What Motivates You To Improve?

Motive: something as a need or desire that causes a person to act; moving to action

I have been thinking a lot about motivation this week. Perhaps it’s because I have fallen asleep on the couch each night watching the Olympics. One can’t help but wonder about the factors that cause these young athletes to perform with such persistence, to fearlessly get back up on their skis following a treacherous fall, and for many, to return home with no medal, despite years of practice. One often hears the winning athletes thank their parents, who no doubt sacrificed to drive them to practice, pay for lessons, and in numerous other ways supported their dreams. Coaches also get thanks, because, we know that they are often the ones who spot and cultivate talent, push for performance, and although they will never stand on a podium as the national anthem plays, somehow, vicariously, they will know they have also won.

When working with patients with voice, speech, and swallowing problems I often refer to myself as a “coach”. When acting in the role of coach, it is important that the individual and I feel a personal connection, but it is also important that I quickly discover what is motivating the patient to pursue treatment. I need to ask about the individual’s goals, so in my first visit or interview with the patient I try to perform a “reality check”. If the individual states that they are coming to see me to “speak better” I might ask:

”How often do you exercise now?”

“What is it about your voice, speech, or swallowing that currently bothers you?”

“How much do you talk and socialize?” “Do you care about other people’s opinions about your speech?”

“ How quickly do you think change will occur, and how willing are you to continue a program of exercise once we are no longer working together?”

The answers to these questions are important in identifying what, if anything, is motivating the individual to actually meet with me and consider treatment.

I am fortunate to work with a local neurologist who is very proactive in his approach to speech therapy. He doesn”t wait until patients are symptomatic to refer them for voice and swallowing treatment, but, rather, realizes the insidious nature of Parkinson’s disease and acknowledges that years before the diagnosis is confirmed, physiologic changes have already occurred. But, his patients are not always so motivated. Below is a recent phone exchange with a prospective patient who I called to schedule a consult:

(Patient) “How about if I take your number and call you back. I’m not really having a problem right now.” ( oh yes you are, I think, as I listen to hesitations )
(Me) “You don’t really want to wait until your having symptoms, do you?”
(Patient) “I only cough occasionally” (so, you are already having symptoms, I think)
(Patient) “I’m a professor, and I’m busy working with a research assistant right now.” “I’m not really interested.”
(Me) “You’re a professor,” I say, “all the more reason you should care about your speech and voice.”
(Patient) “I’ll call you next year when I’m in Florida.” (and time marches on, I think)

Will he become motivated and desire improvement before it’s too late? Are you motivated?

Re-printable with permission from the author: Mary Spremulli,MA,CCC-SLP.
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