At any given time, 6%-7% of Americans show diagnostic signs of substance dependence (O’Brian and McKay, 1998, p 127). In this research, substance is used in the strict sense of substances such as alcohol, cocaine, cannabis, or opiates. The research excluded nicotine and caffeine dependence, as well as behavioural dependence such as compulsive gambling. In this article, we will focus on substance use, but the same interventions will work with any addictive problem. There’s no doubt the level of addiction in our societies is a serious problem. Alcohol alone is implicated in half of all driving fatalities, a quarter of all suicides, a third of all assaults, and in the medical cause of death for 100,000 Americans a year (Dorsman, 1997, p 2).
In trying to define dependence, psychiatrists and others refer to more than just excessive use, and to more than a psychological sense of needing the substance (American Psychiatric Association, 1994, p 108-9). They refer to what counsellors call ambivalence (Miller and Rollnick, 1991, p 36-47) and what NLP Practitioners would call sequential incongruity (Bandler and Grinder, 1982, p 179-188). The person accesses the part of their neurology that wants to use the substance, and then the part that doesn’t want to use, in an ongoing sequence. For example they may take more of the substance than they originally planned to. They may make attempts to stop, or say they want to stop using the substance, and then carry on using it. They may abandon other activities which are important to them, as a result of using the substance. They may continue using the substance despite actually suffering persistent, painful problems as a result of this use. They may even have tried to stop using the substance, and experienced extreme discomfort (called withdrawal). In short, an addiction occurs where one part of a person wants them to stop, but (and that word “but” is used intentionally) another, apparently more powerful part wants them not to stop.
People Naturally End Most Addictions
There are a large number of programs offering to assist people in stopping using substances they have been addicted to, including the famous “12 Step” programs such as AA (Alcoholics Anonymous). However, contrary to popular belief, most people break free of addictions on their own. Several surveys by the institution for Health and Aging (University of California) show that drinking problems up to the level where blackouts occur almost always disappear before middle age, without medical assistance, as do most teenage drug addictions (Peele, 1989, p 66). Over two thirds of those addicted people who stop drinking alcohol, do so on their own with no help. 95% of the 30 million Americans who have quit smoking in the last decade or so, did so without medical or AA style help. (Prochaska et alia, 1994, p 36). These people have better long term success than those who choose treatment programs: 81% of those who stop drinking on their own will abstain for the next ten years, as compared with only 32% of those who are going to AA (Trimpey, 1996, p 78; Ragge, 1998, p 24).
The same seems to hold true for lifestyle based “addictions”. In 1982, Stanley Schachter announced the results of a long term study into obesity. He set out in the early 1970s with the idea that while most overweight people can lose weight, few ever keep it off. In two separate community based studies, what he actually found was that 62% of obese people succeeded in taking off an average of 34.7 pounds and keeping this weight off for an average of 11.2 years. Those who never entered weight loss programs showed better long term weight loss. Incidentally, he stumbled on the truth that many smokers give up smoking on their own. He followed up this variable too, and again found that those who attended treatment programs did not do as well as those who gave up on their own! (Schachter, 1982, p 436-444).
What about so-called “hard” drugs? In a 1982 study of morphine use, 50 surgery patients were given uncontrolled use of morphine for 6 days. Though they used far more than street addicts, they all decreased the use of the drug and stopped with no problems after their discharge from hospital. Of U.S. soldiers who used heroin in the Vietnam war (and most did) 73% became addicted and displayed withdrawal on return. Authorities were terrified, expecting a huge surge in addiction numbers. In fact, 90% simply stopped once they got back to America. Researchers noted “It is commonly believed that after recovery from addiction, one must avoid any further contact with heroin. It is thought that trying heroin, even once, will rapidly lead to re-addiction … Half the men who have been addicted in Vietnam used heroin on their return, but only one in eight became re-addicted to heroin.” (Peele, 1989, p 167-168; Trimpey, 1996, p 78).
