 This episode was prerecorded as part of a live continuing education webinar. On-demand CEUs are still available for this presentation through All CEUs. Register at allceus.com slash counselor toolbox. Hi everyone, welcome to happiness isn't brain surgery, understanding the multiple dimensions of motivation. Over the next little bit, we're going to define motivation and review the concepts about what motivation really is and how we can enhance it. Motivation is basically doing something in order to get a reward. If you want to do something, you're motivated to do it. What makes you motivated to do something? Generally, there's a good outcome. You're going to get something that you want. So some basic assumptions we need to understand is that motivation is the key to change. If you don't want something, if it's not worth it to you to exert the effort, you're not going to do it. Motivation is multi-dimensional. It's not just wanting it. There are a lot of different ways you can increase your motivation and we're going to talk about those. Motivation is dynamic and fluctuating. When the going gets tough, motivation gets going. So a lot of times when people start to embark upon a behavior change, at first they're really, really excited to do it. Think about New Year's resolutions. And about two or three weeks into it, it's taken a lot of effort and you're starting to question, you know, is this really something that I care that much about doing? So it's important to understand what makes your motivation wane and how you can increase your motivation again. Which takes us to motivation can be modified. Even if it starts to wane, you can pump it back up again. Even if you're not really motivated to do something, you can get yourself motivated by adding rewards and making the new behavior more rewarding than just doing what you always used to do. Again, let's think about those New Year's resolutions. Going to the gym. Some days you're just going to be like, really, I don't want to go. And that's okay. That's normal because you've got a lot of other things draining your energy. However, if getting to the gym is important to you, you need to figure out how are you going to increase that motivation to go? Can you meet a friend there? Can you go there and watch TV? Can you, you know, fill in the blank? I know for myself, sometimes getting there is drudgery, but I feel so much better when I'm leaving that it's worth it. I just need to remind myself how much better I'm going to feel if I go and how much worse I'm going to feel if I don't go. Part of enhancing motivation is timeliness. The PI's approach helps us remember how to do motivational enhancements in the most effective way. Proximity. You want to provide the intervention in a natural environment. You don't want to wait to increase motivation until somebody comes into your office and says, okay, this is what was going on last week. I didn't fulfill any of my goals. I mean, obviously you can do it then. But ideally, which takes us down to immediacy, you want to intervene as soon as their motivation starts to wane. Which means either coaching in the natural environment, having worksheets or handouts or even flashcards that they can refer to to remind them what to do, having a sponsor or some sort of other coach that can work with them. There are a lot of different ways to provide immediate intervention in the natural environment. Additionally, the person has to expect the intervention will be successful. If you're telling them to do something and they're like, no, that's just weird, then it's not going to work. For me, and I've used this example a lot, I am not a journaler. I never was. It works wonderfully for, you know, hundreds of thousands of people, not me. I have difficulty with journaling. I can talk to my dog. I can write down bullet points. I can do all kinds of other things, but actually writing prose in a journal doesn't work for me. So I expect it not to work, which means I'm not motivated to do it. And simplicity. Don't get too hung up in looking at all the when's, where's, why's and what's. What's going on right now is the fact that a person's motivation is waning or your motivation is waning. So have empathy for yourself. Do a mindfulness scan to kind of figure out why that motivation is waning. Understand yourself, understand what you need and take steps. It's not getting back into all the undercurrents of, you know, things that happened when you were six or things that are coming up. We want to stay right in the here and now and increase motivation in the present. The more types of motivation that are involved, the stronger the motivational force. So if I'm doing something just because somebody told me to, that's not a huge motivator. It's a motivator, but it's not a lot unless I really have a big stake in what that person thinks. You know, if it's my boss's boss, I'm probably going to be more motivated than if it's, you know, my neighbor across the street that asked me to do the same thing. Signs of decreasing motivation in yourself or others. Failure to attempt change. Quit going to the gym. You quit trying to implement some of those strategies that you wanted to use to try to quit smoking. Whatever it is, whatever you're trying to do, you just lose enthusiasm for it. Resistance, anything that gets in your way when you start making excuses for all the reasons you