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Work with Ambivalence _Final

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>> Ambivalence. You've likely heard this word before. But what does it mean? It means that you're on the fence about something or that you have mixed feelings or contradictory ideas which can make taking action and making decisions really tough. So in this lecture, you'll learn why ambivalence is an important part of the change process and how you can leverage it to help your clients move forward faster. As a coach, your job is to help your clients contemplate and move through ambivalence. The first step to properly doing this is to adjust your expectations. Often, we mistakenly view change as a linear trajectory. We meet with our clients, discuss goals, come up with a plan, and from there, they slowly and steadily improve, maybe with a small hiccup or two along the way. While this is ideal, it's not realistic. Setting the standard for how our clients should progress through their program will only create disappointment when things don't go the way you both had planned. Behavior change is a trial and error process. Consistency is, of course, a goal, but more often than not, people go back and forth between thinking about a change and actually doing it before moving forward, and this is totally okay. And we need to convey this to our clients so that they feel empowered by their own process. Making change is like hiking Mount Everest. Did you know that to hike Mount Everest it's mandatory to first hike to a base camp, stay there for a few days to acclimate to the difference in oxygen, then you hike up a bit more and head all the way back down to base camp? You do this a couple of times before you actually go to the next base camp until you finally reach the summit. You can't just hike all the way up Mount Everest in one day, it would literally kill you. Behavior change is the same way. To successfully climb your way there, you have to acclimate to the changes in your environment in increments before you can go the rest of the way up. So as change ebbs and flows, we must flow with our clients. As coaches, we have a tendency to rush our clients through ambivalence and into clarity thinking that once they know what they're supposed to do, they'll do it. Unfortunately, that's rarely the case. That's why it's so important to stop and take time to fully explore ambivalence. The existence of an inner conflict tells us there's some kind of block to moving forward. What your client wants is in conflict with something else that they want. If they know they need to make a change but they're resistant or hesitant to doing it, there's a significant reason for that. And our job, as their coach, is to help them figure out which of these conflicting priorities is their bigger want. For example, your client may truly value healthy eating, but they really don't want to give up going out to eat. As much as they want to make healthy home-cooked meals, they don't want to give up the fun and social bonding of going out to restaurants with coworkers, friends, and family. So now they feel stuck. Is healthy cooking the bigger want or is going out to eat? Your job is to help them figure out which of these is more important and, if there is a way they can create a shift, to still do both. So how do we do this? We need to slow down and guide our clients through a deep exploration of their own ambivalence because when we try to coast through it, they do too. Ambivalence makes us feel uncomfortable and frustrated. Since most people's inclination is to run away as fast as you can from icky feelings, we need to be the ones to encourage our clients to swim out to the deep end or else they're never going to resolve their inner conflicts. Ambivalence often appears in the form of excuses. How many times have you heard, "I want to exercise, but I can't afford to join a gym." Underneath our clients' excuses is a conflict. They really want something, but they're not willing to do whatever it takes to achieve it because that would deprive them of something else they want. This is happening beneath the surface, so they wonder why, despite their strong desire to change, they keep ending up where they don't want to be. When we hear objections, excuses, confusion, and indecision from our clients, we need to peel back this top layer and help them get to the root of their inaction, what do they really want and why. Ultimately, we want to help our clients reach a place where they decide that the benefits of behavior change exceed the costs of the action involved in obtaining it. We want them to see that there's a place of balance where they can make shifts in their life that will get them results while still satisfying their other wants in other ways. Attempting to create an action plan before reaching this point will likely backfire in the long run. To be effective, our clients need to reach these conclusions for themselves. Telling someone why they should change or how they can do it is a totally ineffective strategy for promoting long-term behavior modification. And pointing out that someone's ambivalence is really an excuse is a quick and easy way to lose a new client. When you're getting to know a client and helping them understand their inner world, labeling what they perceive to be obstacles as excuses will be seen as the opposite of empathy and can make clients shut down and feel resentful. I recommend waiting until after you've established a working relationship and your