Recently in the world of Motivational Interviewing the authors of the coding system (MITI 4.2.1) are asking this question. What does “cuddling the problem” look like and how does it change the direction of the session?
If a client states: “I know I should drink less, but it’s the only way I know how to relax after a stressful day” what would you say next?
An empathetic reflection might be “stress reduction is important for you and alcohol helps with that.” After reflecting this, what do you imagine the client would say next? Possible statements might be “yes, I can’t imagine my life without alcohol” or “alcohol is super helpful with my stress.”
Although you are being empathetic you might be making your client more ambivalent by reflecting “sustain talk” or talk that reflects the status quo, essentially “cuddling the problem.”
How do you be empathetic AND move the conversation towards change or change talk?
A different reflection might be “you’d like to figure out a way to help with stress reduction without alcohol.” This is a hypothesis – a skill we use in Motivational Interviewing to “pull” for movement towards change. If you’re wrong and have the spirit of Motivational Interviewing (partnership, acceptance, compassion, evocation) the client will correct you and usually you will hear more information on the direction they would like to go.
It’s all about listening to what matters to the client – i.e., what is underneath their words? What is the hope or dream they have and why are they meeting with you?
Many times, we get caught up in the smoke screens our clients present us with. It’s all about keeping our eyes on the horizon of hope for each person we encounter. Do they feel more inspired and leave our presence with a little movement towards change?
James Clear, author of Atomic Habits states: “Rome was not built in a day, but they were laying bricks every hour. You don’t have to do it all today. Just lay a brick.”
You as the helping professional are there to guide clients through the uncertainty in their minds and move towards change….by just laying a brick with each conversation.