Ep. 197- How to Talk to Someone About Getting Help When They Don’t Think They Need It
This episode breaks down practical strategies for getting more out of therapy and the common mistakes that can quietly get in the way of real progress.
Have you ever left a therapy session feeling better for an hour, only to find yourself stuck in the exact same patterns a week later? Or wondered why someone can spend years in therapy without seeming to change?
In this episode, Dr. Kibby explores the habits that often prevent therapy from being effective. She talks about emotional avoidance, people pleasing, staying in "problem talk" instead of focusing on change, and why honesty with your therapist matters more than trying to be the "perfect" client. She also explains how to choose the right therapist, what questions to ask before starting treatment, and why the work that happens between sessions is just as important as what happens during them.
Whether you're in therapy yourself or supporting someone who is, this episode offers practical ways to make treatment more meaningful and increase the chances that it leads to lasting change.
Resources:
- Chapman, A. L., & Rosenthal, M. Z. (2016). Managing therapy-interfering behavior: Strategies from dialectical behavior therapy. American Psychological Association.
-
Welcome back, little helpers. Today I'm gonna talk about how to talk to someone about getting help, especially when they don't feel like they need help. So this is really for anyone who has been in a position where someone they love, like a friend, family member, partner, is struggling with emotions or their mental health in general. And you've thought, my gosh, something's wrong. I don't know what's
I don't know what to do. They don't act like themselves. They seem unhappy. And I don't know, this is getting this feels bigger than me. And you might have thought, God, you know, this person really needs therapy, or we need a therapist. We need to get them help. Why can't they see that something's wrong? Right? Everyone else sees it but you. Right? That is a situation that is so tough because.
You're like, okay, I love this person. I care about them. Or maybe not. Maybe you're, you know, at odds with them. But you have to try to tell them, hey, I care about you. I want you to get better. I want you to get help. and here are some options, or here, you know, let's get you into therapy. Let's get you into treatment. Let's get you the hospital. But often the tricky part with mental health is that sometimes when people are the most
ill, they don't have enough self-awareness. So they don't even recognize that they are sick or struggling. Right. So how do you get someone in to help when they don't think that they need it? And that's what I'm going to be talking about today. So if you before I dive in, if you have a loved one like a partner
An ult adult child or anyone else that you care about who's really struggling, who really is struggling with their emotions or mental health. Maybe they're lashing out, maybe they're saying things that are out of character. you could always look up KulaMind, K-U-L-A-M-I-N-D. It's the program that I made for you to really learn the skills for how to support someone else who is struggling without losing yourself.
Right. So I teach a lot of these skills that I'm gonna go into today. how to communicate, how to set boundaries in a kind, compassionate way, how to connect to them again, how to take care of yourself. So I talk about all these skills and walk you through doing them. So I give real hands-on help in KulaMind . So just check it out. the link is in the show notes, or you could just look up KulaMind K-U-L-A-M-I-N-D. So that's out of the way.
In KulaMind , especially, people who are reaching out asking to learn more about KulaMind they're I'm hearing a similar thing. Help my kid, my partner is like enraged, exploding enraged, or they're depressed, they're anxious. And I really think they need help, but they're like, I'm not the problem here. Right. I you know, it's it's really like you are the problem, or the world is the problem, or you know.
There's something else. So they don't see that they actually can benefit from therapy. It's so frustrating. I've I've definitely been there personally and professionally. especially when you it there's like substances in the mix, right? Like when my mom was drinking a lot, she was really angry about stuff. She was really angry about, you know, her divorce or her situation in life. And it was like that was the only problem. But
She didn't see how much drinking caused a lot of the issues, right? That it caused a lot of the fights, a lot of her depression, a lot of the, you know, eventually the physical problems too. Now that makes total sense because for her and for many other people, they see something as a problem, but drinking, for example, is a solution, right? It's a thing that makes them feel better, makes them feel like they could actually.
cope with the situation, changes the way they feel, right? So it's like they're they're not seeing the situation the same way. They're like, no, I have this pain and this is my solution. They might be aware it's not the best solution, but they're like, this is what works for me. And how could you say that my solution is the problem? How can you tell me to stop drinking? Right. Similar for, you know, even anxiety, right? They're like, this
The what-ifs are the problem, the thing that might I'm scared of happening, my worries are the problem. So avoiding something that's terrifying me. you know, not meeting anyone new, not talking to someone new, that is that's that's my solution to my problem, which is I'm afraid afraid of rejection, for example. So you're like,
Yeah, but the thing that is your coping mechanism, your solution, is causing more problems, right? So drinking is making you angrier and causing more issues with your relationships. Your avoidance is actually like cutting you off from things that you really care about. So it's a really tough situation. So what I'm gonna do today is I'm gonna talk about why people resist treatment. I kind of mentioned a little bit right now that, you know, like they feel like
You you they might have a different perspective of what the problem is, right? And that means that a different perspective of what their solution is. But we'll talk about why some people resist treatment. and then I will go into some of the common principles or strategies that you see in all different kinds of approaches to talking to someone about treatment and change.
