Expanding the 5 Stages of Change: The Role of Relapse

The 5 Stages of Change

This information just tickles my little psychologist heart! If you took any psychology classes or if you read self-help books, you learned about the 5 Stages of Change. I'm going to tell you that there's a 6th stage, and the best news about this 6th stage is that it means you are not a failure, that you have not failed, that you are not failing. The 5 Stages of Change that you might have heard about would be Pre-Contemplation, where you are not even thinking about it. I’m sure you’re wondering, “How does that even happen?” It probably means that someone is telling you that you need to start doing something or to stop doing something, and you don't think so. So that's pre-contemplation.

Then there's Contemplation, and now you're thinking about it and weighing the pros and cons of it. “Should I do it? Should I not do it? What would be good about doing it?” The next stage is Preparation, where you start planning to do it. So now you've decided to do it, you're going to start planning to do it – and that's pretty simple, right? Maybe you've decided to start exercising, and your implementation plan would be to go for a 20-minute walk 4 nights a week after dinner. That's your plan. The Action has been doing that plan. Then you get to maintenance. Maintenance obviously is that you're going to continue doing what you said you were going to. We can see it's very hierarchical, that it just goes one after another, and that's what they call the stages. 

A 6th Level of Change?

I'm going to call it now the 6th one “levels”, but I don't even think that's right, because they are going to come and go. The 6th stage is relapse. Yes, friends, it is so common for people not to stay in maintenance and to go back to some other stage that they’ve added a stage – which is brilliant, because I don’t think anyone ever stays in maintenance forever. They came up with the stage because more than 99% of everyone relapses, basically. Relapse is that you were doing something and now you are not. It's just that simple. But a lot of people take it as a personal failure. They had the idea that they were going to do it, and there is this perfectionistic fantasy that you are going to plan, it’s all going to go perfectly, and you're going to stick with it forever. But that’s not the way human life works. For example, I don't normally eat birthday cake, but guess what I eat on my birthday? Birthday cake. So, if it was my plan to never eat birthday cake, I would fail. But no, it's not a failure, it’s a decision. You made a decision that day. 

Why Isn't Relapse a Failure?

So, let's go back to why relapse is completely not a failure. For one thing, you never ever, ever go back to the beginning. Let's say these stages/levels were actually in order, because you can think of them as a progression. You can never go back to pre-contemplative because you literally can never go backward in your amount of knowledge. You now know that this action is something you decided to do and did it for some amount of time, so you can literally never go back to not knowing about that action or not having decided to do it.  

You can, however, return to contemplation. I happen to be contemplating something right now, and what I’m contemplating is not doing this behavior ever again. How about that? Just because I made a plan does not mean that I have to stick with it. I decided that it would be really good for me to drink a green drink every day – you know, where it has like 28 different vegetables and fruits in it. Oh, the amount of dread in my heart when it's time for me to drink this drink. So, I hate it before I drink it; I hate it during drinking it because it tastes awful; and I hate it after because I feel so sick to my stomach and like I might lose it. And so, I have returned to contemplation. I went, “Yes, I will do it. I'm implementing the plan.” I maintained the plan for two whole days before I said, “No, I'm not doing this anymore, but I might,” so I kept it there like it was going to happen. Then finally, after 3 weeks of having only done it two more times, I finally thought, “Do I need to do this, or can I go right back to contemplating and weighing the pros and cons and seeing if it's worth my time?” This is viable. You don't have to live with the choice that you made. 

Now let's say the same thing but, instead of returning to contemplation, I could have gone back to the preparation stage. Maybe the problem was the way I implemented it. So maybe 4 nights a week going for a walk after dinner won't work because your kid has soccer, and you can't do it. Maybe you can take a walk at the soccer field, so it's actually before bed, for example. You could go back and change the plan like that. For me, it could be that maybe I implemented the wrong drink, or maybe I need to find a different vendor. (I've actually already done this stage, and why I'm way back at contemplation now.) 

You Never Go Back to the Beginning

You can also go back to the action stage and say, “No, I'm absolutely doing this.” Whatever it is, maybe I fell off the wagon, and I'm going back to the action, and you’ll get back to maintenance. Just remember you will still relapse at some point and here are reasons for the relapse: your schedule gets messed up, you get sick, someone you love gets sick, you go on vacation. Maybe you want to put down your technology when you are with your family or with friends so it can be social time. But what if someone in your family ends up hospitalized—are you really not going to pick up your phone if some emergency happens? 

So just be aware that relapse is just a word. All you did was make a choice to prioritize in a different way or something about the implementation didn't work out well. It's super normal, and it's super fine. So, relapse, the 6th level of change, is the most humanizing of all.