Is relapse a part of recovery?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Relapse

Relapse.
Photo courtesy of Pixabay.com

Is relapse a necessary part of recovery?

Relapse Prevention

Relapse Prevention

You will hear this a lot if you hang around treatment facilities, even self-help groups. I suppose it comes from seeing people relapse and feeling helpless to prevent those relapses. But is relapse really a necessary part of recovery?

Mostly this is applied to substance abuse, drugs, and alcohol, but more and more we are seeing that other emotional, mental and behavioral challenges can follow the same processes. People get unhealthy; they may get sick and then they recover.

Do symptoms have to get worse before they get better?

Every time one of my colleagues says that relapse is a part of recovery I cringe. It feels like saying that heart attacks are a part of treating heart disease. I do not believe that good treatment should accept any negative outcome as a part of the recovery process.

Relapse is common, but it is not universal. Some people, more than you might think, recover and never relapse.  A surprisingly large number of people report that they were able to quit drugs, get over their depression and anxiety and stay quit and recovered.

So how do they do recover without relapse?

We need to talk about several things. What is recovery, what is relapse, and how do people go about changing?

Emotional challenges and substance use problems are a lot like chronic physical disorders. If you have had a stroke there has been some damage done. If you have been diagnosed with diabetes you will never be “cured.” Some changes will always remain as a result of your experience.

While you will never be “cured” you can, and most people do, recover from that disorder. The same thing happens to those people who have had an emotional or substance use disorder. They can and do recover but they are never fully cured. There is a risk that if they are not careful they may slip back into an active stage of their problem but if they are vigilant about their recovery they do not need to keep getting sick again and returning to their provider to, again and again, be treated and recover over and over.

These ideas about substance use problems and mental health problems are both included in the The Big Book of Alcoholics Anonymous. Bill W. wrote about the issues that those with Bipolar Disorder will face that may make their recovery more difficult than that experienced by people who do not have an underlying mental health disorder.

Bill W also wrote that in the early days of those who came to the program and stuck (meaning actually continued to attend and participate in the program) 50% quit drinking forever. That does not sound to me like he believed that relapse needed to be a part of recovery.

He went on to report that of the remaining half about 25 % had to quit a few times to get it right but those people did eventuality stop for good.

What about that last 25%? The big book reports that while some people never did manage to stay stopped those people, while attending A.A. were much improved. I take that to mean that while the treatment for a mental or emotional problem may not fully effect a cure, reducing your symptoms is a way to reduce the harm that a mental, emotional or substance use problem creates.

These days we are applying the stages of change model to both mental health and substance use disorders. Take a look at some of the books on how people change such as Changing for good.

Changing for Good: A Revolutionary Six-Stage Program for Overcoming Bad Habits and Moving Your Life Positively Forward

I have written posts in the past on this model and how it can help you change and stay changed.

In this model, we see that people need to recognize they have a problem, gather information, get ready to change and then go through the process of making real meaningful changes in their lives. In this model, we see that maintenance, those things you need to do to stay changed once you have made a change, those maintenance steps are the key to preventing relapses.

Relapse is a failure to maintain recovery.

Relapse is not a part of recovery, but the result of failing to continue doing the things that helped you get better in the first place. Whatever you did to get your emotional problem or substance use issue in remission in the first place, those actions need to continue to be a part of your life if you want to insure yourself against relapse.

If you do relapse, do not beat yourself up. Get back into recovery and practice the things you need to stay well. Just know that repeated relapses do not need to be a part of recovery if you practice your maintenance program.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. 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.

5 Steps to addiction

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs of addiction

Addiction.
Photo courtesy of Pixabay.com

What does it take to turn a normal person into a drug addict?

I remember some career information when I was in high school. We took a test to see what our abilities were and what careers might interest us the most. I don’t remember drug addict or alcoholic being on the list of possible careers. Even without any guidance a lot of people end up making a lifetime occupation out of their addiction.

How does addiction develop? Take these five steps to find your chemical dependency.

1. Experimentation with substances.

Involvement with chemicals begins with some experimentation. A friend offers you one of their cigarettes and you try it. Forget all you have heard about this or that drug being a gateway drug. Far and away the “gateway” drugs of choice are nicotine and alcohol.

Lots of kids get their start at abusing drugs by swiping a few cigarettes, maybe a pack if they can, from a family member. A leftover beer, a partial bottle sitting around, that is all it takes. Lots of seasoned drug addicts remember with me the time they took some sips on a family member’s beer or drank from mom and dad’s liquor cabinet when the folks were away.

