Monday, November 2, 2009

Cycle of Change - Stage 1

Eight years ago at 230 pounds, Larry was a body builder. One day at the gym he was doing squats without a spotter and ruptured a disc.

When he came to see us in July of this year, he was 175 pounds and he’d been through eight years of escalating opiate use. . The opiates were decreasing his quality of life. With his doctor’s encouragement Larry decided it was time to try to stop; he wanted see how much pain was really present, and if it was tolerable without narcotics.

The detox went beautifully. He hasn’t touched an opiate, benzo or alcohol for two months. His cravings are gone. His back pain is manageable with anti-inflammatory medication.

The problem is: Larry feels extremely depressed. When he wakes in the morning sometimes he doesn’t want to even get up to go to work. Things that used to be fun for him no longer seem to interest him.

The depression is surely a multi-faceted problem. His doctor is working with him to find the right anti-depressant medications, and his brain is still trying to restore the neurotransmitters which have been depleted over the years of opiate use. But clearly, Larry is struggling with a more fundamental issue: who is he without his pain medication?

Martha Beck, a Life Coach with a PhD in Sociology from Harvard, would put Larry in Stage 1 of the Change Cycle. Any cataclysmic event which causes a person to ‘meltdown’ or have to drastically change the way they see themselves qualifies as a Stage One-r, also known as the Death and Rebirth phase.

Without opiates, Larry can no longer define himself as he has for the last 8 years. He also no longer has the identity of a body builder. The general cry of stage one is “I don’t know what the hell is going on…and that’s OK”. Larry needs to grieve the loss of the life he knew—as fraught with problems as it was—before he can move forward through the Change Cycle. How long this stage takes for anyone is variable, but knowing that there are predictable components and helpful tools can be most reassuring.

I think the first three steps in the AA recovery process speak to Stage I and are the perfect tools for dwelling peacefully in a chaotic transitional phase: admitting powerlessness, realizing there is a greater Power at work and turning one’s life over to the care of God.

At some point Larry will start to get little glimmers, glimpses, ideas and visions of things he wants to do again. They may be things he has never done before or even thought of doing before. Some of these ideas may first show up in his dreams. When this starts happening, Larry has moved into Stage II of the Change Cycle: Dream and Scheme. He’ll start plotting his New Life.

Stage III, The Hero’s Saga will come when he starts trying out his new ideas—some will inevitably fail, and he’ll briefly move back to Squares I and II. But some ideas will succeed—and his New Life will be underway as he moves into Stage IV: The Promised Land, having achieved the visions he saw for himself.

Needless to say, all of us are always dynamically moving between different stages of the Change Cycle in various aspects of our lives. But anytime a person chooses to become sober, he or she is re-inventing him or her self and must go through the Change Cycle. There are no short cuts beyond Acceptance. Our staff at The Coleman Institute is devoted to supporting our clients make this transition to the ‘Promised Land’ of Recovery.

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