So I'm gonna draw from community reinforcement and family training, which is what I was trained in craft for loved ones of people in substance use recovery or substance use disorder, really. I'm also gonna borrow from motivational interviewing, which is also developed in the addiction and substance use world, but talking to someone about like, okay, you like let's talk about treatment.
and also I just recently learned about the leap method. so that is a method that was developed by someone who's saying, okay, like this is how you could talk to someone about getting treatment if they don't see that they have an illness. So I'm gonna just kind of like synthesize the common factors among all of them and kind of like teach, you know, what do you do?
So why do people resist treatment? It might seem crazy to you because you're saying, hey, I'm telling you you should get a therapist, someone who will like be dedicated to helping you. Like if you're sick, go to a doctor. What is the problem here? It doesn't make any sense why someone will refuse it, but if you think about it this way, I I'm hearing unfortunately.
A lot like thankfully a lot of us are much more comfortable with mental health and therapy than ever before. So we're, you know, this this is less of a problem than it was in other generations or other cultures and and or other recent years. So a lot of people are like, okay, great, I recognize that I need help. The problem is that sometimes it's weaponized. Sometimes loved ones can be so fed up.
And so hurt or furious or scared by someone's mental health behaviors, right? If someone's like depression looks like lashing out, screaming, rage texting, the other person could feel so like assaulted by this pattern that when they say, you need therapy, you need help, it could come across as I don't like you.
You need to change. You are the problem. Right. So that's what a lot of people are hearing when someone says, you need help, right? You need to go to therapy. It's you are the problem and you need to change. so there's a lot of shame there. There's a lot of sometimes, I mean, even as a as a psychologist and someone who knows r about this really well, I remember times when I was really struggling with my infertility process with my ex-husband, and it was just
Awful. It was every month was like a hope and grief depression cycle. and it was really getting to me over over like several months. I was getting more and more ground down by that up and down, right? The hope that maybe this will be it'll be this month. And then like seeing the pregnancy test that's negative, I'm like, it would just crush me. And at the time, I was getting more and more depressed, right? I was anyone who tried to help, I was like, ugh.
That doesn't help. It doesn't feel good. I feel annoyed by people's suggestions, and I feel even more hopeless and I was more angry. so I was really getting depressed. And my husband at the time gently, like actually did a pretty good job by saying, you know, I'm wondering if you're getting depressed. And immediately I there was a moment where I was like, he's right. But then I also had this resistance.
I had this feeling of you are saying that me being mentally ill, having a mental illness, to me, that felt like you're invalidating my feelings and perspective. That this is not an issue. It's really the way you're seeing it, or you're sick in the head, or like there's something wrong with you, right? When someone says you're depressed, like gives you a diagnosis or tells you to go to therapy, it's often taken as
there's something wrong with me. Right. And everything that I'm worried about, everything that I feel is a problem, the things that I'm shouting out, like, hey, pay attention to this. This is really a problem and I need a solution. that's nothing. That doesn't mean anything. It's really just I'm depressed and I'm not seeing things right. Right. So even in that moment, there's this defensiveness around it. So there's this like shame defensiveness around.
being told by someone that you should get therapy. so there's the whole piece of like what does it mean and what does it communicate? But there's also sometimes a fear of therapy, right? There's a fear of of getting help, let's say, fear of getting help in general. Some people have bad therapists, have bad have had a bad experience. Some people have gone to couples therapy and felt like, I don't know, they didn't feel heard. They felt like their spouse and the therapist
ganging up on them. They may have had you know, bad experiences with therapy where they don't trust therapists before, or they might not even, if they haven't had therapy before, they might not even think that that that's what helps, right? They're like, why should I talk to someone? Why should I talk to a stranger about my problems? Like that's not going to do anything, right? It's really, I need to get pregnant or whatever. So they might not trust that therapy was is actually going to help. They might not have hope.
this is not even to mention that, you know, other levels of help, right? That I'm just talking about right now, just like help, like a psychotherapist, but I also mean psychiatry or going to the ER, right? Going into inpatient, something that really stabilizes someone. So if someone is like really, really severe in an episode, like they're manic or they're gonna hurt themselves or they are in a really bad place, they might be afraid of being taken to
The ER because sometimes hospitals are scary, right? Like I I feel so sad that that is like our only option. I mean, now, now having some experience working in the ER, I kind of get, you know, the the whole workings of it. So it's less scary to me. But it could be terrifying. You're at the your worst state and you're sometimes picked up by the police, which you know could have lots of systemic racial, social.