can't do it. Yes, but if you're talking to somebody and they're like, well, why don't you come to the gym with me and we can work out together and you have an excuse for it. Yes, but them. Yes, I could, but yes, I thought of that, but that's decreasing motivation. If there's a but there, it means that you're not motivated. And just a general lack of enthusiasm. When we embark upon goals, there has to be something a light at the end of the tunnel a carrot at the end of the stick, whatever you want to say. But there has to be something that gets us sort of jazzed about putting the effort into it because right away, when you first start doing it, there's probably not going to be a whole lot of immediate rewards. So how can you increase your enthusiasm? One of the ways you can work on maintaining motivation and being aware of motivation is to rate your motivation on the target behavior each day. Now, we've talked before in behavior modification about the fact that goals are often a conglomeration of multiple target behaviors and motivation will wax and wane for each target behavior. So if a person's goal is to lose 15 pounds, great. But what are they going to do? They're probably going to have to adjust their nutrition. They're probably going to have to exercise more. They're probably going to have to drink eight glasses of water. So we start listing those and we say, okay, for the target behavior of going to the gym, what is your motivation today? Do you feel like going to the gym? If not, why not? And how can we increase it? Target behavior of drinking eight glasses of water a day. You think that would be easy, but some days you're just looking at that sixth glass going really. I don't know if I can do this. So what is your motivation to do that? Is there something you can do to make it more pleasant? Another goal would be to improve happiness or address your depression. This is one of the things or goals that a lot of clients have when they come into treatment. So some of the target behaviors we may assess are taking medication. Sometimes medication makes people feel better. Sometimes medication, they don't really feel much of an effect at all. And other times medication makes them feel worse. Some of the medication is either not the right medication so they'll start feeling anxious, or some of the medication may be too slowing and it may make them too sleepy and it's hard to function. So they don't want to take the medication and they're not motivated to take it. Some work around you can do with that is obviously work with their doctor, but there are different times a day they can take it. If it's slowing, maybe they need to take it in the evening so that depressant effect, if you will, wears off by the time they're getting up the next morning. It may also help improve their sleep. If they're not feeling any effect, then you may have them ask other people that they live with or that are close to them, are you seeing an effect? Because sometimes the changes are so small, the person taking the medication doesn't really notice it, but other people will and they'll be like, yeah, that's making a difference. And then obviously if it's working, people are probably going to be motivated unless it's too expensive and they've got a way, is the expense worth feeling better? And medication can get expensive. Remember, you can always go to pharmaceutical companies, patient assistant programs to get vouchers for people who truly can't afford their medication. Anyhow, target behavior, walk 30 minutes. No exercise is helpful in increasing circulation, increasing oxygenation, which increases energy, and it also increases serotonin levels. So is this person motivated to just walk for 30 minutes? Another target behavior, when I feel sad, I'll write in my journal. If the person has the expectancy that that will help and they do it, that's awesome. If not, then we need to figure out alternate interventions. Another common target behavior is to reduce anxiety or improve people's stress management capabilities. Target behaviors for this can include getting adequate sleep, delegating unnecessary stressors, and reducing caffeine. Now, getting adequate sleep, you may be saying, well, who wouldn't want to do that? Sometimes, especially if you tend to be a type A personality driven, overly stressed, overobligated, you may feel guilty about getting enough sleep because you've got so much to do. It may be difficult to get sleep. There are a lot of reasons that sometimes people put sleep on the back burner. Delegating unnecessary stressors. Again, it sounds great. It's like, okay, I can push this stuff off on people. However, there are a couple of main copyouts. Some people feel guilty when they delegate tasks. Other times, if they're perfectionistic or if they don't have a lot of people they can rely on, it may take more energy to delegate those tasks or those things that need to be done. Then it does just to do it themselves. If people are not motivated to delegate, we need to say, why? And see if we can address it. And reducing caffeine, really good for you, really not motivating for some people. I love my caffeine. I love my coffee. But I can tell you that reducing it does tend to help a lot with just overall energy levels throughout the day staying stable. If people really like the caffeine part of it, the stimulant part of it, then we need to look at