How Medicalisation Reinforces Addiction
Addiction has been described by AA as an uncontrollable physical disease, and alcoholics are told that just one drink sets off the uncontrollable disease process again. Research consistently invalidates this claim. In 1973, Psychologist Alan Marlatt gave alcoholics heavily flavoured alcoholic drinks and found that – as long as they believed the drinks were alcohol free – they drank only normal amounts. On the other hand, alcoholics who were told their drink contained alcohol began to drink compulsively, even though their beverage contained none. Such studies have been repeated numerous times under varying conditions. Those who believe that they are powerless once they have had a drink of alcohol, do far worse in long term studies. One four year study followed up 548 diagnosed alcoholics initially treated at 8 different AA centres, and found that while only 7% had managed abstinence, 18% were now social drinkers with no instances of drunkenness. In this study, those who most strongly agreed with the AA disease model of alcoholism were the most likely to still be heavy problem drinkers four years later (Ragge, 1998, p 32-34).
Consider the 90% of Vietnam veterans who gave up heroin use after their return. What caused them to become addicted in the first place? Did they have a disease that other Americans their age missed the gene for? No; they were placed in a situation that produced extreme incongruity. One part of them kept them in a war zone, where another part of them suffered extreme pain. They suppressed the awareness of that pain with heroin, just as the surgical patients in the hospital study cited above suppressed their pain with morphine. After their return to the United States, 90% of the veterans found that they no longer had the pain. Just over 10% still had severe unmet needs on their return. The others simply stopped, because the need had stopped. They were never “powerless” over the drug, they were overwhelmed by their own inner yearnings; remarkably sane, understandable yearnings. No “disease” is required to explain this process.
Stanton Peele emphasises “When narcotics relieve pain, or when cocaine produces a feeling of exhilaration, or when alcohol or gambling creates a sense of power, or when shopping or eating indicates to people that they are being cared for, it is the feeling to which the person becomes addicted. No other explanation – about supposed chemical bondings or inbred biological deficiencies – is required. And none of these other theories come close to making sense of the most obvious aspects of addiction.” (Peele, 1989, p 151) The medicalisation of addiction has even more unfortunate side effects when the person actually stops using and terminates treatment. They are then told that their very feeling of being completely okay is proof that they have a disease! This is a classic double bind which is contradicted by the vast majority of addicts who recover permanently on their own.
How “Confrontation” Reinforces Addiction
Imagine a psychotherapist working with a client who has a sequential incongruity, where the client gets drunk and then wishes they didn’t. The therapist decides that the part of them that wants to stop is “right”, and begins to argue and “confront” the client from that point of view. The result is predictable. The client will argue from the other side. This has led to the belief that “denial” and “rationalisation” are personality characteristics of addicted people. Five decades of research has shown no correlation between denial and addiction (Miller and Rollnick, 1991, p 9-10). In fact, the only character trait associated with addiction is the ambivalence about the addictive substance! However, denial has been shown to increase as a result of confrontive treatment programs. In fact, the longer a person remains in a “12 Step” addictions program, the higher they score on measures of guilt, defeat, fear and other personality characteristics usually associated with addiction (Ragge, 1998, p 25).
To restate the basic NLP presupposition; resistance simply indicates lack of rapport! Several meta-reviews of research studies show that therapist style is more important than the content of the therapy, in predicting outcomes with addiction. The style which is most effective is less confrontational, more empathic and uses more communication skills (Finney and Moos, 1998, p 160; Miller and Rollnick, 1991, p 4-7). Even within one session, use of “confrontation” and labelling (“Face up to it! You’re an alcoholic!”) has been shown to increase client arguing and denial (Miller and Rollnick, 1991, p 9-10). This is extremely important to understand. At least one book claiming to present an “Ericksonian approach” to addictions counselling urges the use of extreme confrontation (Lovern, 1991). Addiction is not in itself evidence of a personality based on denial and argumentative rationalisation, and aggressive approaches such as John Lovern’s actually create the problem they claim to solve.