Implications, right? You're treated like a criminal when you're feeling just like really sad or really out of control. And then you're taken to this room where you're kind of locked up and taken and your stuff is all taken away. It could be pretty traumatic to get help, right? I mean, all of that is in service of keeping someone safe, right? Like they take away all your stuff in your pockets and your phone and stuff like that because they don't want you to hurt yourself in the in the hospital. But that could feel terrible. So it doesn't feel like help, right? So it makes sense that a lot of people.
don't trust getting help. Even inpatient hospitals, if they've if people have had experience in that, it's not pleasant, right? You're around people you don't know. You feel controlled. You feel like you don't have a say over your schedule. You know, it's just sometimes the hospitals themselves are just like scary. So if anyone has that experience or even misconception that all
Hospitals are terrifying and not doctors are just there to like drug you up and leave you there, then you're not gonna trust getting help. Right. So there's not only the shame or the feeling of like something's wrong with me, but there's also like, what does help look like? And it will it actually be helpful or is it just gonna make things worse?
And if you are dealing with someone who has really severe mental illness, like they they might be in a psychotic episode or they're manic or they're delusional. Like sometimes even BPD and emotion dysregulation, when emotions get really intense, it could get to levels of like delusion, right? They're their reality is different. with psychosis and mania, like truly, like they they see reality very differently and they don't have a grasp on reality.
and in that case, they really don't think that they don't have enough insight. Like there's actually, gosh, I wish I I could rattle off the the brain mechanisms that actually involved in in insight and awareness. But when someone is in like an active episode, those parts of the brain that's able to reflect on yourself are like turned down, right? Turned off. So they're not able to go, huh, this is really out of character.
What I saying? Is this really true? Am I, you know, so they they're they're just fully in those thoughts and they don't think that they're the problem. They well, they they're not the problem, but they don't think that there's anything amiss. They're just like fixated on the problem itself that they're worried about, like this conspiracy theory, everyone's out to get me. my God. and they just really don't see how, like they don't see the impact on their behavior and they don't are able to like look at themselves.
in their own mind.
So there's a lot of reasons why someone might be resistant to getting help, right? Even if you know it's gonna help. And you know that it's like just get over the hump of like the resistance, and then you know, you're gonna find relief, you're gonna find, you know, like a support. You know, it's it's it's so frustrating to be the loved one who could see the bigger picture. but there are real reasons why someone might say no.
So just being just being aware of that and not jumping to you need help, right? To just knowing that there are factors that might make it seem scary or make it make them defensive against the idea of getting help. And for all of those reasons, like this is the biggest mistake I see, is they all those reasons why someone resists therapy is like ignored or no someone doesn't understand or see that.
And then they just like go in to keep pointing out the problem, right? They try to convince and push and demand that that person goes into treatment. and that usually backfires. So come trying to convince someone to get treatment usually backfires because people hear you need help as you are the problem and
I'm gonna give you a solution that you don't want, right? It's like you need to change. That's what they're hearing. And when people feel criticized or controlled or judged, they're gonna, they're gonna get polarized, right? They're gonna resist, they're going to defend themselves. No, I'm not, you know, like the even even when I, you know, in that that time of IVF, I knew that my reactions were getting like too intense, but I was just like, but for
Infertility is like devastating. This is really hard. Like for some people, it might not be a big deal to try for five months and you know, not see, not get pregnant. But for me, it was like, you know, is there a bigger problem? Am I infertile? Will I ever have kids? is something wrong? Am I doing something wrong? Why can't you know? So all of that felt like the real problem, right? but even
feeling like someone will just like discredit that and ignore it, maybe polarized. Actually, like the secret is I actually did go get therapy at that point because I like I was aware that I was getting I was having a really hard time. So that might not be the best example, but because I was more open. But if s if you try to push someone to get therapy and especially like threatening or especially like
Trying to throw a diagnosis at them. You have BPD and you need help, right? You are depressed and you're ruining my life. So you have to stop. You're being such a jerk and you, you know, you need to change or else otherwise I'm leaving, right? Like any of those like pushing someone into it automatically makes them defensive. And then they're gonna be polarized so it becomes a fight. And you don't want that. You don't want it to be a fight.
