When someone comes to us facing an important decision or struggling with change, it can be tempting to think that our job is to help them find the right answer.
We listen to the problem. We recognise something they may not yet see. We draw on our professional knowledge and experience. Quite naturally, we want to help.
And then the Fixing Reflex appears.
We begin explaining, advising, persuading or pointing out what seems obvious to us.
Motivational Interviewing invites us to do something different.
Rather than asking, ‘What wisdom can I offer this person?’, we might ask:
‘What would help this person think more clearly, openly and deeply about their own situation?’
That small shift opens up an interesting possibility.
Perhaps one of the things a good Motivational Interviewing conversation does is create conditions in which people gain greater access to their own capacity for reflection, perspective-taking and considered judgement.
In everyday language, we might call that helping people hear their own wisdom.
What do we mean by wisdom?
The word wisdom needs some care.
Wisdom is not simply intelligence, knowledge or expertise. Nor does being wise mean always making the correct decision.
Contemporary psychological research increasingly understands wise judgement as something that happens in context, particularly when circumstances are uncertain or complex.
Grossmann and Weststrate describe an important part of wise judgement as perspectival metacognition. This involves recognising the limits of our own knowledge, coordinating different perspectives, and remaining alert to uncertainty and change.
That has an obvious relevance to Motivational Interviewing.
Consider someone who has been prescribed medication to manage a long-term health condition:
‘I know the medication is supposed to help.’
‘I don’t want my condition getting worse.’
‘I feel fine most of the time.’
‘I don’t like thinking that I might need tablets for the rest of my life.’
‘Sometimes I wonder whether I really need them.’
Several things can be true at once.
Wise judgement in such circumstances may not begin with deciding immediately which statement is correct.
It may begin with becoming able to hold more of what is true at the same time.
What becomes possible when we feel safe enough to reflect?
Research into attachment, emotional regulation and mentalising gives us an interesting developmental perspective.
Meta-analytic evidence suggests that more secure attachment is associated with stronger effortful self-regulation in children and with more adaptive emotional regulation and coping.
Mentalising is also relevant. It refers broadly to our capacity to make sense of our own and other people’s behaviour in terms of thoughts, feelings, beliefs, intentions and other mental states.
Research suggests associations between mentalising, attachment security and interpersonal functioning, although these relationships are complex and should not be treated as simple causal pathways.
None of this means people who have experienced secure early relationships are necessarily wiser. Nor does it mean difficult early relationships prevent someone from developing considerable wisdom.
A more cautious proposition is that relational security may support some of the capacities that make reflection and exploration easier.
There is also experimental evidence that temporarily activating a sense of attachment security can influence affective, cognitive and behavioural functioning. A large meta-analysis of security-priming studies found positive effects across all three areas.
That does not mean an MI conversation creates attachment security.
It does, however, support a broader point: how secure or threatened we feel in a relational situation can influence what becomes psychologically available to us.
From protection to exploration
Imagine that I am talking with someone about something difficult.
If I experience them as judging me, correcting me or trying to persuade me, some of my attention shifts towards managing the interaction.
I may begin wondering: What does this person want me to say? Do they think I’m being irresponsible? How can I explain myself? Are they actually listening to me?
My psychological task has changed.
Instead of exploring myself, I am now also dealing with you.
This may help us understand one of the difficulties created by the Fixing Reflex.
The problem is not simply that people dislike being advised.
Attempts to influence us can sometimes be experienced as threats to autonomy. Research on psychological reactance suggests that people who are particularly sensitive to control tend to respond better to receptive, less directive therapeutic approaches than to more authoritative ones.
Research in health contexts also suggests that autonomy support is associated with more self-determined motivation and beneficial health behaviour. Experimental studies have found that increasing a person’s sense of autonomy can reduce defensive responses to potentially threatening health information.
So our efforts to help can inadvertently move attention away from ‘What do I really think about this?’ towards ‘What do I think about what you think I should do?’
The practitioner has become another problem for the person to solve.
The importance of relational safety and autonomy
Attachment theory uses the concept of a secure base to describe how a dependable relationship can support exploration.
We should be careful about importing this directly into Motivational Interviewing. An MI practitioner is not recreating a parental attachment relationship, nor should they attempt to become an attachment figure.
But there may be a useful functional comparison.
A skilful MI conversation communicates something like:
I am interested in understanding your experience.
You don’t have to defend yourself from me.
I can hear different sides of this.
I will not make the decision for you.
You remain free to choose.
Your experience and knowledge matter.
This connects closely with Partnership, Acceptance and Empowerment in MI.
When a relationship is experienced as sufficiently safe and autonomy-supportive, less psychological effort may be required to manage interpersonal threat or defend against influence.
That can create more room for curiosity, self-exploration and reflection.
This is not yet an established mechanism of MI. It is a theoretically informed proposition supported by related evidence from attachment, autonomy and psychotherapy research.
Mentalising and seeing more than one perspective
Mentalising adds another part of the picture.
When we mentalise well, we recognise that our immediate interpretation is only one possible perspective.
We become curious about ourselves: Why does taking this medication bother me so much? What does having this condition mean to me? Why do I sometimes avoid thinking about it?
And about others: Why is my partner so concerned? What is my doctor seeing that I may not be noticing?
This does not require abandoning our own point of view. It expands the field of view.
That has something in common with what wisdom researchers describe when they talk about recognising epistemic limits, coordinating perspectives and tolerating uncertainty.
