Motivational Interviewing & Ambivalence

Misinterpreting Ambivalence

“It is easy to misinterpret ambivalent conflict as pathological — to conclude that there is something wrong with the person’s motivation, judgment, knowledge base, or mental state. A sensible conclusion from this line of reasoning is that the person needs to be educated about and persuaded to take the proper course of action” (Miller & Rollnick, 1991 p. 14)

Ambivalence is a frustrating dilemma that involves feeling two ways about something.   For example, I have been feeling lonely for a while and looking to establish new friendships.  I’m finding the task somewhat daunting with so little free time.  As adults, we establish friendships based on convenience, with those we have an opportunity to interact with regularly. Individuals at my stage in life tend to have quite a bit on their plate.  Between work and home life, where does one find time to establish new friendships?  My ambivalence reflects a conflict between two opposing desires. On the one hand, I feel lonely and desire to establish friendships. On the other hand, I have insecurities stemming from earlier childhood experiences, and am fearful of opening up to others.

When others misinterpret my ambivalence.

There is a coworker I chat with often via text at work.  We are both employed by healthcare float pools and often work at the same facilities, (although rarely on the same floor).  She is a social butterfly who is always urging me to just be more friendly and strike up conversations every so often.  From her perspective I would surmise she is frustrated by my lack of “motivation, judgment, and knowledge base” (Miller & Rollnick, 1991).  In other words, she could easily interpret my ambivalence as an unwillingness to take the initiative and establish friendships.  Alternatively, she might interpret my as a matter of social anxiety or ineptness on my part.  (Mind you, this is just an example, of the sort of consructive criticism I’ve heard before.  Coworkers, friends, and even my sister express advice of this sort from time to time regarding my “shyness & reclusive nature”)

What others miss about my ambivalence…

So what is my perspective? As I stated earlier, I have two conflicting emotional reactions to the idea of establishing friendships.  On the one hand, I feel lonely and wish to cultivate a few meaningful female friends.  Every once in a while, I might have something on that I want to share with somebody…Or mabye I might just simply want to sort things out: (I’m a verbal processor :))  From time to time, I can unknowingly bombard my poor hubby with assorted idle chatter.  As somebody who likes “thinking out loud” to verbally process my thoughts and come to a conclusion, it’s a habit I’ve have had difficulty breaking.   My hubby always tries his best to listen.  However, every once in a while he’ll comment jokingly: “You need to get a few female friends to go out with so you can talk about this at greater length.”  When he says this, I’m aware that he’s done all the listening he can take, and I need to find somebody else to talk to…

At moments such as these, when I need somebody to talk to, I become sad.  As feelings of loneliness arise, so do feelings of fear and anxiety.  I am fearful of opening up to others, primarily because I don’t want to re-experience the rejection and ostracism I dealt with in high school.  I can then berate myself for a lack of experience due to years of self-imposed isolation.  The alternative thought arrises at some point:  Wouldn’t it be much easier to stay home and lounge on the sofa while binge-watching something on Netflix?

…And then there are the pragmatic aspects of developing friendship that produce more frustration… First off, Idespise technology and/or social media as required forms of interaction in today’s social world. However, these things are here to stay and I’ve learned tried to adapt. For example, I might exchange texts occasionally with a coworker or fellow intern.  Every once in a while I might also call to ask a question, discuss a concern, and/or brain-pick.   I stress occasionally about how my text might be interpreted. I also worry about how my own texts are interpreted.   If she doesn’t call, I worry what that might mean.  If I call I worry about being a bother.

So here’s a breakdown of my example of misinterpreted ambivalence.

  1. 1st HAND P.O.V – My social ambivalence reflects unresolved insecurity and hurt stemming from early childhood bullying and ostracism.  In large part, I am anxious and fearful, because I don’t want to get hurt again.
  2. 2nd HAND P.O.V. – Other’s might misinterpret my social ambialence as reflecting the fact that I’m a shy or introverted.  Alternatively, someone could interpret this ambivalence as reflective of social ineptness or simply a lack of motivation to put a little effort into the establishment of friendships.  
  3. THE MAIN POINT – Ambialence is a normal part of the process of change,  it reflects a psychological conflict that needs to be resolved for change to happen.

A Different Perspective on Ambivalence…

“Ambivalence is a common human experience and a stage in the normal process of change. Getting stuck in ambivalence is also common, and approach-avoidance conflicts can be particularly difficult to resolve on one’s own. Resolving ambivalence can be a key to change, and indeed once ambivalence has been resolved, little may be required for change occur. However attempts to force resolution in a particular direction..can lead to a paradoxical response, evening strengthening the very behavior they were trying to diminish” (Miller & Rollnick, 1991, p. 19).

