I have written about how methamphetamine transits the globe and how it ultimately finds it way to users in the San Francisco Bay Area. The methamphetamine story is varied and complex. It will take a great deal of elucidation to get a handle on it. Nick Reding’s book, Methland: The Death and Life of an American Small Town, goes a long way toward doing this for the heartland. Redding does a great job of going back to his roots in the mid-West to describe how methamphetamine has become such a popular and, in many ways, essential drug in rural and small town America. The book is well-researched and contains many personal anecdotes regarding how this drug is affecting the people using the drug, their families and the communities to which they belong.
The book is difficult to put down. I highly recommend reading it. If you are not so inclined or need more reason to invest your time, Kevin Nenstiel, an author and English professor living in Nebraska, has done an excellent synopsis and review of the book. You can find it here.
We all have bad habits that get in the way of our enjoyment of life. These habits can be highly self-destructive; heroin addiction is an example. Or they can be small things that might hold us back such as watching too much TV. Whatever the case, you may be wondering how people go about changing; understanding change might make it easier to do.
Quite a number of years ago now, Prochaska and DiClemente (1983) came up with a model of change that explains how people modify a problem behavior or acquire a positive behavior. Initially it was applied to smoking cessation and is now used to explain changes in behavior in general. The primary organizing principle in this model is called the Stages of Change; it describes a person’s readiness to change in 5 stages. Let’s look at how this might apply for someone with an alcohol problem.
In this stage a person is not even thinking of stopping their use of alcohol. Either the consequences of use are not grave enough or the person is willing to deny the seriousness of the problem despite evidence to the contrary.
As problems multiply due to excessive alcohol use a person may begin to accept that they have a problem. As a result of their drinking they may have financial, relationship or work difficulties or they may develop a health or mental health issue. Essentially, at some point, negative consequences may allow a person to develop some insight into the nature of the problem.
Contrary to what many people think, most people do not stop drinking in a vacuum. An often overlooked issue is that people have more success when they PREPARE to stop using once they have acknowledged a problem. Preparation could include decreasing how often or how much they drink each day, changing their social circle, changing their everyday routine so they don’t walk by their favorite bar, or beginning a meditation practice. They may decide on a stop date. The manner in which a person decides to prepare to change their drinking habit is as individual as they are.
At a certain point enough supports are in place to enable the drinker to decide to stop or modify their use. This does not only include elimination of a problem behavior but also includes the addition of positive behaviors. In short, a bad habit is replaced by a good habit. For example, it is not unusual for people to become involved in some kind of sport or exercise regimen as a replacement for their alcohol use.
A person becomes more confident about the changes they have made when they have a period of sustained abstinence or non-problematic use of alcohol. They are actively using strategies that they developed in the action phase and are able to maintain and build upon positive changes, preventing relapse.
Relapse is not included in the original model but can be considered to be a sixth stage. It is important to remember that relapse is very common and that a great deal can be learned from what precipitated the relapse. It is advisable to examine what may have preceded a return to problematic drinking so that the person can develop strategies to cope with this in the future.
On the path?
I have described a way that people change that has been validated by the research and by many people’s experiences. If you want to change a behavior it helps to know what the terrain looks like as you move forward. Nothing changes unless you do the footwork….
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.
This information is for educational purposes only and should not in any way be considered a substitute for professional help. If you are in need of immediate help please contact your local psychiatric emergency services.