Carrot and Stick Analogy of Motivation

Within therapy we often make it a non-negotiable to set goals. Something to strive towards, but often there’s a lack of motivation. I’ve come to understand that fear is a far greater motivator, and something vastly overlooked with patients.

A carrot and stick approach for garnering motivation works much better. It maybe a little trite, but it’s accurate. Picture a donkey. We want it to move forward. We dangle a carrot in front of it (a reward, a goal, a reason to move). That’s one form of motivation. We poke it with a stick. That’s another. The carrot is the promise of reward: goals, dreams, futures worth striving for. The stick is the threat of pain: the cost of standing still. Within therapy, I see this model play out all the time.

Ask someone recovering from an eating disorder what they want, and you’ll hear the carrots:

“I want to travel without obsessing over food.”
“I want to be healthy enough to have children.”
“I want to stop missing life while I’m stuck in my head.”

These are wonderful, necessary aims, but they often aren't enough.

To understand why, we need to look through the lens of Daniel Kahneman, an economist. His theory of loss aversion anchors on that we are more motivated to avoid losses than to pursue gains. In his theory of loss aversion, Kahneman showed that the psychological pain of losing £100 is roughly twice as powerful as the pleasure of gaining the same amount. This is prospect theory and it applies far beyond money. It explains why someone might know they should recover… but only start recovery when they’re on the edge of losing something they can’t bear to lose.

The pain of staying where you are, if properly defined, is often more motivating than the hope of where you could be. That’s what makes the stick so powerful, and it sounds like this:

“If I continue like this, I’ll be back in hospital.”
“My physical health will continue to deteriorate”
“I’m terrified of passing this on to my future children.”
“I’m this many years old and can’t go on a dinner date without spiralling.”

The stick gets the donkey moving long before the carrot comes into focus. When people fail to change, it’s often because they’ve only written their goals - not their consequences. They know what they want, but they haven’t faced the risk of staying the same.