Glowing reports of success at addiction treatment centres often disguise the fact that over 80% of clients do not complete the programs (Trimpey, 1996, p 78). Because their own publicity is so pervasive, 12 Step programs tend to appear successful, but this success has been hard to demonstrate in research. Dr Keith Ditman, head of the Alcoholism research Clinic at the University of California studied 3 groups of alcoholic offenders randomly assigned by a court to AA, to a medical clinic or as controls (no treatment). In the follow-up period 69% of AA clients re-offended and 68% of clinic clients. Only 56% of the controls did (Ragge, 1998, p 21-22). Two studies emerged in 1997 suggesting that AA groups fared as well as cognitive behavioural approaches, but there is no justification for the claim that 12 Step groups are the most effective solution to addiction.
Remember that most people recover from their addictions on their own. What has happened in these peoples lives? Research on 2700 British smokers showed that, at the time they stopped, they often changed their job, altered their relationship or otherwise solved some lifestyle problem. Also, they stop when they “lose faith in what they used to think smoking did for them” while creating “a powerful new set of beliefs that non-smoking is, of itself, a desirable and rewarding state.” (Marsh, 1984).The program which show the highest effectiveness in meta-analysis of research on addiction is social skills training (training of the type offered in our Transforming Communication course; see Bolstad and Hamblett, 1998). Using roleplay and coaching, this training teaches people how to state their own concerns clearly and non-blamefully, how to listen effectively to others’ concerns, and how to work towards solutions that suit both them and others. The most effective approach to addiction is not in fact to deal with “the addiction” but to solve the interpersonal problems in the person’s life (Finney and Moos, 1998, p 157). To use an analogy, most addiction treatment is like setting up AA clinics for the soldiers in Vietnam. What works is bringing them home.
The second most successful treatment program for addictions is Brief Motivational Interviewing (Finney and Moos, 1998, p 157). This is based on a model developed by James Prochaska, John Norcross and Carlo Diclemente, who interviewed 200 people who quit smoking to find out what happened (Prochaska et alia, 1994). They followed up with studies of people who had given up a number of other addictions, finding the same patterns. Amazingly, Motivational Interviewing is delivered in a four session format, which makes it the briefest treatment available in the field! The methodology of Motivational Interviewing does not focus on the content of the addiction (eg by educating people about the dangers of drinking) but on the process of becoming motivated to quit.
The Six Stages Of Change
Prochaska and DiClemente (Prochaska et alia, 1994; Miller and Rollnick, 1991, p 14-18) found that successful self-changers cycle through a series of six stages. Helping a person in one stage requires an entirely different approach to helping someone at another. The authors describe resistance as a result of applying a change strategy designed for the wrong stage of change (eg treating a person in the contemplation stage as if they should be ready for action). The stages can be diagrammed as below:
Summary of the Model
In the second part of this article, we will consider in more depth how to utilise NLP interventions in this sequence that has been shown to work with addiction. We will also discuss how to identify the stage the person is at. Summarising, the effective responses to each stage are:
Pre-contemplation. The person doesn’t consider the addiction an issue at this stage. Refuse to collude with the problem, and simply seek permission to give information.
Contemplation. The person seesaws between wanting to change and wanting to use. Explore values and use NLP decision-making processes.
Commitment. The person says they really want to change. Help set goals, and provide tasks for the person, to check out their intention to act.
Action. Once the person is ready to act, elicit and alter their old strategy for using, and integrate the conflicting parts to resolve the problem.
Maintenance. Build a new lifestyle by integrating change at the level of mission, values, and time line; and teaching interpersonal skills, state changing skills, health skills.
Recycling. Future pace the person through possible future lapses to a life beyond “recovery” to ensure that they can quickly respond to any new challenges.
