Therapy Resistance

[David Baxter PhD]

The way I read the text, it looks like the techniques can/are used for both reluctant and resistant clients.

I wouldn't say so. A resistant client is one who may be resistant to a particular issue or analysis of that issue for any number of psychologically significant reasons, but who may still be quite motivated for therapy on other issues.

I do quite a bit of work with teens, who initially are almost always reluctant to come to therapy. Once there, however, they are not necessarily resistant. Reluctance and resistance are what the statisticians would call orthogonal factors - they may be related but not inextricably so.

By the way, on the subject of reluctance and even mandated treatment, all of the conclusive research I have seen on that issue says quite clearly that motivation is motivation - what matters is how strong the motivation is, not whether it is intrinsic or extrinsic. I think this is an error a lot of drug rehab programs and mental health programs make, i.e., to assume that if the individual is only externally motivated it is not "real" motivation.

Get the client to the therapist or treatment program any way you can. After that, it is up to the therapist to engage the client.

 

[foghlaim]

hmm i'll have to look up them "foreign " words and come back to this, thn i'll understand it better.

but i clearly understand the last line.
what happened to the old saying " you can bring a horse to water but you can't make him drink" ?? surely that has relevance to your last line?

 

[Peanut]

I wouldn't say so. A resistant client is one who may be resistant to a particular issue or analysis of that issue for any number of psychologically significant reasons, but who may still be quite motivated for therapy on other issues.

Oh interesting. Have you ever come across complete resistance? And if so, does the preclude treatment or do you keep trying?

I actually have experienced being both a "relunctant" client and "resistant" client, I think. The reluctant times were when I was a child. Both times the therapy went nowhere and the counselors terminated (to my extreme pleasure).

By the way, on the subject of reluctance and even mandated treatment, all of the conclusive research I have seen on that issue says quite clearly that motivation is motivation - what matters is how strong the motivation is, not whether it is intrinsic or extrinsic. I think this is an error a lot of drug rehab programs and mental health programs make, i.e., to assume that if the individual is only externally motivated it is not "real" motivation.

Wow, I that is not what I would have thought! I am surprised, I would have thought internal motivation would be much more powerful. Very interesting. Thanks for explaining that. Research talks man! :wink:

 

[David Baxter PhD]

what happened to the old saying " you can bring a horse to water but you can't make him drink" ?? surely that has relevance to your last line?

That's true. My point was "lead a horse to water and it's my job to show him why it's in his best interest to drink".

Have you ever come across complete resistance? And if so, does the preclude treatment or do you keep trying?

Yes, I have a few times.

I give it my best shot. If I don't see any hint or hope of progress (i.e., reistance beginning to weaken) within a few sessions, I'd probably suggest that another therapist might be more helpful.

 

[vi]

Great topic!
Personally, I though I was very open with my therapist.
He didn't seem to find me very cooperative though. Maybe I thought I was
but actually wasn't, compared to others?
I really tried, but he would tell me that I was superficial and cold!
After going on like this for a while, I did start feeling defeated and became
resistant in a way. I did continue going every week, with hope of a better outcome.
Once I told him that my brain turns into mush after 20 min. into session!
I would get drained quickly from confusion, frustration, fear from his cold expression
and getting overstimulated by it all to the point of not being able to be aware of anything, and not understanding it all, at that time.
By the way, that book from Elaine Aron that is recommended on this site is excellent!( started it recently).
One possibility for feeling like you 'don't know', could be because you're overstimulated, for what ever
reason(intimidation?).
Before I venture into any further therapy, I want to finish this book.
So far, it's helped me understand my emotions better and not feel I'm abnormal for having them.
That is worth it's weight in gold for all situations, including when facing a complete stranger who wants to know all of your little nitty gritties!

 

[Peanut]

Thanks for answering Vi!

Personally, I though I was very open with my therapist.
He didn't seem to find me very cooperative though. Maybe I thought I was
but actually wasn't, compared to others?

Yes, I think that happens to me too. A lot of times I'll feel like I'm making a lot of effort but maybe it doesn't come across that way. It can be frustrating.

Once my psychologist asked me something uncomfortable and after quite a bit of beating around the bush I finally gave him a straight answer. What he said after that was simple but extremely helpful, he said "Thank you for sharing that with me, I could tell it was hard for you." Actually I think that may have been one of the most helpful things he's ever said in terms of building a therapeutic relationship.

It's kind of interesting how something doesn't have to necessarily be profound to be really meaningful.

 

[Banned]

It's kind of interesting how something doesn't have to necessarily be profound to be really meaningful.

Toeless,

I have to agree with you. My therapist will often thank me for being honest. One time I was really shocked when he did this because I was telling him that if I had to lie to him in order to keep seeing him I would. I expected him to freak on me. He thanked me for being honest. After that, I had to do a whole lot of thinking, and then went back a few weeks later and said that I now felt like I could be honest, so I would be.

I'm often resistant at times, but we just work through or around it, and we'll come back to the issue when I'm ready. There's not a whole lot of pushing on his part.

