For anyone wanting to make a behavior change in their life, it is likely that they will need to resolve ambivalence around the advantages and disadvantages of making a change. This is a normal process that almost everyone goes through in order to make a change and for the change to be sustainable. The advantages of making a change must eventually outweigh the disadvantages. And our role as clinicians is to help facilitate and support our clients in this process so they do not get “stuck” in any one place. The process is typically a gradual one where the client often goes back and forth, exploring both the advantages and disadvantages, and ultimately determining that the motivation to change is more important than the motivation to maintain the status quo.
Ambivalence is when there are, at the same time, conflicting motivations for the client. This can be an extremely stressful and uncomfortable place to be and one that anyone would want to resolve as quickly as possible. However, a skillful clinician will want to make sure the client has done “due diligence” and not rush through this process simply because it is uncomfortable. The clinician may want to point out the tension that exists between the advantages and disadvantages as well as normalize this experience. What can be interesting about this situation is that the more someone moves in one direction, the opposite side of the argument gains strength. Or, if someone else voices an opinion about changing or not changing, the client will often take the opposing stance. It can be quite a process and one where the clinician needs to remain as neutral as possible.
The client will often be doing a great deal of self-talk during this process with the eventual hope of talking themselves into the change they want in their lives. And our clients will be more committed to the reasons and motivations they have come up with rather than from anyone else. There is a great quote by Pascal that states, “People are generally better persuaded by the reasons they have themselves discovered, than by those which have come into the mind of others.” I hope you would agree based on your own experiences working with your clients.
Again, our role in this process is to encourage our clients to explore the advantages and disadvantages of making a change in their lives and to keep the process moving so the client does not get “stuck” or continue to go around in “circles of thought.” Next month, we will continue with the process of Evoking and discuss more strategies to support the client in discovering their own motivations for change. I hope you all have a great month and have opportunities to use and practice Motivational Interviewing!
UNC CFAR Motivational Interviewing 