Boys usually get their start with the help and encouragement of a male friend or an older family member. It’s not a drug pusher that gets the disease of addiction going, it is a brother, uncle, cousin or another close male.

Girls most often learn how to use drugs from their first boyfriend. They may go on to share this knowledge with other girlfriends but mostly they all compare notes and then get the next lesson from the next man in their life. Keep the learning up long enough and one of those men will teach you how to save money by sharing needles and then you can share everything that man has, especially the diseases.

2. Social drinking and drug use.

After the first trial of drug use, the budding young experimenter is likely to finds some collaborators in drug learning. The guys or gals get together and drink a few beers, sometimes they get wasted. Eventually, sooner probably, rather than later, someone brings some weed, bomb, some 420 to the party. The group has discovered marijuana; they have also discovered doing an illicit or illegal drug.

Some people have to steal the weed, others buy it, a few have “friends” who in the beginning will front it to you for free. This is probably too early in the trip for the aspiring popular person to have heard the old expression “the first one is free; the second will cost you double.”

Every week the group gets together. Say Friday night. Eventually given enough good stuff, the party stretches over into Saturday morning. There may be some getting drunk, some learning to throw up and to treat hangovers the next day.

There may be some violence, some unplanned, even unwanted sex. People may start doing illegal and dangerous things. Occasionally people get in trouble, get arrested or even killed. Usually, that is someone else in some other town, someone who wasn’t careful enough. It won’t happen to one of your group.

As long as it is social it is all good. But what happens when the group is away?

3. Substance use becomes a habit.

The time will come in everyone’s life when the group is not there that one Friday night.
This is the turning point.

It is Friday. That is the night you drink and party right? Tonight you are alone. What will you do? This is the point where a few will decide enough is enough. A few beers with friends is fine, but this getting drunk and stoned every weekend is too much.

Far too many people at this point decide that it is Friday and on Fridays, we drink and drug. They will go on with the party, friends or no friends. They may look for another group to use with or they may use alone, but at this point, they have turned a social event into a habit. They will use no matter what it takes.

4. Psychological need for substance.

The user will struggle along for a while, months, years, maybe even decades. The use now is accelerating. There is more using alone. The negative consequences begin to mount up.

There may be DUI’s. When using they do things they will regret later. There are fights, violence, possibly arrests. They decide they want to quit. At this point, they have had enough. They vow to stop drinking and drugging, well not stop exactly, but they will cut back.

The person on their way to addiction is at the point where when they try to control their use they find it is so much harder than they thought. They have lost the ability to control their usage. They need to drink more and use more to get the same high. This is called tolerance. They can’t function without the drug.

In those brief periods of not using or drinking they can’t stop thinking about the drug, how long till five and the next time they can drink?

This person is not yet fully psychologically dependent but they have developed a mental need for their drug of choice. Without that drug, they are not happy. Even with the drug they are no longer enjoying the use. They now use just to get back to normal.

5. Physical need for a drug completes the process.

At this juncture, the person is having physical problems. They may get sick when without their drug of choice. They can’t stand the thought of running out. The alcoholic now needs an eye-opener in the morning. The meth addict tries to keep back a taste to help get them out of bed. It is no longer using to feel pleasure, now it is using to get well again.

The alcoholic may have D.T’s. They may risk seizures and death if deprived of their drug. The process has gone to the end. The experiment is over. The drug has taken control of the person.

If you recognize yourself in this story, consider where you are in the process and where you want to go. If you have reached the point where this is a habit or an addiction know that there is help available to stop the disease of addiction before you reach the end.

Beyond psychical addiction, so the story goes, there are three destinations, Jails, institutions, and death.
Changing the outcome is not easy but it is possible.

Are you ready to change your direction or are you on the 5 steps to addiction path?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. 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.

Top 4 reasons people drink or use

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs of addiction

Addiction.
Photo courtesy of Pixabay.com

The top 4 reasons you began to drink or use drugs.

Many people want to find the reasons they drank and used. Here are some common reasons and what to do about them.

1. Good day – celebrate.

In the beginning, it is all good. A little of this or that will help you celebrate. Your drug of choice helped you feel stronger, more attractive, more outgoing and smarter. No one gives up a substance that makes them feel like that.

Drinking and using is often a social thing, you do it with your friends until your abuse of substances drives friends away and it is just you and your drug.

At the start of addiction, it is all good. As time goes on the wreckage mounts. What the addicted person eventually learns is that the drug was not their friend, making them happy, sharing their happiness. Addiction is a thief that steals your happiness.

Solution? Learn to celebrate without drugs and alcohol.