Summarising The Story So Far
Addiction refers to the situation where a person is sequentially incongruent (ambivalent) about their use of a substance or lifestyle. Over two thirds of people suffering from substance addictions recover fully by themselves. Many factors in current 12 step and medical treatment programs impede this normal resolution process. These factors include the belief that addicts are powerless to deal with addiction because it is a physical disease, and the belief that addicts require brutal, confrontive therapy to force them to face reality. In fact, the two most successful treatments, in research, are based on 1) equipping these people with interpersonal skills, and 2) choosing helping responses carefully based on a stage model of change. Use of this stage model, called Motivational Interviewing, dramatically reduces the time needed to assist someone to end their addiction.
The Motivational Interviewing model is based on research showing that self-changers go through six stages before final exit from their addiction: Pre-contemplation, Contemplation, Determination, Action, Maintenance, and Recycling of the process.
Pre-contemplation. At this stage the person is not consciously aware of the sequential incongruity that others might consider “an addiction”. They do not “own the problem”. Useful help at this stage is aimed at creating a situation where help is acceptable. The helper can:
- Get permission to provide information and act as a consultant. An effective consultant knows their facts, shares information respectfully, listens to the person’s response, and leaves the decision-making to them.
- Refuse to cover up the incongruity for the person, while not trying to “convince them” to act on it. The aim is simply to assist the person to become more aware of what is happening. The use of effective communication skills by helpers and people involved with the client is crucial at this time. This includes the ability to send a clear I message (eg “When you arrived home two hours later than you arranged, it meant I ended up missing out on the movie we were going to. I felt really disappointed because I’d been looking forward to going with you.”) and being able to respond to the person’s reaction with reflective listening (eg “You think I’m over-reacting. You just forgot, and you’re sorry about that.”) before restating your concern in a new I message. These skills are discussed in considerable depth in our book Transforming Communication (Bolstad and Hamblett, 1998).
- Find ways to present advantages of changing to the person, rather than simply using away from motivation. Research shows that towards motivation is extremely important in shifting from pre-contemplation to contemplation, while reducing internal conflict is more significant in moving from contemplation to actual commitment (Prochaska et alia, 1994, p 162-171).
Contemplation. This is the stage where the sequential incongruity is most obvious. The person is now engaged in the change process, and oscillates between wanting to change, and wanting to ignore the problem. They may say “Sure, it’s a hassle; but I think I can manage it.” The helper’s goal at this stage is to assist contemplation. It is tempting to try and rush the person through the whole change process, but this is unlikely to be successful. Where incongruity is severe, the person can often present a plausible demonstration of readiness for action over the 30-60 minutes of a consulting session, but still demonstrate complete disinterest in change outside of the session. Particularly where the person has had experience before of confrontive “Recovery” programs, they have often learned to present only the part that wants to change, within your session. To be helpful, the session needs to contact both sides of their ambivalence.
- Values elicitation and goal setting help the person to identify what they want to do about the problem.
- Explore, without attempting to force a decision, the risks of continuing with the problem behaviour (elicit away from motivation) and reduce the perceived risks of changing.
- Have the person themselves state why change would be useful; this can be done by pointing out all the advantages of continued using, and asking why they’d want to change.
- At this time the process of Parts Integration can enable the person to access and integrate both sides of their ambivalence about changing (which is a step further back from using the method to actually change!).
Commitment. Every so often, a window of opportunity opens within the contemplation stage, when the person shows evidence of commitment. This evidence might include:
– Stopping presenting reasons why the problem behaviour is “okay”.
– Making motivational statements (eg “I need to change this!”).
– Discussing what it would be like to have changed.
– Experimenting with change processes, or with stopping the problem behaviour.
The helper can strengthen commitment in a number of ways:
- Identifying and utilising the person’s usual motivation strategies and metaprograms. Carol Harris offers an excellent assessment and utilisation guide in the context of weight loss (Harris, 1999), dealing with more than ten core NLP metaprograms. She suggests pacing each of these as you design goalsetting and visualisation.
