Healthy Aging

Motivating Change

How many psychotherapists does it take to change a light bulb?

None. The light bulb has to want to change itself.

This joke makes light of a prevailing truth about human psychology: the most powerful shifts happen when we are ready to lean in and change ourselves.

There are all kinds of incentives out there for growth, healing, and change – from positive affirmations, to motivational speakers on YouTube, to peer pressure, to saying negative and shaming messages to ourselves – and yet research has shown again and again that we’re most likely to make positive changes in our lives – and sustain those changes – when they’re driven by our own deep, heartfelt desires for evolution.[1],[2],[3]

This allows us to pair our intended changes to our own values, thus helping us live in full alignment with our own selves. By doing so, we get to feel like we’re living in integrity, which further validates and encourages us to stick with the healthy habits we’ve adopted – even when hankerings for our “old” ways come to call. It’s perhaps no surprise that change arising from aligning a certain behavior with our own value system – or “integrated regulation,” as therapists call it – has been shown to yield the most stable and enduring changes in our lives.

Change arising from aligning a certain behavior with our own value system – or “integrated regulation,” as therapists call it – has been shown to yield the most stable and enduring changes in our lives.

In fact, an entire counseling approach is designed to help us connect our desires for change with our core beliefs, thus engendering a powerful catalyst for healing. Known as Motivational Interviewing, or MI, this approach helps us work through our ambivalence, connects us with our true desire to change, and guides us in putting a plan to action.[4]

Recent meta-analyses show that MI works just as well as, if not better than, other treatments like cognitive behavioral therapy (CBT) and pharmaceutical drugs. MI has been shown to help both adults and adolescents decrease their use of alcohol and drugs,[5],[6],[7],[8] quit smoking,[9],[10] and reduce risky sexual behavior.[11] MI has also been shown to help people stick with medical treatments and take their medications as prescribed,[12] and can even help people eat healthier and exercise more regularly.[13],[14]

MI has been shown to help both adults and adolescents decrease their use of alcohol and drugs, quit smoking,and reduce risky sexual behavior.

Although MI is designed for use within a therapeutic relationship, such as that between a therapist and client or a doctor and patient, we can nevertheless draw on some of the foundations of MI in conversations with trusted friends or even just ourselves. The new year is a wonderful time to create space for reflection and intention setting, whether it be while we’re hiking in the forest, meditating silently, or sitting down with a cup of a tea and journal.

When it comes to making positive changes, it can be helpful to repeat the phrase “I am willing, able, and ready to change.” Let’s look now at each of these three states:

I am willing to change: Resolving ambivalence

People sometimes mistakenly confuse the term “ambivalence” with “indifference,” but the two are rather different. Whereas indifference refers to a lack of interest or concern,[15] ambivalence describes the mixed feelings or contradictory ideas we may have about a matter.[16]

Ambivalence is not laziness; it’s actually a state of conflict in which we feel the pull of opposing attitudes and feelings. We may desperately want change and simultaneously oppose it. This can be why despite “knowing better” we sometimes continue engaging in harmful habits like drinking alcohol, binge eating, and partaking in risky sexual behaviors. Despite the long-term consequences in these harmful behaviors, there can be an immediate reward in continuing them, and reward can pull strong on our minds and bodies.[17]

Ambivalence is not laziness; it’s actually a state of conflict in which we feel the pull of opposing attitudes and feelings.

There can be other reasons we might oppose change, such as our identity being linked to our harmful habits. For instance, somebody who’s been obese their whole life might be known as “Big Guy” and like having that clearly delineated role in their social circle. Others who drink, smoke, or use drugs might find that all of their friends engage in these behaviors too, and that quitting the activity might feel like an abandonment of their “tribe.” Yet others might fear that if they give up “small” harmful behaviors they might relapse on some of their “bigger” struggles – like the alcoholic who has been sober for 10 years and worries she might start drinking again if she attempts to quit smoking.

There are countless reasons to stay stuck in a harmful behavior, and while it can be helpful to identify those reasons, it eventually comes time for us to ignite a deeper desire within ourselves – the desire for change.

