1. Presented by Suzanne Mouton-Odum, Ph.D. For the Austin Trich Support Group Austin, Texas February, 2014 Readiness for Change

2.  Ambivalence: Raise your hand if you want to stop pulling/picking?  It is not the pulling/picking that you want to stop, it is the consequences of the pulling and picking that are unpleasant.  Which comes first, motivation or action?  Can you have motivation without readiness?  Can you increase readiness? YES!!!!! Motivation vs Readiness

3. Behavior change is a process, not an all or nothing event. It involves a shift in motivation or readiness to change. Your decision to change is like a weight scale; the balance shifts depending on how you view the pro’s and con’s of changing. Are You Ready?

4. The Pro’s and Con’s of Change Less worry about bald spots/scabs/scars. Less time getting ready and more time for fun. Less family conflict. I will be happier. More money for me! It is hard! It will take a lot of time and energy. I will miss it. I will have to find other ways to feel good. I will have to allow things to exist that are uncomfortable. Pro’s Con’s

5. 1.Pre-contemplation:  Not even considering changing your behavior.  Maybe you think it will go away on its own or maybe you don’t even really acknowledge to yourself that you do it or that it is a problem.  Resistant to ideas of change.  Has no intention to take action within the next 6 months The 6 Stages of Change Prochaska and DiClemente

6. 2. Contemplation:  Maybe you have looked it up on the internet.  Maybe you have done some reading.  You still have not told anyone except maybe spouse or very close family members.  You want it gone, but not sure you want to do anything about it. (Tumor analogy)  Intends to take action within the next 6 months. The 6 Stages of Change Prochaska and DiClemente

7. 3. Preparation:  Maybe you have called a therapist.  You are at this workshop voluntarily.  You are possibly planning to make some changes.  Interested in hearing about what change would involve.  Intends to take action within the next 30 days and has taken some behavioral steps in this direction. The 6 Stages of Change Prochaska and DiClemente

8. 4. Action:  You have started behavioral therapy.  You have begun monitoring behavior.  You have started to make changes in lifestyle to support a non-pulling/picking existence.  You have accepted that this is a part of you and that you, like someone with diabetes, will have to manage it to be successful.  Has changed overt behavior for less than 6 months The 6 Stages of Change Prochaska and DiClemente

9. 5. Maintenance:  You still may experience slips, but these are rare.  You have changed overt behavior for more than 6 months.  Slips occur, but are well managed and not frequent. 6. Termination:  You can look back and think about “when I used to pull” and not have any urges, slips or setbacks.  Overt behavior is unlikely to return, and there is complete confidence that you can cope without fear of relapse. The 6 Stages of Change Prochaska and DiClemente

10. 1.Acceptance: (Pre-contemplation, Contemplation and Preparation)  Are you dealing with the shame surrounding your BFRB?  Are you in denial about your BFRB? Do you think it will just“go away?”  Understanding how BFRBs affect your life, both positively and negatively.  Can you talk about it?  Do you love yourself despite your BFRB?  Who have you told?  Can you educate others about BFRBs?  Have you abandoned the search for the magic bullet?  Do you understand that improving your BFRB involves changing many aspects of your life? Is that OK with you? i.e., no TV  Have you made a plan? Elements of Readiness

11. 2. Taking Responsibility: (Action, Maintenance and Termination)  Are you active in your recovery? Do you work your plan each day?  Do you acknowledge your BFRB and/or recovery each day? Use markers?  You are the only one who can effect change in your behavior. Are you relying on others to help you make changes?  Are you making changes because they are what YOU want, not to please others?  Are you making sure your needs are getting met in all areas of your life?  Are you being proactive?  Are you rewarding your successes?  Are you learning from your failures?  Can you visualize yourself BFRB free or in recovery? Elements of Readiness

12. Visualize yourself as a person who is attending to his/her needs daily, that is thinking ahead, predicting hard times, and using strategies accordingly. Visualize yourself as a person who is OK with his/her BFRB, not angry at it or in denial. Visualize yourself accepting that your BFRB just “is” and that this is not a terminal illness or a death sentence. Visualize yourself as a person in recovery. What would that look like? How would that feel? What is recovery for you? Visualize yourself as a person who is actively dealing with slips and relapse, who can predict and anticipate hard times. Visualize Readiness

13. Readiness Plan: What Can I Do?  Acceptance:  Exercise self-compassion. Be your own best friend.  Get social support (TLC, support groups, friends/family).  Forgive yourself for not being perfect.  Accept that this is a process, not a light switch.  Taking Responsibility:  Turn anger/self-pity into action.  See each minute, hour, day as an opportunity to do better.  Get excited about the possibilities.  Walk out of here with a plan, even if it is just to be kinder to yourself.

14. “You are not responsible for the fact that you [or your child] have a BFRB, but you are responsible for how you approach it. You can either choose to be a victim, or learn to walk with grace.” Christina Pearson, Founder TLC Remember…