Expert: John R. Cross - 7/15/2010

Question
working with the unwilling

Hi, I do have a question I hope you can help me with.  I am just staring a new position where I will be working with therapists, administrators and doctors helping people get better and manage their pain levels.  I was initially asked how I would deal with someone that really didn't want to get better.  I was surprised and unprepared but I have worked with people that were skeptical they could get better, but they were not against getting better.  I told them that I try to make the experience pleasant and fun.  I may also try to do some things to get them to smile.  Once I can do that I can usually persuade them to give it a try on an ongoing basis so that we have at least tried it and given it a fair shot.  I also suggested that working outside in a pleasant area might also be conducive to motivating them to try what we are going to do.  They also advised me that these are the kinds of people I'd be working with.  I have 2 questions.  1) do you think my response was a good one and a legitimate one as far as it working, 2) if this is not the best approach what would a positive and constructive approach be to get a person who "does not want to get better" motivated.  It is difficult for me to believe that down deep inside a person can't, somehow, be motivated towards healing and getting better.  Oh, by the way, I am using alternative methods such as Qigong, breathing methods, etc., to compliment the therapy they are currently receiving.  Thank you in advance for your response and your assistance!

Answer
Hello Rick,

This is not really a question on acupressure, my speciality, but I will answer it using my experience as a therapist of over 40 years. You are correct that some people do not want to get better and there may be several possible reasons.

1. One of the most common is that there is an insurance claim pending (e.g.on an accident) and the patient will not improve until the insurance claim has been settled!

2. Some people 'need' their illness - either as a result of low self esteem as they wish to have fuss and attention or because they have become conditioned that because an illness 'runs in the family' they feel guilty until they also have that illness.

3. Your approach is an excellent one because as soon as you start to raise their spirits and have a good smile or laugh, they immediately change their outlook. Some people are not aware that they are in a rut of illness (such as hypochondria) and need gently to be coaxed out of it.

4. Whatever method you use (and I am not a psychotherapist), it must involve them talking about themselves - to get things off their chest as it were, plus be involved in fun activities, preferably within a group situation.

Hope this has helped - JRC