The Myth of Being "Unmotivated"
Or, have you ever lied to your dentist about how often you floss?
Posted Nov 01, 2015
Have you ever lied to your dentist about how often you floss?
(Well, “lied” is a strong word; let’s say, “fudged” a little)
How about being less than completely honest with your doctor about taking the medication you were prescribed, or about what you eat, or how much exercise you get, or how much you drink or smoke, or how many sexual partners you’ve had? Or what about telling a well-meaning friend that you really were going to start your diet even though you knew deep down you wouldn’t, or not being forthcoming about troubles you've been having while talking about work with your loving and concerned partner?
If you answered “yes” to any of these questions, you’re in good company. In fact, when I ask these questions during trainings of psychologists and social workers, doctors and nurses, counselors and caseworkers, only a tiny number insist that they’ve never shaded the truth in any of these situations.
So you’ve voluntarily gone to your dentist or doctor, partner or friend, about a problem (and if the helper was a professional, you’ve paid for the privilege). And yet, you’ve withheld information that may affect their ability to address the very problem you’ve sought help for. Why?
If you’re like most people, you’re thinking about the reaction you’d get if you decided to be honest: maybe you’d have to listen to a lecture, or you’d be judged as a bad patient or a foolish or weak person. Giving the “right” answer allowed you to avoid unpleasantness, preserve the relationship, and go on with your day.
You may also be thinking that you weren’t willing to do anything different at that time, anyway, so what would be the point of talking about it? Maybe you felt a little sheepish, knowing that change would be good for you but you weren’t quite ready for it. Or maybe you felt defiant, dead set against being told what to do and determined not to give them the chance.
And that raises another question. Why wouldn’t you be willing to do something that’s good for you? Why didn’t you take your medication as prescribed? Why wouldn’t you agree to change your behavior to improve your health or your situation at work? Why don’t you floss every day?
It’s probably not because you don’t have the resources—that if someone would only provide you with floss, you’d be on it. Or that you don’t know why you should floss—that if someone would only explain the benefits of flossing to you (yet again!), you’d be doing it religiously. Or that you don’t know how, so you need further instruction in the delicate art of flossing your teeth.
When a person isn’t doing the “healthy” or “right” thing and no other reason seems to apply, the tendency is to throw up our hands and say—in a blaming or exasperated tone, no doubt—“You must be unmotivated.” But that’s not really an answer at all—just a label that gets us no closer to understanding what’s really going on.
Why would people not be motivated to make changes that could improve their life? Why would they mislead the very people they’re seeking help from? In this blog I’ll be exploring these and other questions from the perspective of motivational interviewing, a counseling approach with a track record of effectiveness at helping people resolve dilemmas about treatment and change.
Don’t be thrown by the name: motivational interviewing (or “MI,” as it’s known for short) has nothing to do with journalism or job interviews, and it’s not a “rah-rah” method of motivating people. MI helps people who are considering change to access their own natural, internal motivation and capacity for positive action. It’s designed to be brief because it relies not primarily on the practitioner’s knowledge or expertise but on the recognition that the most powerful force for change resides within each of us, and that the key to change is finding, strengthening, and acting on it.
Over the past three decades MI has spread from its origins in addictive behaviors to areas from healthcare to criminal justice, and problems from anxiety disorders to sexual risk reduction, cardiovascular health to dentistry, domestic violence to weight management. It has been tested and found effective in hundreds of studies and is practiced by thousands of clinicians in more than 20 languages and 35 countries.
Yet, what makes practicing, training, studying, and writing about MI most exciting for me is that our understanding of how it works (and how to help professionals become better at providing it) continues to evolve. I look forward to introducing you to the vital and growing field of MI, highlighting what it teaches us about helping people change.
“Why would people not be motivated to make changes that could improve their life?” “Why would they mislead the very people they’re seeking help from?” At the risk of sounding like the therapist I am, for now let me end with two more questions that point us toward the answers we’ll be exploring in blogs to come. What would have to be different—what would you need?—to be ready to change the behavior you talked to your dentist, doctor, partner, or friend about? And what would have to be different about them so you’d feel comfortable talking openly about it, unafraid to tell the whole, unvarnished truth?
© 2015 Allan Zuckoff, Ph.D.