Five Stages of Recovery

  1. Denial / Pre-Contemplation. The patient does not know, cannot see, or refuses (usually out of irrational fear) to observe to notice to recognize his or her actual thoughts, emotions, sensations or behaviors.

  2. Contemplation / Consideration. The patient becomes willing and open to at least looking at and thinking about his or her actual thoughts, emotions, sensations or behaviors.

  3. Identification / Acceptance. The patient has looked at and thought about his or her actual thoughts, emotions, sensations or behaviors long enough to recognize, acknowledge, accept and own them.

  4. Commitment / Action. The patient has become motivated enough to engage in the action of detachment and distancing from his or her actual thoughts, emotions, sensations or behaviors in favor of continuing direct observation, noticing and recognition, as well as acknowledgment, acceptance and ownership of what he or she thinks, feels, says and does.

  5. Relapse Prevention / Maintenance. The patient has worked with the skills of observing to notice to recognize to acknowledge to accept to own to appreciate to understand his or her thoughts, feelings and behaviors long enough that he or she can now pick up those tools whenever his or her thoughts, feelings and behaviors are recognized, acknowledged, accepted, owned, appreciated and understood to be taking them back into their misery, depression, anxiety, mania or anger.

It is (according to the guys who put this list together about 30 years ago) only possible to be of help to those who are at at least the second stage. And they can only get to that stage if their suffering and remaining accurate sense of what is is sufficient to shake them up enough to observe to notice to recognize to acknowledge to accept to own that they need to contemplate and consider.


I was at stage one until I was forced hospitalised. 99 problems but schizophrenia was one I didn’t see.


Damned good description of what was going on in my head, as well.


This one is a difficult one in schizophrenia for me. For my intrusive thoughts and hallucinations typically have such outrageous contents that I do not want to own them. They seem to go against the things I used to be most sure about myself. This gives rise to a tension for me. Because of these contents, it is difficult to accept it is me generating these thoughts.

On top of that, their mode of presentation is diffferent from my usual thoughts that I can or cannot own at will. Hallucinations present themselves as alien, as not-mine. In their form, and sometimes also their content. Similarly, intrusive thoughts feel different in mode of presentation than regular cogitations. Beyond control - the very lack of a sense of ownership is what makes these thoughts appear intrusive to begin with.

Now, I do believe in, and have experience with, the transformation of such symptoms through reconceptualization. That is to say, to conceptualize a hallucination as a hallucination, rather than as a distinct alien subject - this makes a difference for my (emotional) reactions to it. In similar fashion, if I would be able to claim ownership over intrusive thoughts, almost per definition, I would not be surprised if their mode of presentation would alter as well. Yet their outrageous contents stand in the way of doing so for me. So I do not quite own them but conceive of them as products of an illness that is not-me.

One approach that I have used to move towards ownership over such thoughts, granted, a very small step, is the following. Whenever the contents are negative, I conceive of it as an expression of my discomfort, and as such I can own them. Whenever they are positive, I can own them as expression of a good mood.

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Amen, bro. This is right straight up what one learns how to do in all of these five psychotherapies:

DBT – What is Dialectical Behavior Therapy (DBT)? – Behavioral Tech
ACT – ACT | Association for Contextual Behavioral Science
10 StEP – Pair A Docks: The 10 StEPs of Emotion Processing
MBBT – An Introduction to Mind-Body Bridging & the I-System – New Harbinger Publications, Inc

One of the 10 StEPs, no less. Great stuff.

Hehe… I am at 2nd stage. Recently I am touched by the kindness of the medical team providing psychiatric service. So I wrote a letter as token of appreciation to them.

Terrific. Treatment teams really are human and do appreciate that.


You’re pointing out techniques which are somewhat useful for my next stage. Thanks.

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Just notice my self importance is probably delusion of grandeur. And I observe a housemate might be depressed as he doesn’t want to get along with other housemate. (He was just prescribed with Sertraline) And I think being open to critique is a sign of maturity.

I didn’t see either, but I have symptoms far as i remember, first big strike was couple years after the war, or so. I don’t really remember. And back than i didn’t get real diagnosis. And last time 3 years before i finally see my problem number 100.

As for bipolar sufferer, I can see how he or she can identify and own them. It is as simple as:

  1. I realize that I have mania and depression (Identify them)
  2. Both are my mood. (Own them)

Sorry for double post.
As for stage 4 (Action / Commitment), if the bipolar sufferer knew that he or she has became talkative because of mania, he or she will take action to avoid it – stop talking or wait until a more suitable time.

My son is diagnosed with schizoaffective disorder. He is 23, it started at 20.
I’m his mom, so frustrated and sad…he is still stuck at Stage 1. Has been going to therapy for three years, two hospitalizations, two IOPs and a six week dual diagnosis rehab. Last IOP was last summer, out of state. When we came back, I got him a new therapist. His old one wasn’t really up on what he has. The new one told him she wasn’t sure if his diagnosis was correct , after the second visit…which really earked me…
Of course, I was hopeful as well…couldn’t help it…well needless to say the psychotic son has turned up during the holidays… Very paranoid, doesn’t trust us, argumentative…
I tried Sarcosine about a week and a half ago have since stopped since his symptoms have reappeared…I should have just let it be…he also has negative symptoms so I was hoping the Sarcosine would help…it didn’t… I feel like we are going backwards…anyone have a bad reaction with Sarcosine? How long does it last?

On Nov’15 (about 2 years ago), I was at 2nd stage. I am happy to announce that finally I am looking forward to 4th stage.

Yes, I recognize, acknowledge, accept that I have schizophrenia. I know the delusional thoughts are part of mine.