One way to explore and transmute ambivalence can be with a brief series of questions for discussion with a friend or for self-reflection in a journal or voice recording:

On a scale from zero to 10 (where zero is not important at all and 10 is extremely important):[18]

  • How important is it for me to change this behavior?
  • Why is my score ___ and not zero?
  • What would it take to go from ___ to a higher number?
  • What is coming up for me when I consider this discrepancy between where I am currently and what I want for myself?

This series of questions can help us identify the discrepancy between our current state and where we would like to be. Facing this discrepancy can often motivate us to change.

Other questions can also serve as powerful prompts for self-discovery. After identifying the behavior you wish to change (eg: using tobacco, smoking cannabis, eating refined sugar, drinking alcohol, watching pornography, living a sedentary lifestyle, etc.), psychology professors Dr. William Miller and Dr. Stephen Rollnick[19] suggest asking yourself:

  • What are the benefits (good things) of keeping things exactly as they are and not changing a thing? What are the risks (down sides)?
  • What worries me about this behavior? What are my concerns about this matter?
  • What difficulties have resulted from this behavior?
  • What will I lose if I give up this behavior?
  • What would be different in my life if I made this change?
  • What will my health/happiness be like in five years if I keep this up and don’t change?
  • What will my life look like in five years if I make this change?
  • Without focusing on how I’ll do it or get there, what do I want my life to look like?

I am able to change: Believing it’s possible.

Journaling about and/or discussing the following questions can help us assess if we can make the changes we’re contemplating:

  • Have I made a major change in my life before? What helped me do it?
  • What strengths do I have that would help me make this change?
  • What resources do I have available to me? (Friends, family, doctor, therapist, books, movies, self-care practices, etc.)
Give yourself a pat on the back.

It’s important to show yourself empathy through this process. Pause every few minutes to pat yourself on the back, and say something like:

  • It’s taking a lot of courage for me to be thinking/talking about this today.
  • I am very resourceful and have done hard things before.
  • This isn’t easy for me to do, and I’m proud of myself for thinking/talking/writing about this.

Even if you think it’s corny and useless, your subconscious doesn’t know the difference. Stopping to offer yourself empathy and encouragement can go a long way.

I am ready to change: The action plan

The next step is to assess how ready you are to make a change. Maybe you know you want to make a change but just aren’t sure what to tackle first or next – or if now is even the right time to make a shift in your behavior. That’s okay. Even if you’re not ready to turn things around 180 degrees, chances are there’s at least one tiny thing you can start doing now – even if it’s just putting a note on your calendar to revisit this exercise in a month.

Even if you’re not ready to turn things around 180 degrees, chances are there’s at least one tiny thing you can start doing now.

Questions at this point in the game might look something like this:

  • Where would I like to go from here?
  • What’s the next step?
  • What would I like to do at this point?
  • How do I want things to turn out?
  • Who do I know who will genuinely support me in making this change?
  • When would be a good time for me to make this change?
Reflect and summarize

This is a step that’s typically done by the doctor or therapist, who, after hearing you out, summarizes and repeats back to you the gist of what they heard you say. With some creativity, however, you may be able to do this step yourself. Review back over your answers to the above prompts, and come up with a concise summary. Write it down if possible, or record yourself saying it aloud.

A summary might look something like this: “My use of alcohol has gotten a little out of hand at times. It’s gotten me into trouble, and I’m afraid that if I don’t stop something bad will happen. I’m going to do something, but I’m not sure what just yet. I know I can get a handle on this problem. I’m going to start by calling my insurance plan tomorrow and getting a list of therapists in my neighborhood.”

Change is the constant – you can do it

You are neither lazy nor stupid. You lack neither motivation nor intelligence. Change can be frightening – paralyzing so. Thankfully, you are creative and resourceful. There are tools available to help you do the important work of becoming the highest, happiest, healthiest version of you. By inviting you to access your own inherent resources – like motivation, goal setting, learning, creativity, and problem solving – MI is but one tool for engendering change available to you.[20]

 

Click here to see References
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Taking a Month Off Alcohol: What Will a Month Booze-Free Do for You?
The Healthspan Imperative

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