why. Is there something else that we need to address? Do we need to have them go to the doctor and have a blood panel run for hypothyroid or hyperestrogen or something out of whack that they are just not able to get the energy? Tiredness and fatigue is also a side effect of depression. So it could just be the depression that's in there. And exhaustion can also just come from being stressed out all the time. When you're constantly on, when you're constantly in a state of alertness and trying to get things done, even when you're trying to sleep, your body will get exhausted. So now that we understand that we want to identify target behaviors, not overall goals in order to be successful, we also want to identify the different types of motivation. Emotional motivation are things that make the person happy or things that take away their sadness. Mental motivation is the logical choice. Some people like facts and they want to do the thing that is the most logical choice. Physical motivation is anything that improves people's physical health, energy or reduces pain. Now, if it improves their health and increases pain, for example, exercising because they are working out too hard or when they initially stop smoking or stop using drugs, the withdrawal symptoms, you have to address those motivations. You have to address those hurdles and obstacles to motivation. Eventually, the improved physical health will kick in. Social motivation, anything that improves relationships with themselves or others. And I emphasize this because so often a lot of stress and depression is caused because people don't have a relationship with themselves. They don't like themselves very much or they don't know how to reward themselves. So they're constantly looking to others to give them validation and positive feedback. One way to help address a whole myriad of mental health issues is to help people start being able to provide themselves validation. We also want them to be able to create relationships, healthy relationships with other people. Spiritual motivation means that whatever they're wanting to do or embarking upon is in alignment with their values. It's meaningful to them. For me, animal rescue is in alignment with my values. So my motivation to go out and constantly have fosters in the house. Yeah, it's exhausting. There's a lot of stress with it. But my motivation to keep doing it lies in my value system. Financial motivation, pretty simple there. And environmental motivation is something that makes the environment more comfortable. But there's something that you can do and this can be a reward you give yourself. Maybe redecorating the living room or if you lose a certain amount of weight, you can buy a whole new wardrobe. Or whatever it is that makes your environment more comfortable to touch, smell, site, etc. So emotional motivation are things that make the person happy. When you do a decisional balance exercise on why are you going to do this task, we want to identify all the reasons the new behavior makes the person happy. Why are you doing this and how is it going to make you happy? And we also want to identify all the ways the old behavior adds distress. So if we're thinking about sobriety, why is sobriety going to make you happy? How is it going to improve your life? And what about using or being in your addictive self adds distress to your life? We want to make sure that these are salient points. I encourage clients to keep a bullet point list, because like I said, I'm not into pros, but some people are. Keep a list of all of the reasons that they don't want to do the old behavior and all the reasons that they do want to do the new one. And then we also want to decrease the reasons the old behavior makes the person happy. Remember, substance abuse addiction is a way of escaping from intolerable pain. So yeah, it served a purpose and it served a big purpose. So how else can we help them escape from this intolerable pain other than the addictive behavior? We need to decrease the pull of whatever that is. And let's look at the ways the new behavior adds distress. They're going to have to change people, places and things. They're going to have to feel feelings, which is great, but it can also suck at the same time. How can we help them manage these sources of stress? So the effort that they're putting into recovery is actually worth it. And recovery maintains its motivational value. This is especially useful to people who have more of a feeling temperament. If you remember back to the Kiersey or the MBTI or any of those that have the 16 temperaments, people who are feeling tend to be more motivated by their emotions and the connection with other people and concepts like fairness and justice. Mental motivation. These are things that the person sees as logical. What is the purpose of this? What is the logical reason? What is the outcome? Available information to support desired behavior is always useful in increasing mental motivation. What are all the tangible benefits of stopping smoking? We can provide a whole list of things, a whole list of reasons. We can also provide a whole list of techniques that the person can use because they may feel kind of overwhelmed and like, well, a lot of people don't succeed at this, so I'm not sure I will. And we can provide them information that says, you know, we've got multiple avenues to help you