In a recent post I discussed a study that found that substance use disorders often begin when people are experiencing mental difficulties use substances to self-medicate. The study focused on people who struggle with anxiety, but it’s not uncommon for people with mental health problems to turn to alcohol and other substances to get relief from painful symptoms.
Once you begin drinking, using substances or engaging in some other problematic behavior, you may recognize the risks and costs of that behavior, but still be ambivalent about whether to make a change. There are a variety of reasons for being ambivalent about changing problematic behaviors. Change is both difficult and scary. The more strongly you believe that alcohol or other substances result in positive symptom relief, the harder it is to get motivated to change.
If you’re stuck in ambivalence, consider the following questions from Miller and Rollnick’s book Motivational Interviewing:
- What things make you think that this is a problem for you?
- What difficulties have you had in relation to your drinking/substance use?
- What worries you about your drinking/substance use?
- In what ways does this concern you?
- What are the reasons for making change?
- What makes you think you should keep on drinking/using substances?
- What would be the advantages of making change?
- What makes you think that if you did decide to make a change that you could do it?
- What do you think would work for you, if you decided to change?
- What encourages you that you can change if you want to?
Your problem may be drinking, substance use or something else. If it’s something else, you can substitute whatever behavior you’re considering change for drinking/substance use. Sometimes before you begin to change, you need to focus on your ambivalence and get clear about whether you want to make changes and why. Motivation is an important factor in making successful changes.
Photo by Foxymoron, available under a Creative Commons attribution license.