After the Meeting

There is no such thing as false hope.
— Mary Pipher, American psychologist and author of Reviving Ophelia (1994)

William Miller and Stephen Rollnick’s Motivational Interviewing offers practical techniques for helping people change. Here’s what they might look like in a hypothetical conversation.

A newcomer sits down with me after a meeting. He says he wants to stop but doesn’t know if he can. He’s tried before and it didn’t stick. Where do I start?

I could give advice. I could tell him what worked for me. Instead, I ask, “On a scale from 0 to 10, how confident are you that you could do this?” He says 3. “Why a 3 and not a 0?” Not “Why aren’t you at a 10?” That invites him to list obstacles. Asking why he’s not at zero invites him to name what’s already working. He knows what the first week feels like. I reflect it back. “So you’ve been through the hard part before and survived it.” He nods. He hears himself say it, then hears it again from me.

He mentions he was able to stop for two months last year. I ask, “How did you do that?” He tells me he stayed away from certain people, kept busy with work, went to the gym every morning. These are strategies. I reflect them back. “So you already know what works for you.” He hadn’t thought of it that way. Research shows most people need several serious attempts before change sticks. Two months wasn’t failure. It was practice.

I ask, “What qualities do you have that could help you?” He struggles. I try asking, “What might someone who knows you well say about you?” He says his brother would call him stubborn. I ask for an example. He tells me about a time he refused to quit on something everyone else had given up on. I let him hear himself describe his own resilience.

He feels stuck on how to start. We brainstorm together. I encourage him to generate as many ideas as possible, no matter how unrealistic. I write them down without critique. Then I ask which seem most promising and why. I’m not solving his problem. I’m helping him discover he has more options than he thought.

I try hypothetical thinking. “Suppose it’s a year from now and you’ve done it. Looking back, what worked?” The distance frees up creativity. He starts describing a life he can picture.

I ask, “Who could help you with this?” Recovery doesn’t happen in isolation. Sometimes naming the people or organizations who could help makes the path feel less impossible. He mentions his brother again. A co-worker who’s in recovery. The people at the meeting tonight.

I raise challenges before they arise. “What might you do if the craving hits hard?” He solves obstacles in advance. When he names the solution himself, he believes it.

He asks what I think he should do. I offer a menu. “Here are three things that have worked for me or other people I know. Which fits you best?” Even in giving advice, I’m drawing out his judgment about what will work.

By the end of the conversation, he has his own plan. I didn’t install it. I drew it out. He arrived thinking he couldn’t do this. He leaves having heard himself say, out loud, in his own voice, why he can.

According to Miller and Rollnick, this is how we help people change. The person across from me has wisdom about themselves that I don’t have. They’ve lived inside their own skin longer than anyone. Our job is to ask questions that help them hear what they already know.