out. Again, do a decisional balance exercise and identify the mental motivations. What are the reasons the new behavior is logical and helpful to the person in achieving their goals, whatever those goals are. So if stopping smoking is their goal and their new behavior, they want to do whatever it is to stop smoking, why do they want to stop smoking? Why is it logical to stop smoking? Money savings, health benefits, they won't smell of nicotine. What are their motivating factors? These are the observable, measurable, quantifiable things. The old behavior is unhelpful to achieving their goals. So why is smoking unhelpful to them achieving their future goals? What is it that's motivating them? What is that that's finally gotten them to say, hey, I need to stop smoking? And then we want to decrease some of the reasons that smoking was rewarding or whatever the old behavior was. So why was the old behavior logical and helpful to achieving goals? Well, they may say, well, if I went out and smoked a cigarette, then I didn't freak out on people. That's logical. Yeah, I got you there. What can you do to handle stress instead of smoking? You can still leave the building and maybe take a walk around the building instead of going out and immediately lighting a cigarette. You're going to have to work with people to help them figure out what works for them. And how is the new behavior unhelpful to achieving their goals? Again, when we're talking about smoking, a lot of people smoke when they're stressed and it's also a habit. So maybe they're afraid that they're going to gain weight or maybe they're afraid they're going to be too anxious and just not able to cope with life. As clinicians, as coaches, we can help them figure out ways to deal with this. Addressing mental motivation is especially useful to people who have more of a thinking temperament. That is they want the facts. They want the objective information that they can look at, meta-analyses, whatever you can provide them that's factual so they can analyze it for themselves. Social motivation are things that increase the person's self-esteem and self-acceptance. We want to ask them, how does this new behavior increase your self-acceptance and approval of yourself and, not or, and other people's ability or willingness to accept you and approve of you? Because we all have people whose acceptance that we desire. Do we have to have it? No. But we desire. The first thing is to be able to accept yourself. So we want to say if we're quitting smoking, quitting using, starting exercising, addressing depression, how is this going to increase your feeling of satisfaction and approval of yourself? Because that will radiate out to others that, hey, I'm all that in a bag of chips. Why don't you come over and be my friend? The old behavior is in opposition to their self-concept. So we need to help highlight how this happens. Whatever the behavior is, how is it in opposition to who they want to be? And if it applies, how does the old behavior lead to rejection or isolation or withdrawal? So when they're engaging in this old behavior, do other people reject them or are they embarrassed and they withdraw from social supports? We want to decrease the way the old behavior is socially rewarding. When we talk about addictive behaviors, we know that people who have addictions tend to hang out with other people who have addictions. So they have a peer group that is rewarding of that behavior. They're going to have to change that peer group, most likely in order to stay in recovery. How are they going to do that? And how can we help them manage the anxiety that revolves around that? And the new behavior does not provide self or other rewards. So again, when you're having to change people, places and things, there's a lot to do and it can be really overwhelming. So how can we help people find new people to associate with that are going to be positive and motivating? How can we help people find new places to hang out and things to do that are embracing or supportive of a sober lifestyle? Spiritual motivation highlights the ways that the new behavior is in alignment with the person's values. It may not be your values, it's just the client's values. So we want to increase the ways the new behavior is in alignment with the person's values. Ask the person what's important to you or why is this particular behavior important to you? Why is it meaningful? What is it that makes you passionate about it? We want to increase their awareness that the ways old behaviors are not in alignment with values. Again, we'll take addiction because that's a really easy one to use. The new behavior of being sober is in alignment with their values because they're not going to be manipulating, justifying, rationalizing, lying. There's a lot of things that go into it. They'll be a better friend, they'll be more dependable. A lot of this also repeats when we look at the ways the old behaviors made them not in alignment with their values, the honesty, hope, faith, courage. In their addiction, those things were probably absent. We want to decrease the ways the old behavior aligns with their values if there are any. So if the old behavior somehow supported their value system, we want to figure out a different way to meet that. And we also want to identify the ways the new behavior does not align with their values. Maybe one of their values is