- Enabling the person to set goals for change. Solution focused questions are extremely useful (eg “How will you know that this problem is solved?”, “When is a time that you noticed this problem wasn’t quite as bad?….What was happening at that time? What were you doing different?”)
- Reframing the problem as changeable, perhaps using some of the information given above in this article.
- Negotiating a strategy for changing.
- Setting achievable tasks which presuppose commitment. Such tasks could include monitoring the behaviour to identify how often it occurs and when it doesn’t occur. The person’s response to these tasks allows you to assess whether they are ready for the action stage yet (see Overdurf and Silverthorn, 1995 A, p 29-32).
Action. Once you have evidence that the person is acting, the action stage involves replacing the person’s old “problem” strategy with a new one (called “countering” by Prochaska). This can be done on a number of different levels, including:
- Elicit the person’s strategy/strategies for using the addictive substance (Overdurf and Silverthorn, 1995 A, p 32-34). This is the sequence of thoughts they regularly go through from the time they were not thinking about using, to the actual use. This strategy will involve being triggered by some external event which they see or hear, or by a physical sensation. Often it will involve some sequential incongruity (eg telling themselves they shouldn’t use the substance, and then adding to the stress until they feel they have “justified” giving in to their desire to use). Using NLP strategy notation, and taking an example of someone who smokes cigarettes after each meal, the strategy might look something like this:
Ve ® Vr Ki ® Ad Ki ® Ki / Ki ® Ad ® Ke
Polarity Operation Test (comparison) Exit (A) Exit (B) Ve ® Vr Ki P® Ad Ki ® Ki / Ki ® Ad ® Ke See meal finished Remember cigarette and feel enjoyable feeling Say to self “It’s wrong to smoke! This is terrible!” and feel guilty Compare feeling of guilt to feeling of smoking Say to self “Damn it! Why should I have to feel bad!” Smoke cigarette
This strategy can be interrupted at a number of different places, as described below.
- Design a visual swish from the Trigger image to an image of a resourceful person who no longer smokes. The power and the risk of this method are demonstrated by a case of a man who came to see us because he smoked while playing the piano. After a visual swish from the image of the piano, he reported that he no longer felt like smoking when he thought of the old trigger. A year later we met him and found that he had never smoked while playing the piano again (he found other places!). It is important to clear all possible triggers.
- Directly alter the strategy in some key way, such as having the person smoke a cigarette before the meal, or having them always smoke two cigarettes where they would have smoked one. Anything that disrupts the strategy will tend to work if the person has actually decided to stop. Milton Erickson, acknowledging that an alcoholic needed to be “sincere” before his work would succeed, gives several examples. In one case (Lankton and Lankton, 1986, p26-27) he worked with a man whocame in for treatment for alcoholism. Erickson elicited his strategy for drinking, and found that he would sit at a bar and drink a beer, followed by a whiskey chaser, and repeat this process until drunk., one drink at a time. Erickson told him that next time he went to the bar, he was to order three whiskeys and three beers and to line them up in a row. As he drank each drink, he was to curse Erickson, in prescribed ways (the tamest being “Here’s to that damned Doctor Erickson; may he drown in his own spit!”). That was the end of the therapy. The man came back three months later to thank Erickson for curing his addiction. He was unable to drink with these alterations to his strategy.
