#174 Sustain Talk and How to Address It

 

Sustain talk is anything the client says about not making the change you are talking about. This might be, “I can’t do that.” Or “I don’t want to join a gym.” Or “but that won’t work.”

It’s not what you’re eating.
It’s what’s eating you.
Anonymous

I have no special talent.
I am only passionately curious.
Albert Einstein

It is tempting to respond right away to ask more about the obstacles or to give advice or to argue. In Tip #150, Addressing Obstacles to Change, we looked at how it is best to put off finding solutions and to offer hope first. Check out examples of that process here. We first agree on the target behavior change and evoke the reasons for this change. It is most effective to listen selectively for change talk, while mostly side-stepping the sustain talk at this stage. Once the specific behavior and the reasons to do it are nailed down, then we ask the client for his first steps. This will move the session into the planning process. Once this process begins, sustain talk may naturally come up and can be addressed. (More on the flow of a session in Tip #167)

Here is an example. During a session the client has bought into becoming more physically active. You then offer a summary with an emphasis on the change talk you heard. “You came in wanting to find a way to take better care of yourself, given this new diagnosis of high blood pressure. We’ve explored a few ideas of changes that will address this and you would like to focus on exercise first. You know it will help your blood pressure. You have experience with exercise and know you have more energy and feel proud of yourself when you have a regular habit of activity.” After confirmation from the client that you have it all, you ask a key question, “What are your thoughts about how to be more active?” If you get sustain talk, such as, “I hate gyms.” You can reframe it first, “So in order to be more active, we’ll need to find something that doesn’t involve a gym.” You can once again ask for his ideas, “What do you see fitting for you at this time in your life?”

You may have some suggestions. Ask permission first: “I have a couple ideas that other people have found useful. Would you like to hear them?” After getting permission: “Some people find a walking partner to meet a few times a week, or take dancing lessons or a yoga class. Your response to those ideas?” If what has been lacking is ideas of how to proceed, this will get you going in the planning process.

If all your ideas get shot down, it may be time to further explore what else is getting in the way. The answers here are inside the client, not in you. I have been surprised so many times by the complexity of my client’s lives and life stories and I have learned to keep an open mind. So, take a deep breath, let go of trying to come up with ideas and ask permission to get curious together. For example, “This sounds like it’s a bit more complicated than we imaged. Might we slow down and explore this more? Take yourself to that moment when you might head out for a walk. What comes up in your mind?” Or “what would have to be different for it to be easy to head out?” Another path to take would be, “Tell me of a time in your life when you were exercising easily.” Listen. You might follow up with, “What was different then?” or “What happened around the time you stopped?” Just listen, reflect what you hear (ideally complex reflections, Tip #171).  Perhaps ask elaboration questions (Tip #139).

If you hear what sounds like a part of the person which has a belief or worry that is getting in the way of change, it may be useful to find out more about this part and its intention. Here is an example. One of my clients wanted very much to get back to her regular walks and believed they would help her mood and energy. When we explored it further she realized that a part of her believed if she began she would have to do it daily or she would be a failure. She immediately said, “That’s stupid. Every walk is useful even if not every day.” I slowed her down and asked her to listen to the worried part some more. She did and realized that it was trying to help her avoid the feeling of failure. She saw this as a good intention and thanked it. I asked her to sit with this a bit longer. She was quiet and then said that she knows she has a voice that comes up and yells at her. It has high standards and would want her to walk every single day and believes that if she doesn’t, she is a failure. I asked her what that voice is trying to do. She smiled and said it assumes that if it doesn’t yell at her she won’t do anything. She was able to see the circular aspect of this stuck pattern. The next week she told me that this whole worried/failure/yelling pattern had calmed down and she had walked several times.

 

This example is based on the model called Internal Family Systems. For more on IFS, check out https://selfleadership.org/. I have begun offering introductory training on IFS. Future trainings will be announced in my email newsletters.

 

 

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