Improve your Human-service Effectiveness

  

Motivating People to Change

Why Some Interventions "Work"

By Peter K. Gerlach, MSW
Member NSRC Experts Council

colorbar

The Web address of this article is http://sfhelp.org/pro/basics/change.htm

      Clicking underlined links here will open a new window. Other links will open  an informational popup, so please turn off your browser's popup blocker or allow popups from this nonprofit Web site. If your playback device doesn't support Javascript, the popups may not display. Follow underlined links after finishing this article to avoid getting lost.

      This article is one of a series of Web pages for lay and clinical human-service providers who work with troubled people and groups. The series is based on my full-time professional study and clinical experience since 1979 as a family-systems and trauma-recovery therapist with over 1,000 international clients and students.

        This series assumes you're familiar with:

  This article examines...

  • Perspective on human change

  • How change is caused or blocked by personality subselves

  • Managing resistance to change

Background

      From birth tto death, each of us must adapt to subtle and sudden shifts in our bodies, our knowledge, our environment, and our family, society, and culture. Human nature promotes achieving and maintaining comfort, and change can threaten that by upsetting what is familiar and predictable.

      Absence of change in our lives can promote boredom and stagnation. Choosing to - or being forced to - change familiar things can promote anxiety. So we people (you) ceaselessly seek to balance keeping the status quo with trying out - or adapting to - new conditions.

      By definition, providing 'human service" is about planning for, and adapting to, significant physical and evironmental changes.       

Paradox: human and environmental change is constant, yet often people can't make it happen when and how they wish (e.g. diets that "don't work"),

 Questions

      As persons, we are confronted by questions like these:

  • why can't I make some changes I know would help me or other people?

  • how can I minimize worrying about making certain changes?

  • can I reduce the procrastination I feel about making some uncomfortable changes?

  • how  can I avoid making impulsive changes that I later regret? 

  • why6 are s0me chyanges easier to make than others.

        Premise: people who seek help in healing and problem-solving and who provide such help have evolved a set of beliefs) about human change. Lay and professional helpers (service providers)

        See how your premises about systemic change compare to these:

  • Human attitudes, preferences, and behaviors are caused by a mix of active personality subselves. Depending on many factors, they either seek or resist local and long-term changes

  • Typical clients seek clinical help because they're unable to define, make, and sustain personal and other systemic changes. Therefore, the  basic purpose of counseling and therapy is to facilitate desired and beneficial systemic change in individual clients and/or selected relationships and/or their family.

  • Human physical, mental, emotional, and spiritual change is constant and inexorable. It is caused by aging + new knowledge, perceptions, and experiences (like therapy) + environmental shifts.

  • Changes in one member of a human system (like a household or family) affect (a) all other people in the system, and (b) may cause changes in related systems like extended-family homes and relationships, neighborhoods, communities, etc.

  • Personal and family-system change may be voluntary and/or forced by aging and/or environmental shifts.

  • When a person's subselves disagree on the safety or utility of making significant systemic changes, the person experiences ambivalence, indecision, self-doubts, and confusion. These promote "resistance," hesitations, "second-guessing," double-messages, and approach-avoid behaviors and relationships.

  • Some changes cause losses (broken emotional-spiritual bonds) that require grieving, and others don't. Part of clinical assessment is discerning significant losses and the status of related grief.

        More premises about human change...

  • Human changes are temporary (primary attitudes, values, and beliefs haven't changed) or permanent because dominant subselves have changed these variables. Some clinicians call these first-order and second-order changes, respectively. Option explain and use this concept with clients and co-workers to facilitate making appropriate systemic changes.

  • All animal ((human) behavior is motivated by the ceaseless drive to reduce current physical, emotional, and spiritual discomforts (fill current needs). Needs are either surface (symptoms) or primary. When people reflexively focus on filling current surface needs, they usually cause tem-porary (first-order) changes because their underlying primary needs remain unfilled.

