**The Art of Motivational Interviewing: Insights from Dr. Steven Pearce and Dr. Bruce Berger**

Motivational interviewing (MI) serves as a crucial instrument in patient-centered care, holding the potential to transform the dynamics between healthcare professionals (HCPs) and their patients. Fundamentally, MI is not about convincing or compelling individuals; it focuses instead on understanding a patient’s intrinsic motivations, values, and obstacles to change in a compassionate, nonjudgmental manner. A recent discussion between Dr. Steven Pearce, a gastroenterologist and filmmaker, and Dr. Bruce Berger, a leading pharmacologist and MI proponent, illuminated the vast possibilities this method presents in both clinical and personal settings.

### **The Experts Behind the Movement**
Dr. Steven Pearce is both an active gastroenterologist and the creator of *Love Evolved*, an impactful film that documents his personal journey and examines the connections between mental health, spirituality, and growth. Pearce’s experiences shape his patient interactions, placing a strong emphasis on connection and empathy.

Dr. Bruce Berger transitioned from pharmacist to a specialist in behavioral health, holding a PhD in social and behavioral pharmacy. A key player in integrating MI into healthcare practice, Berger advocates for the notion that the relationship between a clinician and patient is the most significant factor influencing health outcomes.

Throughout their dialogue, complemented by insights from physician advocate Kim Downey, the duo explored MI’s transformative potential and shared practical strategies for clinicians to refine their practice.

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### **What is Motivational Interviewing?**
Dr. Berger characterizes MI as “an evidence-based, patient-centered methodology” aimed at addressing ambivalence or reluctance regarding behavior modification. Contrary to common misconceptions, MI does not aim to impose a patient’s motivations. Instead, it seeks to reveal the patient’s inherent motivations and align treatment approaches with their personal values and priorities.

### **The Key Principles of Motivational Interviewing**
As articulated by Berger, MI is founded on several core principles that enable HCPs to establish trust, promote collaboration, and cultivate a setting conducive to change:
1. **Seeing the Patient as an Equal Partner:** MI positions patients as the authorities on their own experiences. While clinicians might have medical expertise, patients comprehend their lived realities.
2. **Understanding Patients’ Perspectives:** Central to MI is appreciating:
– How patients view their illness and care.
– Their emotions related to the condition.
– Their healthcare priorities.
3. **Recognizing Effort:** Berger highlights the significance of recognizing what the patient is already doing. For instance, if a patient takes their medication four times a week instead of the prescribed seven, the focus begins with validating that initial effort: “You’re already taking your blood pressure medication four days a week—that’s an excellent starting point.” This sets a constructive tone before discussing further improvements.
4. **Creating Positive Connections Without Judgment:** MI focuses on collaboration devoid of reproach or criticism. Authoritative language or correcting behaviors (such as dismissing concerns—e.g., “No, the COVID vaccine can’t give you COVID”) often result in resistance or disengagement from the conversation. MI encourages patients to feel acknowledged.
5. **Functioning with Empathy and Autonomy:** At its essence, MI respects and empowers. HCPs recognize that patients ultimately possess the authority to make choices regarding their health. Clinicians’ roles are to supply information and promote collaboration in a manner that leaves patients feeling supported and in control.

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### **The Impact of MI**
The evidence supporting MI is substantial. As Berger noted during their discussion, MI significantly enhances treatment adherence and health outcomes across a range of conditions, including diabetes, hypertension, smoking cessation, and mental health issues. Furthermore, MI accentuates “connection,” an essential element of care that ensures patients feel acknowledged and valued.

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### **Steven Pearce: Humanizing the Patient Encounter**
Dr. Pearce shared an honest account of his growth as a clinician. Early in his career, he became so engrossed in fulfilling clinical checklists that he inadvertently neglected the individual on the opposite side of the exam table. Patients departed his practice not due to a lack of expertise but because they felt unheard.

After adopting a more empathetic methodology, partly inspired by his work on *Love Evolved* and spiritual psychology, Pearce transformed his practice. A key exercise he discovered—”seeing the loving essence”—involves engaging with someone through deliberate, meaningful eye contact. Pearce tailored this practice to the clinical environment, emphasizing moments of authentic connection with his patients.

The outcomes were profound. Patients remained with his practice, built trust, and became more involved in their care. As Pearce reflected, “We become so preoccupied with needing to check every box that we forget there is a soul experiencing something.” For him, MI embodies this philosophy— a way to engage deeply with patients.