2. Bad day – drink, use to cheer yourself up.

People drink and use to change their mood. If you are sad, use a chemical to brighten your day. It works for a while. Then the drug or the alcohol stops working. It leaves you still miserable. Eventually, that drug begins to beat you up. The drug becomes the reason you are sad and depressed. The drug makes you anxious and scared.

We hear the refrain everywhere we go. This went wrong – I need a drink. That was late or unpleasant – I need a drink. People around you will tell you “You look like you could use a drink.” Not till years later will you hear “I think you have been drinking too much.”

Solution? – Learn to manage negative emotions without chemicals and learn that sometimes it is normal to feel bad for a while.

3. Boring day use drugs to create excitement.

In the early stages of use, it sounds exciting. Things are dull and boring – get high. Don’t know what you want to do – get high. For everything that is missing the refrain is get high. When there is nothing left and your life has passed by unlived you might realize that getting high day after day is the same old boring thing.

Solution – Learn to become excited about the things you already do and learn to enjoy the benefits of peace and quiet sometimes.

4. Any other reason to use whether it satisfies you or not.

Most addicts or alcoholics have a reason the tell themselves is why they drink. They had a lousy childhood, that’s why they use. They lost a partner and that means they will forever be alone. The drug promises comfort and companionship.

Drugs and alcohol pretend to be your friend. They promise a cure for loneliness, anger, and pain. In the end, they take everything you have and leave you to defeated to care anymore.

Alcohol looks like a cure for anger; it takes your mind off the thing that made you angry for a moment. But it also lowers your inhibitions. People who treat anger with alcohol are more likely to get violent, not less. People who treat depression are at an increased risk to attempt suicide or other self-harming behaviors. Treating negative emotions makes the emotion more of a problem not less.

While many people with a drug or alcohol problem would like to find a hidden reason why they drink and drug – the truth is that even when they think they have discovered the reason they still have the addiction. The reason for addiction is simple, addicts and alcoholics put chemicals in their bodies to change the way they feel and act. Once there the drug turns on the user and takes control of their life.

Solution? Build a life with meaning and purpose that is built on real experiences not the fraud of addiction.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. 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.

Relapse on anxiety, depression or another mental illness?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Urge Surfing Prevents Relapses.

Urge Surfing Prevents Relapses.
Photo courtesy of Pixabay.com

Can you relapse on anxiety, depression or another mental illness?

Relapse is a concept that has been borrowed from substance abuse treatment. It is easy to think in terms of an alcoholic drinking again as a relapse, but do people with a mental illness relapse? What would a relapse for anxiety or depression look like and what can we do to prevent a mental health relapse?

We are starting to view mental health and wellness as a continuum so people can move from well to less well to unwell and back again. In that respect, a mental health relapse seems to make sense.

A lot of people experience a mental illness at least once in their lifetime. Estimate run from 25% in any one year to 50% at some point in a lifetime. For an Anxiety Disorder, the estimates run from 10% to 20% and may even be higher than that when we consider the increase in PTSD.

In a previous post, we talked about Bob and Ellen who were treated for anxiety disorders, social phobia and specific phobia using systematic desensitization sometimes called exposure therapy. This is a proven effective treatment for specific phobia. As we last saw Bob and Ellen, after getting better they had both relapsed and were having symptoms of anxiety again. This is not surprising.

From one-third to two-thirds of everyone treated for anxiety disorders relapses, despite the fact that we know why this happens and how to prevent it.

Anxiety is fear based.

It shrinks when approached. We tend to avoid scary thing but the more you avoid them the harder they become to face the next time. Once people complete treatment they tend to stop thinking about the thing they feared. Over time the gains they made fade away. Substance abuse treatment tries to avoid this problem by encouraging people to continue with self-help groups to maintain the growth that has happened. Self-help groups for emotional issues are much harder to find.

Treatment for fear in the office does not equal less fear out in the backyard.

A recovery skill needs to be practiced in many settings so that it is usable any time or place. Fear is worse in new novel situations. Learning, to be useful, needs to “generalize” into many settings. People who are in treatment for an anxiety disorder need to practice their skills in as many situations as possible.

Many people use medication to reduce or manage symptoms.

As soon as the symptoms are reduced they discontinue the medication. Discontinuing medication too soon is likely to result in relapse.

If there is an actual injury fear is more likely to return.

Getting treated for irrational fear is likely to stick but if you were in an accident you have good reason to be afraid of the same thing happening again. You should expect to use extra caution in dangerous situations if you have been injured in the past. Anxiety is meant to keep you safe. The goal is to manage the anxiety not to completely eliminate it.

If nothing else happens fear tends to return with time.

Treatment for anxiety needs occasional “boosters” to prevent its return.

