We hear from carers on our Family Support Services, that at all stages (from pre-contemplation to contemplation, from preparation to action, and from maintenance to beyond), it is challenging to motivate their person for change, as change can be very daunting.
In the New Maudsley Carers Skills Series, we focus on motivational skills that carers can implement, to create an environment where their person wants change for themselves. It’s important to keep in mind that we cannot change other people, and that the only behaviour we can directly change is our own. However, it is often the case that when we change, other people change in response to us.
What are the Challenges?
Carers shared about the challenges they experience creating ‘Motivation for Change’ in this session of Conversations with Carers. Some of the main challenges included:
- Person finds it difficult actioning/implementing change
- ED voice becomes very loud when thinking about change
- Carer falling into accommodating and enabling behaviours
- Person very perfectionistic
- Change feels too overwhelming
- ED behaviours changing to something new
- Person rationalising the ED behaviour
What’s Helpful?
Many carers spoke about the difficulty their person experiences when trying to action the changes that they have thought about making. Oftentimes, the ED voice can creep in, preventing them from trying to implement a change. What can be helpful is to externalise the eating disorder when this happens. Affirming your person’s voice, and drawing a distinction between what your person is thinking and how the ED is ‘ruling,’ can be very helpful. Carers recommend meeting your person where they are at, as it may take some time before your person is ready to try a change.
When change feels daunting and overwhelming for your person, it can be valuable to break it down into small steps. Carers recommend collaborating with your person: to write down the changes they are thinking about, break it down into smaller tasks, and then try something that isn’t too difficult. This echoes a phrase we say in Maudsley – “take the path of least resistance.” Carers find that coming back to the list and ticking off a completed task can really contribute to a sense of achievement, which boosts their person’s self-esteem and encourages them to try another change.
Motivating your person for change relies on communication. Carers highlight the importance of thinking about how you would like to engage and respond to your person. Having empathy, kindness and compassion in your voice can be particularly helpful. If you are feeling like you are ‘walking on eggshells’ about something, carers find it useful to have an open conversation.
Being able to talk about difficult topics and not minimise them, helps to create space for your person to talk about their feelings.
Other things that carers find helpful when motivating their person for change is to encourage your person to engage in hobbies and activities that bring them joy. Not only does it provide a distraction and relief from the ED voice, doing a hobby can also boost a person’s self-confidence, which is important when thinking about any type of change.
Carers also find it helpful to remind their person that they have an illness, especially when they are being hard on themselves for not making a change, or being perfectionistic about a change. This can also be motivating as it provides hope for the future, as although they have an illness at the moment, they can get better. Remember, full recovery from an eating disorder is possible!
Carer’s Quotes
“I find these sessions an enormous help, having the support of other carers and the opportunity to express your thoughts and concerns in a place of understanding is of real benefit to me.”
