Part 4 – Helping People Who Are Not Sure They Want To Be Helped

Originally, I had healthcare professionals in mind when writing this article.  In fact, I have put it as a 4th page in my Diabetes Education series.  But really, the techniques I discuss here are just as helpful for lay people teaching lay people.  In other words, when you are trying to help a family member or friend try to see the benefit of embarking on a healthy lifestyle, this post may help.  I am even going to use the methods I discuss here on my kids, and they will be none the wiser, lol!!

How many of us have run across people that we REALLY want to help to adopt a healthy lifestyle, but they just don’t seem to feel the need to act?  EVERY DAY, RIGHT?  In fact, I find this more so than not, to the point that it sometimes becomes discouraging to try to help people.  And, when writing on this website or on social media, the techniques I am about to discuss really don’t work, as they require face to face interaction.  So what I am about to discuss will not change the writing style of this page much.  I will still say what needs to be said without much fluff.  But, when dealing with folks one to one, in person, we have a unique opportunity to really help people, even people that may feel that they do not really need or want to be helped.

I will say that this article will be lengthy but very worth your read.  I am so excited about what I am learning about how to deal with this situation in a new book I’m reading (that was given to me as a gift).  So excited that I am sharing some of the things I have learned before I even finish the book.  I may be sharing more along the way.   Here we go…

So, I need to use an example.  Many of us have run across people on social media who are very passionate about their particular nutritional point of view.  But rather than having a rational conversation about it, they accuse or insult others choices, post sarcastic memes and try to guilt others into making the same nutritional choices as them.  How does that work out?  Personally, I have never seen anyone win anyone else over to their point of view by posting a judgmental meme, or by shaming anyone for their choices.  Why is this approach not helping?

Let me say up front, I understand being passionate about something.  I really do.  If you know me, you know that I’m FULL OF IT (passion that is, lol).  But if we are truly passionate about something, we should be trying to draw someone to our message, not chase them away.  Often, it’s not that our viewpoint is wrong, it’s how we convey it to others, our delivery.

SOOOO….

I recently ran across a great book that helped me understand something about, not just what to teach, but how to teach it.  And I learned a lot about myself and how I could teach by being a better listener.  I am going to share a great deal of content from the first chapter, then you’ll have to get the book for yourself.  If you are a healthcare professional that is in the position of educating others, I think it’s a great tool for you to have.  If you are not a healthcare professional, but just want to motivate others to be healthy, then this post may help.  (Quotes from the book are in green).

motivational-interviewing

So, one of the first things brought out in the chapter one is: there are basically three types of communication styles and they exist on somewhat of a continuum.

Directing <–> Guiding <–> Following

“A director is someone who tells people what to do and how to proceed.  The implicit communication in directing is “I know what you should do, and here’s how to do it.”  A directing style has complementary roles for the recipient of direction, such as obeying, adhering and complying.”

So when we direct, we tell people what to do and how to do it.  Sometimes this type of communication is necessary.  When a doctor prescribes a medication for a patient, he/she needs to tell the patient how to take the medicine.  And in return, the doctor expects for the patient to follow the direction.  (When people don’t do so, they are often labeled “non-compliant.”  I can’t tell you how much I hate that word!!!)

“At the opposite end of this spectrum is a following style.  The implicit communication in following is “I trust your wisdom, will stay with you and will let you work this out in your own way.”

So when we follow, we are there simply to listen.  For example, if we are dealing with a person with strong emotion.

In the middle, is the guiding style.  (An illustration from the book.)  When we travel to a foreign county and hire a guide, it is not the guide’s job to direct us everywhere and tell us absolutely everything we are going to do.  But it is also not the guide’s job to just follow us around everywhere we go.  “A skillful guide is a GOOD LISTENER and also offers expertise where needed.”  (An illustration from the book).  Guiding is helpful when training a young child to do a new task.  We don’t want to do too much for them, but we need to guide and help them.

So keep these three things in mind.  We are going to tie it all together soon.

The next thing discussed in the book is THE RIGHTING REFLEX.  Here is where passionate people are going to start seeing themselves.

Firstly, the book commends those in life who choose to be helpers, quoting “anyone who willingly enters into the pain of a stranger is truly a remarkable person.” (Henri Nouwen 2005).

