When Students Resist Change: Part II

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A round man cannot be expected to fit in a square hole right away. He must have time to modify his shape - Mark Twain

Who has not experienced changes in her or his life? Some changes are subtle and occur so gradually as to be unnoticeable, the changes in our bodies as we age for example. Others are dramatic and occur with little notice and in what seems like an instant, think - weather. The type of change that presents us with the greatest challenge, however, is adapting to a change in the “status quo,” a change from the way things are…and should remain.

Sandra Anis Barnes wrote in her collection of poems, Life is the Way It Is, “It's so hard when I have

to, and so easy when I want to.” This is the hinge on which the probability of change swings. If I do not want to do something...or think I need to do something, I won't. You can "make me behave differently," but that is manipulated change and all but certainly temporary. What differentiates between “having to do something” and “wanting to do something” rests with the perception of relative value. If what I am doing has more value to me than what you propose I do instead, I am not going to change. It is only when I come to the realization that an alternative to my current behavior proffers greater opportunity or has more value that I will consider changing.

Consider Matthew's New Testament parable about “the treasure” and “the pearl,” (Matthew 13:44-46). In the first, a man finds a treasure in a field and realizing its value, hides it, sells all he owns so he can purchase the field and thereby possess its now hidden treasure. In the second, a pearl merchant finds a gem of immeasurable value. He too sells everything he owns to purchase the pearl. In both cases, the protagonists’ awareness of the value of their newly discovered finds results in their willingness to sell all they own to acquire the new treasure. Their “change” in willingness to part with all they possess occurs because they encounter something of greater value than that already possessed; they alter their behavior to advance their position. In economics, this is referred to as conducting a cost-benefit analysis, that is, asking oneself if what I possess is of lesser or greater value than what I can obtain through change. In the case of Matthew's protagonists, the perceived ROI or return on investment is significant...the value of what is possessed is less than that of the newly discovered alternative and therefore the decision to give up the old in exchange for the new, that is to say “change,” is made.

Everything has value although the exact nature of that value is subjective. Consequently, alcohol as a substance and drinking as a behavior may have great value for the college student who sees them as the antidote for social anxiety or the price of admission to "a good time," or a convenient escape from the stress and demands of collegiate life…or simply believes “that’s what college students do.” When the value of alcohol and its consumption are high, students perceive the cost in changing the behaviors associated with their pursuit as “too great” and they resist making any changes. The challenge for those concerned about high-risk and dangerous collegiate drinking is to engage students in such a way that when they contemplate this exchange, they “want to change” because they recognize it as in their best interest…the value of the "the change" is greater than the benefits of their current pattern of drinking. For this to happen students need to become aware of the benefits associated with a change and how they outweigh the costs associated with making the change.

For change to occur, any change, something must be given up. To expect me to “give up” what to this

point I have valued highly, I need to recognize the potential to realize even more or greater benefits from the new behavior than I am losing by giving up the old one. In other words, when something better comes along and is recognized as being better, it changes the way I evaluate everything. Put another way, change represents receiving something that I did not have before and realizing that it is of greater value or more desirable or less costly than what I must give up to get it. Change, if nothing else, is the act of gaining something while at the same time losing something else. The relative values of the “thing lost” and “thing gained” determine if the change will occur.

Let's look at two examples to illustrate the point I make above. In the first, ask yourself if you would pay $1 to use the restroom. If you have no need for a restroom your answer is likely an emphatic no. If, however, you have dire need to relieve yourself, what do you think now of the $1 charge to use the facilities? In the second example, ask yourself if you would complete a 10-minute survey to save $1 on a $500 purchase; then ask, would you do so to save $1 on a $5 purchase. If I view the $1 discount as .2% savings I am likely unwilling to invest the time necessary to realize such minuscule savings. If, however, taking the 10-minutes survey results in a 20% savings, I may very well look at the time as "well spent."

