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When we start working with someone, we encourage the person to identify every reason (or motivation) to change but we also suggest that they not get too attached to any given one. We want them to be prepared for the shifts in motivation that will inevitably come with time.

maybe he would have been more motivated to exercise if his doctor told him he must lose fifty pounds or have a heart attack. The point? Motivation is specific to a behavior and a context, and you can be an influence for good when you understand that.

The reality is that the motivation to use a substance rather than engage in some other behavior is based on how the outcome of that choice feels to the person—smoking pot feels relaxing, for example, and doing a crossword feels boring. By understanding the different motivations behind each choice your loved one makes, you will be better equipped to look at the problem clearly without judging.

Motivation is a state, specific to a given behavior, not a general trait inherent in a person.

The traditional treatment mandate to “come back when you’re ready” partly got it right: maintaining change usually requires that people develop their own reasons for wanting that change.

The brain and the world in which it operates are inextricably intertwined; we literally take in substances, people, and other stimuli, and they affect the very structure and functioning of our brains.
you can see the value in staying engaged. Your loved one is affecting his brain chemistry with substances; you can affect his brain chemistry with the way you interact.

Motivation works in the same way with the decision to use a substance. Substance use increases dopamine in the brain (or the substance itself acts like dopamine). If someone who is struggling with depression uses cocaine and feels more alert, engaged, and less tired, they may be motivated to use cocaine to “feel better” again, even though going on a camping trip would also make the person feel better.

When we’re there, we take in the sounds, smells, and adventure of the experience and dopamine flows and we feel good. In the end, the decision to do all the work associated with a camping trip is motivated by the anticipation and actual reward of smelling pine needles, hearing babbling brooks, and eating s’mores.

In neurobiological (and simplified) terms, we are motivated to do things that have been associated with dopamine in our experience. So we are motivated to go camping if dopamine flowed the last time we went or, if you have never been, perhaps when you looked at pictures of a beautiful camping spot. As we look forward to the trip, we summon the drive it takes to pack up backpacks..

Until recently, traditional methods of treatment for substance problems conceived of motivation as a fixed trait: you have it or you don’t.
Thanks to good research, we now know that treatment providers, family members, and others important to your loved one can all have a positive impact on his motivation. Conversely, we know that certain ways of interacting cause people to push back.

Hopefully, too, you will be relieved to know that your loved one is more than “just not motivated” and, in fact, always has the potential to change.

It could be that when the person finds another way to feel better and a better way to cope with not feeling better, she won’t choose to drink. Of course she probably drinks for other reasons too, and she might drink for different reasons at different times. Regardless of the pattern, understanding what it is doing for her lets you start moving in another direction.

The first, critical step in helping people change is to understand the motivation for their behavior in the first place—not the deep-rooted, historic motivations (though sometimes these too), There’s nothing crazy about the statement “I like to drink because it makes me feel better.” IUnderstanding the reason behind a person’s behavior, however, contains the seeds of a solution to the problem.

Do you think of your loved one as unmotivated? Does his decision to continue using substances seem inexplicable, stubborn, and even crazy to you? You may have given up trying to understand why he does what he does—and why he doesn’t do what you wish he would do. You may be so frustrated and angry that you don’t care anymore why he does it; you just want it to stop.

A person chooses to stop using something (like alcohol or a habit) for a short time—like a week or a month—something that feels possible for them. This helps them see that they can do it, and it builds their confidence. This way, quitting doesn’t feel scary or forever. People do better when they think of it this way instead of feeling forced to give it up forever.

A key piece of problem solving is learning from what has or hasn’t worked, and making adjustments. Often, people have made attempts at change previously and had some success; it is valuable to acknowledge this and examine it in order to see what might be helpful moving forward (or what might get in the way).

How hard would it be for her to stop and stay stopped?
Or to continue moderating, if that’s the goal? The moment of stopping tends to receive more attention than it deserves. For most people, maintaining change over the long run is the real challenge.

it’s equally true that change doesn’t happen in an instant, and often can’t be forced. Friends and family understandably worry all through the ebb and flow of their loved one’s use and its consequences. This can go on for years, with worry crossing over to panic when calm and patience would serve everyone better. Staying calm is easy to say and much harder to do, but it is doable.

Substance abuse can be dangerous—we see lives destroyed and terrible things happen. Sometimes people die. AND . . . it’s equally true that change doesn’t happen in an instant, and often can’t be forced. This can go on for years, with worry crossing over to panic when calm and patience would serve everyone better. Staying calm is easy to say and much harder to do, but it is doable.

Jude, a professional woman in her fifties, smoked more than a pack of cigarettes a day and felt that, for a long list of reasons she could recite to herself (and often did), she was a horrible person. Even though she was successful in her work, she felt worthless and afraid, and when she smoked she forgot those feelings temporarily. A person may never have any signs of physical withdrawal,

Highlights:
"When flooded with a substance, this part of the brain basically shuts down. (Teenagers have a distinct disadvantage here, as their young cerebral cortexes aren’t even fully developed."
"even though he promised he would stop, perhaps you will consider that it happened as a result of craving states generated in his brain rather than assuming he lied to you and doesn’t care about your feelings."

Highlights :
Substance use floods the brain with dopamine, reducing natural production. Without it, even simple joys feel flat. This dopamine crash makes early recovery feel worse before better, driving relapse. The good news: the brain can heal over time. Knowing this helps you support your loved one through the tough phase, and meds or strategies Sol: other means of stimulating dopamine (exercise)

Addiction isn’t caused by a single gene but by a mix of genetic, environmental, and social factors like trauma or early use. Positive family bonds can protect against it. Substances impact brain function, influencing behavior, but recovery is possible—brains can heal. Understanding this helps you support loved ones with empathy, not blame.

Highlights :
"Reducing all problems to addiction oversimplifies the person's situation. Issues like failure, isolation, or instability may persist even if addiction is treated, and ignoring them increases relapse risk. It's essential to understand their unique struggles, emotional vulnerabilities, strengths, and support systems to truly help them recover."

Highlights from the book :
"As difficult as it is when your buttons have been pushed and you’re impatient for change, try to stay calm."
"In short, you can hope for change, and you can do something about it."
"We encourage you to step back and think through what might be effective (a kind word), not just what would feel justified (a loud shout). "