A friend of mine shared with me a conversation she had with a neighbor about his choices around COVID exposure. Let me set the scene:
This friend does some caretaking for her elderly neighbor, walking his dog and other things that require contact during this Social Distancing time. He is 85, and lives alone. She watched a car pull up to his house one afternoon. A person knocks on the door. Her neighbor let this visitor into his house, and hours later, she watched him leave.
Now, people are somewhere on the spectrum of SUPER cautious about COVID exposure to the not-so-careful. You know what I mean. And if you encounter a not-so-careful person, you may experience the reflex to warn them or persuade them to be more careful.
Motivational Interviewing calls this the “Righting Reflex.”
I call it my Fix-It Reflex. I sense something out of place, inefficient, or wrong, and I move into persuasion to Fix-It!
Seeing her neighbor let someone into the house for HOURS set off her Fix-It reflex. So, that evening when she goes to walk his dog, she begins her confrontation.
“Who was that who came over and you let in your house?!”
He responds, “Oh, he was an old student of mine. He came by for a visit. He drove all the way here from over an hour away, and I just didn’t have the heart not to let him in. We ended up watching a movie and visiting. I didn’t know how to usher him out, he came from such a long way away, so he stayed for a while.”
She just about blew a gasket. “You are 85! You let him IN?! What were you THINKING? Not only are you exposing YOURSELF, you could DIE, but you are exposing me too. Think about it! You should never have even let him past your front stoop, let alone breathing the same air as him for hours! You just weren’t thinking!”
What do you think he said? Do you think he hung his head and said, “You’re right, I shouldn’t have, and I won’t do it again?” Nope.
Consider the normal response to persuasion, psychological reactance.
Psychological reactance means that when you give someone advice, they either don’t do it, or they do the opposite. Even if they agree with you.
“Well,” he said, “I’m a grown man and I can make my own choices. He drove all the way here for a visit and I’m not going to leave him standing on my stoop!”
So the argument continued until they were both so worked up they had to take a break! I have an image of two bulls, horns locked, trying to overpower the other. How tiring! Not to mention that this wrestling hurts the relationship AND doesn’t work.
So MY Fix-It reflex kicked in and I wanted to tell her how she could have used Motivational Interviewing to make the conversation more effective! (And like a good MI provider, I asked permission first).
When I ask myself if Motivational Interviewing skills are a good tool for the conversation, I ask myself what is in the best interest of the person I’m talking with. Was it in the best interest of this 85-year-old-man to not let this visitor in? Unfortunately, yes.
So here’s what a Motivational Interviewing COVID conversation could have looked like.
“I saw you had a visitor this afternoon. Tell me about it” (Open ended question)
As he said before, “Oh, he was an old student of mine. He came by for a visit. He drove all the way here from over an hour away, and I just didn’t have the heart not to let him in. We ended up watching a movie and visiting. I didn’t know how to usher him out, he came from such a long way away, so he stayed for a while.”
And you could say, “Ah, so an old student of yours came by for a visit. Sounds like you struggled with the decision about letting him in, and weren’t sure how to navigate that gracefully. I’m hearing you were torn, and perhaps wished you’d made a different call.” (Reflection, reflection, reflection)
He may have responded, “Yeah, I do, but it was good to have some company. I just didn’t know what to do, I know I’m not supposed to have close contact with people. I guess watching a movie on my couch is breaking the rules.” Little chuckle.
Using MI, you may respond, “On one hand, you enjoyed the company, and on the other, you’re aware that being in close contact with him for an afternoon could have put your health at serious risk.” (Double sided reflection!)
“Yeah, yeah, I’m kinda regretting I did that,” he may have said, “It was awkward and I just didn’t know how to visit with him without inviting him in. Gosh, I imagine it worried you to see me let him in.”
More MI reflections, “You are wishing you had made a different choice for your health, and you are considering how it impacts me as well. Thank you for talking with me about this. I wonder, if another visitor came knocking, what ideas do you have now about a safe visit?”
VERY DIFFERENT OUTCOME.
Motivational Interviewing conversation skills can be used to help someone resolve their ambivalence and make choices that are better for them and for their health! Let me know how it’s going using Motivational Interviewing in those COVID conversations!