- Provide more useful reframing and metamodeling skills for the person to challenge their auditory responses at either the polarity operation or at the exit. Instead of talking to themselves about how wrong it is to smoke, they might, for example learn to talk to themselves about how good it would be to have healthy lungs; or instead of saying “Why should I have to feel bad?” they might ask themselves “How could I feel even better than I feel when smoking?” Using these skills would lead the strategy in an entirely different direction. Cognitive behavioural therapy focuses most fully on these sort of auditory digital challenges (Lewis, 1994, p 117-146). The Rational Recovery system for changing addictions has the person identify the internal submodalities of the voice with which the addicted “part” speaks (eg when it says, “Damn it, why should I have to feel bad!”). This voice is called the “beast” in Rational Recovery. The person learns to identify that when it says “Why should I have to feel bad, it means itself (the part that wants the addiction) rather than the person. This is a technique which further dissociates the person from the addictive part. The only reason for doing this in NLP terms would be to prepare for the next intervention, namely…
- Turn the comparison into an integration of the two conflicting parts. Use the NLP parts integration process to integrate the part that feels guilty smoking on the one hand, with the part that enjoys the feeling of smoking on the other. This can also be done linguistically, using Tad James Quantum Linguistic patterns (James 1996, p 58). For example, one NLP Practitioner asked me how she could stop smoking, which she had attempted for some time. I asked her what the intention of the part that smoked was. She said to have her relax. I then said to her “Please listen carefully. Does that part realise that anything less than completely stopping smoking isn’t totally getting you the relaxation you want?” She actually couldn’t hear what I’d said (because to understand the question requires simultaneous accessing of both the conflicting parts). After I repeated the question several times, she went away none the wiser consciously, and reported some months later that she hadn’t smoked since that moment. The structure of what I said is “Anything less than completely stopping [problem behaviour] isn’t totally getting you the [higher positive intention of that behaviour] you want”. A third NLP method of resolving the parts conflict is the older Six Step Reframe, described in a 12 Step context by Chelly Sterman (1991).
- Use Time Line Therapy™ or Reimprinting to clear the cause of the addiction from the person’s time line. John Overdurf and Julie Silverthorn clear three things: the representation of the first use of the substance, the root cause of the addiction, and the unconscious decision to become an addict (1995 B, p 31-32). These may have all occurred at the same moment, or they may be widely spread apart in time. We have had the experience of simply clearing the root cause of addiction and having a person unable to access the craving for cigarettes any further.
Maintenance. Maintaining change requires different skills from making the initial shift. For example, a person could congruently stop drinking alcohol in the NLP Practitioner’s office, and then find themselves without any resources to cope with interpersonal conflicts at home. This is why actually teaching communication and conflict resolution skills is such an effective technique for ending addictions. Maintenance involves building a new life without the addictive process. Helpers can:
- Teach conflict resolution skills (Bolstad and Hamblett, 1998) including 1) problem ownership, 2) reflective listening, 3) I messages, 4) Win-Win solution finding, and 5) skills for resolving values collisions. Remember that this intervention alone is the most successful change program known for ending addiction.
- Release any other harmful emotions and decisions or beliefs from the time line using Time Line Therapy™ or Reimprinting. Albert Ellis points out that the addicted person may have self imposed limitations at several levels of Robert Dilts neurological levels model (Lewis, 1994, p 153). These could include environmental limitations (only having friends who use the problem substance), behavioural and capability limitations (eg not knowing how to respond to the feeling of craving), belief limitations (eg “It’s not fair that I can’t drink alcohol when I want.”) and identity limitations (eg “I am a broken person.”). These limiting beliefs can be elicited, cleared from the time line, and/or replaced using any NLP belief change process.
- Assist the person to create a new sense of mission for their life, and align values and goals to support this mission. The belief of AA is that this sense of mission needs to involve connecting to a “higher power”. In her work, which challenges AA and its twelve step program, Charlotte Davis Kasl (1992) has invited clients to rewrite the twelve steps. Her re-writings of the last step seem remarkably similar to the original (which was “Step 12: Having had a spiritual awakening as a result of these steps, we tried to carry this message to others and to practice these principles in all our affairs.”).
- Teach the person state changing skills such as the use of a relaxation anchor. It is important to check that solving the addiction will actually solve the person’s problems. It is quite possible for a person to have anxiety difficulties or depression at the same time as an addiction. In such a case, obviously, using the NLP trauma cure to heal the origin of anxiety may solve the addiction. Remember the 90% of Vietnam veterans who were cured of heroin addiction simply by returning home.