What is my point...until and unless I perceive the value of change as exceeding the value of what I must give up to make the change, I will likely be unwilling to make the change. So, back to Ottis Redding's lyric cited in the previous essay, I can't do what ten people tell me to do, so I guess I'll remain the same. The operative phrase here is "what ten people tell me to do.” Students are willing to change and do so regularly. We see this in what is referred to as the “maturing out” or “aging out” phenomenon. Student behavior changes as they advance through the subsequent semesters in college as they associate the costs and benefits of their behaviors with their resulting consequences.

In drawing this series of essays to an end, note that I do not advocate just “letting students be students.” This is not an option for two reasons: (1) The aging out phenomenon often takes significant time to occur. Yes, one's behavior fall semester freshman year is quite different from what it is the spring semester senior year but much can happen in 4 years, including significant untoward consequences associated with high-risk and dangerous drinking; (2) regarding the use of alcohol--and other drugs as well for that matter--high-risk use can become a substance use disorder in a relatively short time. For these reasons, practitioners concerned about high-risk and dangerous drinking can consider some or all the following options[1]:

• Instead of "intervening" with students regarding their behavior, intercede. An intervention is confrontation irrespective of how carefully or lovingly it is conducted. An intercession is to present students with the opportunity to conduct the aforementioned "cost-benefit analysis" without feeling as though they need be on the defensive. For example, asking students if they only take 2 Advil or Tylenol for a headache instead of 8 or 10, why do they consume 8 or 10 drinks when out socially;
• Understand that students ascribe meaning to alcohol as a substance and drinking as a behavior and the meaning they ascribe affects the decisions they make regarding consumption. If we understand how they ascribe meaning, then we can use those means to help individuals "re-ascribe" meaning and thereby hasten the aging out phenomenon;
• Consider a solution-focused approach to programming rather than a problem-focused approach. Understanding why students who abstain or use in moderation do so can help campuses to replicate as many of these factors on campus as possible as well as showcase most students who are low-risk in their behaviors; 
• Related to the previous bullet, focusing on low-risk or no-risk students helps convey the message that most students do not present a problem. Remember the Premack Principle: 20% of the (students) create 80% of the problems. If you only talk about the problems then you suggest that the problem is greater than it is. 

Although student behavior…dare I say habits…are influenced by many variables, they generally only change when an individual concludes that doing so is in her or his best interest. Those of us who are interested in affecting student behavior are advised to keep this in mind as we consider how best to approach them in conversations about their alcohol or other drug use, or their predilection to engage in high-risk activities.

As we contemplate conversations with students it may be helpful to revisit the advice of Mark Twin; Habit is habit and not to be flung out of the window by any man, but coaxed downstairs a step at a time. 

What do you think?

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[1] More on these and other alternative options can be found on my blog – https://robertchapman.blogspot.com

When Students Resist Change

PART I

Nothing so needs reforming as other people’s habits – Mark Twain

Looks like nothin's gonna change

Everything seems to stay the same
I can't do what ten people tell me to do
So I guess I'll remain the same

This lyric from Otis Redding’s 1968 hit Dock of the Bay suggests that confrontation when admonishing another to reconsider their behavior fails to counter inertia. It is such results of interventions in general that often frustrate practitioners to a point where empathy is diminished if not replaced by cynicism about helping those with a substance use disorder.

I remember reading an article years ago--so long ago that its citation now escapes me--that suggested most individuals with an alcohol problem are aware of its existence several years before deciding to do anything about it. So, why do months if not years pass between one's awareness that drinking has become a problem and deciding to do anything about it? I suspect that there are multiple contributing factors, with several likely working in tandem.

First, Fr. Joseph Martin, back in the early 70s, used to say, “what causes a problem is a problem when it causes a problem.” True, “the problem” caused by substance use is likely apparent to significant others before it becomes obvious to the user. This is the classic “pre-contemplative stage of readiness to change” that Prochaska, DiClemente, & Norcross described when postulating the Transtheoretical Model of Change - see their 1992 article from American Psychologist HERE. That said, this essay is concerned with the delay between a user’s awareness of a problem and a decision to do something about it and our role as practitioners in this process. I will argue that the efforts of significant others, and by extension practitioners to bring this “problem” to the user's attention perhaps result in much of this delay. 

