we’re genuinely eager to find out. The goal isn’t to tell people what to do;
it’s to help them break out of overconfidence cycles and see new
possibilities. Our role is to hold up a mirror so they can see themselves
more clearly, and then empower them to examine their beliefs and
behaviors
. That can activate a rethinking cycle, in which people approach
their own views more scientifically. They develop more humility about their
knowledge, doubt in their convictions, and curiosity about alternative points
of view.
The process of motivational interviewing
involves three key
techniques:
Asking open-ended questions
Engaging in reflective listening
Affirming the person’s desire and ability to change
As Marie-Hélène was getting ready to take Tobie home, the vaccine
whisperer the nurses called was a neonatologist and researcher named
Arnaud Gagneur. His specialty was applying the techniques of motivational
interviewing to vaccination discussions. When Arnaud sat down with
Marie-Hélène, he didn’t judge her for not vaccinating her children, nor did
he order her to change. He was like a scientist or “a less abrasive Socrates,”
as journalist Eric Boodman described him in reporting on their meeting.
Arnaud told Marie-Hélène he was afraid of
what might happen if Tobie
got the measles, but he accepted her decision and wanted to understand it
better. For over an hour, he asked her open-ended questions about how she
had reached the decision not to vaccinate. He listened carefully to her
answers, acknowledging that the world is full of confusing information
about vaccine safety. At the end of the discussion, Arnaud reminded Marie-
Hélène that she was free to choose whether or not to immunize, and he
trusted her ability and intentions.
Before Marie-Hélène left the hospital, she had Tobie vaccinated. A key
turning point,
she recalls, was when Arnaud “told me that whether I chose
to vaccinate or not, he respected my decision as someone who wanted the
best for my kids. Just that sentence—to me, it was worth all the gold in the
world.”
Marie-Hélène didn’t just allow Tobie to be vaccinated—she had his
older siblings vaccinated at home by a public health nurse. She even asked
if Arnaud would speak with her sister-in-law about vaccinating her
children. She said her decision was unusual enough in her antivaccination
community that “it was like setting off a bomb.”
Marie-Hélène Étienne-Rousseau is one of many parents who have
undergone a conversion like this. Vaccine whisperers don’t just help people
change their beliefs; they help
them change their behaviors, too. In
Arnaud’s first study, with mothers in the maternity ward after birth, 72
percent said they planned to vaccinate their children; after a motivational
interviewing session with a vaccine counselor, 87 percent were onboard. In
Arnaud’s next experiment, if mothers attended a motivational interviewing
session, children were 9 percent more likely to be fully vaccinated two
years later. If this sounds like a small effect, remember that it was the result
of only a single conversation in the maternity ward—and it was sufficient to
change behavior as far out as twenty-four months later. Soon the
government health ministry was investing millions of dollars in Arnaud’s
motivational
interviewing program, with a plan to send vaccine whisperers
into the maternity wards of every hospital in Quebec.
Today, motivational interviewing is used around the world by tens of
thousands of practitioners—there are registered trainers throughout
America and in many parts of Europe, and courses to build the necessary
skills are offered as widely as Argentina, Malaysia, and South Africa.
Motivational interviewing has been the subject of more than a thousand
controlled trials; a bibliography that simply lists them runs sixty-seven
pages. It’s been used effectively by health professionals to help people stop
smoking, abusing drugs and alcohol,
gambling, and having unsafe sex, as
well as to improve their diets and exercise habits, overcome eating
disorders, and lose weight. It’s also been applied successfully by coaches to
build grit in professional soccer players, teachers to nudge students to get a
full night’s sleep, consultants to prepare teams for organizational change,
public health workers to encourage people to disinfect water in Zambia, and
environmental activists to help people do something about climate change.
Similar techniques have opened the minds of prejudiced voters, and when
conflict mediators help separated parents resolve disputes about their
children, motivational interviewing is twice as
likely to result in a full
agreement as standard mediation.
Overall, motivational interviewing has a statistically and clinically
meaningful effect on behavior change in roughly three out of four studies,
and psychologists and physicians using it have a success rate of four in five.
There aren’t many practical theories in the behavioral sciences with a body
of evidence this robust.
Motivational interviewing isn’t limited to professional settings—it’s
relevant to everyday decisions and interactions. One day a friend called me
for advice on whether she should get back together with her ex. I was a fan
of the idea, but I didn’t think it was my place to tell her what to do. Instead
of offering my opinion, I asked her to walk through the pros and cons and
tell me how they stacked up against what she wanted in a partner. She
ended up talking herself into rekindling the relationship. The conversation
felt like magic, because I hadn’t tried to persuade her or even given any
advice.
*
When
people ignore advice, it isn’t always because they disagree with
it. Sometimes they’re resisting the sense of pressure and the feeling that
someone else is controlling their decision. To protect their freedom, instead
of giving commands or offering recommendations, a motivational
interviewer might say something along the lines of “Here are a few things
that have helped me—do you think any of them might work for you?”
You’ve seen how asking questions can help with self-persuasion.
Motivational interviewing goes a step further, guiding others to self-
discovery. You got a glimpse of it in action when Daryl Davis asked KKK
members how they could hate him when they didn’t even know him, and
now I want to unpack the relevant techniques in depth. When we try to
convince
people to think again, our first instinct is usually to start talking.
Yet the most effective way to help others open their minds is often to listen.
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