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Motivational Interviewing

Motivational Interviewing

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A Quantum Approach To the Concept of “Motivational Interviewing” in Mental Health and Treatment Settings

“Life will give you whatever experience is most helpful for the evolution of your consciousness.” – Eckhart Tolle

 

OVERVIEW

“Western health research and practice, particularly in the addiction treatment setting, has been guided by a cognitive, rational paradigm where inputs produce linear modalities, based on Newtonian, materialistic science.”(1) This includes the current trend of using “Motivational Interviewing” (2) in various clinical settings. Because of this, the current conceptual and statistical assumptions underlying this paradigm may be flawed. In particular, this perspective does not adequately account for nonlinear and quantum influences on human behavior. I propose that motivating healthy behavior change is better understood through the lens of quantum theory with its contextual understanding of unity, nonduality, and that Consciousness is the subspace of all reality. Relevant points I will discuss include:

  • That the essence of “Motivational Interviewing” (2) is more a state of being than a cognitive process. 
  • A broadened contextual framework of the “new” quantum paradigm enhances successful possibilities when engaging “Motivational Interviewing” (2). 
  •  One’s state of motivation occurs within a complex system that includes physical – as well as – vital (feeling level), mental, and supramental (unifying) components. 

 

History and Intention of Motivational Interviewing

Before one can investigate how the use of “Motivational Interviewing” (2)  might be of assistance in helping persons within the context of addiction and mental health treatment, it is important first to look at the history and intention of MI (Motivational Interviewing)(2). It is necessary to specify the theoretical model one is employing the use of MI within to establish a contextual framework. This will serve to eliminate arbitrary desired outcomes.  Having multi-dimensional awareness will keep the practice of MI person-centered and holistic in its scope of intention.

What prompted the writing of each subsequent edition of  the book,  Motivational Interviewing (2), has been because “research has provided important new knowledge on MI processes and outcomes, the psycholinguistics of change, and how practitioners use MI.”(Motivational Interviewing p. vii) The author, Miller, talks about how it evolved intuitively and organically while practicing Carl Roger’s concept of accurate empathy coupled with behavioral techniques. Through research, it was discovered that clients who were paired with therapists who had the highest level of empathic skill, had the highest level of success regarding changing their behavior and significantly reducing their drinking. So, it seems that the use of accurate empathy is the most significant component of the current model of MI over all other components. Regarding the more cognitive/technical aspects of MI, “We have found that it is possible for counselors to learn and demonstrate substantial levels of MI proficiency without having any significant effect on client change talk. (Miller et al., 2004, p.384) Let us try to discover why.

Throughout the book, the authors emphasize that it is the underlying spirit of MI   – the mind-set and heart-set  – that is of primary importance in the actual practice of MI. In the 1990s, an important decision was made to  not copyright MI as a brand name, sense, since its inception, it has been organic, emerging, and is meant to continue to evolve through collaborative, ongoing processes. In other words, MI is not a fixed, prescribed course of training. Reducing it to such a confined box would make it static, and remove the creative, mindful, continually evolving aspects. “The particular descriptions of MI must be allowed to evolve over time, much like a musical theme with variations, in order to stay with its desired intentions”. What a great insight that is – an observation that could apply to any system copyrighted and institutionalized. It is like, it freezes it in time, and thereby forces it to function solely in a legalistic, bureaucratic, and standardized environment. Such an environment does not allow for creativity, growth, or expansion. Rather, it tends to become stagnant and boxed in. 

We have now established that MI is not a trademark name but a clinical style. The authors state that “MI is foremost a clinical style and not one amenable to formulaic presentation.” (2)  The creators “advise against consensus use of a therapist manual to standardize practice because this would severely limit the practitioner’s ability to respond to clients flexibly.” (p.386) This is a valid concern. We saw this demonstrated in watching the video of motivational interviewing, where the interviewer was so focused on procedure and technique that she missed all the opportunities that the MI process was designed to uncover. (10)

 

Accurate Empathy – Cognitive Phenomenon or a State of Being?

The core of MI is based on Carl Roger’s style and person-centered approach of reflective dialogue. “Reflective listening is a wonderfully useful skill, called accurate empathy by Rogers (1965) and ‘active listening’ by his student Thomas Gordon” (Gordon, 1970; Gordon and Edwards 1997). However, accurate empathy and active listening are two completely different contexts thereby producing different dynamics. Carl Rogers was looking at accurate empathy as an internal process, of being in the flow with someone on an intuitive level.  His student, Gordon, is interpreting the meaning through a narrower focus, which reduces active listening to an external, strictly cognitive process. According to Rogers though, he describes his style as more of a “way of being” that promotes positive change. (Rogers, 1980, MI p. 381)

This indicates that accurate empathy is a state of being rather than a cognitive approach. Perhaps a better description would be to call it authentic empathy. I believe I am already practicing what could be called motivational interviewing with my clients as a registered, licensed Quantum Healing Hypnosis Practitioner(sm) (QHHT ®), (11).  Each session with a client typically starts with an hour or two of interviewing, in which I gather information about the entirety of a person’s multi-dimensional life. When I first started, I stuck to a formula – asking open ended questions, and then basing my next response or question on what they said. I was operating on a strictly cognitive level.

