Drink and Drugs News DDN Feb2018 - Page 20

Psychology A STEP TOO FAR? Have we been right to embrace the ‘cycle of change’, asks Natalie Davies hen Bill Wilson, who went on to co-found Alcoholics Anonymous, was hospitalised for the fourth time for alcohol detoxification, he cried, ‘If there is a God, let Him show Himself!’. As AA’s story goes, ‘the room became ablaze with light and Wilson was overwhelmed by a Presence and a vision of being at the summit of a mountain where a spirit wind blew through him, leaving the thought, “You are a free man”. Wilson never took another drink.’ Though Wilson’s story is spectacular – so much so that we might be inclined to think it a ‘fable’ rather than a blueprint for what might actually happen – it’s not unusual to hear about ‘revelatory moments’ or moments in which someone suddenly or spontaneously discards a substance that up to that point they had depended on. An example is the smoker who suddenly becomes disgusted with their smoking, spits out the cigarette half way through, dumps the remnants of W 20 | drinkanddrugsnews | February 2018 the packet in a bin, and never turns back, as if something had overtaken them. But another important narrative, and perhaps one more pertinent to the conversations between practitioner and client, is of the ‘longer road to recovery’ – of a process of change rather than a one-off event; of an experience mixed with conflict, ambivalence, vacillation, regret, and often relapse. And it’s this process that Prochaska and DiClemente’s ubiquitous ‘five stages of change’ model endeavours to describe. The ‘five stages’ plot the journey from Point A (‘no acknowledged problem’) to Point B (‘no problem now’) – each marker along the way representing a shift in motivation, intention, and capacity to change. Dealing frankly with the possibility of relapse, the popular depiction of the five stages as a ‘cycle of change’ (see the illustration opposite) shows the continued work that people can do or redo until the day they successfully achieve what is known as a ‘lasting exit’ to recovery. The cycle shows the progression or evolution through the stages of pre-contemplation, contemplation, preparation, action, and maintenance, and how this can come full www.drinkanddrugsnews.com