Implication - clinical work that focuses on making superficial systemic changes will often be ineffective, as judged by the client.

  • Often, "logic," "reasoning, " and "common sense" will not convince dominant personality subsel-ves that surface or primary changes are safe enough. Therefore, people (i.e. their ruling subselves) continue frustrating and/or unsafe behaviors despite painful and/or dangerous results until their subselves hit true bottom.  A strategic option is to assist clients to hit bottom safely.

  • When kids and adults change their attitudes, values, beliefs, and perceptions, their private and social behaviors usually change. Conversely, new behaviors can promote such changes because of new experiences (behavior outcomes).

  • "Hitting bottom" often follows years of rationalizing and trying various surface changes and accep-ting that they don't produce desired second-order changes. Addiction relapses, failed diets, and serial divorces provide classic illustrations of this primal dynamic.

  • Effective thinking and communication knowledge and skills promote achieving desired permanent (second order) changes. So a powerful clinical meta-intervention is teaching clients such know-ledge even if they don't ask for it. Lesson 2 and its related guidebook provide practical information and resources to do this effectively, based on over 50 years' experience and study.

  • People are more apt to make second-order (lasting) changes in their attitudes, thinking, and be-having if they experience satisfying results from the changes, vs. talking about such results. This suggests the strategic value of clinical role-plays and homework assignments - i.e. giving clients "therapeutic experiences."

  • Every adult, child, and human system has a unique tolerance limit for concurrent inner and outer change. When perceived changes approach or exceed their limit, people and systems will "resist" new changes (i.e. their ruling subselves will resist overwhelm - systemic chaos). Effective clini-cians stay aware of and honor clients' limits to systemic change. They accept and adapt to a client-system's pace in stabilizing after significant internal and/or environmental change.

        A final premise about systemic change...

  • Families benefit by their leaders intentionally planning and managing major systemic changes, like geographic moves, altered roles and/or rules, marriages, divorces, cohabiting, retirements, babies, custody changes, kids leaving (or returning) home, adoptions, job losses, and deaths. Difficulty planning and managing major personal and/or family changes effectively usually indicates one or more family leaders is ruled by a false self .

+ + +

        Notice these premises at work within you right now. If you're reading this to improve (change) the effectiveness of your work with clients, are there some subselves who c/overtly don't want you to risk changing?

        Pause, breathe, and notice your self-talk. Recall that our goal is to clarify your concept of how to overcome client "resistance" and promote beneficial systemic change. Review the four questions above and see if your answers have changed.

About Subselves and Client "Resistance"

        Premise - personality subselves often differ on their willingness to change their attitudes, values, priorities, roles, and goals. Until each active (dominant) subself approves, personal and clinical attempts to make lasting personal and family changes are likely to fail. Inner child and Guardian subselves' beliefs are often based on the past, not the present, and are often myopic, unrealistic, and rote. These subselves will usually not change because of "common sense" or "logical explanations."

        Typical subself beliefs that block beneficial systemic changes are...

"If I change, something really painful will happen. Common symptom: you or a client feels significant anxiety despite demonstrable realities and safeties.

"I'm worthless, disgusting, and unlovable. I don't deserve (to change and increase my) comfort or pleasure!"; and/or "If I seek pleasure or comfort - specially if other people are needy - I'm selfish (bad)."

Common symptoms: marked apathy ("I'm just too lazy..."), self neglect and rigid justifica-tions, and/or admitted or denied "indifference." These are usual manifestations of excessive subself shame, fears, and distortions).

"If my host person or I change, we'll break one or more important rules [should (not)s, must (not)s, have to's...] and we'll be bad - so important people will scorn or reject (abandon) me again." Common symptom: acknowledged or denied excessive guilt. 

"I don't know (a) what I feel or need, and/or (b) how to fill my needs safely." Common symp-toms: high reactivity, emotionality, and an "inability to focus" - i.e. excessive local or chron-ic confusion and/or overwhelm. Probable cause: inner-family chaos because of a disabled true Self;

And some ruling subselves resist change because they believe...