family-centeredness, yet their family is not supportive of their recovery. Their family is in active addiction or there's a lot of abuse that goes on and it's an unhealthy environment for them to be in. So if one of their main values is family-centric behavior, but getting clean and sober means they may have to put some distance between them and their family, how are you going to help them realign those values? Not necessarily change them, but understand in their own mind how this behavior still actually does support that. Because in recovery, as they become more able to handle life on life's terms, and become more able to be honest, hopeful, disciplined, they will be a better family member and they will be able to set boundaries so they can still interact with family, but they have to put some distance between them and the dysfunction. It's not them and the family, it's them and the dysfunction. Financial motivation. These are the ways that the behavior is financially beneficial. So how did all behaviors reduce your savings, reduce any additional money you could have brought in, or what I call redirectable funds? Addiction, smoking, gambling, even depression can reduce savings if you're not able to go to work or if you're using your money in order to maintain some sort of an addictive behavior. It can reduce additional money from coming in, again, by not being able to go to work, by not being able to look for work because you're on disability, because you just can't deal with life on life's terms right now, or because you're in jail. And it also reduces redirectable funds. If you have money that you're using to support the old behavior, you can take that money and redirect it to support the new behavior. We also want to look at how new behaviors increase your savings. So if you're not spending as much money on going to clubs or on drugs or on gambling, how is that going to increase your savings? How is that going to enable you maybe to make more money and or have funds that can be redirected to something that is supportive of your new goal? And environmental motivations are really broad. You want to identify the ways the new behavior will allow the person to improve their environment with the people that surround them. How can they find kindred spirits, people that they feel comfortable being around? How can they improve their environment through places? Sometimes this means having vacations, moving to a better neighborhood, or even just going to a nice restaurant for a meal. It's not always about redecorating. It's not always about moving. Sometimes it's about just taking a break from life on life's terms and having sort of a little mini vacation. The environment also involves things. So you may have an upgraded car or redecorating. If you go to a rental car place and they give you a free upgrade, are you likely to go back to that rental car place again? Heck, yeah. Because they increased your environmental motivation. They increased your comfort level. So you're saying, yeah, I like this. Again, using decisional balance with environmental motivation. In what ways will the new behavior improve their environment, improve the people that they hang around that are supportive of whatever this goal is? How will it make the environment more stressful? So we want to look at maybe they're going to have to make new friends and that's stressful. So how can we deal with this? In what ways do the old behavior create a comfortable environment? What are you going to miss about the old behavior? We need to figure out how to deal with that. Maybe it was, yeah, I can't think of a reason. But if there is something about the old behavior that created an environment the person would miss, we need to help them figure out how to recreate that with the new behavior. And also, how did the old behavior create an uncomfortable environment for them? Because this is something we want to make sure they remember, that they didn't want to be homeless. They didn't want to be living in a flat house. They didn't want to have to crash on their so-and-so sofa because they got kicked out of their apartment. Motivation is essential to behavior change. It involves choosing the behavior that provides the greatest rewards for effort. And increasing motivation means enhancing rewards and reducing punishments and drawbacks. So if you have a client that is getting ready to do something, look at each dimension of motivation, emotional, mental, social, financial, spiritual, environmental. And figure out how many different ways you can increase the motivation or increase the rewards for the new behavior and decrease the drawbacks of the new behavior. A lot of times, since there are so many things to remember, I find it's very, very helpful to write it down. Make a chart that has each one of the types of motivation and identify and do a decisional balance exercise for each behavior. If you enjoy this podcast, please like and subscribe, either in your podcast player or on YouTube. You can attend and participate in our live webinars with Dr. Snipes by subscribing at allceuse.com slash counselor toolbox. This episode has been brought to you in part by allceuse.com, providing 24-7 multimedia continuing education and pre-certification training to counselors, therapists, and nurses since 2006. Use coupon code, counselor toolbox, to get a 20% discount off your order this month.