- Help the person explore how to keep their body healthy. Feeling healthy is a positive motivator psychologically, and many writers suggest that physical health problems may encourage cravings for unhealthy substances (Kasl, 1992, p 186-211).
- Run the person’s old strategy for addiction with the new content of health. For instance, in the example above, the smoker’s strategy after a meal was to think of how good a cigarette would feel, and then tell themselves off. Then, feeling guilty, they would compare this discomfort with the imagined pleasure of smoking, say “Why not!” and light up. To re-run this strategy healthily, I might say during a trance induction “Sometimes you may find yourself digesting the successes in your life, and imagining achieving an even healthier lifestyle. You can react against that, telling yourself you shouldn’t ask too much of life; but when you compare how suffocating those limits feel, you’d probably just say “Damn it; why should I have to feel bad about asking more of life!” and find yourself reaching for the planning diary!”
Recycling. It is unusual in NLP to recommend planning to recycle a change process at a future time. And yet that is exactly what is suggested for addiction treatment by Richard Bandler (Bandler, 1989, Tape 3) and by John Overdurf and Julie Silverthorn (1995 B, p 33) . Futurepacing the person beyond the possibility of a future “lapse” means reframing any time the person “uses” again as part of their long term success. The very concept of a “lapse”, Bandler points out, suggests that the person will have not been using for some time. James Prochaska (1994, p 227) simply says “A lapse is not a relapse. If one swallow does not make a summer, one slip does not make a fall.” Re-read that last sentence. To futurepace success, you may:
- Arrange a followup session some months into the future.
- Plan strategies to deal with stressful events, including recontacting you for help.
- Design reframes to remind the person that they can easily restart their new life with the strength that comes from their new learnings.
Futurepacing is one thing, but the context of successful change is that when you look back on it, it seems almost silly to have been worried about how to maintain it. The 95% of smokers who give up smoking without any help don’t spend the rest of their life in “recovery”. They have better things to do. Charlotte Davis Kasl says she prefers the term Discovery for this final state, rather than recovery. She says “Dis-covering suggests opening, expanding and growing.”
Research shows that successful assistance of someone wanting to end an addiction is very different from the endless, confrontive, labelling approach of the recovery industry. The stages of the Motivational Interviewing model parallel the RESOLVE model for NLP consulting (Bolstad and Hamblett, 1998, p 107-108). In summary these are
Resourceful State For The Practitioner (Pre-contemplation). At this stage the NLP consultant needs to get hired. They need to be very clear themselves about their own stand, and check for permission before offering to assist.
Establish Rapport (Contemplation). While the person alternates ambivalently between wanting to change and not wanting to change, the NLP consultant mainly reflects their experience and ambivalence, assisting their clarification of the decision to change.
SPECIFY Outcome (Commitment). Once the person says they really want to change, the NLP consultant is able to help set goals, and provide tasks for the person to check out their intention.
Open Up The Person’s Model of the World (Action; A). Once the person is ready to act, the consultant can elicit and alter their old strategy for using.
Leading (Action; B). The core of addictions treatment is to integrate the conflicting parts which have created the sequential incongruity in the person’s life.
Verify Change (Maintenance). The success of this change is verified over time as the person builds a new lifestyle, integrating change at the level of mission, values, and time line. If ongoing assistance is desired, the NLP consultant can teach interpersonal skills, state changing skills, and skills for healthy living.
Exit (Recycling). Finally, the consultant can futurepace the person through possible lapses to discovery and delight.
