Awareness of a problem can happen in many different ways and over different amounts of time. There is a mistaken notion that knowledge is simply a matter of knowing the right words. This is not always the case. There are often cases where we may know someone is trustworthy or a situation is safe, yet we still have a hard time trusting and unafraid. Knowing the words “This is a safe situation,” sometimes even when you know there are good reasons to believe it, does not mean that you can fully latch on that knowledge. It may take time and reinforcement before those words sink deep within you as true.
The same is often true in cases of addiction and substance abuse. There may be early points in substance usage where someone mentions that there might be a problem or a thought in the back of the mind that something may be heading in the right direction. But it might take time before this becomes realized and reflected upon. In some cases, these realizations and believing the words “You have an addiction” may not happen until a crisis brings the truth home suddenly and harshly.
The Transtheoretical Model
When thinking about recovery, the Transtheoretical Model, which characterizes recovery in five stages, seeks to capture the intentional and multi-faceted nature of progress in recovery. The five stages are known as Precontemplation, Contemplation, Preparation, Action, and Maintenance.[i]
The first stage of recovery on this model is contemplation and is at the stage at which an individual would be considered “not ready.” When it comes to an understanding ourselves, it is important to remember that we are not transparent. What that means is that we do not always fully realize the motivations for our actions or fully understand ourselves. If you have ever done something and then later sat back and wondered why then you understand this. In many cases, especially in the fast-paced world of the “West,” this happens because we are not taking time to think about ourselves and our lives. We are swept up at the moment, in responsibilities, in trauma from the past, in social media and television, or anything else. Not to say that all of these things are wrong, but it can be easy to miss what is going on within our heads if we do not consider ourselves.
The point at which we do begin to reflect is known as contemplation. This can be thought of as an exploratory phase. We begin to think about “if”; if there is a problem, if we can change, change, and so forth. This stage may take some time, as it can sometimes be difficult to tell the nature and extent of a problem. We may also become acutely aware of the consequences. There may be fear of judgment from family, friends, or society and simply a desire within not to give up the pleasure of the substance. The perceived enjoyment of drug use may not seem outweighed by the negative consequences in life.
There will often come the point, though, where a decision is made to change. In most cases, this does not immediately result in doing something but rather in preparing. This means getting a plan for addressing problems and discussing the details with those around you. Even when you have decided you want to make a change, actually moving forward with it can be intimidating and difficult. This is okay as long as you face it directly and do not let the fear and difficulty derail you.
This is the stage in which clear steps have been taken to change one’s life. In most cases, when we think of individuals in recovery, this is the step we think of because it is most visible. While this is a misunderstanding of the journey to recovery, it is important and helpful that this stage is visible. Seeing change and progress, steps begin taken, can be a rewarding and encouraging experience. This may mean a measurable decrease in substance usage, lifestyle changes in nutrition and exercise, beginning a treatment plan with a doctor or treatment facility, or any other steps.
While the Action stage can be exciting and invigorating in its measurable progress, this excitement and satisfaction can decrease over time. The sensation of progress and feelings of seeing recovery in action is not permanent. Maintaining the progress can be a significant challenge, especially as withdrawal can sometimes last years, and cravings may continue to appear even longer than this. Most researchers have suggested that the maintenance stage is often around six months to five years in length.[ii] This may seem disheartening, but it is simply the reality of the situation. It is important to realize this so that individuals can mentally prepare for the experience.
One of the most important things to keep in mind when reading about the transtheoretical model is that recovery is much more than the “Action” stage. Those who are currently struggling with substance abuse realize that all of the steps are part of the process. You cannot force these things. Knowing what it means to say “I have a substance abuse problem” is not easy. It will take reflection and contemplation; it will require you to come face to face with the reality of who you are, what you have done, and how you can respond.
Another grouping of words can be hard to fully believe and own for yourself as knowledge and truth: There is hope. It is so easy to discount these as meaningless and untrue, especially when you’re in the midst of the deepest darkness. It may seem like all hope is lost, like this is beyond your power like nothing will ever change. It will be easy to despair.
I often find strength in thinking about the dawn. Every single day, the sun goes down, and the world gets increasingly dark. It becomes difficult to see, and it becomes easier to get lost. There comes the point where it the darkest in the night. And then the sun begins to rise. Gently, along the horizon, little flickers of light and color, growing and growing. The sun rises, dawn arrives—a new day.
There is hope.