and Pain Associations: 14 Steps to Change & Personal Growth
For most people, reducing or
stopping drug use is linked to pain. Pain avoidance is one of
the strongest biological urges.
This method aims
to shift negative associations which stops change to become a
motivating force for change. Subsequently,
reinforcement of positive outcomes from small action steps
builds over time to develop positive change habits.
This is particularly useful for those
who have previously tried changing and not been successful.
Its application can be generalised to other life issues which
can also improve motivation.
The key points are:
- Know what you really want
- Know what's been stopping you
- Shift focus to the pain of not changing
- Shift association of drugs use from pleasure to pain
- Enhance confidence
- Use coaches, role models, buddy
- Take immediate, small ACTION
- Notice positive differences (less pain, more pleasure &
Start with the end in mind. If everything went well in
life, how would you be living? Consider life areas of: physical,
social, emotional, financial, relationships, family, recreation
How does your drug use
get in the way of you goals, your life?
(The Life/Drug connection as it relates to you and your goals)
Identify where drug use inhibits the
development of these life areas
Develop goals around what will be
achieved (rather than what will be absent). If
reducing or stopping drug use is included, you could say something
like "reducing drug use will allow me to create a stronger,
more loving relationship with my partner".
scale of 1-10 how important is making a change?
Rate confidence. On a scale of 1-10 how confident are
you about making a change?
Acknowledge pain associated with changing
(physical & psychological & social discomfort - move out
of comfort zone).
Shift association to the pain of not changing
(ie if you don't change, what will be
the costs in the present and future?).
association with drugs from pleasant to unpleasant.
a. Tell me what's good about your drug taking.
b. Does thing about these things help you change for the better?
c. Now think about the bad things about your drugs.
d. Possibly use visualisations to strengthen
negative associations with drugs by describing scenes where drug
use starts of with some positive elements from the client's list
and then turns bad. Try to involve a range of sensory and
emotional elements to reinforce negative associations. You
might include an escape scene where the client uses a strategy
to get away from drugs towards more positive behaviours.
Link pleasure with changing What are the immediate and longer-term benefits of changing?
Link benefits of changing with life goals. Possibly visualise
life in one month from now having make positive changes.
(self-efficacy). Identify successful steps previously taken
towards changing drug use behaviours (times when drugs were used
less or not at all). Identify associated behaviours (the
who, how & what - include
environmental influences such as helping others or
availability of substances, etc ) and determine willingness to
replicate these now.
Use other confidence building strategies such
as positive self-talk (affirmations) challenging negative
beliefs, use of positive body language, etc.
Identify other negative, pain associations with making positive
changes in life (it's too hard, I'm not worth it, I'm not
clever/strong enough, etc) and shift association to success
orientation (I have powerful coping mechanisms, I have made
changes before, I have resources I didn't consider, etc) I deserve
to be successful and free. Remember times when feeling
positive in life and begin to associate the now with those times.
Find a coach/role
someone who can encourage you, support your energies, bounce
strategies off and make suggestions. Also look for someone
you admire who has already achieved the goals you are trying to
achieve or has been successful in changing the behaviour you are
trying to change. Find out from them exactly how they did it
and copy that.
build ACTION muscle Develop a next step (a short-term
goal). Emphasise that change is an accumulation of taking
action through small steps (similar to building muscle with
On a scale of 1-10 how willing are you to
carry out this next step? (If under a 7, ask what would be
required to bring it up one or two points - if too low, consider
an alternative next step which would get a higher rating).
Review how the action went within 24 hours. Reinforce
benefits associated with taking a next step.
success habits. Maintain success focus with continuing
refocus on positive action to avoid pain and increase pleasure
through daily practice. Increase sensitivity to small
changes while using journals or goal maps to identify larger
changes over time. This will make ongoing change effortless as it
becomes a habit