Want to change
If you can forgive me for relaxing, I start with a joke. One guy wanted to join a group of superheroes. He sought out the leader of the superheroes, who inquired about the candidate's superpower. The same answered: "My power is to want". The leader of the super heroes looked under his super mask at the candidate's eyes and said “Wanting is not power!”
There are many lines in psychology. Some approaches point out that behavior change requires willingness and that the subject, when acting contrary to his health, is because, in some way, he does not want to make the change. Others understand that there are factors to behave in a certain way, and that by changing these factors the change becomes more likely. Some of these factors are external, and others may have more to do with interpretation, or, how these external factors are perceived and what is their impact on maintaining or modifying behavior. Speaking in good Portuguese, hunger would be one of these: if we are well fed, it is easier to maintain the diet. If we’re starving, it’s easier to let it go. And in fact there are studies showing that a diet that has hunger as a component has less chance of success ...
Helping the person, then, to change their outlook on their life as a whole can help these changes, in addition, of course, to change concrete questions about their life. Now, there is no doubt that the behavior in question is right, but also that healthy habits are superior. There is a way to classify this roughly. When a person doesn't even think about changing his behavior, what we might call “pre-contemplative” (before thinking about it), a respectful exploration of his context as a whole may be the best way to deal. Confronting, at this moment, is a guarantee that the person feels cornered. But a good exploration will demonstrate the damage of the painting, sooner or later.
From that point on, the person might think about, one day, who knows how to change their situation. This we could call “contemplative” (thinking about it). At this point it is interesting to be a little more assertive, and to compare the advantages and disadvantages of having or not that harmful, or suboptimal, behavior against a proposed behavior (good habits, abstinence from a substance). We can also start to help the individual to think about the possible adventures and obstacles such as, in the case of the example of the diet, having a healthy snack before going to social events with seductive foods, or at the supermarket to buy the foods of the week. This allows the person to take courage and start planning for behavior change. At this time, the balance weighs less to exploit advantages and disadvantages and more to prepare, anticipate obstacles, create support networks, modify contact and social networks. At this point, you can change your behavior.
For some people, this can all happen in a single meeting. For others, it can take a long time. Factors such as empathy, therapeutic connection, life history, previous attempts, all influence. There is no magic and instant formula. But in fact, when this process is done well, things that were once very seductive may become less seductive, and things that were once very uninteresting may be redeemed. It helps a lot to have a worthwhile life, a life that is worth living. Besides, of course, not going hungry in front of the ice cream shop! So, when in fact I can eat an ice cream, it is for self-care, for love, and not something to be upset after. And, in some cases, this, of course, involves the end of a moment in life, such as the use of substances or some behaviors that put the person at risk. Still, we will have other things in life that will make this worthwhile.
Text by Psychiatrist Emmanuel Kanter of the CEFI Integration team - multidisciplinary treatment for Chemical Dependence