When helping gets in the way of thinking
Now imagine the person says:
‘I know the medication is supposed to help, and I don’t want my condition getting worse. But I’m going to be taking these tablets for years, maybe for the rest of my life. Some days I feel fine and wonder whether I really need them.’
For a knowledgeable healthcare practitioner, the Fixing Reflex is understandable. We know the evidence. We know the possible consequences of not taking the medication as prescribed. We may feel professionally responsible for making sure the person understands those consequences.
So we might respond: ‘But it’s really important that you take the medication every day because…’
Everything that follows might be clinically accurate.
The difficulty may be the timing and relational context in which the information arrives.
The person’s attention can shift from exploring their experience towards processing or responding to our argument.
A reflective response might instead be: ‘Looking after your health really matters to you, and at the same time there’s something uncomfortable about seeing yourself as someone who needs medication every day.’
The person might respond: ‘Yes. Every time I take them it reminds me I’ve got this condition. Sometimes I’d rather just forget about it.’
Something important has emerged.
What initially looked like a problem of medication-taking may also involve identity, loss, autonomy and what it means to live with a long-term condition.
Another reflection might deepen that understanding: ‘So sometimes not taking them gives you a break from feeling like a patient.’
We have not told the person what to think. We have helped create the conditions in which they can hear themselves thinking.
Epistemic trust: who and what can I believe?
Another developing field may help us think about what happens when people receive information from others.
Epistemic trust broadly concerns our capacity to regard socially communicated information as trustworthy, relevant and potentially useful.
Healthy epistemic trust does not mean unquestioningly believing someone because they are an expert. It involves selective openness.
This is an intriguing concept for Motivational Interviewing, but we need to be cautious. A 2024 systematic review found that the empirical relationship between attachment, mentalising and epistemic trust remains underdeveloped and sometimes inconsistent.
So we should not claim that MI increases epistemic trust.
What we can say is that the concept raises an important question: What makes it easier for someone to genuinely consider information offered by another person?
The practitioner may possess important information about the medication, including its benefits, possible risks and consequences of missed doses.
MI does not require us to withhold expertise. It asks us to consider how and when we offer it.
After exploring the person’s perspective, we might ask: ‘Would it be alright if I shared something about what we know about taking this medication regularly?’
After offering the information clearly and neutrally, we return to the person’s perspective: ‘What do you make of that?’
This is the logic behind Ask-Offer-Ask.
The practitioner contributes expertise while the person retains ownership of the judgement.
Evocation and hearing yourself think
This brings us to one of the defining features of Motivational Interviewing: evocation.
MI assumes that people already possess important experiences, values, hopes, concerns, reasons and knowledge relevant to their situation.
The practitioner’s role is therefore not simply to insert motivation from outside. We help bring something into conversation.
Our person might eventually say: ‘I don’t actually want to stop taking them. I think I hate what taking them represents. It makes the condition feel real.’
That is quite different from: ‘I can’t be bothered taking my tablets.’
The practitioner has not supplied this understanding.
Through conversation, the person has articulated something that may previously have been experienced without being clearly recognised.
This is reflective capacity in action. And it creates new possibilities.
Ambivalence contains information
We sometimes talk about ambivalence as though it is simply a barrier to change.
But ambivalence can contain valuable information.
One side may tell us about health and the desire to remain well. Another may tell us about independence, identity or reluctance to see ourselves as ill.
One side may recognise future consequences. Another may be responding to how we feel today.
Neither side necessarily tells the whole story.
The task is not simply to defeat one side.
It may be to help someone listen closely enough to both sides to understand what each is protecting or pointing towards.
MI process research is interesting here. Meta-analytic research has found that MI-consistent practitioner behaviours are associated with the emergence of both change talk and sustain talk.
Good MI is therefore not simply a technique for getting people to verbalise arguments for change.
It can create space in which the complexity of motivation becomes speakable.
A proposed pathway
Research has not established that Motivational Interviewing works through the pathway below.
It should therefore be understood as a conceptual model rather than an established mechanism of MI.
However, findings from attachment research, Self-Determination Theory, reactance research, mentalising and MI process research allow us to consider a plausible sequence:
Relational safety and autonomy support
↓
Reduced need to defend against interpersonal threat or control
↓
Greater openness, emotional regulation and curiosity
↓
Self-exploration and reflective capacity
↓
Perspective-taking and mentalising
↓
Exploration and integration of ambivalence, values and experience
↓
More autonomous and considered judgement
In everyday language, the later stages of this process might sometimes feel like gaining greater access to our own wisdom.
Wisdom is therefore not the proposed mechanism. It is a way of describing what may emerge when someone is able to reflect more openly and integrate more of what matters to them.
Creating the conditions rather than supplying the answer
Perhaps one way to understand excellent Motivational Interviewing is as the creation of a particular kind of reflective space.
A space in which people can say things they are uncertain about.
A space where contradictory feelings can coexist.
A space where changing your mind does not mean losing face.
A space where information can be considered without feeling controlled by it.
A space where values can emerge.
A space where people hear themselves thinking.
We should be cautious about calling the psychological process itself wisdom. Terms such as reflection, mentalising, perspective-taking, integration and autonomous judgement are more precise.
But wisdom remains a useful human description of what can sometimes emerge.
For practitioners, that leaves us with a question worth carrying into our next conversation:
When I feel the urge to offer someone my wisdom, could I first become curious about what might help them hear more of their own?
