Whether you think you can or
think you can’t, you are right.
Henry Ford
It does not matter how slow you
go as long as you do not stop
Confucius
We are all familiar with the
adage, you can lead a horse to water, but can’t make it drink. Although
the first phrase in this proverb may be true, the second only applies because
it presumes that change is something motivated by an intervention attempted by an
outside force. If, however, we abandon that premise and consider change an “inside
job” resulting from internal motivation, then a 21st Century version of this
adage may well be, You can lead a horse to water
but can’t make it drink...but you can salt the oats.
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This “salting of oats,” although
accomplished by an “outside force” is nonetheless intended to evoke—although sometimes
provoke—an internal shift in perspective. It is this shift that enables those
being interviewed to evaluate their situation differently, to view the facts in
their life through a “new set of lenses” so to speak. Like the teacher who asks
a class if two-minutes is a short or
long period of time and then responds, smiling, to a pupil who blurts out Short, Okay…then hold your breath for two-minutes, a shift in perspective
can affect one’s interpretation of the facts, which becomes a precursor to a
change in behavior. A humorous allegory to illustrate:
Lipstick in school
According to a
news report, a certain private school in Washington was recently faced with a
unique problem.
A number of
12-year-old girls were beginning to use lipstick and would put it on in the
bathroom. That was fine, but after they put on their lipstick, they would press
their lips to the mirror leaving dozens of little lip prints.
Every night the
maintenance man would remove the lip prints, and the next day the girls would
put them back.
Finally, the
principal decided that something had to be done. She called all the girls to
the bathroom and met them there with the maintenance man. She explained that
all these lip prints were causing a major problem for the custodian who had to
clean the mirrors every night (you can just imagine the yawns from the little
princesses).
To demonstrate
how difficult it had been to clean the mirrors, she asked the maintenance man
to show the girls how much effort was required.
He took out a
long-handled squeegee, dipped it in the toilet, and cleaned the mirror with it.
Since then, there have been no lip prints on the mirror.
There are teachers...and then there are
educators.
Reflecting on this, one might argue, there are
interrogators…and then there are interviewers.
The less ready one is to
change, the less motivation there is to make a change. Effective interviewers
know this and resist the temptation to engage in what William Miller (2013) refers
to as the “righting reflex” (p10) or an attempt to provoke change in the belief
that doing so prevents additional untoward consequences resulting from the
maladaptive behavior. However, as the old saying goes, right church…wrong pew. Instead, a more efficient approach to accessing
an interviewee’s internal motivation is to assess where she or he may be on the
continuum of readiness to change and then engaging the individual in such a way
as to facilitate movement along that continuum toward change.
It may seem counterintuitive to
delay interceding in one’s high-risk behavior, especially if that behavior
presents the real potential for physical harm to the individual or those with
whom she or he interacts. In fact, many who resist this approach to
interviewing argue that a delay in confronting one’s reticence to change is
tantamount to enabling the continuation of maladaptive behaviors. But consider
this question: Which is the shorter total
amount of time, the time between when someone is confronted prematurely about
making a change and terminates treatment before returning a year later in a
crisis, ready to consider that very change, or the three—or two or four—months
it may take for a practitioner who recognizes the importance of moving through
the stages of readiness until the point is reached where the individual
chooses, of her or his own accord, to change? In short, as William Miller (2013)
asks, is it more productive to wrestle with one’s interviewee or to dance?
Economists refer to something
similar conducted by business executives and their chief financial officers as
a “cost-benefit analysis.” When considering the costs involved in realizing a
benefit, one can assess if the ratio between the costs associated with
realizing the benefit(s) are such that they warrant continued “payment.” If the
costs are deemed too high, exploring change becomes logical if not obvious.
Facilitating this consideration of “costs vs. benefits” constitutes the “salt”
added to the oats our interviewee is fed, thereby evoking a “thirst” for change.
What do you think?
Miller, W. & Rollnick, S.
(2013). Motivational Interviewing:
Helping people change. Guilford Press: NY, NY
