Recognizing There Is A Problem by Sarah Frank, LMFT, ATR

In 12 Step Programs the First Step reads “We admitted we were powerless over (fill in the problem/addiction) and that our lives had become unmanageable.” This is a seemingly simple yet somewhat paradoxical suggestion for those looking for a solution. There is the recognition of a problem beyond managing as well as an admission that one cannot control this problem. It may seem disempowering to admit powerless over a problem but, to the contrary, detaching from trying to control it may be the best way to view it more objectively. For being only the first of twelve steps, this step can be a challenge, even off-putting, for those who are only starting to recognize there even is a problem.
According to the widely used Stages of Change Model (Prochaska & Velicer, 1997), there are six stages involved in making a behavioral change. This model shows that change actually occurs over time vs. instantaneously, and is a process that involves progressing through six sequential stages. The first stage is “Pre-contemplation”, which is where a person has no recognition of there being a problem at all. Some might call this being in a state of “ignorant bliss”. For a person in this stage, they do not intend to make any changes in the foreseeable future either due to lacking awareness of potential consequences or having become demoralized by unsuccessful past attempts at change. The next stage is “Contemplation”, which typically entails recognition that a change may need to happen. In this stage the costs and benefits of making the change are examined and negative consequences may already be acting as motivators.
When a solid need for change has been recognized, one has now arrived at the “Preparation” stage. This could include immediate preparatory thoughts or actions leading to change such as researching treatment options online, calling a therapist, making a doctor’s appointment, purchasing a self-help book, or asking a friend who is in a 12-step program how it works. At this point one is able to move into the “Action” stage. This stage requires that specific and overt modifications have been made and continue through 6 months. The next stage, at least six months from the time of making the change, is where a person progresses to “Maintenance” where healthy routines and relapse prevention tools have been incorporated sufficiently enough to maintain stability with the changes made.
The sixth stage is “Relapse” and is seen as separate from the aforementioned stages as it is a form of regression from “Action” or “Maintenance” to an earlier stage, where one ideally can reenter the cycle and recommit to making the change. Relapse takes different forms depending on the problem addressed. It could mean using a substance one has been abstaining from, re-engaging in a problematic behavior, or not participating in self-care practices that result in the return of a negative emotional state.
Taking the Stages of Change into account, a desired shift can occur with ownership over the existence of the problem. Admitting there’s a problem is not likely to be easy or comfortable. Look around you for support and resources, do some journaling about your struggles and goals, talk to others who may be able to relate, and know that change is possible.

Prochaska, J. O., & Velicer, W. F. (1997, Sept. & oct.). The Transtheoretical Model of Health Behavior Change. Retrieved August 17, 2017, from

Elana Clark-Faler
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