Miller & Rollnick changed the terminology from "rolling with resistance" to "dancing with discord" in the third edition of their book. I appreciate how this further enforces the notion that it is not our patients that are "resistant," "in denial," or "difficult," but rather how we as providers may be misreading their readiness to change, trying to push change into them rather than elicit desire to change from within. Imparting information does not work effectively when a client isn't ready to hear it. In addition, we may believe we know best how clients should go about making change. However, clients know more about how change will work in their lives. Resistance and discord in the provider/patient relationship provides us with an opportunity to revisit our intervention and change course. Instead of arguing for clients to change behaviors, it is far more effective to elicit their internal drive to change. The more we elicit their desire, ability, reasons and needs to change, the more likely they are to make that change.
Motivational Interviewing has many specific techniques for working with clients through discord toward effective change. I had the opportunity to provide a 2 hour MI training specifically on working with discord recently. We had a lot of fun practicing using complex reflections in response to difficult client statements, role playing, and revisiting the spirit of MI (acceptance, partnership, evocation, compassion). Carl Rogers taught us about the concept of unconditional positive regard. MI teaches us that especially in our work with people on difficult behavior change, in an atmosphere of acceptance & compassion we can effectively elicit motivation toward change.