“A life of service to others is a profound gift.  A variety of selfless motives can draw people into helping professions: a desire to give back, to prevent and alleviate suffering, to manifest the love of God or to make a positive difference in the lives of other and the world.”

Wow, right?

“Ironically, these very same motives can lead to the overuse of a directing style in an ineffective or even counterproductive way when the task is helping people to change.  Helpers want to help, to set things right, to get people on the road to health and wellness.  Seeing people head down a wrong path stimulates a natural desire to get out in front of them and say “Stop!  Go back! Don’t you see? There is a better way over there!” and it is done with the best of intentions, with one’s heart in the right place.  We call this the “righting reflex” – the desire to fix what seems wrong with people and to set them promptly on a better course, relying in particular, on directing.  What could possibly go wrong with that?”

Indeed…

I see myself very much so in this description.  How many of you out there do?

So, what is wrong with that?  One word: ambivalence.

What is ambivalence?  Ambivalence is being undecided, having mixed feelings.  People who need to make changes are often ambivalent about doing so.  They may see reasons to change, and reasons not to, all at the same time.  This is not a bad thing.  A person who is ambivalent is often, close to change.  They are ahead of folks who absolutely see no need to change, people who like things the way they are, or people that have given up due to past failures.  These folks are not even at the level of ambivalence yet.  Ambivalence would be a step forward.

So although ambivalence is not necessarily bad, it is a place where people can often get stuck, for a LONG TIME.  For instance, many people with heart disease can recite all the reasons to quit smoking, eat healthy and exercise.  But other motives may be conflicting with doing the right thing.  “Ambivalence is simultaneously wanting and not wanting something, or wanting both of two incompatible things.”  This is just human nature folks!  Plain and simple!

So with folks that are ambivalent, you may hear both “change” talk, acknowledging the desire to change, and “sustain” talk, arguments in favor of not changing, or keeping the “status quo.”  This often takes place in a “yes…but” fashion.  (Yes, I know I need to exercise but I really don’t have the time.)

So here is what happens when an ambivalent person meets a helper with a “righting reflex.”

“The helper’s natural reflex is to take up the “good” side of the argument, explaining why change is important and advising how to do it.  Chances are, however, that the person has already heard the “good” arguments, not only form others, but also from a voice within.  Ambivalence is a bit like having a committee inside your mind with members who disagree on the proper course of action.  A helper who follows the righting reflex and argues for change, is siding with one voice on the person’s internal committee.”

“So what happens next?  There is a rather predictable response when a person who feels two ways about something hears one side of the picture being emphasized” YES…BUT. Argue for one side, and the ambivalent person is likely to take up and defend the opposite.  This sometimes gets labeled as “denial” or “resistance” but there is nothing pathological about such responses.  It is the normal nature of ambivalence and debate.”

Here is the problem with that…

“Most people tend to believe themselves and trust their own opinions more than those of others.  Causing a person to verbalize one side of an issue tends to move the person’s balance of opinion in that direction.  In other words, people learn about their own attitudes and beliefs in the same way that others learn them: by hearing themselves talk.  If you as a helper are arguing for change and your client is arguing against it, you’ve got it exactly backwards.  Ideally, the client should be voicing the reason for change.”

Bingo!  And there you have it.

Let’s put this into simple terms.

Many people, for many pure reasons, are drawn into wanting to help other people.  We are passionate.  We want what is best for others.  We want to right things that are wrong.  However, most of the time, people in general know that they need to get healthy or stop some harmful behavior, but they have lots of reason why they can’t or won’t make changes.  So, they often have this ongoing battle.  Who hasn’t had a battle at one time or another?

Picture this scenario.  You’re at some friends house for dinner and looking at the dessert and thinking to yourself, “should I have that?  I really shouldn’t.  I’ve been trying to lose weight.  But I worked really hard this week, I deserve it.”  And then your spouse, who really got on your nerves in the car on the way there (lol) says “you know you can’t have that.”  Are you more likely to say, “oh honey you are so right.  Thank you for telling me what to do.”  Or “watch me scarf it down in less than a minute.”  LOL!

We will re-visit this scenario later.

