How to address ambivalence in early recovery

I train several counselors and therapists about substance and process abuse, but I also think that there’s always a family member or a friend who does a lot of the dirty work in getting someone with a substance abuse issue into recovery.  Therefore, I want to share a few thoughts that I’ve adapted from a Treatment Improvement Protocol (TIP) about addressing the ambivalence that comes with giving up a substance (or process) of abuse.

1.  When talking with someone who’s at the cusp of making a change, keep in mind that ambivalence about change is normal and that resistance to change is simply an expression of that ambivalence.  The ambivalence itself derives from the split nature of the person struggling with a substance abuse disorder (or addiction); being resistant doesn’t mean the person is “bad” because he or she seems to want to continue to abuse his or her respective substance.

2.  Some examples of questions that can be useful in helping explore ambivalence about engaging in behaviors that decrease substance use:
— What are the good and not-so-good things about using? There is a payoff in abusing either  substances and processes and understanding the payoff can be useful in finding other ways to attain the same payoff.
–What are the advantages and disadvantages of taking medication or exercising to combat your substance use?
–Who in your life would appreciate your decision to take care of yourself by exercising and improving your diet?
— On a scale of 1–10, how important is it to you to make some changes to reduce the negative impacts of using the substance in your life?

3.  Invite your loved one to explore his or her ambivalence more deeply by writing a journal as he or she goes through the “deciding” process.

4.  Remember that the closer a person gets to change, the more his or her ambivalence can increase. It is important that people make a life change because they see the need, not because someone forces them to change.  Please be particularly careful about not pushing your agenda on your loved one. It is through the exploration and expression of their own experience that people resolve their ambivalence and make positive changes.

Adapted from TIP 48