At some point, I started being in what I call, the flow, with the person I was talking to. It is more of a feeling, a synchronicity. I am no longer thinking, I am simply in the moment, creating and responding within this flow. It is like – you enter into a unified field of consciousness. Often, I can visualize exactly what my client is talking about – sometimes even before they verbalize it. This especially happens while they are in a deeply relaxed state, and we are riding various waves/levels of consciousness. Jiddu Krishnamurti, an Indian philosopher, suggests that “when attention is maintained in moment-to-moment occurring reality, without the interference of thinking (thought), understandings arise on their own accord from awareness.” (Krishnamurti, 1993) (5). This state of being is congruent with MI. “MI involves a collaborative partnership with clients, a respectful evoking of their own motivation and wisdom, and a radical acceptance of a person’s autonomy and right to choose for themselves.”(MI p. viii) This mindful state of being I believe is what Buddha, through his experiences of mindfulness and non-duality, discovered – that the conditioned mind obscures us from the truth that unfolds in the moment-to-moment reality. Below is a graph depicting linear, analytical thinking, or state, with non-linear quantum. 

Continuum of motivational processes: (1)

 

Added Discoveries of Consciousness-Based Quantum Paradigm Shift

The authors of  MI themselves are confident that most of what there is to know about MI and change is yet to be discovered. They believe that “the therapeutic process they have been observing and practicing are not unique to MI, and in a sense are more broadly about human nature.”(MI p. 386)  The new paradigm shift of quantum physics provides new levels of understanding. This is no longer an entirely new concept in the modern substance abuse field. The new ASAM model is based on this approach. The work of Dr. David R Hawkins, world-renowned author, psychiatrist, spiritual teacher, and researcher was one of the first who changed the face of addiction by putting it into the larger context of the science of consciousness. He states, “What the addict is seeking is not to be ashamed of. Change your technique, not your aspiration. The state does not have to be sought; it is always within us.”The basis of the quantum paradigm shift recognizes that consciousness is the “stuff” of reality – not matter. Perhaps the fourth edition of Motivational Interviewing will update its scientific basis with the inclusion of the quantum paradigm shift. 

Graph depicting evaluation module for clients/patients in Integrative Medicine (2)

 

CONCLUSION

Mindset is of primary importance. MI should not focus on fatalistic parameters but on strengths and life-enhancing  parameters. When a practitioner interviews with the patient/client, he/she should try to tap into and look at  all layers of information so that the possibility of helping restore them to their full potential is fully utilized.“The patient-centric, nonjudgmental, and non-confrontational nature of MI is a flexible and empathetic approach.”(7)“ Moreover, changes made through quantum processes appear more enduring than those that involve more rational, planned processes.” (1) When we become quantumly entangled with our client/patient, we enter into a unified state of consciousness where we have the potential to raise the vibrational state back to the original morphogenic blueprint of well-being. 

Motivational Interviewing/Positive Psychology can help bring individuals to greater introspection and self-awareness, as long as it is not used to coerce or manipulate and is practiced within the context of quantum entanglement. Engaging Quantum entanglement increases doors of possibilities. Western research methods with a dualistic worldview cannot fully comprehend the nature of quantum mindfulness/awareness. Amit Goswami, leading quantum theorist and champion of the philosophy of Monistic Idealism postulates that, “The non-dualistic worldview also proposes that ontological truth, in which the person and the phenomenon under investigation are the parts of the same reality, emerges from the experience of an ontological oneness.” (4) When utilizing MI, I propose a more integrated, inclusive hermeneutic to achieve greater congruence and uplifting, holistic outcomes – especially within treatment settings for marginalized populations.Dr. David R Hawkins sums it up: “Motivation proceeds from meaning, and meaning, in turn, is an expression of context. It remains for motivation to activate potential – without the exercise of (awareness) choice, no progression will occur.” (8) Not solely during the initial interview, but also for all subsequent communications and therapies mutually engaged between practitioner and client(s).

 

Sources Cited:

(1) Resnicow K, Page SE. Embracing chaos and complexity: a quantum change for public health.  Am J Public Health. 2008;98(8):1382‐1389. doi:10.2105/AJPH.2007.129460

(2) Miller, William R., and Stephen Rollnick.  Motivational Interviewing: Helping People Change. The Guilford Press, 2013.

(3) Drouin, Paul.  Creative Integrative Medicine: a Medical Doctor’s Journey toward a New Vision       for Health Care. Baboa, 2014.

(4) Goswami, A. (2011).  The Quantum Doctor: A quantum physicist explains the healing power of integral medicine. Hampton Roads Publishing. 

(5) Singh Sikh, B., & Spence, D. (2016). Methodology, meditation, and mindfulness: Toward a mindfulness hermeneutic. International Journal of Qualitative Methods, 15(1).

(6) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3330017/

(7) Johnson B.E., Mimiaga M.J. (2017) Motivational Interviewing for LGBT Patients. 

(8) Hawkins, David R.  Power vs. Force: the Hidden Determinants of Human Behavior. Hay House, Inc., 2014.

(9)  https://www.youtube.com/watch?v=OivULUs–l0&t=8s

(10) https://www.qhhtofficial.com

 

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