How to Help Someone Who Doesn’t Want Help

How to Help Someone Who Doesn’t Want Help
by on January 30, 2020 in

Trying to motivate someone to change a behavior they have no interest in abandoning may seem like a futile effort, especially when it comes to addiction. Push someone struggling with addiction too hard to get help or acknowledge they have a problem and your efforts can backfire, driving them to cling harder to the behavior or substance that’s causing them problems or making them more likely to cut you out of their lives. Accommodate their behavior one too many times and you may feel you’re enabling them—and watching them get worse and worse.

Why Forcefulness Backfires

Few of us like being told what to do. Hearing what we “should” or “ought” to do can feel invalidating and condescending, and may elicit a range of negative emotions, including shame, guilt, and anger. Many people on the receiving end of unsolicited advice may pull away from or push away those giving their two cents so as not to feel worse about themselves—and to preserve their own agency, autonomy, and independence.

What’s more, continuously being told what to do—or how to do it—can be an added source of stress for someone who is already struggling to manage as is. To cope, the person may engage in even more of the undesired behavior, thereby perpetuating the problem.

Research tells us that abandoning our impulse to compel, coerce, shame, or guilt someone into changing a problematic behavior is a much better bet. But this doesn’t mean abandoning someone or just standing by as their addiction overtakes them. Your odds of successfully motivating someone to seek the help they need increases when you stop forcing your own agenda upon them—and try to gain a better understanding of theirs.

We can never change another person’s behavior for them. However, there are some ways to tap into (and help embolden) a person’s motivation to change that are slightly more successful than others. Below, a look at several strategies that decades of research—much of it spearheaded by William R. Miller and Stephen Rollnick, co-founders of Motivational Interviewing—work best and how to implement them with people you love.

Consider Their Perspective

Getting a better sense of the purposes a substance or behavior serve for another person helps you see things from their point of view, which can feel validating and affirming to them while also improving your ability to tune into what might incentivize them to change.

This means asking and listening, without expressing your judgment, to the person whose behavior you dislike—paying special attention to their reasons for engaging in that behavior. What does a particular activity or substance do for a person? Perhaps it alleviates emotional or physical pain, offers distraction from responsibilities and obligations, or simply offsets boredom. Maybe it provides a sense of purpose or order to someone’s life. A specific behavior or substance could also be someone’s sole means of socializing with others. Or simply a method to avoid the physiological and psychological effects of detox or withdrawal. The reasons can be numerous.

Reassure

People in the throes of addiction often feel isolated and alone, and ashamed of their behavior. Communicating to them that you aren’t there to judge them but are simply there to understand and support them helps convey to them that you’re on their side—and won’t further shame them or ostracize them for needing help. Once you take the time to learn what their addiction does for them it can also be helpful to reflect back to them that you see why they may engage in a particular behavior or consume a specific substance to excess. This can feel validating to another person and may help them see you as trustworthy—or safe enough to open up to more fully and seek guidance from.

Ask Them What They Think are the Downsides of Their Behavior

Many people who abuse substances or go overboard on a particular activity are able to identify some drawbacks to their behavior. Common ones include it interferes with my close relationships; it’s cost me a job; it’s really expensive… You can explore these downsides with a struggling person—but gently and, ideally, after you convey to them that you understand why they use or overdo a certain behavior (and that you still love or care for them regardless).

You may wish to say something along the lines of “I can see why you smoke/drink/exercise until you feel faint. This seems to give you a sense of relief/empowerment/freedom. I’m curious too if you’ve ever found this behavior to hamper you in any way? Or get in the way of other pursuits or things you care about?”

The most important factor here, as Miller and Rollnick’s work has shown, is allowing the individual to articulate negative consequences of their behavior themselves. In so doing they are retaining agency and thus are far less likely to feel that someone else is telling them what to do or why they should change. In fact, simply asking someone in a neutral and nonjudgmental tone what if any downsides they see about their behavior you’re not even broaching the topic of behavioral change. You’re simply drawing to the forefront of their mind what they already know to be consequences of their behavior, and thereby prompting them to reflect on how such consequences might be impeding them from living a more gratifying life. This in and of itself can be a natural motivation for someone to change—albeit on their own time frame and terms.

Explore their likelihood of change

People who don’t seek help aren’t always wholly opposed to the prospect of behavioral change. In many cases they simply may not be ready. In helping to motivate someone to change it’s important to assess their degree of motivation, as Miller and Rollnick’s work has also shown—say on a scale from 0 (not at all motivated) to 10 (100% ready). From here you can explore with a person what might need to happen in order to  increase their motivation to change—or move from a lower to a higher degree of motivation. Some people, for instance, may feel they have to lose more or face more dire consequences in order to feel adequately galvanized to seek help. Others may feel they need more support from people or more reassurance that seeking help will actually improve rather than worsen their lives—think: reassurance that taking time off to go to rehab or adding biweekly therapy or support groups to their schedule won’t hamper their productivity at work or their social life, that admitting they have a problem isn’t a shameful disclosure, or that other coping skills and social outlets can be equally if not more satisfying than a substance or behavior has become for them.

Invite them to imagine what they might be able to do if they didn’t abuse a substance or engage in a particular behavior to excess

Part of helping to elicit someone else’s motivation to change, according to Miller and Rollnick, involves encouraging them to imagine a world in which their addiction didn’t impede them from their pursuit of goals, dreams, hopes, authentic connection with others, higher purposes, or other aspirations. By picturing a hypothetically less encumbered life, a person may feel more inclined to change the behavior that’s holding them back from this enhanced existence.

It can also help to explore with a person struggling with addiction what their life was like before their addiction took hold (or, if they aren’t willing to endorse being addicted, before they began using a specific substance or engaging in a particular behavior excessively). Some people may not remember a time in their adult lives when they weren’t addicted to something. Others may recall that time unfondly and see the use and abuse of a drug or behavior as a refuge from past trauma. In these cases it is helpful to return to offering the person hope and encouragement that with treatment, on their own time and at their own discretion, more lasting refuges and psychological stability can be found—as well as to ask them whether the substances really help deal with the trauma or just make it worse.

Be aware of trauma’s influence

It can help caregivers or loved ones to keep in mind that trauma, especially adverse experiences in childhood and young adulthood, has a huge influence over whether someone becomes addicted to a substance or behavior. Trauma is also a factor in determining how severe an addiction becomes. Substances or addictive behaviors can provide people with an escape from traumatic memories and a means of coping with a dysregulated stress response system that results from trauma. (Unfortunately substance abuse further dysregulates our stress response systems.) Regardless, the prospect of removing the substance or behavior that someone uses to cope can feel akin to the prospect of ripping off someone’s skin or robbing them of their home or livelihood. When you become frustrated with a person’s resistance to change—or refusal to seek help—remember this. In so doing you’re more likely to convey the understanding and empathy a loved one struggling with addiction may need to feel safe enough to consider, or take steps towards, changing their behavior.

The takeaway

You can’t force someone to change their behavior. But by steering away from shaming, blaming, or moralizing and, instead, trying the above active listening and motivational interviewing skills you can help someone tap into their own motivation to change, help them better articulate what they may need in order to seek help to begin with, and support them in their efforts to learn how to change and to prepare for change.