Irrespective of the role that love and genuine concern play in motivating a confrontation with a user, such interventions invariably focus attention on what the user did, the “inappropriate behavior,” and only then mention the confronter's concern about the user's health or well-being. Such confrontations, although understandable and well-intentioned, succeed in first and foremost pointing out the user's faults, mistakes, and shortcomings. Although likely eliciting a promise to “never do it again,” this promise is quickly broken, either because it was never proffered sincerely or more likely because such is the nature of substance use disorders. The irony is that if the promise was proffered sincerely when broken the user experiences what can best be referred to as shame.

Shame is an interesting emotion. It is often paired with guilt and many come to view the two emotions as all but synonymous. Guilt is when I feel bad about something I have done. Consequently, guilt can serve a useful purpose in that it can motivate one to change as one's conscience gnaws away at self-respect. In the beginning, this is what happens when the user is confronted...there is genuine regret about what was done and the forthcoming promise is made with a sincere intent to change. Interestingly, this guilt related to inappropriate behavior often elicits not a promise to stop drinking but rather an assurance to not repeat the objectionable behavior. But when dealing with a substance use disorder, even the sincerest of pledges to change inappropriate behavior can be derailed by one's continued use. Consequently, when the promise to change one’s behavior is broken, repeatedly, the user experiences shame.

If guilt results from “feeling bad” about what I have done, shame is when I feel bad about who I am. It is one thing to regret one's behavior. Something can be done about this by making specific personal changes that result in changed behavior. But when I apparently seem unable to make the promised changes, this leaves me with only one logical explanation...there is something wrong with me…I am a failure as a human being. This is the insidious nature of a substance use disorder. Because attention is placed on the inappropriate behavior rather than on the use, the logical explanation for continued inappropriate behavior is to view the user as defective, hence the shame. So, back to the cited lyric from Redding's "Dock of the Bay"...

"Looks like nothin's gonna change." I tried, failed, tried again...failed again...there must be something wrong with me. Keep in mind, I may still be in denial that my use is a problem. In fact, it is entirely possible that I view my use as a solution for my failings as a human being...or at least a balm to sooth the resulting shame. I clearly cannot see the proverbial “nose for my face” or as Joe Martin suggests, recognize that what causes a problem is a problem when it causes problems.

“Everything seems to stay the same,” croons Redding. I try to change and cannot. I may begin to wonder if my use is a contributing factor but the barrage of confrontations from family, friends, and “others” make it too easy to blame them for my problems...“You'd drink too if you were nagged and badgered like I am!” Redding continues, “I can't do what ten people tell me to do”...the badgering…“So I guess I'll remain the same.”

The irony here is that the more confrontational others become, the more I resist their efforts. Jung once said, “that which you resist persists.” I see my life reduced to a fight to exist...confronted by those who intervene to share their concern. Unfortunately, this tends to suggest they think I am a “bad person” because of the “bad things” I continue to do, or at least that is what I hear. I know the things I do are “bad” and I want to change, but try as I will, I cannot. Like the inebriate looking for his keys under a streetlight rather than down the alley where they were lost because the light is better, I am looking in the wrong place. This is because I continue to look for change as existing somewhere “out there,” outside of or beyond me, something that is done to me rather than by me. As times passes I begin to think that not only am I a failure as a human being but that I am unworthy of the “something out there” that can make things different. In short, I just sit on the dock of the bay and watch the tide roll away, an apt metaphor for the disparity so commonly experienced by those in the later stages of their addiction.

So, is the course of addiction intractable? Must it run its course with only three possible exit ramps...death, incarceration, or having to lose everything, the proverbial “hitting bottom” before being able to turn the corner and pursue recovery? Although this was the view of those treating substance use disorders for most of the 20th century, fortunately, such is no longer the case.

Next time...PART II of When Students Resist Change

Dr. Robert