Archive of ‘Priorities’ category

Why Aren’t They Ready Yet?? The Stages of Change.

Have you ever been frustrated when you know somebody needs to change something in their life, but they just can’t seem to understand it the way you do? It could be anything from working on physical health, to drug addiction, to a quasi-bad habit that needs to be broken. The other person just doesn’t see how bad things are and that they need to change! What this COULD mean is that you and the other person are at different stages of change.

What are the Stages of Change?

The Stages of Change as discussed in this blog come from Motivational Interviewing, which is a type of therapy that can either be practiced independently or in conjunction with other therapeutic modalities. Here are the stages:

1. Precontemplation Stage

In this stage, someone would not even realize that there is something worth changing. They wouldn’t think they have a problem, and they wouldn’t be contemplating any change. They could be in denial, they could be back at square one after trying a change and giving up, they could be told by folks that they need to change/have a problem but they say “I’m the exception” or “That’ll never be me” statements. 

An example: Jonah smokes a pack of cigarettes a day, and his friends tell him they are worried about his long term health. Jonah responds to his friends “I’m not worried about it. It’s just a pack and I could stop any time I want to! Other people get cancer, but it doesn’t run in my family and it won’t happen to me!”

2. Contemplation Stage

This stage is when someone knows they want to make a change, and they begin weighing their options. Here, therapists and friends will often hear this person express ambivalence about making the change, fear talk, and “I would, but…” statements. 

An example: Mel has been having stomach problems with her anxiety for a few months and knows that a trip to the doctor would likely help her figure out ways to feel better. She is afraid that they may have to run invasive tests or change her diet, which give her even more anxiety and make her stomach issues worse. She has talked to her partner about her stomach issues and has said many times, “I should make that doctor’s appointment soon, but I’m just too busy with school to take a day off!”

3. Preparation Stage

Here, folks will start to get ready to make a change, or they may make small steps toward the change. This could be the point at which we hear someone say “I’m about to start doing ___” as they get ready to make their change. They may start sampling their new lifestyle, or dipping their toe in to test the waters, but haven’t taken any formal action toward the change. 

An example: Jess has become aware of the fact that social media consumption exacerbates her depression and anxiety. She decided that deleting her social media apps off of her phone will be a big step to helping her mental health. She recently posted to her friends that she will be deleting her apps and will be much harder to reach soon. She gave them her other contact information so they can still text and facetime, without the obligation to see everything that has been giving her FOMO and anxiety. The apps are still on her phone for the time being, and she is mentally preparing for the day next week that she will delete them. 

4. Action Stage

A person in this stage is actively trying to make their change happen. This is often where the bulk of therapy work occurs, as our clients have taken steps to call our office and schedule a session, sit with a therapist and discuss their concerns. It is possible to get to the Action stage multiple times (like, with a pesky New Years’ Resolution) only to revert to an earlier stage a few times over. 

An example: Evan started going to the gym Monday through Thursday after work, made an accountability buddy at the gym, and is loving it! He used to go to the gym about once or twice a year, and recently became fed up with his sedentary lifestyle. He is really trying to find ways to keep his gym habit sustainable this time. 

5. Maintenance Stage

This is the stage that we would aim to be in for the longest amount of time. Maintenance is the goal of making a change; we want to maintain our change over time. A person in this stage has become proficient at their action stage and is looking to maintain the change. 

An example: Ori calls himself a “recovering anger-holic.” He grew up with enormous difficulty with expressing his emotions, and often would have angry outbursts. When he became engaged to Amber in his thirties, she asked him to go to therapy for his anger. In this way, Amber helped Ori move from stage 1 through stage 4. He worked with his therapist to express his feelings in healthier ways, manage his anger, and grow his support network. Ori and Amber participated in couples therapy a few times over the years (especially when Ori’s anger looked like it was relapsing), but now that they are in their fifties, they hardly need outside help. He can still be triggered into what used to be fits of anger, but now are fits of coping and emotional expression. Amber knows all of his most reliable coping skills and they use code-words when he really needs to go cool off and take a walk. 

6. Relapse Stage

A relapse is when an individual returns to a previous stage for any amount of time. It is common, when making a change, to be tempted to return to the pre-change lifestyle. It is important during a relapse temptation to seek support and try not to relapse. A relapse could be small or large, and it doesn’t mean you or your treatment failed. After a relapse, an individual could return straight to maintenance, or it may require a return to an earlier stage. It is possible to return to precontemplation after a relapse, as someone could say “oh that wasn’t as bad as I remembered” and be enveloped once again with their pre-change lifestyle.  

