Resistance in therapy – infinitely variable

 

This week’s lecture was on resistance in therapy. This was particularly useful given that I am now seeing clients at the drop in centre. Resistance is viewed as a positive force which opposed the return to memory of painful experiences.  Freud talked about the positive sign that the truth was emerging.

It is important to understand that defences are there for a reason.  Coping strategies help us survive.

Types of resistance:

Repression resistance

transference resistance

Secondary gain resistance

Super ego resistance

Poor or faulty technique

Due to change my pose to relationships

Due to the dependency on the therapist

Caused by a threat to the patient’s self esteem by the therapy

Due to repetition compulsion

Fixed personality traits

How does resistance manifest?  The most common ‘acting out’ are not turning up, not paying, silence or indeed talking too much (intellectualisation), overt avoidance of specific issues, forgetting, casting a spell (colluding with resistance i.e. spinning a yarn), sleepiness (yawning, dislodging tension, the unconscious sends everyone to sleep), boredom (hard to pay attention because no feeling attached to it), bringing loads of material (no agreement on what issues to prioritize), small talk or chit-chat, door knob therapy (the client tells about some major issue on their way out the door at the end of the session).

How to work with resistance? It is important to remember that resistance can be useful.  you know you are getting close to the truth.   It is important for a therapist to remember that it is not malicious ill will but a coping strategy to avoid pain. Be aware of your own resistance.  You can’t help a client in an area where you are unwilling to go yourself eg. active addictions.  Check your own interventions.  You could be too rigid with boundaries or on the contary too loose.  Like in parenting it is not good to be over controlling or too permissive.  The child needs someone to say stop. Freud originally saw resistance as a block but he later changed his mind when he realised it was an integral part of therapy.

The first requirement is to be supportive.  There is no value in taking on the will or ego of a client.  Hopefully a sense of containment will happen but this could take a lot of time.  It is best to offer interpretation and insight.

The broad stages of therapy:

1, Client presents as unhappy, but doesn’t know the problem. Work with insight to uncover unhappiness.

2, Clients knows the problem so brainstorm the territory. The transpersonal way is to uncover qualities to overcome the problems. Thats perhaps why we get difficulties in life so that we can grow.  There is a reason why we have resistance. The only people who can withdraw resistance is the client.

Unhelpful practices by therapist: Colluding, being impatient or hostile, blaming, unhelpful attitudes to beliefs, inconsistent messages (eg. hugging, agreeing that hugging is okay one time and then not the next time).

Counsellor Responsibility

Counsellors are responsible for working in ways which promote the client’s control over his/her own life, and respects the client’s ability to make decisions and change in the light of his/her own beliefs and values.

Counsellors are ethically bound to respect the client’s right to choose. The counsellor’s role is to facilitate the client’s work in ways which respect the client’s values, personal resources and capacity for self determination.

Resources:


File Format: PDF/Adobe Acrobat 
RESISTANCE IN PSYCHOTHERAPY
: A PERSON-CENTERED VIEW

by CH Patterson
The purpose of this paper is to consider client resistance from a client- centered view of psychotherapy. Client or patient resistance in psychotherapy
www.sageofasheville.com/…/RESISTANCE_IN_PSYCHOTHERAPY_A_ PERSON-CENTERED_VIEW.pdf –

Psychological resistance – Wikipedia, the free encyclopedia

Jump to How do therapists handle resistance in psychotherapy??: Working with theresistance provides a  their therapy, which may reduce resistance

Psychoanalytic Origins – Freud’s Treatment of Resistance

en.wikipedia.org/wiki/Psychological_resistance 

Resistance in Therapy: how to handle it?

5 May 2009  The very basics of your relationship with your therapist: trust and openess in a good communication and interaction.
www.life-cycles-destiny.com/n1/resistance.htm 

Resistant Clients Psychotherapy Article

Resistant Clients: We’ve all had them; here’s how to help them. Article on effectively dealing with resistance in psychotherapy. CE credit available.
www.psychotherapy.net/article/resistant-clients 

Dr. Deb: Hope Therapy and Resistance

21 Aug 2008  I think a multidimensional approach is important in therapy. And I do believe that looking at resistance is a very important and helpful  drdeborahserani.blogspot.com/…/hope-therapy-and-resistance.html  

Dealing With Resistance in Psychotherapy — WETZLER 164 (1): 176 

by S WETZLER – 2007 –
Dealing with Resistance in Psychotherapy by Althea Horner is an old-fashioned book in the psychoanalytic tradition. ajp.psychiatryonline.org/cgi/content/full/164/1/176

Further reading:

Michael Jacobs The Presenting Past

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