My Introduction to Motivational Interviewing

There isn’t much left out there now. There are no surprises anymore. More accurately, the secret, which the client thought was well-kept, was nothing less than obvious to the rest of the world. In times like this there are no places left to hide and all one can do is face the consequences of their actions.

I met a little man, red-eyed, with distended belly and older than me by at least a decade. He was tired of life and tired of waking up sick, tired of always finding himself at the same outcome, and tied of the cycle that comes with addiction. He was tired of living homeless, working small jobs or odd jobs or having no jobs while trying hard to feed his habit. After his third overdose,he was tired of the hospital visits. He was tired of being reversed from death and waking up in an emergency room, with an IV stuck in his arm, oxygen tubes in his nose, and an inquisitive nurse asking questions.

He thought about dying and talked about dying. He saw no reason to live or at least try to live. He so no purpose in life when so much of him seemed dead already. I met this man while visiting someone else. I was in the emergency room of a hospital that I will not mention for reasons that I will not disclose; however, I saw him on a gurney with tear-filled eyes and a look that I saw as familiar.

He was at his wits end, ashamed, humiliated, and tired of finding himself at the same place. There was nothing left to surprise him anymore. At his wit’s end, the last thing he wanted was a preacher to preach to him. The last thing he wanted was someone to talk to him or “At” him or tell him what he needs to do.

Walking passed his spot in the E.R. the man recognized me from a program I had worked with before. I did not know him nor did he know me personally; however, he sensed who I was and knew why I was there.

There is something about the word “Hello.” There is something about saying hello to someone when everyone else passes and no one else seems to care. There is something about saying the word hello in a wholehearted way. Something miraculous happens when a person, man, woman, or child is dignified as human and treated like a person instead of a patient or stigmatized in any way.

Sometimes, a basic introduction without any jazz to it, or a true “hello” without any sense of hierarchy or authority, or sometimes, saying hello without the condescending hint of sounding better than, or a hello delivered without an “Oh. Look. You poor soul,” is the most uplifting and inspiring thing.

Speaking with someone is more empowering and impactful than talking to someone. In this regard, speaking with someone grants a sense of dignity, which might otherwise go undignified in a conversation had with someone else. Nobody wants to feel beneath or below. No one wants to feel less than or belittled. More importantly, no one wants to feel kicked when they’re already down.

No one wants to be preached to or feel judged and diagnosed. And when the moment is intense,especially in cases like this, it makes better sense to allow a person to come out of their shell instead of scare them back into it.

I often hear parents ask how to discuss difficult topics with their kids. Whether the subject is about drinking or drugs, or whether the topics range from vaping, smoking cigarettes, to sexual curiosities, rather than push their agenda and lead the conversation, it is more helpful to mutually build the conversation.

What is motivational interviewing?

Motivational interviewing is a useful method that helps people resolve their own problems by coming to their own conclusions. Basically and put simply, by asking open-ended questions without judgement and while expressing an honest empathetic interest,this allows someone to draw their own conclusions to find their own motivation to make the changes and decisions they need to have a better happy life.

To be an advocate means to be on someone’s side. In times like this, an advocate is the best thing to be. It’s not about being right or trying to make someone choose what you ask them to.

It is important that to steer clear of judgement. Do not diagnose; instead, develop the conversation with a sense of support.
Remember, no one is going to talk if they feel like you are on “Their” side.And when I use the term, “Their” side, or by saying them, it is important to recognize where the opposition lies. No one will ever talk openly to the opposition.

Also, the best realizations come when self-realization comes to light. Rather than making someone aware or telling someone there is a problem, if they come to the conclusion on their own instead of being told what to do, they feel the freedom of their choice, which motivates them to take different steps.

Ask questions that steer them toward understanding themselves. Give them a view of themselves.

In the case of my emergency room visit, I heard things like, “They want me to do this,” or “They want to send me to some program.”

I was told, “They want me to go to those goddamned meetings and I hate those goddamned meetings”

Instead of defend they or them and rather than support their claims, I asked why they wanted to send him. This allowed the conversation to open up. I was able to learn what happened. I was able to learn how this happened. I learned about his past. I learned that he had been previously clean but after a relapse, he went back to heroin, and after going back to heroin, he lost housing, family, and on three separate occasions, he almost lost his life to an overdose. I was able to learn why he had reservations about going back into program and because I was able to learn this, we were able to discuss his shame and the guilt, which is more painful than physical pain itself.

Shame has no place in this conversation. Blaming has no part either. Instead, we talked about what happened, how he felt, and how he reacted. This allowed him an understanding of where his pitfalls were. And then he had a moment. Eureka!
“That’s where I always fall down.” he said.
“This is what always happens!”
“This is how I always screw up!”

After we spoke for a while, my new friend shook my hand. He was otherwise unruly with the hospital staff. He was angry and ashamed. Yet with me, we laughed and cried and talked openly about life.

I suspect he didn’t expect me to become emotional. I suspect he never thought someone would show him real emotion or cry for him or with him. I suppose he thought I was going to preach. But yet, at the same time, he obviously wanted to talk. He obviously wanted the help. He just needed to feel comfortable.

I assume he didn’t expect me to talk about his right to refusal, which, if he wanted to leave,he could stand up and walk out. I also gave him a sense of dignity by recognizing him a man. But, I also introduced a fear of loss.

What this means is I showed him a sense of what he could have. However, if it were taken away, this would mean that the feeling of inspiration might leave as well, and likewise, so would his motivation to feel better.

The human mind works in such a way that we don’t want to lose anything—especially when it comes to dignity. Therefore, instead of arguing, he asked for direction. Instead of debating, he asked for suggestions to learn more about his options.

We shook hands.

Before leaving he asked, “You ever think about doing this for a living. They could sure use a guy like you around here. It’s like these fuckin people are speaking a different language.”

I apologized.
“I’m sorry,” I told him.
“I forgot to properly introduce myself. My name is Ben but some of my close friends call me Benny.  I’m an addict and alcoholic. I’m just like you. I’m no different. The only difference between us is that I’m not lying in that bed right now.”

“Thanks Benny. You’re a good kid.”

One of my favorite movies of all times is The Outsiders. And one of my favorite scenes is before a rumble between Greasers and Soc’s (pronounced So-shh;) Ponyboy Curtis sat in a car with a young man named Randy. They talked for a while like people instead of enemies on different sides of the line.

After they talked, Two-bit Matthews asked Ponyboy, “So what did Mr. Super-Soc have to say?” to which Ponyboy replied, “He wasn’t a soc. He was just a guy that wanted to talk.”

When I walked out of the room before leaving, I was asked about the man I spent time with by one of the hospital staff that had to endure some of the man’s rants.Similarly put, I was told that this was his third time at the E.R. in less than a month. I was told he is an addict. That he’s got it bad. Then I was asked what he had to say.

“He’s just a guy that wanted to talk.”

We lost touch after a while. But this man did become clean. He came to his own conclusion and was able to move back home. Wherever he is, I hope that he is well.

This was my introduction to motivational interviewing. Only, I’m not sure who was more motivated, me or him . . .

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