"If I allow change, I'll lose my job or my status! I don't know what I would do, and that's too scary!" (This is a distorted belief. Subselves are (probably) discrete brain regions, so they can't be "fired" or "killed." They can learn to accept a useful new personality role when they believe doing so is safe and beneficial to themselves and the young subselves they guard.

"I'll never be able to change or stay changed - I can't do it." Common symptoms: "irration-al" self-doubt, self-discounting, and "unreasonable and/or rigid pessimism." The real cause is a protective Skeptic / Pessimist and/or a Worrier subself distrusts the true Self and a be-nign Higher Power to make and stabilize desired changes safely.

"It's not safe to feel significant hope or desire for (i.e. to want) something, because I'll just be hurt and disappointed again." Common symptoms: "low affect," emotional numbness, "weak motivation;" ambivalence, and/or "apathy."

        Implication: to promote desired second-order (lasting) systemic change, clinicians need to want to work with individual subselves to help them try out new beliefs and trust the resident true Self to effec-tively manage any stressful reactions to changing like those above. My professional experience consis-tently suggests that discounting "intrapsychic work" as part of a multi-modal clinical strategy will inher-ently limit therapeutic effectiveness with any clients.

 General Clinical Options

        Over time, clinicians (like you) develop semi-conscious strategies ("habits") for implementing their model of systemic change with their clients, patients, and/or students. Can you identify your general strategy now? Use these illustrative  options to help articulate your strategy.

       Two essential first steps are to (a) empower your Self to guide your clinical work and (b) clarify your beliefs about what promotes and blocks systemic change. Notice your subselves' reactions to each of these options... 

        After stabilizing any client crises, interest client adults in learning a version of the personality-subself ("inner family") concept. Option: use a handout like this to reinforce or expand your verbal expla-nations. Expect initial (false self) anxiety that "having a bunch of people inside me" means "I must be weird and crazy" or have "multiple personality (disorder)."

        Help clients appreciate that their Young and Guardian subselves are not bad or evil, and are each trying to help them in short-sighted, impulsive, misinformed, and often distorted ways. Invite skeptical clients to try this safe exercise and read and discuss this letter.

        Premise - all systemic change is made or blocked by the personality subselves that govern each family member. Typical clients aren't aware of this and what it means, and/or how to harmonize their subselves under the expert guidance of their true Self. Lesson 1 here and the related guidebook offer a practical way to do this over time.

        Encourage client adults to (a) keep their true Selves in charge, and (b) maintain a long-range outlook (e.g. 15 - 20 years), vs. focusing only on filling immediate surface needs.

        When appropriate, encourage clients to describe their own model of human change, including what blocks it. Then invite them to become more aware of their thinking and behavior - i.e. how they apply their model of change to resolving their presenting problems.

        Teach clients the difference between first-order and second-order change, and why this difference is useful. Help them see each type of change occurring in their lives and relationships, including in your clinical work together. Then teach and illustrate how distrustful, conflicted false selves cause approach-avoid, first-order (temporary) changes. ("You committed to being on time, and you were for several sessions. Then your ruling subselves reverted to coming in late.")

        Interest clients (including kids) in the difference between surface and primary needs. Then help them experience digging down below their presenting problems to discern the latter. Options: illustrate this with relevant problems like these, and note the connectrion to temporary and permanent change. Reinforce this two-level needs concept with a summary handout like this.

        Help clients distinguish between focusing on the problem, and focusing on their process - i.e. how they're trying to fill their needs. Often the latter is the problem. For example, typical couples ignore, deny, blame, defend, explain, or argue about unmet surface needs, rather than doing patient win-win problem solving as mutually-respectful teammates.

        Help clients learn common false-self fears that can inhibit desired change. Then help them free their true Self to develop strategies to overcome these fears respectfully and safely. To do this, you'll need to have such strategies yourself.