I in the motivational interviewing literature, something that I found really helpful to know is it is really normal for someone to need to change and want to change or even be motivated to change, but then they also have another part of them that doesn't want to change. Right. That that was so eye-opening to me.
You know, might seem obvious to you, but even when someone wants to change, even if you're like, Yes, I'm gonna lose ten pounds, I'm gonna, you know, I'm gonna get this job, I'm gonna like, even if you want to change, there's gonna be another part of you that feels conflicted, that is resists that change, that wants to stay the same. Right? It makes sense that it that might sound crazy, but for some people, changing and stepping out of their comfort zone means a sacrifice, means
well, if I'm gonna quit drinking, it's gonna be hard. It's gonna feel bad. And I'm not gonna have my coping mechanisms, right? Is that worth the change? For some people, there's a part of them that says no, right? Like they know that drinking is wrecking their life, it's causing a lot of problems, it's making them sick. But the alternative is quitting that and then having to face that discomfort and that pain and you know.
So there's a part that resists change, right? We all like to stay the same. We all like homeostasis. People don't want to change all the time. It's it's hard. So that just to just to remember that, that someone who's struggling, they're even if they are whole on board wanting to change, they might have a part of them that goes, No, no, no, no, don't change. I see this even when
I start to work with people in therapy. I mean, this is why a lot of us therapists, especially when you're dealing with a substance use, addiction, that we talk about like, why do you want to change? Right. Why do you want to get better? Why do you want to do this therapy? it's gonna be hard that you're gonna if for people who are dealing with, you know, painful emotions and want to work through them and cope with them, like you're gonna feel painful emotions a lot, right? That's that sucks.
why? What makes it worth it? What makes it worth that discomfort and that sacrifice? and getting that other side to speak and just assuming that other side that's pushing back against a change is there, right? Because I've I've dealt with so many patients who have come in who are like, I'm
hurting myself, I'm hurting the people around me. I'm screaming. I lost my job. Like my life is terrible. I want to change. I'm ready. my God, you seem like a great therapist. Let me, you know, like I will do whatever you say. I will do all the homework. And then like a couple weeks later, suddenly they're not doing the things or not showing up. And they start to what's interesting is that they start to when someone has a conflict inside and they don't want to own both sides, like they want they don't feel comfortable in that conflict, they might project one side onto you. So
When they start when their resistance side pops up and says, No, no, no, no, do the things that you've always done. That's what that's what worked, and it's too hard to change. Then they might come in and be like, you know, Dr. Kibby, whatever. You like, you just want me to change, you want me to be different. I don't want to do this, right? They suddenly like I'm the holder and the responsible one for the side of them that wants to change. And
I'm like forcing them into it sometimes. They're like, you know, I don't want to do this. And it's it it's it's interesting, and that's a kind of a normal part of the process. But it's it's weird because you're like, wait a minute, you just you came to me. Like I'm I'm this is helpful for you. I don't understand what's going on. but just know that there are two warring sides inside someone: one that like wants a change and one that doesn't. So
The more we get polarized, like if I were to in those situations be like, no, you should change, you should come to therapy, you're doing, you're doing great, like, you know, come on, do your homework, then that makes the other side have to get polarized against me. No, I don't want to do this, right, right, right. So the more you push for someone to get treatment, the more their other sides, the resistance sides, you know, push back. So
That's why trying to convince someone to get treatment usually backfires because you're just like you're just externalizing the fight inside them. You're like you're you're at odds.
There is a concept called psychological reactance. Meaning when some people feel like you're trying to take away their autonomy or freedom, they become more motivated to protect it. Right. So really think about that that if you're trying to convince or force or push someone into anything, they might feel like they're losing control. So they're going to fight back and be like, no
I get to choose. Even if their choice was gonna go to the treatment, they like people naturally want to be like, no, I'm protecting my my freedom of choice. So the convincing usually backfires because you're pushing on one side, representing one side of the argument, and then threatening their autonomy, threatening their independence and their freedom of choice. So if we act like we're gonna take away their choice, they get to be freaked out. But
I want to also I w I also want to point out how hard this is because I've been in that situation with my mom and I've been in situations with my patients and stuff. I can imagine having a child. You know, my son, you know, he I'm I'm hearing this from a lot of parents and I totally get it. Where the idea of your kid hurting themselves, self-harm or doing something to ruin their life, like you're you feel like your whole
Existence is to protect them and save them. And even your partner, like you care about them, and you're like, I want to keep this person alive or healthy. I you know, I don't want to hurt themselves. so that urgency would make you so desperate to you're like I call it survival mode for the other person. It's not survival for you, it's survival for someone else. You're trying to protect someone like I wanna call it something. I don't know, other survival mode. So I don't know.
