I need to talk about.
There is a lot of pain out there and we know how to help more than ever before – so why is it hard for people to find the help they need? Why doesn’t therapy always work? What makes counseling helpful? I will give you my take on these issues and would appreciate yours.
I also want to talk to all of you, very soon, about how you might find help when you don’t have the money to pay for the help you need. Till then, here is wishing you all a happy life.
Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency
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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page or my Facebook author’s page, David Joel Miller. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.