What a perfect illustration of ambivalence she presented! We know that smoking is a notoriously difficult addiction to treat, and I told her that people attempt to quit on average 7 times before they stay quit. Our brief conversation provided me an opportunity to use all OARS skills.
Me: So you think you should quit smoking. Can you tell me why you think that? (Open question)
Rebecca: I know it’s bad for me, and has probably already damaged my health. (Change Talk) I had quit for a number of years, and then my sister got sick and died, and I just needed some relief from all the negative emotion. (Change Talk, mention of having been successful in the past)
Me: So, you’re concerned about how smoking has affected your health. (Simple Reflection)Tell me how you were successful at quitting in the past. (Open question, asking about past success)
Rebecca: I’m not sure, really. I just decided to quit and did it. (Change Talk) The grief around losing my sister was just too much and I didn’t know how else to cope. But I really love smoking! It gives me a break from whatever is going on around me, and relaxes me. (Sustain Talk)
Me: You’ve been successful before and that’s great. (Affirmation) But you’re ambivalent about quitting now. On one hand you love smoking and it helps you relax and cope, but on the other hand you’re worried that it’s damaging your health. (Double-sided Reflection) I’d be happy to help, if you wish. What do you think?
Rebecca: I’m really not sure I want help. I’m not ready to think about quitting right now. (Sustain Talk)
Me: Of course. If and when you decide you want to do it, I’m sure you will succeed. If you ever want to talk about this with me, I’m available!
**Remember to leave such a conversation about ambivalence with a positive statement.
Dr. Ellen is available for individual or group coaching in MI. Contact her at ellen@TrainingWithDrEllen.com for details and pricing.
