Levels of Action
In the previous blog, we talked about five stages of acceptance. Now we are going to talk about five stages of action. Do you remember why we talked about acceptance first? Because we can’t change reality until we first accept it! But now that we know how to recognize—and overcome—the obstacles to acceptance, we can next focus on taking action.
In the previous lesson, we talked about the importance of accepting the original trauma, as well as the affects of the trauma. As you recall, trauma affects us in many ways: our emotions, our thoughts, our relationships, and our behaviors. Sometimes one of the most difficult things to accept is that our own behaviors, as a result of the trauma, have not always been the healthiest. Well, as it turns, our own behaviors are not just difficult to accept—they can be even more difficult to change!
In this blog, we are going to focus on the five stages of changing our behaviors: Pre-Contemplation, Contemplation, Preparation, Action, and Maintenance (Connors, DiClemente, Velasquez, & Donovan, 2015).
1. Pre-Contemplation: To contemplate means to think about something. Therefore, pre-contemplation refers to a time before you are even thinking about how your behavior might be a problem. Notice that pre-contemplation resembles denial. Just like acceptance starts with overcoming denial, change also starts with overcoming pre-contemplation. Pre-contemplation is another example of a blind spot: Other people often notice what needs to change before we do!
· Example: Not sure why the wife is always on my case. Joe drinks way more than I do, and his wife never complains about it!
2. Contemplation: Remember, contemplation is the act of thinking about something. Therefore, contemplation refers to a time when you start thinking about your behavior. Contemplation does not mean that you are necessarily convinced the behavior is a problem, just that you start to think more about the behavior, and how it may or may not be problematic. Have you ever heard the phrase “paralysis through analysis”? The problem with too much contemplation is that it resembles constipation: There’s no movement!
· Example: You know, I’ve called in “sick” 5 times this month. Now my boss AND my wife are on my case. I can’t pack down my liquor like the good ol’ days. Must be getting older!
3. Preparation: This stage is all about getting ready to potentially deal with the behavior. This stage implies that you have already thought long and hard about the behavior, and you have decided that something needs to give. You would finally like to change something. At the very least, you start to make some internal or mental changes. Or maybe you have even taken some small baby steps to help change at least some aspects of the problem behavior.
· Example: I have got to find a way to get everyone off my back. That’s it: No more drinking till Friday night. I am not going to stop at the bar on my way home from work. And that hidden stash of booze in the closet has gotta go…
4. Action: This stage is all about finally making a decisive change in your behavior that other people can actually observe. At first blush, it seems like you have arrived at your destination. After all, you have finally changed your problem behavior. Congratulations! Everyone should celebrate…right? Not yet. The action stage is still full of landmines. Many people let down their guard when they reach the action stage. They think they have the problem licked. They start to take “harmless” risks as they allow themselves more and more freedom. That’s why people with too much over-confidence tend to experience relapse at this stage.
· Example: Okay, so only drinking on Fridays still didn’t work. I think I just need to bid farewell to my long and storied drinking career. Out with the Old Me. In with the new Upgrade: Clean and Sober! Now I will be attending AA meetings on Friday evenings! Fast forward: Now that I have a month of sobriety under my belt, surely my sponsor won’t mind if I head over to Joe’s apartment for his birthday bash. Maybe I can even brag about how sober I’ve been…
5. Maintenance: The last stage of change is when you have not only made the decisive change, but you have found ways to successfully maintain that change over time. Regression back to old habits is still always possible,
but now you realize that. Therefore, you have found ways to avoid relapse—and get back on track right away if you do slip up!
· Example: After a few painful relapses back in my early days of sobriety, I have now been abstinent for five years. I have learned the key to maintaining my sobriety is to avoid certain people, places, and things—and never to miss an AA meeting!
Working through the stages of change is a lot like working through the stages of acceptance: Nobody goes through the stages perfectly; not everyone goes through these stages in this exact order; it is possible to go through different stages at the same time; and it is also possible to regress in the stages.
Here’s one analogy that has always helped me to understand the stages of change—and especially the importance of making it all the way to maintenance. Let’s assume that someday you would like to have a garden full of vegetables. However, right now it’s February, and you are not even thinking about the garden yet. That’s pre-contemplation. How many vegetables will you have if you stay in this stage? Now let’s assume it’s March, and you finally start to think about the garden. You think about what kind of tools you will need, what kind of soil you will need, and what kind of seeds you will need. That’s contemplation. But how many vegetables will you have if you stay in this stage? Now let’s assume it’s April, and you start to get everything ready for the garden: You buy the tools, you buy the soil, you buy the seeds. You even rototill a little plot of ground. That’s preparation. But how many vegetables will you have if you stay in this stage? Now let’s assume it’s May. You finally plant the garden! That’s the action stage. Congratulations! But now let’s assume you do absolutely nothing to maintain this garden for the rest of the summer. You don’t water. You don’t weed. You don’t fertilize. How many vegetables should you expect by the end of August if you stay in this stage? Now do you see the importance of making it all the way to maintenance? Lifelong changes are not one-time deals: They need to be maintained!
For practical exercises to learn more about the stages of acceptance, please refer to my new workbook: DBT Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma and Post-Traumatic Stress Disorder.