In order to resolve ambivalence, it is vital to understand that stuckness is a normal part of the process of change.  In fact, at the heart of the matter, is resolving one’s own conflicting feelings on an issue. Miller & Rollnick, (1991), suggest conceptualizing one’s dilemma’s as a decisional balance.  “Transactional analysis often regards the experience of ‘ feeling stuck’ as the manifestation of an impasse or an intrapsychic conflict or interpersonal roadblock…Impasses occur each time we encounter a situation in which our current adaptations cannot make sense of or handle meaningfully…(Petriglieri, 2007, pp. 185-187).”  Addressing the issue, from this perspective can be seen as a matter of weight costs and benefits for each course of action.   So how might this explanation apply to my social ambivalence?  

  1. Unresolved insecurities stemming from childhood experiences pollute my thinking today.
  2. My interpretations of others’ opinions becomes a foundational element of how I see myself.  
  3. When I think with my feelings in a knee-jerk manner, my unresolved insecurites turn into self-fuffilling prophecies, by withdrawing and isolating myself.  
  4. Examining how my knee-jerk coping styles perpetuate my insecurity and loneliness can provide the clarity necessary to overcome this ambivalence.
  5. Tipping the decisional balance chart, involves carefully breaking down decisional alternatives in this manner. Which route is the preferable alternative???

In these posts, I share how I’ve worked through ambivalence & feelings of stuckness in my life:

“Getting Unstuck & Why I Started this Blog” 

“An Underdog’s Credo: Choking vs. Panic”

Types of Psychological Conflict…

Miller & Rollnick (1991) describe three types of ambivalent conflict. “In the approach–approach conflict, the person must choose between two similarly attractive alternatives An avoidance–avoidance conflict, in contrast, involves having to choose between two evils—two (or more) possibilities Still more vexing is the approach–avoidance type. This kind of conflict seems to have special potential for keeping people stuck and creating considerable stress. Still more vexing is the approach–avoidance type. This kind of conflict seems to have special potential for keeping people stuck and creating considerable stress” (p. 15).
  1. Here is an example avoidance-avoidance conflict, in which I keep a crappy job because it pays well to support my family.  My choices here: a shitty job or being broke.  

  2. Here is an example of approach-avoidance, described my Miller & Rollnick (1991) as a “fatal attraction..kind of love affair”

Ambivalent Paradoxical Responses…

“The theory of psychological reactance predicts an increase in the rate and attractiveness of a ‘problem’ behavior if a person perceives that his or her personal freedom is being infringed or challenged. Secondary effects of a change within the person’s social environment may also account for detrimental shifts” (Miller & Rollnick, 1991, p. 18)

Miller & Rollnick, (1991) note that  common response to the utilization of deterrents to curb negative behavior is an increase of that behavior.  I like to think of this as a passive-agressive rebelliousness.  As a married mother of two boys, I’m the only source of estrogen.  The males in my family tend to utilize this response to any repetitive requests for them to do/not do something, (i.e. nagging) 🙂 ….  For example, my son hates being late for school, if I keep nagging him to get up earlier he can rebel by dragging his feet in the morning.  The consequence is he gets to school even later and complains about it more.  My youngest complains about being tired at school, yet responds similarly when I tell him to get to bed earlier.  When I  discussed this with my husband, he noted this knee-jerk, response is probably a result of the boy’s picking up on his bad habits 🙂 … These behaviors could be interpreted as an innate desire to challenge the restrictions placed on personal freedom.

A Solution to Ambivalence

So how do you resolve ambivalence?  I’ve spent too many years on a hamster wheel in my own life. Overcoming my own stuckness has been at the heart of my efforts to create forward-motion.  As I mentioned earlier, Miller & Rollnick (1991) discuss a decisional balance chart as a useful tool to overcome ambivalent. When I reflect on my own decision making processes at different points in life, I see flaws in my thinking.  At the heart of the matter, underlying my stuckness, were unresolved hurts and traumas that caused flaws in my thinking.  Addressing these issues head on and allowing healing to occur has been critical for forward progress.

Understanding & Handling Resistance

“My Mental Merry Go Round”

In conclusion Miller & Rollnick, (1991) also suggest the following as a solution to ambivalence:

“Instead of focusing, then, on why a person doesn’t want to make a particular change, it is sensible to explore what the person does want. This is not to ignore the topic of change. Rather, it provides a context for change. Sometimes a behavioral course adjustment does not occur until people perceive that change is relevant to achieving or preserving something that is truly important or dear to them” (Miller& Rollnick, 1991, p. 18).

References

Miller, W. R. and Rollnick, S. (1991) Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford Press
Petriglieri, G. (2007). Stuck in a moment: A developmental perspective on impasses. Transactional Analysis Journal. 37(3), 185-194.

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