Other emotional issues increase the risk of a return of anxiety.

An untreated Depression greatly increases the risk of a relapse of anxiety, so does substance abuse. If you have multiple problems, anxiety, and depression or anxiety and substance abuse you need to be working on all the issues at the same time. Leave on issue untreated and the risk of relapse for the others increases.

Continue to work on your recovery to prevent a relapse of anxiety, depression or another mental illness.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. 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.

4 Stages of recovery

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Ball recovery

Recovery and Resiliency. Photo courtesy of Pixabay.com

How does recovery grow and develop?

Recovery does not happen suddenly, out of nowhere. It takes time and work. From my way of thinking there are customary predictable stages of recovery. People may move through these stages at varying rates, some people move backward at times, but the goal for all should be to reach a final place where recovery is stable and less at risk.

The concept of recovery used to be mostly applied to substance abuse. Recently the concepts of wellness and recovery have been incorporated into Mental Health and physical health issues.

In a series of earlier posts, we talked about stages of change. Those stages begin with Pre-contemplation, the I don’t have a problem and even if I did I wouldn’t want to change anything, to Contemplation, yeah so – maybe I do have a problem but I am not sure I am ready to do anything about it. After that is Preparation, sometimes called Determination, and finally the action process, which we divided into Early Action and Late Action phases. The last part of this recovery journey was Maintenance.

In this model, Relapse is seen not as part of recovery but as the inability to maintain recovery once we reach it. This is understood as a common result of failure to do the maintenance activities. There has been lots of literature on relapse, triggers and lifestyle changes to make to avoid relapse. Much less has been written about what someone might expect during recovery.

Here are the four stages of recovery as I see them

1. In recovery.

People in this stage are seeking answers, working on themselves and investing time in their recovery. This is the time when people are taking action steps or may begin to do maintenance to hold onto the gains they have made. Lots of people will describe themselves as “in recovery”

2. Recovering.

People who describe themselves as recovering have moved from the point of being hopeless and lost to having hope and seeing their symptoms reduced. The urges and cravings may decrees even if they are never totally gone. People with mental health symptoms, while not fully back on their feet, may find they are able to do more things more days. Symptoms while present are shrinking.

3. Recovered.

Some people are afraid to say this. They are afraid that feeling recovered, they will let down on working on themselves and relapse. The A.A. Big Book uses this language on the title page of Alcoholics Anonymous, “The Story of How Many Thousands of Men and Woman Have Recovered from Alcoholism.”

People who call themselves “recovered” are quick to point out that they are not cured. Just as when someone is diagnosed with diabetes they may get their disease under control but they will never go back to being a non-diabetic. With any chronic, relapsing disease you may recover but you are never really cured.

People who are recovered begin to get their life back. They may go back to work, volunteer or be able to participate fully in everyday life.

4. Life on life’s terms.

Every recovered person will have bumps on their road of life. This is a real life, good happens and bad happens. A person’s recovery is secure when they are able to withstand the things that happen, good or bad, in life without a return to active symptoms.

Doing the maintenance steps helps, so does building a comprehensive support system. The real test of someone’s recovery is – can bad or unexpected things happen in your life without triggering a return of your symptoms.

Best wishes on your recovery and having the happy life you deserve.

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

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. 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.

Is Relapse a part of recovery?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Relapse

Relapse.
Photo courtesy of Pixabay.com

At some point, every recovery program has to tackle the issue of relapse. Why after losing all that weight do people suddenly put it back on? Do all alcoholics; sooner or later pick up a drink? Once you have depression you will always have recurrent bouts right? The way in which relapses are understood separates the Stages of change model from almost every other model of recovery. I have been told more than once that relapse is a part of recovery. I am not buying that! It doesn’t have to be that way.

So if relapse were a part of recovery, every person signing up for a self-improvement program should get out their calendar on day one and plan for their relapse. Doesn’t AA even say a relapse is a part of recovery? No, it doesn’t. The AA book says that a certain percentage of people get it the first time and don’t relapse. Bill W. estimated that percentage at 50%. In the early days, it appears that a lot of people who really wanted the program and stuck with it got it the first time around. He also said that there were some people, maybe 25% who tried a few times and eventually got it. The rest were better while they were in the program but kept going in and out. The stages of change model agrees with that thinking.

So why do people say that relapse is a part of recovery? Mostly, people say that because relapse happens a lot. And if relapse does happen, rather than giving up, the objective is to pick yourself up and try again. One article I read said smokers typically have to try to quit seven times. Now some people quit on the first try, a few people become nonsmokers in a few tries and there may be some people who just don’t seem to be able to quit. Any self-change is like that. It takes more than trying hard.