I can't think of a good, but if you guys have a good name for it, like please let me know. But like wanting someone else to survive. And that could be so put you in survival mode, right? That that you don't think clearly, that you're terrified, that you are more reactive. And so of course it makes sense that if you see your kid or someone you care about hurting themselves, you're like, you need to get help. Stop doing this, right? Because like you are all fired up and scared.
So I see that all the time with parents. Like, you need to do this, you need to get help, you need that, right? They they start to to really push. Like, why get you know, why why can't you just convince my kid to get get help? I need to force them into treatment. I will say, all these things that we're talking about here, they apply when someone, it's tough, but it's it they apply when
You're dealing with like escalating circumstances. When someone is at risk of harm to themselves or others, like they threaten to hurt them, like kill themselves, like get violent towards you or stuff like that, that's when unfortunately autonomy is taken away because safety becomes a priority there, right? It's like, yes, I want to preserve your dignity. I want you to have freedom of choice. I want you to not feel judged. But if someone's like,
going to literally hurt you or themselves, it makes sense to be like that becomes a priority, even if that means they're you call 988. the in in the US, call 988 for the mental health crisis line, you take them to the emergency room, or you call 911, you call the police and and say this is a mental health emergency. In that case, when someone's life is at risk, safety is at risk, autonomy becomes a second priority. So that's just
to keep that in mind. Like, I know there's a dance of like noting want not wanting to upset them, not wanting to like get them polarized and something like that. But when it comes to like
They're at risk of hurting of harm safety, number one priority.
So I'll talk a little bit about the leap method. And it's funny that I'm going to talk about it because I know the least about this, but I I think it's a really nice, clear framework. it's it's proposed by Dr. Xavier Adore, and he talks about this, these are the kind of strategies you get us someone who needs to get help, but really, you know, refuses to believe that they they actually need help. Like they don't have any awareness of their illness.
So this is present in leap, but this is present like all these things I'm gonna talk about are in a lot of different therapies and approaches. The first one, the first step is L, which is listen.
The goal here is to understand their perspective and feelings before trying to change them. Right. I know this is really hard when you're desperate and scared and you know there's someone's lashing out and screaming at you. But this is what I this in KulaMind, one of my KulaMind clients, this is like the number one thing I always try to, you know, lean people towards is start with trying to understand more. And if you could think
should have a mindset shift. Think about this. Instead of thinking I need to tell them to get get them help so they can change, think let me understand their perspective. Let me understand what they're feeling. Let me understand what their pain is, what they're struggling with, what they see is the problem. And also understand why it might be scary to go get help. Right. So
This is really just mindset shift of listen, but you can ask clarifying questions. And I always, I always go into clarifying questions when, you know, people say, you know, I don't know what to say. I don't get it. Like they're so upset and it doesn't make any sense to me. They got this text message from someone and they say that everyone's out to get them. Like it just seems crazy to me. So if you kind of have the I don't get it.
Shift into the L, the listen, and ask for more. I like to pretend that I have a big puzzle piece in my head that I'm a big puzzle in my head. I'm trying to put the pieces in, right? It's like I don't understand why someone got this text and now they're like trying to hurt themselves. I want to fill in those pieces. So I just ask clarifying questions. Tell me more about that. Help me understand. Wait, okay. you got this text messages and then you
Drank a bottle of wine. Can you f can you tell me what happened? Can you tell me what that was like for you? clarifying questions could be like, what happened next or what happened before? Like timeline questions, like, and then what happened? And then what did you feel? Wait, what's going on right now? What's the hardest part? Right. So it's really just hey, I'm just trying to analyze I'm just trying to see the problem.
I'm trying to do a really good problem analysis before I jump in with solutions. Right. Also asking, like, you know, if you've talked about treatment before, you could be like, you know, we talked about therapy, but what do you think about that? What what does that bring up for you? I like that. I like that's a really like therapisty. That's my one of my favorite ther questions as a therapist. What was coming up for you right now? What does this bring up for you? Because it it's true that it it really depersonalizes.
You know, like not like, why are you so upset about this? Right, which feels very confrontational, but like what's coming up for you? Kind of highlighting with my words, this is something that comes and goes, right? Thoughts and feelings come and go. Let's kind of together look at what's coming up for you in this moment. So listen, number one. Two is E empathize. this is.
The skill that I love to teach, which is validation, right? And this is treating, this is like basically saying, I've listened and now I understand. I've heard you. I've heard you. I understand your perspective now. It doesn't mean agreeing. I wanna jump in with that. Every time I talk about a validation, especially online, people go, Well, you know, how could I?
