MAY 04, 2015 1:50 PM PDT

Quitting bad habits by answering the right questions

WRITTEN BY: Will Hector
New research supports the use of motivational interviewing-a technique described below-to treat addictive behaviors like cigarette smoking. This is exciting because addictive behaviors can be one of the most entrenched patterns to overcome.

The roots of most unhealthy patterns are defensive-they emerge to protect us from a perceived or real threat. The patterning inherent in addiction, however, has the added punch of working at the neurochemical level. Substances like nicotine and alcohol cause feel-good neurotransmitters like dopamine to spike.

The problem with that is contending with the low. What's worse is that the baseline dopamine level gets reset so that the user begins to have difficulty finding a state that feels "normal." This is why we often hear those with substance-use issues speaking about coasting through, getting by, or various other terms to describe a cocktail behaviors that might include sleep, sex, caffeine, a morning dose, or really attempt to acclimate to the new baseline until the next high can be attained.

So what is motivational interviewing and how can it help?

Well, it's a direct intervention that seeks to produce changes in behavior. The key to its success is that the therapist must ask open-ended questions and allow the client to identify any ways their addictive behavior interferes with the life they want to pursue-on their own terms and in their own time.

It might start out looking like grief over losing a beloved relative, then reflection on a possible future outcome. Eventually, it might look like: "I don't want to die of lung cancer like my father did, and miss seeing my daughter's wedding or meeting my grandchildren." The trick is getting the client to make such a statement as part of a self-reflective response versus being force-fed your "logical" conclusion about his or her smoking. If you've ever tried that approach, you've likely encountered strongly entrenched justifications such as "My grandmother smoked until she was 93 and she lived a long, healthy life."

In the University of Granada study, 53 moderately heavy smokers with no desire to quit were subject to a 20-minute motivational interview.

The results, published in the journal Behaviour Research and Therapy, were quantified by measuring the level of the shock reflex in participants when they were shown a series of disagreeable images associated with tobacco.

Before the motivational interviews, the smokers responded to the images in a similar way as they did to pleasant images. But after the intervention, participants responded to the same tobacco images at the level of other disagreeable images, such as corpses or images of violence.

"Motivational Interviewing," the study says, "manages to change, at least temporarily, the emotional response that smokers present before stimuli associated to tobacco, from pleasant to unpleasant, which helps them overcome one of the main obstacles for quitting tobacco consumption, i.e. motivation for change."

This remarkable technique directly attacks the notoriously low motivation to change that accompanies addictive behavior that capitalizes not only on psychological and physical habit, but on neurochemical dependence.

At least in this study, motivational interviewing has been shown to be able to make smokers see tobacco as something disagreeable in as little as 20 minutes. This has tremendous potential to help relieve a major health burden to the one billion worldwide smokers and the people who love them.

Follow Will Hector on Twitter: @WriterWithHeart

(Source: Science Daily)
About the Author
Will Hector practices psychotherapy at Heart in Balance Counseling Center in Oakland, California. He has substantial training in Attachment Theory, Hakomi Body-Centered Psychotherapy, Psycho-Physical Therapy, and Formative Psychology. To learn more about his practice, click here: http://www.heartinbalancetherapy.com/will-hector.html
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