If we want to change something that we do, we have to actively make a decision. It won’t happen just by wishing. We might want to quit smoking, or lose weight, or stop being controlled by our addiction. Knowing how to use this For and Against Decision Making Chart can help us decide to change what we do, and also to successfully stick to that decision into the future.
Most people don’t wake up one morning and say to themselves, ‘I think I’ll stop drinking today’, and then never drink alcohol ever again. Unfortunately, it’s not that simple.
We need to have a plan to follow - a cheat sheet – something we can turn to, that reinforces our commitment whenever we are on the brink of returning to our old ways – when the rational side of our brain (that does not want to relapse), is under attack from the irrational demands and cravings of an addiction.
How to Make a Decision Making Chart
Addiction doesn’t play by the rules of rational argument. That is why having our own personalized For and Against Decision Making Chart can help us, even save us, from relapse.
I recommend that before you read on, you first read, or read again, my article How to Change Our Behavior which is an introduction to this topic. This article you are reading now, is a practical guide on How to Use a Decision Making Chart to change what we do.
How Does a For & Against Decision Making Chart Work?
Creating our own personal For and Against Decision Making Chart is a practical way to sort out in our heads what we really want to do with our life, and then stick with that decision against the daily pressure from addiction, which is constantly trying to tempt us back into our old ways.
If we can fully understand the problem, we can begin to sort out how to tackle it. ‘Know your enemy’ is essential when confronting an addiction, and we want to win. Constructing a For & Against Decision Making Chart sets the point from where we start, and provides a means of planning our future.
Note: Use of this chart is not something that applies only to decisions about addiction. It’s also a useful way to help anyone make up their minds when they have any difficult decision to make, and they are struggling to decide what they should do.
Once you know how to use this chart, anyone can use it for themselves, as an aid in making difficult everyday difficult decisions, such as “Should I change my job?” or “Should I move house?” or “Should I reach out for help and stop being controlled by my addiction?”
Here’s how it works.
Whenever you have a difficult decision to make about anything, and you are not sure what you should do, you draw up a personal ledger – a Cost/Benefit chart of your For and Against motives as follows:
If you are seeing a health professional about your addiction, their goal will be to help you shift your personal For and Against balance sheet, so you reach a Score out 10 that indicates you are likely to succeed in your desire to change what you do. That might be somewhere around 7 or greater – the higher your score, the more likely you are to succeed in your goal of regaining control over your addiction.
So whenever you make a For and Against Decision Making Chart, (or re-examine your Chart to assess how your Readiness to Change Score has shifted), you have to decide how ready you feel to really start changing what you do, TODAY - and put a number down as your current score.
What Does Your Score Tell You?
Obviously, if your Score turns out to be 2 or 3, you are unlikely to be able to successfully stop being controlled by your addiction – because you don’t really want to – yet. That is a valid personal choice. It means that your motives for continuing doing what you currently do, outweigh your motives to change. Your therapist will try to help you shift that balance of motives, to a score where you have a good chance of success.
As you can see, there are 4 different, but related, sections to fill in. What this process does, is to make you stop, and really think honestly about your own personal motivations that govern what you are doing now, and what you want to happen in the future – the advantages, disadvantages and consequences of specific choices and decisions.
Just by taking time out to sit down and fill in your chart like this, you are forcing yourself to analyze what you really think and feel about all the personal motives that dictate each side of your personal decision Cost/Benefit equation. It allows you to be in control, by forcing you to consider what your options are, and how you feel about them. You are no longer just doing something without really thinking about it – if forces you into self-examination, and gives you a better understanding of why you do what you do.
Yes or No? What is the thing I really want to do? Every box you fill in reflects your own personal feelings, experiences, circumstances, and motivations. There are no Right or Wrong answers. If you really want this Decision Making Chart to be of value to you, you have to be truly honest with yourself. It’s time to stop fudging the truth, stop denying reality, or trying to convince yourself to believe something which you know, isn’t really true.
I have never met a problem that didn’t have 2 sides to it. If it doesn’t have 2 sides to it, it wouldn’t be a problem. For example: eating that extra slice of chocolate cake is not a problem for the slim, healthy person. But the same situation for the overweight diabetic person becomes a problem, so there is a real decision to be made. There is a conflict of clashing motivations – what psychologists often refer to as ‘ambivalence’. What you decide to do, depends on the how your For and Against Motives balance out.