An example: Ellee realized she had a gaming addiction when she was 22. After the challenge of quitting video games and seeking help, she maintains an abstinence from video games as a 28 year old. She recently relapsed when a new group of friends had a housewarming party for their friend. She didn’t know that there would be a console with the expectation to play some party games over drinks, and she had gone home afterward and continued a game-watching binge on Twitch. Ellee felt guilty and embarrassed the next day when she realized what she had done. She called her dad (her “biggest supporter”) the next day to tell him what happened, and told her therapist about it in their next session. She made a plan to tell the new group of friends how they can support her and why she has to stay away from video games. They worked together to make a plan to have console nights without her, and include her for other activities instead. It was her third ever relapse, and she commented in therapy that the aftercare seems to “get easier every time” when she relapses. She will easily get back into her maintenance stage, as she does not own any platforms that allow for her previous video game habits, and she has now blocked Twitch on her laptop to prevent another similar relapse. 

Fun Facts

Fun Fact 1: Someone can bounce around to various stages many times before coming to their “final” maintenance stage. Even then, relapses may occur and require a re-do of some earlier stages before returning to maintenance. 

Fun Fact 2: It can be extremely frustrating when you are at a different stage of change from a loved one with a change that needs to be made. These stages can be discussed with your therapist, and you and your loved one can come to a decision about how best to proceed together in sessions. 

If you are ready to talk about making a change in your life, reach out to us at [email protected] or 512-298-3381. 

(The Stages of Change discussed in this blog are taken from Prochaska and DiClemente’s 1983 Stages of Change Model, and the book Motivational Interviewing, Third Edition: Helping People Change by Miller and Rollnick)


The Container You Create

With the rise of telehealth and the quick ubiquitous implementation of it, and then the long year that has followed; it might be a good time to pause and consider how your therapeutic container is treating you.

One marked benefit of hosting sessions in your own space is the fluidity with which therapy can exist in the midst of your daily life. Being in your space means being around your preferred creature comforts (including possible “therapy animals”). This shift means skipping the commute to the office, creating possible ease in childcare or work/school scheduling. 

There are also noted drawbacks to this technological switch. 

Pre-Covid, there was a certain ritualistic bookending on either end of the session that occurred by way of driving or walking to the office, sitting in the waiting room, then traveling to your next destination. There was inherently a moment for reflection and integration. On the front end, preparation time was available- a review of the week, or of existing material. Post-session, there existed a buffer between what came up in session and whatever real-world situation required your immediate attention. If something difficult arose or trauma processing occurred, that time and space enabled a somatic come-down before the stressors of the day reared their incessant heads.

Now, when working over a telehealth platform, it is not uncommon to jump from work into session then back into life mode, and vice versa. 

Here are some considerations to create appropriate space and get the most out of your sessions and reclaim the quiet spaces that used to buttress session:

– To prepare for session: Dedicate a space in your home for this time. If possible, make sure not to be backlit, and sit in a comfortable seat. Have a glass of water and blanket within reach. Whenever possible, use this dedicated space for each appointment. 

– Ensure you have a sonically private space where there won’t be intrusive noises and no one is within earshot

– Plan for at least 15 minutes prior to the session to prepare. This might look like making some tea, taking a walk, free-writing, or some form of creative expression 

– During the session: turn off your self-view. If using a platform that enables the removal of your tiny thumbnail mirror, I suggest it. Not only is it distracting, but it potentially feeds the part of you that might be tempted to ensure you’re doing therapy “right.” 

– After the session: instead of closing the computer and heading back into your life of working, emailing, parenting, or erranding— make a conscious choice about what this transitional moment looks like. Can you use another 15-minute pause prior to quotidian demands beckoning?

– Grounding both into session and after the session as a form of aftercare is an integral part of this work. You can enlist your therapist for some specifics here based on what you’re working on

Reflect on what this switch has meant for you— what are you missing from in-person sessions? What is working better for you remotely? The space itself, no matter its iteration, is part of the therapeutic processing—this can be a topic you internally and externally and consciously explore within the therapeutic realm.

Written by: Ash Compton, LMFT-Associate, EMDR-Trained Supervised by Susan Henderson, M.Ed, LMFT-S, LPC-S


The Benefits of Committing to a Long-Term Relationship with a Therapist

Therapy. Sometimes we get the idea to enter therapy when life is going smooth, but we’d like to tend to our self-growth anyway. More often we get the idea to enter therapy when something traumatic has occurred in our lives or we’ve tried everything else we could think of first (aka we’re desperate).

