Think about a time you swore you would start something important to you. 

Maybe it was finally getting back to the gym for some daily cardio. Maybe you made a new year resolution to start responding to emails in under a week, like you’ve been promising yourself you would. Or maybe you decided to cut back on coffee and replace your caffeine habit with green tea. 

Did you get really pumped up for the first 3 weeks, only to slip back into your same old habits when life threw you something you weren’t prepared for?

Ambivalence: The cost of change vs The benefit of change. 

Making changes is hard. 

Forming new habits takes work, and it’s so easy for life to get in the way of our good intentions. 

Your patients are likely dealing with a lot of the same challenges while trying their best to meet their very well-intentioned goals.

Ambivalence happens when the amount of work it takes to implement a change seems higher than the perceived benefit of that change. 

This can turn into your patient wondering if the change is worth the trouble.

• It sounds fantastic for your client to have an A1C below 7. But that might mean no more sharing McDonalds with their grandkids, which is something they look forward to every week. 
• It’s a great idea to start drinking more water and less soda. But that might mean having to start drinking something your client says they hate and stop drinking something they love. Where’s the fun in that?
• Avoiding another hospitalization for CHF exacerbation by cutting way back on salt is clearly the smart move. But that might mean you client would have to stop eating the frozen meals and easy snacks, and find someone who’s able to cook for them instead.

In each of these examples, the cost of making a key change is outweighed by the cost of keeping the status quo. 

There are clearly solutions that can be formulated for each of these scenarios. But if your patient isn’t ready to believe that the price of keeping things the same is more expensive than the price to make a change, you’ll be fighting an uphill battle.

This is where readiness comes in.