How can I, you know, they're being abusive or they're being crazy. Like, how can I, they're they are saying everyone's out to get them and their boss is spying on them. And I I can't agree with that. I can't empathize with that. It's like you don't have to agree with everything they're saying, doing, or thinking, but you can reflect back that you are making an effort to understand their inner world, understand what they're feeling.
And message received. You see that they're feeling something and is legitimate, right? It's real.
If someone's like, I have this conspiracy theory and I think everyone's out to get me and I'm furious and I want everyone to go away, I in my mind I might think, well, that's probably wrong. Like I don't think that everyone's out to get you. But I can validate by saying, Okay, like, yeah, if you think everyone's out to get you, I get why you're terrified right now. I get why you want to def defend yourself. Right. So if you're like really stuck.
with this empathy piece and validating, you could just reflect back the the things that they're saying. Reflect back the words. Yeah, I get you're furious right now. I understand that. I hear you. I hear how hurtful those texts were. Yeah, I get that. Right. And so just empathizing the sense of like reflecting back. Hey, I hear and I I am acknowledging your legitimate emotional reactions.
So this part of Leap is kind of new. I I really like it, but I like thinking about this. So the A in Leap stands for agree. This is finding the common ground.
This might be really hard when someone's reality seems totally different to yours. They're like, You said you hated me and you're the worst and you're a narcissist and you're blah, blah, blah. And you're like, what is happening? None of those things I said. And this person's furious at me for something that I don't think I don't think that happened. Like, how can I find common ground here? Instead of again polarizing, right? Like be like, no, you are a pro you're the problem. Go get treatment.
Find something that you can agree agree on. I really like always going with you know finding the kernel of truth and what they're saying and what they're feeling. But I all I often really like this is from the DBT my DBT background, but but agreeing on the behavior that's problematic. I especially like it when it's a joint behavior, when it's a dynamic. So for example.
If you're dealing with someone who's screaming, you know, they're they're in a rage episode, they're yelling and they're like, you're the problem, and you go back and forth on that. Well, you could find common ground. You could see things completely differently, but you could find common ground that this way of fighting, this way of working to a solution, is not okay. That needs to change, right? So you don't have to be like, you should get treatment because you are a problem. You could say,
This way we're fighting and screaming at each other right now, that's a problem, right? We we can agree that we need to be able to talk to each other and actually hear each other, right? Or, you know, we gotta reduce this conflict, or yeah, we gotta help you keep that job. Or we gotta find a way to talk about this that doesn't scare the kids, right? So you can.
You ca or you even just like, yeah. like if if I were to look back
Rather look back on my, you know, when my when my mom was going through a really hard time with drinking, she really I mean, I'm sure sh I'm sure after watching this mom, you're gonna have some words to say. But I I I think a lot of the time she felt unheard and unseen and unappreciative for who she was. I mean, that's the things that she would say. and felt like really she really wanted to be close to people and really wanted to be loved and be close to the her family members. But
A lot of the drinking and the fighting was was, you know, pushing them away. So we could agree that the fighting needs to needs to stop. Or we could agree that I really want to hear you and appreciate you for who you are and connect in ways that like I know we can, right? So you can you could agree on that, right? You might disagree on the solution and the path there, right?
That person might be like, well, in order for us to stop fighting, you've got to get treatment. they might, you might not even agree on the diagnosis, right? You might, you might be like, this person has borderline personality disorder or narcissistic personality disorder. And they're like, no, you do. But and they might not even think that therapy or or medication is the path to there. So that's that's something to really keep in mind is like almost like as you're trying to convince, sorry, no, don't try to convince them.
As you're trying to talk to someone about getting help, drop the agenda of getting help. Drop the agenda of like, I gotta get them into treatment. You let go of the outcome. But let's talk about the problem, right? A lot of people go, you know, I'm not gonna be able to be in this relationship unless you get therapy. The other person feels attacked and confused and, you know, because what they're hearing is, you need to change you're the problem you need to change, and that's when I can love you.
So instead, focus on the thing you can agree on, the thing that you both want. we agree that we want to reduce this kind of conflict. We agree that we want to talk through these issues without screaming at each other. Now, I might think that therapy would be the best thing for you in order to do that, but you might think something different, right? The solutions might be a little bit different, but you can agree on a good outcome.
