Motivational Interviewing, by William Miller and Stephen Rollnick (1991), is probably one of the most important books on addiction and change to be published in the past 10 years. The authors uphold that ambivalence is a primary obstacle to following through with change goals. 12-step approaches often mislabel ambivalence as "denial" or "resistance." Ambivalence need not be defined by such pejorative terms. In fact, it is my contention that ambivalence to change is far from maladaptive; it is necessary for survival. If it were easy for individuals to "forget" automatic behavioral coping plans which had been repeatedly reinforced (by reducing anxiety, improving social ease, bringing about euphoria) we would undoubtedly perish. In other words, our brains are designed to push us toward that which we have stored as positive or that which reduces something negative. It is a necessary heuristic. Anyone with an addictive habit will be quick to say that this heuristic is a double edged sword, as sometimes our better judgment tells us to relinquish a behavior (such as problem drinking) and our stockpile of memories ruthlessly continues to drive us toward the behavior we wish to avoid. This conflict is composed of different kinds of information dueling for a behavioral outcome. I like to envision a see saw with two boxes on each side. On the left side we have a box labeled "benefits of not drinking" and another box labeled "costs of drinking." This is the information which is driving your change efforts. We can very often articulate this information with out problem. The other side of the see saw contains two boxes also, and this information is often less readily available, especially in the heat of an urge experience. One box is labeled "benefits of drinking" and the other is labeled "costs of not drinking" Miller and Rollnick have suggested that people can counter ambivalence by "decreasing desirability" of the behavior. And this is exactly what this exercise is designed to help you do.

This exercise will hopefully help you create a "cognitive template" for countering ambivalence in the heat of the moment. This will be done by 1. Helping you to understand the information which supports the ambivalent state: benefits of drinking, costs of drinking, benefits of not drinking, costs of not drinking. 2. Helping you understand that this information is blocking change. 3. The goal is to "tip the scale" i.e. create an imbalance such that the decision not to drink becomes more desirable than the decision to drink. You will do this by "challenging" the information which is impeding change. 4. With practice, you can learn to identify the information which is fueling an urge state and perform a cost/benefit analysis in the heat of the moment.