       Option: help clients differentiate between inner-family chaos and anxiety ("confusion") and healthy uncertainty as they experiment with new attitudes and actions. Restated: reframe some "confusion" as a welcome symptom of beneficial change ("personal growth") in progress. Do you see your own confusions that way?

        Recall - we're overviewing general options for promoting desired personal and family changes in yourself and your clients...

        With clients who are guilty and anxious about identifying and asserting their needs, reframe needs as discomforts. Invite clients (subselves) to accept that discomforts are part of being human ("like breath-ing"), and are not "selfish" or shameful. Affirm that some misguided false-self attempts to reduce discom-forts can be toxic (e.g. addictions), wholistically unhealthy (e.g. deferring health checkups), and/or illegal. Where true, the primary problem is true-Self disablement, not the behaviors.

        Model and teach clients and colleagues to understand and try these seven communication skills. Encourage their experimenting with the skills relative to their presenting (surface) problems, and assess the results. Teach "=/=" (mutual respect) attitudes and win-win problem solving, vs. repressing, avoiding, fighting / arguing, or withdrawing. Options: use these Lesson-2 resources to help, and alert clients to the related guidebook Satisfactions (Xlibris.com, 2002).

        Assess whether lack of relevant knowledge is helping to block the changes clients desire. Specifi-cally, check for toxic ignorance of these basic topics. Then provide needed knowledge via in/direct in-struction, demonstrations, handouts, referrals, etc. Watch for clients' anxious false selves pretending to (want to) learn, but covertly fearing what new knowledge might bring: scary new responsibilities, and painful new awareness (broken denials) and losses.

        A final general option to help clients achieve desired second-order (lasting) changes:

        Experiment with ways to motivate shame-based clients to...

  • limit their Inner Critic's blaming themselves and others,

  • see all family-member needs as equally legitimate and important,

  • validate their own and other's personal rights, and...

  • dig down as teammates to identify primary needs so they can do mutually-respectful problem-solving.  

Typical false selves will anxiously resist this, until (a) shame, guilt, and fears are allayed, and (b) trust in the resident true Self and perhaps a benign Higher Power grows enough, over time. I recommend Stone and Winkleman's useful paperback Embracing Your Inner Critic - Turning Self-criticism Into a Creative Asset (1993) as an awareness-raiser and practical help.

        Pause, stretch, breathe, and meditate on how these proposed general change-strategies compare to your normal clinical strategies and habits. What do you notice? Is your true Self answering, or "some-one else"?

Recap

        Premise - clients seek professional help to make and maintain desired personal or relationship changes that they can't do themselves. This article proposes that counselors, coaches, consultants, mediators, and therapists are more apt to provide effective service if they can articulate a coherent model of why and how systems change - or don't. The article summarizes a set of experience-based premises that comprise a model of human systemic change. Use it to clarify your current premises and model.

        Clinicians focus on (a) facilitating the changes the client wants (a first-order strategy), or on (b)  teaching the client how to identify and overcome the barriers blocking them from making the changes they desire - a second-order strategy. Which strategy do you usually use in your work and life?

        This paradigm proposes that when a person's personality subselves are conflicted on the safety and/or value of some systemic shift, they will prevent meaningful change or allow only temporary (first-order) changes. Classically, this is labeled "resistance." Second-order (permanent) changes occur when active subselves and the resident true Self (capital "S") agree that change is useful and safe enough.

        The article closes with a summary of clinical options for promoting desired systemic changes.

+ + +

        Pause, breathe, and reflect - why did you read this article? Did you get what you needed? If not, what do you need? Who's answering these questions - your true Self, or someone else?

This article was very helpful  somewhat helpful  not helpful  

<<  Prior page  /  Add to favorites  /  Print page  /  Professional index  /  Email this article's address  >>

colorbar

site intro / course outline / site search / definitions / chat / contact