That benefits both of you, right? So find the common ground. And then P is partner. I really like how this is phrased partner. But instead of trying to achieve your goal by getting them help, help them achieve their goal. A problem I see all the time, especially with parents of people who are struggling with.
you know, emotion dysregulation, BPD, trauma, whatever, or trying to get them to launch out of their house and stuff, is that they focus so much on what they want and what they think is best for that person. I hear this all the time where they're like, help my 20, 30 year old son is living in my house, smoking weed every day, playing video games, doesn't have a job, or a girlfriend is very depressed and angry and screaming at me.
He needs to get treatment. He needs to get therapy because then finally he could find a girlfriend and go get a job and live on his own. Isn't that important to want to be independent and self-sufficient by now? And I'm kind of like, yeah, that's something that you want because that's something you value, right? I'm I'm on board with that. Like it is within my values to be independent. So
I'm going to want to find ways to yeah, have all those things, build a family and a partner and a career and my own my own home. But that might not be what they want. Maybe in the long term, like maybe, you know, in some some ways, but not in the short term. What they want is probably a relief from their pain. Right. What they want is to escape into a world of video games where it feels good and fun and predictable.
Right. so you gotta have to do a lot of perspective taking here. You gotta have to be like, okay, I want them to stop yelling at me and stop calling me a narcissist or whatever. I want them to get a job. and that's what I'm gonna tell them to get the treatment for. But think about what their goal is, right? So you could agree on a problem, we're fighting a lot, but then think about what they want.
What they want to get out of it, what their goal is, right? So even saying, like, I I get it, you know, we we need to stop fighting like this. This is really hurtful for both you and me. I, you know, both of us don't like this. I, you know, I in terms of the partner, the different the two different principles. One is offer choices. Again, if you force, if someone feels forced into a choice, they're going to
protect their autonomy. So if you're like, I've, you know, you're going to this clinic right now, they're going to be like, no. Like even if it's a good clinic or a good therapist, they're going to be like, no, I'm, I'm, I want to choose. So give them a choice because even the research shows that if you give people a choice of two things or three things and they choose one of them, they're more likely to be motivated to engage in that choice than if you just force them into that one choice to begin with.
So if you go go to this clinic, they're gonna be like, no, I don't wanna go. Fine, I'll go, but no. But if you say, hey, go to this clinic or the support group, I don't say it like that, but like, here, I'll give you a choice between, you know, I found some really good options. I found this clinic and I found these support groups. What do you think would help? And if they choose the clinic, they're gonna be much more engaged, right? So it's not just about getting them to treatment, right? It's not about getting them in the door.
A lot of people come into therapy or a hospital because they're like, My my wife told me to come here and it doesn't go anywhere. It doesn't change. What you want is the change, right? Therapy and treatment are usually the means to that end. Right? So you're like, I want them to get therapy. I want them to get therapy. No, you don't want them to get therapy. You want them to change. You want them to stop yelling at you. They you want them to stop being depressed. You want them to stop hurting themselves, right? You want that change in the things that are bad.
And you are locked into treatment as the way, right?
Of course I'm on board with that. I think therapy is helpful for a lot of people of all different with all different problems. But I don't know. You can think about this. What if they find Jesus and stop fighting and are healthier and get a career? You know, like what if just a really good group of friends can help them make that change? Right? So stop, just let go of the agenda.
and help them brainstorm what the solution is. You think about this, like I am here to partner, P for partner and leap. I'm here to help you, like us as a team, figure out a solution to your pain. Figure out how to help you with this and get you what you want, which is like the life that you want, the career, the whatever. Like
More connection, feeling loved, feeling admired, feeling approved of, right? All feeling heard. I want to get you those things. how can I help? I had these two options, this treatment or that treatment, or you know, this support group or this church or whatever. what do you think? Right. So just see it as like side by side. I'm your, I'm your thought partner and figuring out a solution.
Another principle I want to talk about. So, like you have leap as the method, right? The different steps. motivational interviewing is awesome because it encourages the person to talk about wanting to change instead of you being the one who is ordering them to change.
Otherwise I'll leave or blah, blah, blah, blah, you know, I'll threaten you, I'll shame you, whatever. It's like, no, have that person talk about their own feelings and thoughts around change. Right? That's gonna go a lot farther and that's gonna get them to be a way more engaged in the right kind of treatment w when they get there.
Motivational interviewing gives a couple of great skills to encourage the other person to engage in change talk, talking about their own change. So they feel agency, they feel control, they feel motivated to change. So a acronym in motivational interviewing is OARS O A R S. We love our acronyms. and that's open questions, affirmations.
Reflections and summaries, right? OARS. so this is these are kind of like different principles you can, you know, weave in when someone starts to talk about the problems, right? Like if they're like, Yeah, you know, fight this fighting sucks and you know, you were you never listen to me and you know, no one likes me and no one pays attention to me, right? So they start to talk about something that is bothering them.