We want something to change, and we want it to change fast because we’re tired of feeling this way.

We may still be hesitant to hand over our time and money to a therapist, but we bargain with ourselves. “I can commit to this for a few months.” And we do. And things may start to feel a little better. The storm settles. We’ve had some time to process. Things might even feel somewhat normal again.

We did what we said we would do. We stuck it out for a few months.

And all the thoughts start swirling in our heads about why it might be a good time to say goodbye:

We’re feeling better.

Money’s a little tight.

It’s not always fun to show up and be vulnerable.

Do we really need this? Or is it an unnecessary luxury? There are so many other responsibilities to manage.

I say this all from firsthand experience. These were the thoughts I bumped into after seeing my therapist for a few months (yes, therapists see therapists too).

Afterall, they’re valid and convincing thoughts.

And yet, I decided to stick with my therapist anyway. Something told me these reasons to leave were emerging as a convenient way to avoid digging deeper.

Now, six months later, I realize I was on the verge of doing some real work with my therapist. Work that has already and will continue to shift my life in some powerful ways. 

It’s not always comfortable, but I’m glad I’ve stayed.

Here are some reasons I’ve come to believe in the value of committing to a long-term relationship with a therapist:

1. Trust and safety take time

In therapy, the relationship is key. The amount of trust and safety you feel with your therapist determines how authentically and vulnerably you’re able to show up. And trust and safety take time. Think about the people you’re truly yourself with. How long have you known them? I once had a mother of a client I see reach out to me concerned. Her son told her he wasn’t being completely honest with me. I had seen him for five sessions. I told her I probably wouldn’t be honest with me either at this point. Trust in a relationship takes time.

2. Deep-seated patterns don’t change overnight

Oftentimes, when we begin therapy, we become aware of patterns that have been part of our lives for years, maybe even decades. And even if they’re not healthy patterns, they’ve become part of how we operate and even part of our identities. There can be a lot of delicate untangling to do. And after we untangle, we have to learn new ways of being and operating. These kinds of shifts understandably take time.

3. Therapy is continuously empowering

Even if you’re not facing something acutely stressful in your life, there is a lot of beneficial work that can be done in therapy. For fifty minutes, you are turning inward, slowing down, practicing being with yourself and your emotions, expanding your capacity for feeling, and taking responsibility for the state of your life. All of this creates a more mindful approach to living that then ripples out and affects the rest of your week. The decisions you make. The behaviors you choose. You begin to have more say in your life. Even if you’re not in crisis, it is always empowering to slow down and become more aware of how you’re feeling, what you’re needing, and what you’re choosing. 

4. Your mental health matters

In a world where self-care usually falls to the bottom of the barrel in comparison to work and responsibilities, carving out an hour each week in which you choose your mental health is a gift you give yourself that fosters a kinder, gentler relationship with yourself where your feelings matter.

5. You learn how to be with your emotions

Everywhere else in our lives, the people who care about us want to offer solutions. When we tell them what we’re going through, they instinctively want to fix it. Quickly. As a result, we are constantly taken away from simply experiencing our emotions. Therapy may be the only place in your life where you can truly be with your experience. Not only is this healing, but it deepens your ability to be with your feelings. When we don’t know how to be with our feelings, we run away and distract ourselves. We blame others. We act out. As we learn how to be with our feelings in therapy, our worlds start to feel safer. We learn how to allow. We take more deep breaths. We react less and thoughtfully respond more. 

6. You learn how to be honest and how liberating it is

To have a place where you can just. be. yourself. Most of the time, we have to consider the feelings of others. We modify or perform in some manner. In therapy, where it just gets to be about you, not the expectations of others, you begin to speak truth in a way you may never have before. As a result, your life starts to feel more honest.

7. Life is constantly offering us opportunities for growth

Short-term therapy is based on the idea that there’s a problem to be fixed. Fix the problem and you’re good to go. But the thing is, that’s not how life works. Life is a continuous process of growth and change. Once we reach the top of one mountain, another appears. Long-term therapy acknowledges this. It acknowledges that to be human, with all of our unique emotions and fears, challenges us in an ongoing manner. It acknowledges that the whole reason we’re here is to keep stepping into growth and to keep doing the work so our lives continue to feel alive and rewarding. Long-term therapy acknowledges that change is constant and so support should be constant too.

Long-term therapy provides a safe and empowering shelter where you continue to grow, heal, and nurture the relationship you have with yourself and life. A therapist is a wonderful resource to support you on your journey. 

Written By: Jamie Alger, LPC-Associate Supervised by Lora Ferguson, LPC-S


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