Smoking
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Talking to a loved one about his or her smoking habit can rank high on the list of sensitive subjects. So how to broach the conversation? Smoking cessation expert Dr. Daniel Seidman offers ideas on being effectively heard without coming off like a nag.
A friend of mine opened a conversation with a smoker he knows and tried to give her a copy of my new book, Smoke-Free in 30 Days. She got very huffy and said, "Please don't bring up this subject again." My friend is a retired minister and not given to leaving things in a state of ill will and tension. He asked her not once, but three times if she would forgive him, before she reluctantly agreed. Several other friends have also told me they want to give my new book to a smoker they care about, but they feel they might stir up a hornet's nest of anger. On the other hand, they are deeply worried about the person's health and well-being and are conflicted about how to proceed. What is this quality of defensiveness that puts certain conversations with people we care about off limits? What can a well-meaning friend or relative do when he or she hits this kind of a wall in a relationship?

When people act defensively, it's a self-protective mechanism with a clear message to the perceived intruder to "back off." The response seems aggressive, but the experience may be more instinctive, like pulling your hand back after touching a hot stove. The experience of pain triggers the self-protective response. So when we see this quality of defensiveness, chances are there's an emotional hot stove being touched underneath. The person may get this way because he/shealready knows this is something that isn't right for them and are already suffering from a guilty conscience about it.

When it comes to smoking, we have stigmatized it to the point where bona fide smoking addicts find it increasingly difficult to rationalize their smoking behavior. Instead they hunker down, and woe be to those who venture into this brittle territory. Of course, this quality of defensiveness applies to many other problematic behaviors such as alcohol abuse or overeating, as well as many other behaviors detrimental to our physical and mental health. One way to respond is to keep focused on getting healthy ourselves, and not try to control the other person through our own anxiety; to "detach with love." This doesn't mean we give up on the person, but it does mean we don't destroy the relationship to "save it." Readiness to change is the nice and neat concept sometimes offered to explain the stalemate. Yet even in the face of defensiveness, we can try to engage the person in a reasoned and cooperative way. It is, of course, reasonable to assert your legitimate interests in a situation by establishing ground rules or boundaries—for example, asking someone not to smoke in your house or around your children. Another example is not buying alcohol for an alcoholic, or drinking with someone when he or she becomes mean or dull. In the practice of psychotherapy, you can offer new perspectives on a problem many times, choosing words carefully and tactfully, and then suddenly the person has an aha! moment and shifts his or her own view of the situation. Another approach used by psychotherapists is to help the person get some distance from the problem by asking: "What if you saw someone you care about doing something detrimental to their health? What would you do?"
With a friend or family member, the ideal is to be firm, forthright and clear about your concerns and preferably offer the person a practical solution or alternative vision to the current situation. Don't be intimidated and cowed by the defensiveness you encounter, but don't trample on it either. If your impulse to help is sincere, be strong and unapologetic in your stance, but realistic about the limits of your influence. The art is to engage the person without nagging or bullying him/her, or withdrawing completely and giving the "silent treatment." The point is not to give up on the person, but also not to engage in a hostile takeover either.

Keep in mind that if the person's response is based on fear, and the person is not just asserting adult choices, preferences and rights, he/she may lack the confidence or knowledge to climb out of a self-defeating trap. Without seeming to condemn or tell the person what to do, you could offer a potential solution or way out of the dilemma for him/her to consider. It is always the person's choice, of course, to make a change in the behavior in question. More often than people realize, it is a matter of lacking the confidence that change is possible that holds people back. People often won't look squarely at a problem unless they see a workable solution. While it is tough to walk the line between the extremes of intruding where we are unwelcome, or just giving up on someone we care about, if we try to get it right, we may be forgiven our trespasses.

Have you tried to talk to a loved one about smoking? How did he or she react? Share your story below.

Dr. Daniel Seidman is a clinical psychologist and director of the smoking cessation service at Columbia University Medical Center. He is the author of Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit—which has a foreword by Dr. Oz. For more details about the book, visit DanielFSeidman.com

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For more on Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit, visit DanielFSeidman.com

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