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Jeffery S. Smith M.D.


3 Kinds of Motivation for Addiction Recovery

How to know you have done all you can

Monet, Wiki Commons
Source: Monet, Wiki Commons

You want to help but nothing seems to work. The addicted person is unable to take hold, but not ready to accept aid from outside. Others tell you it is time to let go, but what if there was something you could do? You would regret terribly not doing everything possible to bring about change. This is where it helps to have clarity about all the possibilities. Only then can you know you truly have done everything in your power.

There are just three kinds of motivation for change in addiction. When you have explored each to the farthest extent, then there are no more options. Here they are:

1. Self-Motivation:

This is the queen of motivations. She is beautify to look at, but not very strong. When the addict expresses his or her own motivation to change, don’t criticize or disrespect her, but don’t count on her either. “Im so glad you want to change. I have been told it takes more than sincere desire to make recovery stick, so I’ll be in a wait-and-see mode, but I hope things go well for you.”

The times when self-motivation works are when the addict has discovered that there is something more precious than the addiction. It might be a child, a job, life itself, or a personal value such as dignity. None of these works for everyone, but hitting “rock bottom” usually means coming to the point where, beyond any doubt, there is a black and white choice between the addiction and something of ultimate personal importance.

2. Leverage:

This is the workhorse of external motivation. It is where circumstances create similar choices to hitting rock bottom. Perhaps it is a boss or employee assistance counselor making it clear that there is a choice between getting help and being “let go.” Or it might be a family who have finished trying to force help on someone who is not motivated and are ready to let the addicted person go out on his or her own.

Once again, the choice has to be crystal clear and the consequences fully credible. Otherwise the addicted person will choose to keep the addiction and hope that others won’t stick to their word. Threats don’t work, both because they are so often empty, and because they pose a challenge. On the other hand, a clearly stated and believable consequence can create a real choice.

Ask yourself if you are fully ready to apply the consequence, and whether there might be unintended effects that you would regret. Often this is a judgment call, one where discussion with a professional can help you come to a decision with which you feel fully comfortable.

The nature of the “if” part of your statement is important as well. “If you don’t stop drinking.” is useless because the nature of addiction is that stopping is not a choice. Addicts can make promises to stop, but, for practical purposes, only non-addicts can do so without outside help. Better are concrete “ifs” like going into treatment. The addict brain may think it can outsmart treatment but the experience almost always has a positive impact, even if it doesn’t immediately result in recovery.

3. Seduction:

I call the third kind of motivation “seduction:” When self-motivation fails and you have no usable leverage, all you can do is tell the truth and be willing to let go. I picture it like this: In the 1890s, going for an afternoon promenade, a lady might accidentally drop her handkerchief. The man might notice and pick it up. Bringing it back to its owner, a conversation might ensue. Of course if the lady turns to watch, the whole effect is spoiled.

That is seduction. Drop a piece of information, but don’t wait to see what will happen. “It looks to me like you can’t stop, and things will only get worse until you chose to get help. If you change you mind, let me know.” Your aloofness shows that you are not going to pursue the addict or wait for a response. You care, but you are following Al-anon’s principle of “detach with love.”

The reason why this can work (It may not), is extremely important. You are making use of the human need for connection, and framing it, without preaching or threatening, as a choice. If you want connection, you will need to do something about the addiction. The key here is that on the level of the brain, the natural need for connection is one of the few things that has a biological pull equal, or nearly so, to the addiction. By the way, this is also why fellowship is so important in recovery.

If you have explored how you might make use of each of these three kinds of motivation, and you have exhausted all the possibilities, then it is truly time to let go, not with anger, because addiction is not a choice, but because that is all you can do. Then you can go to sleep knowing that you have left no stone unturned.

For more on addiction, codependency and personal change, take a look at my website and blog,

Jeffery Smith MD


About the Author

Jeffrey Smith, M.D., teaches at the psychiatry residency program at New York Medical College.