But the decision could easily have been about whether to go to the pub with your mates or not. That’s an easy decision for someone without an alcohol addiction, but for anyone with a ‘drinking problem’ it’s a really important and difficult decision. No matter what the problem is that you are struggling with, once you’ve compiled your ‘For and Against’ Chart, you can clearly see where your conflicts lie.
Think About How Important Each of Your Motives Are Today
As you make your Chart, you can begin to put values on each of your options – you can weigh up each side of the problem: Which course of action produces the outcome that I really want?
So you can ask yourself questions such as,
- Which side of these conflicting motives do I think is the most important for me at the moment?
- Should I say: yes I will, or no I won’t?
- Will I buy more clothes, or are the disadvantages too great?
- Will I continue to gamble, even though I can’t feed the kids?
- Or should I try to get help, so my kids will respect me again?
- Will I continue to drink as much as I do, or should I think about changing my behavior, and finding help?
- Or, will I continue to drink as much as I always do because my desire to drink outweighs what I see are the negative consequences (my ‘disadvantages’) of stopping or moderating?
Important: If you have an addiction, and you have written down as a motive (‘reason’), something like,
“I know I can’t change my addiction, so I have to continue with it”
If something similar has made its way onto your Chart, I would recommend that you seriously think about reaching out for help. Many people, who feel their case is hopeless, can reach out for help and manage to build up enough self-confidence in their own abilities, to be able to restore hope, and beat their addiction. The fact that they cannot see how it could possibly be done from where they are at present, should not have a place anywhere on your chart.
First things, first – what you need to put down now, is what you really want,
not what you think is possible.
The first step is making the decision
How that can be done, is a separate and secondary matter
Once that decision is made, a strategy to achieve that decision can be worked out with the help of your health professionals. Having the belief that change is impossible is ‘only’ a belief (or ‘reason’). It might seem like a true belief, but it’s one that can be changed, even if right now, you don’t see how that’s possible.
Don’t let such a belief block you from reaching out for help, and achieving Recovery. Perhaps you have already given up on the idea that you can beat your addiction, and feel totally helpless to fight it any more, BUT
No Situation Is Ever Hopeless – Even If You Think or Believe That It Is
Thoughts, beliefs, and feelings are not set in concrete
People, events and new information can change how we think, feel and behave.
It’s unlikely that a health professional will give you life-changing information as brutal as the humiliating ‘information’ I received from my very own choice-shifter, Robert, about how disgusting my smoking habit was (See How and Why I Gave Up Smoking). Thanks Robert, wherever you are – no, I really do mean it.
A health professional will be less brutal than that, but if you do go to a doctor or psychologist, or a Rehab facility, they will try to help you to change the way you think and feel about what you do – shift your balance of For and Against Factors, so you can succeed in what you really want to do – not what your addiction wants you to do. That is the basis of Cognitive Behavioral Therapy (CBT).
In the same way that my own choice-shifter, Robert, shifted my For and Against Factors about smoking, they will help you get to a point where the thoughts and feelings you now have about your addiction, have become so negative (Strong ‘Against’ continuing factors) that they outweigh your desire and motives for continuing to give your addiction what it craves – your ‘For NOT changing’ factors.
How your therapist will try to help you do this, will be covered in my next articles.
Magill M, Apodaca, T. R., Barnett, N. P., & Monti, P. M. (2010). The Route to Change: Within-Session Predictors of Change Plan Completion in a Motivational Interview. Journal of Substance Abuse Treatment, 38(3), 299-305.
Apodaca, T. R., & Longabaugh, R. (2009). Mechanisms of Change in Motivational Interviewing: a Review and Preliminary Evaluation of the Evidence. Addiction, 104(5), 705-715. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2756738/
Miller WR, Rollnick S. Motivational interviewing. Preparing people to change addictive behaviors. New York: The Guilford Press, 1991.
Keithly L, Samples S, Strupp H. Patient motivation as a predictor of process and outcome. Psychother Psychosom 1980;33: 87-97