Richard Bolstad and Margot Hamblett are NLP Trainers and the developers of the Transforming Communication seminar. They can be reached at: 26 Southampton Street, Christchurch 8002, New Zealand, Phone/Fax 64 (03) 337-1852
American Psychiatric Association Diagnostic Criteria From DSM-IV™, American Psychiatric Association, Washington DC, 1994
Bandler, R. and Grinder, J. Reframing: Neuro Linguistic Programming and the Transformation of Meaning, Real People Press, Moab, Utah, 1982
Bandler, R Creating Therapeutic Change, (Training sessions recorded on set of 7 videotapes) NLP Comprehensive, Boulder, Colorado, 1989
Bolstad, R. & Hamblett, M., Transforming Communication, Longman, Auckland, 1998
Bolstad, R. & Hamblett, M., “NLP And The Rediscovery of Happiness: Part One” in Anchor Point Vol 13: No 4, p 3-9, April 1999 (A)
Bolstad, R. & Hamblett, M., “NLP And The Rediscovery of Happiness: Part Two” in Anchor Point Vol 13: No 5, p 29-38, May 1999 (B)
Bolstad, R. & Hamblett, M., “Calming Down: NLP and the Treatment of Anxiety” in Anchor Point Vol 13: No 8, p 3-12, 1999 (C)
Bolstad, R. & Hamblett, M., “Time Line Therapy™ And Identity Change” in The Time Line Therapy™ Association Journal, Vol 13, p 5-7, 1999 (D)
Chevalier, A.J., On The Client’s Path, New Harbinger, Oakland, California, 1995
Dorsman, J. How To Quit Drinking Without AA, Prima, New York, 1997
Finney, J.W. and Moos, R.H. “Psychosocial Treatments for Alcohol Use Disorders” p 156-166, in Nathan, P.E. and Gorman, J.M. A Guide To Treatments That Work, Oxford University Press, New York, 1998
Harris, C. Think Yourself Slim, Element, Shaftesbury, Dorset, 1999
James, T. Prime Concerns: Using Quantum Linguistics To Increase The Effectiveness of the Language We Use, Advanced Neuro Dynamics, Honolulu, 1996
James, T. and Woodsmall, W. Time Line Therapy And The Basis Of Personality, Meta Publications, Cupertino, California, 1988
Kasl, C.D. Many Roads, One Journey: Moving Beyond The 12 Steps, Harper Perennial, New York, 1992
Lankton, S.R. and Lankton, C.H. Enchantment and Intervention in Family Therapy, Brunner/Mazel, New York, 1986
Lewis, B.A. Sobriety Demystified, Kelsey & Co, Santa Cruz, 1996
Lovern, J.D. Pathways To Reality, Brunner/Mazel, New York, 1991
Marsh, A. “Smoking; Habit or Choice?” in Population Trends, 37: 20, 1984
Miller, W.R. and Rollnick, S. Motivational Interviewing, The Guilford Press, New York, 1991
O’Brien, C.P. and McKay, J. “Psychopharmacological Treatments of Substance Use Disorders” p 127-155 in Nathan, P.E. and Gorman, J.M. A Guide To Treatments That Work, Oxford University Press, New York, 1998
Overdurf, J. and Silverthorn, J. “Recovering Options: The Transformation of Addictive Processes” in Anchor Point: Part A: Vol 9, No. 6, June, 1995 p 29-35; Part B: Vol 9, No. 7, July, 1995 p 31-36
Peele, S. Diseasing of America, Houghton Mifflin, 1989, Boston
Prochaska, J.O., Norcross, J.C. and Diclememnte, C.C. Changing For Good, William Morrow & Co., New York, 1994
Ragge, K. The Real AA: Behind the Myth of 12 Step Recovery, See Sharp Press, Tucson, 1998
Santoro, J. and Cohen, R. The Angry Heart: Overcoming Borderline and Addictive Disorders, New Harbinger, Oakland, California, 1997
Schachter, S. “Recidivism and self-cure of smoking and obesity” in American Psychologist 37: P 436-444, 1982
Sterman, C.M. ed Neuro-Linguistic Programming in Alcoholism Treatment, The Haworth Press, New York, 1990
Trimpey, J. Rational Recovery, Simon & Schuster, New York, 1996