client is in the action phase of their behavioral change to call them out on their excuses. At this stage, all you'll want to do is sit with them and make them feel heard and understood. The state of ambivalence is a very sensitive place for your client and pointing out their discrepancies can be embarrassing and promote feelings of shame. We need to go out of our way to convey non-judgment and acceptance while working with ambivalence. In your first few sessions with every client, you'll want to listen out for inner conflict. This is super important, so let me repeat. You'll want to look for ambivalence with all clients, even those who seem totally clear on what they want and are ready to hit the ground running. This is because many clients come to coaching confident about what they can accomplish. Their positive attitude and spirit is great and we love these clients for it. But they think just because they paid a bunch of money to work with a coach that their lives will be transformed for them with new knowledge and good intentions. They may not really grasp the type or the extent of the work that lays ahead of them. Otherwise, if it was that easy for them to make this change, they probably would have done it already. So even when you have clients who show up and say, "I want this more than anything, let's get to work," try to assess for any underlying feelings of contemplation or doubts that might be quietly nagging at them. You can ask your clients questions like, "Where have you been holding back? Are you worried about losing weight? What specifically are you worried about?" They might say, "I'm worried I won't stick to my meal plan" or "I'm worried I'll do all for a while like I usually do and then something will come up and I'll mess it all up." These are fantastic jumping-off points for deeper conversations about what's really going on for your client because if they have all of these reasons why they shouldn't lose weight or exercise more or take better care of themselves, they never will. They have to resolve these internal issues first before taking any physical action or these conflicts will continually pop up and knock them off-track. New behavior takes mental energy and sustained attention. Our old habits are automatic. Willpower is a finite resource, and eventually, it's bound to run out on our toughest days when we've exhausted our supply. Ambivalence comes up when we don't want to do something that's unfamiliar or uncomfortable and the action of change starts to feel taxing. So if we're not crystal clear on what we want, we'll inevitably derail. Think about starting a new diet. The first few days you may be totally amped up on it, you read up on the foods you should and shouldn't eat, you stock your fridge and pantry with healthy foods, maybe you even bought a new workout outfit, you feel unstoppable and totally determined. A month in, however, you're exhausted and ready to throw in the towel. Counting calories and preparing meals with specific macronutrient ratios is becoming tedious and annoying. You're missing all your favorite foods and you're just not feeling the repetitive program you signed up for. What happened to that indestructible spirit? Several weeks ago, you felt like the hard work would be totally worth the outcome, now you find yourself giving up and saying things like, "I knew I wouldn't be able to sustain this. I'm just not capable of losing weight. This is too hard. I'd rather just have pizza and feel happy." Your ambivalence, your conflicting feelings between your values and your actions has crept up and taken over now that the going has gotten tough. You never addressed what was going on underneath the surface, your feelings around weight and weight loss. You picked this fad diet because your best friend did it and lost 30 pounds, not because it was something you felt like you could truly stick to long-term. You got overconfident trying to psych yourself up and you suppressed your conflicting feelings, then they popped up a month later in the form of self-sabotage. You'll hear stories of past failures like this all the time from clients. And without really exploring barriers to change and a client's readiness to change before coming up with and implementing an action plan, you'll see this happen time and time again. So to recap, you'll want to set the stage for sustained behavior by rejecting the expectation that change is linear and listening and assessing for ambivalence in all your clients. Pay attention to both verbals and non-verbals. Your client may say he wants to start exercising to improve his health, but he might be nervously tapping or even grimace a little while saying it. These are signs that he also has a conflicting feeling around this. When it comes to verbal communication specifically, you'll want to listen out for what's referred to in motivational interviewing as change talk and sustain talk. Change talk is remarks made by the client that favor behavior change. Sustain talk refers to the remarks made by the client that are in opposition to the behavior change or that support the status quo. Change talk might sound like, "I don't want to have a heart attack, and I know if I continue eating this way, I'm headed towards serious health problems" or "Giving up meat will help me live in line with my values around protecting the environment and not harming animals" or "I have a friend who lost weight by cutting out sugar, maybe I'll talk to her about it and try it out for myself." Sustain talk sounds something like