 

[Lost]

Thanks to this thread, and my suggestion to not say "I don't know" but to say what the feeling really is - I had the guts to tell my therapist something which I've been holding back for a long time... and it's really taken me into completely new territory...

So at least my suggestion helped someone! Me! Thanks Toeless for starting this whole post.

Has anyone else tried?

 

[Peanut]

Hey that's awesome! I'm glad to hear it! I am just excited that I found other people that like to talk about this kind of stuff too! I don't think I said "I don't know" at all last time I went actually! One thing that I noticed, last time I went in I had a whole different demeanor--totally non-anxious, and I really think that made a big difference in the "I don't know" type of thing. It made think that that kind of response, at least in me, is tied in with anxiety, maybe trying to answer to quickly, trying to avoid being uncomfortable, etc.

But anyway, that is soooo cool 8) Good job!

My therapist will often thank me for being honest. One time I was really shocked when he did this because I was telling him that if I had to lie to him in order to keep seeing him I would. I expected him to freak on me. He thanked me for being honest. After that, I had to do a whole lot of thinking, and then went back a few weeks later and said that I now felt like I could be honest, so I would be.

Yes, I do think it feels very good when effort is acknowledged. Especially when the effort may be more emotional, and not so visible, it is nice to have it recognized.

There's not a whole lot of pushing on his part.

That is the same with mine.

 

[Into The Light]

lost, i am so excited for you. way to go! that is a big step forward.

 

[g-scared]

Counselors can also use language, especially metaphors, to soften resistance or reluctance. "Metaphors can be used to teach and reduce threat levels by providing stories, by painting images, by offering fresh insights, by challenging rigid thinking, by permitting tolerance for new beliefs, and by overcoming the tension often present between a counselor and the resistant [or reluctant] client" (James & Hazler, 1998). For instance, in addressing a client who keeps repeating the same mistake over again, the counselor might say, "what does a fighter do when he gets badly beaten up every time he fights?" (James & Hazler 1998).

Yes, I find that this is true with my therapist when I am being resistant. It's not that I'm a particularly indecisive type, but I am very oppinionated and stubborn. The other day I was telling her how I had gotten an email from my ex-boyfriend, how it seemed really scrambeled and weird, and she suggested that I not respond at all. It's difficult because I'm very protective of him, and was planning on communicating with him just slightly, but was going to try to turn the conversation in a way that would make him concentrate more on himself and not on me.

I guess, when she saw that I wasn't convinced, she threw out a metaphor. Said it was like a fire and that any type of communication would fuel his connection to me, and that it would just make everything more difficult.

She is probably right. So, for now I guess I will continue to cut him off.

 

[foghlaim]

hi G-s.. i think you are right in saying that she is probably right, after all if you do respond even with the intention of turning it around to make him concentrate on himself. it's quite possible that it won't have that affect at all if his thinking is really scrambled and weird.

I believe your therapist is protecting you by suggesting you not communicate with him at all, and tho i'm no therapist or dr. i agree with her reasoning.

You have to concentrate now on what is good for you, ok and i'm glad yuo are taking her advice on this.

take care

nsa.

 

[kelsischanging]

Unfortunately I am the resistent client(at least until about amonth ago)...when my therapist would launch into one of those "reflective silences" I would just stare at him...at one session I went 45 minutes with out saying a word except yes, no, and maybe :yikes:...I think the reason people are resistent is because they don't want to change like the article says...the reason I didn't want to change was because even though I hated my routine and the things I was involved in they were familiar to me and bad familiar or good familiar it didn't matter....those actions/routines were comfortable to me even though I hated the outcome...oh yeah my therapist does roll playing all the time...I'm still resistent to that...I hate role playing...maybe I just need a better imagination ...oh yeah sometimes when I really don't want to talk I play w/ my cell phone...not making calls or anything just text messages and games...I can unfortunately be a nightmare of a client :hair:

 

[foghlaim]

Hi Kels: reading thru yur post there, you say the reason I didn't want to change because etc etc.. I take that to mean you are working on changing now with yur therapist. and i can identify with some of what you wrote about things being familiar, whether good or bad, it take a lot of work togo thru them and work them out.

keep at it Kels.. i don't think you are a nightmare client at all. being in therapy can be hard for some and for others easier tohandle.

G-s hoping things are looking up for you.

nsa

 

[kelsischanging]

nsa: I am working on changing...I didn't mean to say the reasons you don't want to change I meant to just say in general and for me those were the reasons...I hope I didn't offend you and if I did I'm sorry..thanks for the encourgement....I hope things are going well for you as well

 

[foghlaim]

oop Kels.. we have crossed lines here and it's my fault,, not yours,, i should have put what you said into a quote..

the reason I didn't want to change because etc etc.

so no danger of any offence being taken here ok. i apologise for giving the wrong impression... stupo me... lol.

Glad to hear you are working on changing.. can't be easy.. well done on working on it.. and I really hope it goes well for you. keep us updated ok.

nsa