Chapter

Psychotherapy

pp 67-77

Date:

Motivation, Internal and External

  • Jeffery SmithAffiliated withNew York Medical College

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Abstract

Change is hard. For this reason, motivation is critical to the success of psychotherapy. In this chapter we examine how motivation is influenced by internal and external forces. Motivation can come from wanting relief of pain or seeking greater pleasure. It can also come from a wish to make reality match values and ideals. Motivation is enhanced by hope, the belief that success is possible. It is strongly suppressed by any perception that efforts will be in vain. All of these inner forces can be influenced by culture, personal networks, family, and the therapist. Murray Bowen’s family systems theory helps understand the reactions of families. Some EDPs, such as addictions, eating disorders, and self-injury, can apply chemical rewards directly to motivational centers, raising the level of motivation required for change. The role of the therapist is complex. With some patients, a positive engagement is helpful, and, in other cases, it can cause problems.

Keywords

Motivation Hope Panksepp The SEEKING system Dopamine Nucleus accumbens Murray Bowen Family systems Closed systems Open systems Enabling Codependency