So, then, when you employ all your “righting reflex” energy at a person, who is undecided, or has mixed feelings, then who is left to stand up for the other side?  THEM!  The person you are trying to help.  The natural reaction of a person who wants two things, is to choose the opposite when someone passionately tries to make a choice for them.  The key then is, rather then YOU stating all the reasons a person needs to do “xyz”, get THEM to voice those same arguments, IN THEIR OWN VOICE.

Let’s revisit the scenario above.

Picture this scenario.  You’re at some friends house for dinner and looking at the dessert and thinking to yourself, “should I have that?  I really shouldn’t.  I’ve been trying to lose weight.  But I worked really hard this week, I deserve it.”  And then your spouse says, “man, I know you had a tough week.  I see you eyeballing the dessert.  I hear ya.  You deserve a treat!  But how do you think you’re going to feel when you eat that?”  You might say “probably lousy.”  He might say “you just bought that great new dress.  How great did it feel to buy it in that smaller size?”  You might respond: “Awesome.  You’re right.  I don’t need dessert, but how about a new pair of shoes to go with that new dress.”  LOL!

You folks know I’m joking.  But what happened in the scenario.  I made the decision to NOT have the dessert, not by someone telling me NOT to have it, but by expressing for myself the reasons why I didn’t need it.

“Imagine a helper who tells you how much you need to make change, gives you a list of reasons for doing so, emphasizes the importance of changing, tells you how to do it, assures you that you can do it, and exhorts you to get on with it.”  More often than not, this leads to the person being “helped” to feel some of the following:  angry, defensive, uncomfortable, powerless.

This may lead the person being “helped” to conclude that they don’t want to change at all.  “People tend to feel bad in response to the righting reflex and CAUSING PEOPLE TO FEEL BAD DOESN’T HELP THEM TO CHANGE.”   Man, how often have we seen this right?  For example, fat shaming.  How many of us have been “fat shamed?”  Did it inspire us?  I think not!

So how do we avoid the righting reflex?  The first key is to listen.  That means, at first, give no advice at all.  Respectfully gather more information with questions such as:

  • “Why would you want to make this change?”
  • “What are the three best reasons to do it?”  
  • “If you wanted to be successful at it, how would you go about it?”  
  • “How important is it for you to make this change and why?”

Then, after patiently listening, reiterate what a person has told you to reinforce what they have said to you.  And then ask something like “So what do you think you’ll do?”

More often than not, this leads the person being helped to feel engaged, open, understood and empowered.  Here is the kicker.  In both cases, the conversation is the same.  It is about change.  But the outcomes are now different.

In future chapters, it is discussed that the purpose of doing this is not an intellectual exercise.  It is not trickery.  It is not a battle of wits where the goal is to outsmart an adversary.  But it is a technique born out of the genuine desire to help others.  It is about creating an atmosphere that is conducive to change, but not coercive.

So, if you have that genuine desire to help others, and I think you do because you wouldn’t have read this far, hopefully this will help you to really reach those who, when confronted with too much of our passion, would be otherwise unreachable.

I have identified much about myself when reading this.  I have a passion.  I feel like I have an urgent message.  But just because I feel that my message is urgent, it doesn’t mean that others feel the same urgency.  We’ve often been told that we need to “meet people where they are.”  (My friend Butter Bob says this.)  And a truer statement could not be made.

Once again, this website doesn’t provide the opportunity to employ these techniques.  So, you will continue to see my passion here, my “righting reflex” in full action, lol!  Sometimes I can tame it, but sometimes, I just want to holler from the rooftops.

But I am anxious to explore this further in my one on one interactions with people.  I feel like I have been effective thus far, because people see my eyes, they know I care.  But I feel like now I can reach even more people.  There will be no stopping me, lol!!

For more information on the book, click the image below.

motivational-interviewing

Let me say a few final words to the helpers of the world.  Sometimes, we try to help so much that we get frustrated when our efforts don’t result in the good we are hoping to achieve.  There is such a thing as “compassion burnout.”  I have found myself in that place.  At times, I get tired, and I have had the desire to shut down my social media page, and this website, and just spend my time reading great mystery novels.  But it is not my way.

In reality, this book is helping me.  It is reminding me, although deep down I know this, that I can’t change people.  All I can do is encourage, support, or maybe even try to inspire.  But in the end, the best help I can give to anyone, is to respect their right to choose what is best for THEM.