49. Motivational Process – Challenges

Positive and Negative Rebound

Thera is always a challenge for the motivational worker when the positive rebound cheges to a negative. The pain that the motivational worker experiences parallels the client’s own. The motivational worker feels a sense of hopelessness and of being a worthless failure and wants to end the relationship. If he could multiply his feelings by a factor of 10,000 he would be able to empathize with the client’s own pain in this respect and his fear of being abandoned. In this situation, he is helped by knowing that the motivational process means two steps forward one step back

Conscious Detransmutation

Because the motivational worker is manifestly motivated, he can receive his client’s pain and reduce its destructiveness through intuitive detransmutation. If this form of detransmutation does not help the motivational worker to avoid energy depletion, he will also have to use conscious detransmutation.

This is done by seeing the negative rebound as something positive, which provides a counterweight to the pain and helps the motivational worker see a sense of purpose in the situation. A rule of thumb for him is, therefore: WHEN YOU MOST WANT TO GIVE UP, THAT’S WHEN IT’S MOST IMPORTANT TO KEEP ON TRYING TO MOTIVATE THE CLIENT.

This attitude is part of the conscious detransmutation of the client’s negative rebound and gives the motivational worker affirmation, understanding and a sense of purpose in keeping up this painful contact.

In this way, the motivational worker meets the client’s pain within himself. Processing with his own emotions and cognitions allows the motivational worker to complete the detransmutation that the client seeks but has insufficient life energy to do himself.

To Sum up

The motivational process, with respect to the positive-negative rebound interaction in the client, can be summarised, experientially, for the motivational worker as follows:

TWO STEPS FORWARD, ONE STEP BACK.

It is, however, difficult to keep a cool head when a negative rebound occurs. The author himself has experienced, as a supervisor, how hard it is for the motivational worker to escape feelings of hopelessness and of being a failure.

Regardless of how much he might know about rebounds intellectually, once the negative rebound happens the emotions are so dominant that it is easy for him to lose his sense of distance.

There is also the risk that the motivational worker loses perspective when the positive rebound returns and becomes unrealistically optimistic, seeing only the visible content and not what is concealed in the client’s transmuted destructive contact rebus.

Added to this is then the greater risk that the motivational worker will be unprepared for the successive negative rebound when it happens (Motivational Work, Part 1, Values and Theory, pages 456 – 492)

Case Study 1

When the social worker begins his motivational work with Elsa (blog no. 47 ), her client is in a negative rebound. Elsa leads a life of active abuse and is dismissive in her contact with the social services. The social worker is surprised that her client seems to want to cooperate and believes that she has turned her back on her destructive lifestyle.

This is bewildering for the social worker, and she fails to detransmute the compliance contact rebus. She is consequently unprepared for the negative rebound that occurs as Elsa runs away from the center.

Discussion

Often, motivational work is terminated just when the negative rebound occurs. The client is then left without help and the motivational worker, with severely dented self-confidence, feels a failure.

At the same time, the negative rebound demonstrates the incredible power inherent to the temporal contact rebus, which it has for the very reason that it follows on from a positive rebound (preferably when the client really does seem to have changed for the better) and because it occurs so suddenly.

If the client had only a negative rebound from the beginning the same effect would not be achieved.

Case Study 2

A psychiatric ward decides to try to motivate one of its patients, Helge (25), in consultation with the ward psychologist. At the start of the process, Helge is very hostile and aggressive. For a year he shifts between this negative rebound and a positive rebound in the form of a compliance contact rebus, which many members of staff find hard to deal with.

The patient is then very ingratiating towards the staff and puts them on a pedestal. Throughout the motivational work, the psychologist has regular supervisory sessions with the staff, during which they talk about the motivational process and positive and negative rebounds.

Negative Rebound as a Confirmation

After a while, the staff doesn’t find it hard to see that the negative rebound (i.e. the aggressiveness) is indirect confirmation that a motivational process is underway, and this helps them to deal with the patient’s threatening and aggressive behavior. They are also able to recognize that the positive rebound is an attitude of conciliation on the part of Helge.

The staff’s commitment to Helge increases and they become more hopeful about being able to motivate him. The psychologist grows increasingly satisfied with how the motivational worker is progressing.

Negative Rebound as a Disproof

But then the shift from the positive to the negative rebound occurs. Helge lies in bed all day and refuses to take part in the scheduled activities. He has been thinking about his life and finds it hard to find any meaning in carrying on. The psychologist looks favorably upon this negative rebound and tries to impress upon the staff that the patient has come into closer contact with his pain and started to see his life situation more clearly.

He points out the indirect affirmation inherent to the negative feedback: the motivational process is continuing. At the same time, the patient also seems to have a more untransmuted contact with his pain, although the staff finds it difficult to detransmute this negative rebound, as they are missing the aggressive destructiveness, through which they knew how to handle the patient.

The Staff’s Anxiety

The staff are worried about Helge’s inactivity and are unsure what to do. Time and again they try to get Helge out of bed and activate him, but in vain. A growing sense of failure descends on the staff, who start to find it difficult to see any sense of purpose to their work.

The staff becomes extremely concerned, and some of them claim that they have done what they could for Helge and it would be good for him to transfer to another unit, where he might become more active.

The psychologist, however, refers constantly to the motivational process and the negative rebound, but the staff is no longer able to detransmute Helge’s withdrawal contact rebus.

They question the psychologist’s reasoning and tell him that his theories could be wrong. The indisposition of the staff increases until the patient is discharged and transferred to another unit.

Discussion

When the negative rebound goes from an aggressive to a withdrawal contact rebus, the staff are no longer able to detransmute it.

The staff enters a demotivational process, which escalates as their emotional experiences reflect their patient’s view of the world. The staff and Helge thus share the same thoughts and feelings, which are, of course, stronger in the patient.

Helge feels worried, insecure, and a failure, and finds it hard to see any meaning in his life. His trust for the staff wanes, which leaves him filled with worry about being abandoned; he would also feel relieved to be able to leave the ward.

There is, therefore, a danger of not being able to solve the temporal contact rebus if the negative rebound shifts from one principle of transmutation to another. The motivational worker must also be prepared for this change, that is two steps forward one step back.

In the above context, the psychologist sees that the shift in principle is per se indirect confirmation of the motivational process’s continuation, although he could have perhaps prepared the staff more for this change.

On the other hand, the psychologist was unprepared for the staff’s inability to solve the contact rebus. Yet he is always able to detransmute the client’s rebounds and is thus in a motivational process or equilibrium process with the client himself. He finds it purposeful to help Helge from the start, and this supplies him with additional life energy.