In the Flow
KATHIE GARRETT, M.A., Clinical Associate
I completed my first MI training in 1995, and, like many newly trained MI practitioners, my first goal was to temper my “righting reflex” or that burning desire to correct my client’s “wrong thinking” with education and persuasion and replace it with a stance of expectancy. A few days after the training, I had the opportunity to try this new approach. I found myself counseling Becca (not her real name), a young breast cancer patient. Like me, Becca was in her 30’s, a writer, and the mother of an adolescent. I learned from her that she had recently been diagnosed with high grade, stage III breast cancer and was refusing conventional medical treatment. She was amazingly resolute in her conviction. The words, “poison, toxic, and deadly,” scurried off her tongue in what sounded like a well-practiced and comfortable monologue.
Although I honestly attempted to be curious, within minutes, my righting reflex was fully activated. I found myself thinking of all the reasons why Becca needed to pursue treatment accompanied by my certainty of illness progression and death if she did not. My judgment arose in part from my knowledge of the aggressive nature of breast cancer in younger women and my belief in evidence-based cancer treatment, but it was also energized by my identification with Becca. In fact, when I looked at her, it was hard to not see myself, my eleven-year-old son, and my own mortality.