That's when you can flexibly apply ors, open questions, similar to the to the L in leap, right? Asking open-ended questions and really just try to get a sense of their perspective. What has this been like for you? What worries you about this? What's the most painful part? When did this start? and then affirmations is nice. Affirmations is
Really recognizing their efforts into finding a solution, like that's another piece of perspective taking in is a little bit of validation of like they've been trying their best. you could say things like I know how hard you've been trying to show up as a dad, given all that you've gone through. I know it's been hard, but I I I see that you've been trying. Or I could see that you really care about this.
Right. So just like give them like a pat on the back, but in a way that's that preserves the dignity and be like, yeah, I understand that, you know, we have problems and there, you know, there's cop the issues with the way you're coping with this, but like I see that you've been making an effort and I or I get that the drinking is a way to soothe the pain that you know you're you're struggling with, right? And then reflections are.
Reflections, same thing as validation, same thing as empathy, right? It's it's saying I I'm hearing and I'm trying to understand your world, your inner, your perspective, your thoughts, your feelings, like what is this is like for you. And I'm going to communicate that I see it, right? sounds exhausting. like, yeah, I'm hearing that you feel stuck. Right. So again, same thing with validation, like.
Saying like I see your I I see your perspective. You don't have to agree with it, but I get it. It makes sense. if you are like a total loss, you could just repeat some of the words that they said, like I get you're furious that I've been an asshole. Right? Like, I get how hurt you must be. And you gotta say genuinely. You can't be like, I get it, you're hurt, I understand, you are upset. No, you gotta be like, yeah, yeah.
I get you feel so unheard, and that's so hurtful. Yeah. I would I would feel that way too. Yeah. Right. You have to be genuine. And then a summary. This the summaries, this is like an interesting thing that like a therapist will do, like this kind of like summarizing the problem and kind of like making a narrative out of it. that is saying, like, okay, problem. just like really like summarizing the problem.
Okay, so it sounds like we've been fighting so much and it it seems like you've just it's just making you unheard and you don't know how to how to feel heard right now. And that's so frustrating. That's what I'm hearing. Is that is that what you're trying to tell me? Is that correct? Right. So with a summary, gonna like summarize what they're saying, but and to show that you're listening and you're you're taking in, but highlight problem.
Like highlight the problem in their words, right? Okay, you've been struggling with so much pain, so much trauma, so much grief. And drinking has felt like the only solution right now. It's the only thing that really takes the pain away. but it sounds also like the more you drink, the more fights you get into and the more pain is caused. So it's like it's re I could hear how tough it is. I get that. Right. Then you could ask, then you could bring in the others like, what do you think would help?
I'm here to help you. Like, let's figure out a solution. Right. and the more you get them to talk about, like, yeah, that's a problem and I want this to be different, that's engaging them in the change talk. Right.
So instead of you need therapy, you could try phrases like, What do you wish were different? What do wish that could be changed right now? what has been the hardest thing lately? God, that sounds so hard. I want to be here with you to understand and help you get some relief from this pain. I really want that. What do you think that we should do? What do you think would be helpful?
I found help therapy helpful, but I also know that support groups are helpful, right? Two choices. what do you think? Would that does that sound good? How can I help? Can I can I help you find that for you? Yeah. So sometimes even just highlighting problem and it's costing you something, it's costing you something you care about. How can I help you get to what you want? Right. Not not go.
Get therapy so that you change it to the person I want. But like I hear that this is a problem, you've been struggling. I know you really want this, right? Like figuring out what they want. I know you really want this. I know you want your life to be changed. I know you want to be heard, you want more friends, you want to feel accepted. What do you think is the solution here? I'm happy to help you, but let's figure out how you could feel heard again. Right. So
Takeaways are you cannot force someone to be motivated to change. You can't. I know you want to because you're scared of what can happen or you love them and you know that it's the best way, but you've got to give them the dignity. You gotta let them choose, right? You're not responsible for making them change. You are opening up the space for them to explore their own need to change and to choose and engage with that way of changing, which could be therapy, but it could be.
Taking up running. I don't know. So I hope that was helpful. And it just think about the shift to creating conversations and open dialogue and understanding their perspective, then forcing them into a choice that you think is best. thank you so much. I will see you next week. And if you've enjoyed this discussion, I hope you share it with people that you love. I hope that you
practice and take in these skills. And if you want help, check out kulamind.com, K-U-L-A-M-I-N-D dot com, and leave me comments and questions and all that fun stuff. Bye.