Liivis started smoking up on weekends 'getting big' with friends. Then she progressed to getting high all by herself. From that, she moved to everyday of the week. She wasn't as high as she thought. She felt low in turns of herself. Liivis wanted to change.
Back to Reality
Robert Davies © 2019
“I guess anyone facing being placed on probation at work would be upset, anxious, frightened. I am sorry to hear that, Liivis. How can I help? What specifically would you like to work on?”
“Well, I have to quit smoking weed in order to keep my job.”
“And your anxiety about maybe losing your job?”
“Yes, that, too.”
“If I hear you correctly, you’d like to deal with the cannabis habit first?”
“When was the last time you got high or ‘big’ as they say?”
"Okay, Liivis, I can help. Let's say there is a MAGIC BUTTON on your chair. If you push it, all your anxiety will disappear plus you will start performing well at your job. In short, your most pressing problems will all disappear. Would you press that MAGIC BUTTON?"
"I sure would."
"Well, before you push the button, there might be reasons to NOT push that MAGIC BUTTON. This would be a major change, not smoking pot. Let's be sure that you really want to push that button. In other words, let’s look at all the reasons you do smoke the drug. Let’s list all the advantages of smoking pot.”
Bob pulled out a sheet called the CBA – the Cost Benefit Analysis sheet. It lists all the costs of smoking up, in short, the disadvantages. The other side lists all the benefits or advantages. This is called Paradoxical Agenda Setting because it is a paradox that agreeing that smoking cannabis is advantageous when clearly to Liivis it isn't.
The habit I want to change: SMOKING MARIAJAUNA
ADVANTAGES OF THIS HABIT
It gives me self-confidence.
It gives me self-esteem.
It is a good social habit.
I feel good.
I can escape from reality.
It makes activities such as watching TV more enjoyable.
I can relax.
It helps me focus.
It helps with sports such as field hockey.
It gives me euphoria.
It helps with sleep.
I can choose to use it only on the weekend.
“Okay, Liivis. Let’s look at these advantages, what you get out of doing it. So you feel self-confident. How does that work?” “Well, I just feel I can do things that I couldn’t before. Of course, it is not helping me focus on my job requirements.”
“And self-esteem?” “I feel like I am important, a somebody.”
“Okay, so you feel more confident in doing things. You feel better about yourself when you are stoned. How about the social thing?” “Well, people would come over and we’d have fun together, smoking up. “ “You said ‘would’? Don’t people come over anymore?”
“Well, I used to smoke up with friends at first. I’d wait for them to come over. Then I’d smoke up. Now I just smoke up by myself.”
“How about this escape from reality?” “Well, it is nice to chill out after work and forget all about your work day.”
“Yes, it is great to relax after work. How many days a week do you do that?”
“Smoke up? Every night, Bob.”
“How does it make activities enjoyable?” “Well, when I watch movies and such, I find I can get right inside the meaning of the movie when I'm high.”
“It helps you relax, too, Liivis?”
“Yes, it does and it helps me focus on what I am doing at the time except when my fiancé comes over. I am usually too stoned to talk to him. That really bothers him, and I do feel really guilty about treating him like that.”
" And video games?"
“It also helps with playing video games with friends. I seem to be able to really concentrate on the game.”
“Does it help with the social part of being with people?”
“Yes, it’ s fun getting high with others; but you know I kind of go off into my own little world, so it does kind of separate me from people.”
Bob, the counsellor, was listening to Liivis automatically come up with a list of disadvantages. He is, more or less, ignoring that. If Bob can get her to fight harder for the disadvantages side by his 'cheering' for the advantages side, he is helping her to voice her disagreement. In short, Bob is actually motivating Liivis. This is the paradox.
“But looking at all these benefits, Liivis. I don’t see any reason for changing. You get so much out of it.”
“I know there are lots of advantages, but they don’t compensate for disadvantages. For instance, I feel guilty that I am most often stoned when my fiancé wants to talk to me. He complains that I am not there for him. That hit hard.”
Mr. Robert Jenkins, counseling therapist, had been using Paradoxical Agenda Setting or PAS, a concept invented by Dr. David Burns. It seems that if we can get the client to fight for healthy change, then any resistance quickly disappears. There are two types of resistance where clients fight the therapist explains Dr. Burns. There is outcome resistance where clients don’t want the outcome because deep down; they really do want to smoke pot. There is also Process Resistance where clients push back against the work required to create the necessary change, such as abstaining from marijuana all together. By using PAS, the client fights against his own resistance, helping the client to follow through more willingly with the necessary change.
"Okay, Liivis, despite all the good things about smoking marijuana, you still want help getting out of your addiction. Okay then, go ahead and push that MAGIC BUTTON and we can get to work helping get rid of that the marijuana habit. Okay?"
"RIGHT YOU ARE, BOB!"
See Cannabis Caveat: Part 2 - Fighting the Marijuana Habit