It is not the quitting of bad habits that is the problem. Some people quit drinking 5 or 6 times in one day. It is the staying quit that is harder. So how does someone make a change, give up a bad habit, make an improvement in their life and then stay changed?

The stages of change model says that after all that effort, that process of change, there is one more thing you need to do to stay changed. See change is not a one-time thing. Real lasting change is an ongoing process. Why do people think that they can excessive like crazy, take off a few pounds and then once they lose the weight they can stop the exercise?  How many days off Heroin before it would be safe to try some drugs again? The truth is that change is not a thing – it is a process. Once you make the change you have to keep doing the process to maintain the change.

The thing you need to do to stay changed is called maintenance. To stay changed you will need to do some maintenance. If you mow a lawn once will it grow back? So if it took an increase in exercise or an improvement in healthy eating to lose weight it will require you to keep doing that work to keep the weight off. The addicted person can’t just put down the substance; they need to keep doing the things that got them sober.  In the stages of change, relapse is not seen as something that is part of change it is understood as a failure to do the one remaining step in the process of change – doing maintenance.

Now, this is easier to see when we talk about weight loss or addiction but what about depression or bipolar disorder? With any of life’s problems, there are things that you can do to make the problem grow and other things that make the problem shrink. Taking good care of yourself is especially important for mental and emotional issues. So if taking good care of yourself makes you less depressed, what might happen if you stopped eating and sleeping well? Your depression might grow. The maintenance step is needed for holding onto any change you made, it is the best antidote to a relapse, whether that relapse is weight gain, addiction or depression.

Next time we will talk about the last stage of change – maintenance. After that, I want to talk a bit about some related problems like triggers and finding help when you have few resources. Till then –

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. 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.

Stages of change part two – contemplation

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Change

Change.
Photo courtesy of Pixabay.com

Contemplation, thinking about your problem is the second stage of change.

Last time we began our discussion of the stages of change by describing how someone might be confronted with a situation where others think you have a problem, a need to change, even before we recognize that something is a problem. We called that stage of change Pre-contemplation.

Lots of people end up in the therapist office, court, child custody mediation, a Drunk driver program or substance abuse treatment who never thought they had a problem. Sometimes they are sent with an ultimatum, do this treatment or else. Sometimes it is a spouse or a boss who says change or else. Sometimes it is too late and the or else has taken effect.

Often they resist thinking that they have a problem despite being required to go to some type of treatment. An interesting thing happens too many of these people, sooner or later. They see other people confronting their problems and those people’s lives are getting better. This is especially powerful in group settings where a group member gets a new job or relationship, someone gets to see their kids again or gets a license back, or someone loses a lot of weight.

Sometimes this mental change can occur after they read a book on solving a particular problem and they start to consider if they might need to change. Once the willingness to think about change occurs they have reached step two in the process of change model.

Step 2: Contemplation

In this stage, the person who is on the road to change is gathering information. That does not mean they agree they have a problem, they may, they may not, but they are open to looking at the facts. So let me continue my weight loss story from our last episode.

I get home and I ask my roommate “Have I gained any weight?” She giggles politely. Maybe it was more like a hysterical laugh. So I go looking for the scale that used to be in my bathroom. Not there. I check in the closet, under the bed, I find it on a top shelf in the garage. I weigh myself. That can’t be. I don’t weigh that much! Do I?  This scale must be broken, that’s why I put it in the garage right?

The next day at work I weigh myself on the certified scale. It gives me a bigger number than my garage scale. This can’t be right. I go to another department and try their scale. It gives me a bigger number yet. I go back to the first scale and reweigh myself. Now the truth hits me. I have put on weight. Not a little, but a lot. The weight gain is getting harder to deny.

Some people get this moment of truth when the judge sentences them. Some when their spouse leaves them or the family doesn’t want them around. For some people, it may be the DUI. Some people get to this realization the second or third time their parole officer sends them to a drug program. Maybe they realize it after the fiftieth job interview that does not result in a job. Could it be me? Do I lack the skills? Do I have a problem?

Whatever it takes eventually those who change get to this point. I am hoping that for you all you need is a little number on a scale. Whatever it is we both have a choice at this point. Change or go on the same course as before.

I could get off the scale at this point and just ignore or accept the fact I am now heavier, maybe even fat, or I can do something about it. I am no longer contemplating. But what will I do next?

Do you have any stories about changes you have made? Want to share them? You can make a comment if you chose.

Check back next blog for the next installment about how people change.

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

Staying connected with David Joel Miller

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Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

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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 my Facebook author’s page, davidjoelmillerwriter. 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.