No one can persuade another to change. Each of us guards a gate of change that can only be opened from the inside. We cannot open the gate of another, either by argument or by emotional appeal. – Marilyn Ferguson
In the end, deciding to change is personal. It can happen in an instant, or be a process that unfolds over time. Either way, it is the result of making a decision and then acting on it accordingly (actually, many decisions over time).
As simple as this sounds, the idea that we each hold the key to our own change is powerful and… not so easy to understand. Clearly, we all know things we should do that would improve our lives – lose some weight, save more money, get a new job – yet we don’t do many of them – why?
When it comes to deciding to change addictive behavior answering the question is even more perplexing.
What ultimately makes people do what they do?
The topic of motivation is not new to research, and decades of studies have revealed that it is best understood as a complex system, involving both internal and external factors, that energize and direct our day to day actions and behaviors.
The PRIME Theory of Motivation is among the most recent and comprehensive attempts to describe this complex system, and was developed specifically to better understand the role motivation plays in addictive behavior. Although still in its infancy, the theory helps us to understand that deciding to change addictive behavior can happen on multiple levels (impulses, motivates, evaluations and plans), and involves various aspects of memory and learning.
Although the motivational system is complex, many studies have revealed that change is most strongly influenced by interpersonal factors within human relationships. More concretely, people most often change their behavior in response to a relationship with a trusted friend, counselor, pastor, spouse, or other concerned party that challenges addictive behavior with empathy.
When a person is acting-out in their addiction, and their behavior is causing so much pain to those around them, how is it possible to confront a person with empathy?
In 1999 a book titled Motivational Interviewing: Preparing People to Change Addictive Behavior by William R. Miller and Stephen Rollnick strongly challenged some of the basic tenants of how and why people change. Central to their case was the idea that addiction is fundamentally a problem of motivation, and that the resolution of ambivalence was key to helping people change.
They also believed certain strategies resolved ambivalence better than others. Up to that time, many treatment programs used aggressive confrontational tactics on patients to break down denial, believing it was the only way to ultimately help an addict.
In fact, even today denial is often considered to be at the root of addiction, so much so that loved ones will go to great lengths to try and get a person to change, including:
What the research says:
Interestingly, in one research study, the more a counselor confronted a patient during treatment, the more that patient was drinking a year later! Even when there is overwhelming evidence of the need for change, people often do not change their behavior.
In the 12-step programs lack of change is most often associated with not hitting bottom. Yet, many people who change their behavior never come close to “hitting bottom” or suffer as a precursor to change.
Why then do people change?
Constructive behavior change seems to arise when the person connects it with something of intrinsic value, something important, something cherished.
Intrinsic motivation for change arises in an accepting, empowering atmosphere that makes it safe for the person to explore the possibly painful present in relation to what is wanted and valued – William R. Miller and Stephen Rollnick, second edition Motivational Interviewing