this. "There's no way I could possibly exercise in the morning. I can barely make it to school on time as it is" or "No way I could ever give up eating red meat, a life without steak sounds like a drag" or "I can't lose weight because every time I try, I fail. I love food too much." Change and sustain talk can often occur in the same breath. This right here is ambivalence. Ambivalence sounds like, "I'd really like to learn how to dance but I probably won't be any good at it and will just embarrass myself" or "I want to lose the weight, but I just hate exercising" or "I love the idea of a vegan lifestyle, but I also love steak." According to motivational interviewing, change talk frequently predicts a client's actual behavior change. So as a coach, you'll want to acknowledge the sustain talk but give extra attention to the change talk. Draw it out, highlight it, and reflect it back to your client. Doing this will help the client hear out loud his or her true beliefs. This is valuable because often it's not until your client hears something they've said mirrored back to them out loud that they can really reflect on the validity of their statement. This gives them the space to consider whether their belief is in fact a personal truth and how much weight it holds in their life. So if your client who's afraid of having a heart attack says, "I really want to lose 50 pounds. If I do that, I won't be considered overweight anymore, which will be really good for my health. I don't want to have a heart attack. I love eating, but I know that if I continue with a diet like this, I'm headed for some serious health problems down the line and I don't want that. I'd also like to feel confident and be able to wear cute clothes again. I feel like I'm ready to change but I just don't know. I feel like I'm just not capable of losing weight because every time I try, I fail. I guess I just love food too much." A response by you, the coach, that acknowledges sustain talk while highlighting and reflecting change talk might sound something like, "You're ready to lose weight and you see the many benefits this would have for you but you're having doubts. You see the value in losing 50 pounds because you'll be in a healthy BMI range, which will have a huge positive effect on your health. You'll feel better and more confident and enjoy shopping for cute clothes again. Because of your past failures and your love of food, you're doubting whether you feel like this is actually something you can and want to do, but you have a lot of strong reasons for wanting to make this change which seem like they could be powerful motivators for you." Do you see what I did here? I didn't give any advice or make any judgments or opinions. All I did was paraphrase and reflect back everything my client shared with me. I acknowledged my client's struggle, the sustain talk, while emphasizing and highlighting the change talk. My client hears that she has mixed feelings about the behavior without feeling any judgment around it. She hears that the struggle is real but that her reasons for change are stronger. Also, do you notice how I ended on a positive note, a reflection of the change talk? You'll always want to end your response noting change talk as your ending remark will most likely be what your client picks up and keeps running with. You'll want to use this formula throughout your early discussions, listen for change and sustain talk, reflect it back with an emphasis on the change talk and elicit further feelings about your client's reasons for and against change. Eventually, if your client feels like he or she really wants what they're talking about, they'll start identifying their readiness to change. They might start saying things like, "I guess I could prep and freeze healthy meals once or twice a month or maybe I can start by cutting out red meat once a week, like a meatless Monday, and see how that goes, or I think I'd rather push myself and exercise than continue to feel this sluggish. Do you have any ideas for a low-impact program I could try?" Now your client is prepared to make an action plan that truly takes into account their fears and hesitations and an honest assessment of their capabilities and limitations. You're now ready to enter the planning or goal-setting phase. So to recap, by identifying ambivalence and helping your clients consider the discrepancies between their actions and values in a nonjudgmental and empathetic manner, they can successfully move through their ambivalence and eventually achieve their goals. This is best accomplished by listening out for sustain and change talk. We help move our clients forward toward their own conclusions by simply acknowledging the sustain talk while highlighting and encouraging the change talk. Are you ready to try this out with your own clients? Listen out for the sustain talk and change talk in your next session and see how it goes when you stay in the moment and reflect back the discrepancy rather than pushing forward towards change. I hope you found this lecture to be helpful. I'd love to hear your feedback on the Facebook group page. Thanks for watching and bye for now.

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Duration: 17 minutes and 16 seconds
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Language: English
License: Dotsub - Standard License
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Views: 5
Posted by: integrativenutrition on Jul 6, 2018

Work with Ambivalence _Final

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