Honoring Ambivalence 

I do, but I don’t. When I get through this crisis, then I will make the change. I need to quit this, but I have been doing it for years. Uncertainty is something we have all experienced, but it can be challenging, even frustrating, when coaching someone through it. “Ambivalence is the simultaneous presence of competing motivations for and against change,” (1, p. 323). 

 

In health coaching, specifically tobacco cessation health coaching, we work with individuals who are undecided about making a change. They realize they need to change. Maybe they do not feel well. A family member or medical provider has urged them to change. Perhaps they have thought about changing for years, but the comfort, enjoyment, or familiarity of their current state overrides charting a different course. 

 

We get it. It often seems easier to continue the way we have been doing it rather than make the effort to try something new. Why can’t we just make up our minds and change? This back-and-forth thinking is part of the process. Thankfully, it is for this very reason that health coaches are needed. If people did not feel conflicted about change, there might not be a place for health coaches. 

 

How do we acknowledge someone’s uncertainty and guide them toward their desired change? First, we need to listen closely to hear it. Next, as we recognize it, we can offer support in their individual journey, explaining that it is a natural part of change. Then, in our coaching conversations, we can let the person know what we heard by reflecting the individual’s ambiguity back to them so they can hear it. For example, a patient or client may state, I really need to stop smoking so I can breathe better, but I really enjoy smoking. It relaxes me. In this scenario, it is most important to focus on the part of the statement that is leaning toward change: I really need to stop smoking so I can breathe better. A next step might be to explore the person’s need for something better by asking open-ended questions. In this example, one possibility is exploring their current patterns of breathing. What are some reasons this change is important, beyond the obvious need to live? How would their life be better if they could breathe more fully? Let the person provide their reasons for change. 

 

A type of reflection that is especially useful with ambivalence is a double-sided reflection. In a double-sided reflection, both sides of ambivalence are noted, the reason not to change and the reason to change. This gives the person the opportunity to hear their conflict and possibly consider their desired change. It is important when combining both sides of change to use the word and rather than but since “but discounts what precedes it and places greater emphasis on what follows it” (1, p. 150). In addition, “the order of the two conflicting sides matters. People are more likely to respond to what you said last, and thereby amplify that side of their ambivalence” (1, p. 150). Using the previous example, a double-sided reflection may sound like, You enjoy smoking because it helps you relax, and you want to breathe better. This provides an opportunity for the conversation to move toward change. You can ask the individual to elaborate. Tell me more about how breathing better would be beneficial for you. 

 

Exploring a person’s values can also be useful with ambivalence. Understanding what someone holds dear can be a powerful motivator for change. Values bring meaning to change. Sometimes you can know what is important to an individual by what they share and focus on during the conversation. Otherwise, simply ask the patient or client what they value. Knowing this can open additional areas for discussion and provide a potential gateway to strengthen change talk.  

 

Ambivalence can occur in about every area of our lives, even spiritually. Have you ever been ambivalent about your faith? How can we minister to someone uncertain about church, about the Bible, or maybe even about God? Did Jesus ever encounter people who were conflicted about the truth or about Him? What did He do?  

 

Let’s take a look at a story in the Bible about a boy who was healed. This boy could not speak, and the spirit that was causing this crisis was violent toward the boy, even trying to kill him. Jesus presented a situation for the boy’s father’s faith to be strengthened. He was ambivalent about belief. “Lord, I believe; help my unbelief!” Jesus honored the father’s ambivalence and healed his son (4). 

 

As we incorporate our coaching principles into ministry, we can encourage others who may be ambivalent about their faith. Actively listening without showing judgment can provide a meaningful start. Individuals may also benefit from knowing that uncertainty about change is normal. We can develop a trusting relationship while listening and sharing our hope. In addition, we can offer support through prayer and Bible study, focusing on specific passages that question our faith. 

 

We are conflicted people living in uncertain times, unsure if we really want to change. These competing feelings can lead to a new start, growth, and renewed faith. Our coaching and ministries provide an opportunity to honor ambivalence as we recognize and reflect it. In highlighting the side that is for change, we can guide the coaching conversation in that direction. Individuals are strengthened as they share their reasons for change. Their reasons for change are most often grounded in their values. Thankfully, Jesus gently, patiently works with us in our ambivalence, so can we as we encourage others toward their desired change.