Resistance

16 Commentsby   |  11.15.09  |  Uncategorized

Nichols (1987) defines resistance as, “anything clients do to subvert or slow the process of therapy. In family therapy, resistance is the rule, not the exception” (p. 251).

There is no debate regarding whether or not we will encounter resistance in therapy. The real questions are these: Why do we encounter resistance? Who is the culprit? Is there something which the resistance is covering?

Why do we encounter resistance?

People do not like change. We would much rather maintain homeostasis, dysfunctional or not, because it is what we know. If we were to change, this would be taking on the unknown, which can be more scary than continuing on the dysfunctional path. We have all heard that we are creatures of habit. We have also heard that it takes various amount of time, everyone has a different opinion about the length, to begin a new habit. This means three things: 1. We have to stop doing what we know, 2. We have to begin doing something different, and most of the time scary, and 3. We have to WORK HARD at doing something else. From these 3 things, how can we blame people for continuing in homeostasis?

Who is the culprit?

This is where the debate in therapy lies. Please review the following video : http://www.youtube.com/watch?v=RNtEvkZ58qk. The man in the video discusses the client-therapist relationship in regards to resistance. He says that psychologists used to think that resistance was all on the client’s part. However, family therapists have argued that it can be a combination of the client and the client-therapist relationship that creates resistance in counseling. Of course there are cases where therapy is mandatory for a particular client, in which case resistance was there before the client-relationship even began. However, there are also times where a therapist can cause or enhance resistance in a client if he or she encourages change too soon or change that is not agreed upon by both parties.

Is there something which resistance is covering?

At times, resistance may be another piece to the therapy puzzle. If we encounter resistance in a client, we would do well to ask ourselves, why? Resistance does not have to come about only in cases where change is encouraged. We can also encounter resistance when asking the client to bring another family member into therapy. We might also encounter resistance when asking questions of an adolecent in a family therapy session and we are met with silence. At all of these times, the action of resistance may give us more insight into the situation than if it was not there.

Discussion Questions:

1. In general (without counting mandatory counseling cases), who is more to blame for resistance: client or client-therapist relationship?

2. What was your reaction to the horse story in the video? Do you think we can use resistance to our advantage in therapy; if so, how?

3. What are some ways in which we can avoid resistance in therapy?

Nichols, M.P. (1987). The self in the system: Expanding the limits of family therapy. New York: Brunner/Mazel.

Guterman, J.T. (2007, March 3). Resistance in Counseling and Psychology. http://www.youtube.com/watch?v=RNtEvkZ58qk.

16 Comments

  1. Tommy Johnson
    10:17 am, 11.30.09

    Briefly I just wanted to add that in Youth Ministry, a lot of the times this is what you are faced with. Kids are pretty resistant. It takes time, and a lot of joining for them to ever want to talk to you about spiritually significant stuff. That said. Every individual resists less and less on their own time, no one is really going at the same speed. The kids in the youth group, or the client might resist only about a certain subject matter. He or she also might resist to change.

    3. I think there are several ways to avoid resistance in therapy. First, don’t take ourselves too too seriously. Yes, we need to be professionals, but we need to also understand that therapy takes time. The individual is not going to share all of their “goodies” the first go-around. Second, be collaborative. Whatever that looks like in the model of your choice. This builds trust with the individual. Finally, of course, genuineness, empathy, and non-possessive warmth. So we be active listeners/empathizers/and not taking one side versus the other (which might cause the most resistance). Let the individual reach the change moment, we will help along the way.

    • Sabrina Johnson
      3:15 pm, 12.04.09

      Very true with kids, Tommy. I can remember when Ryan and I were in youth ministry during undergrad. work and it took time for each of them to trust and open up to us. Some did that rather quickly, and one in particular still was closed off right up until we resigned.

  2. Elizabeth Brown
    7:40 pm, 11.30.09

    I have started recognizing resistance in my own conversations with people. It is so weird when you start seeing all of your relationships differently. I can feel almost before I say it if I’ve jumped the gun by asking a question and the timing is off. It seems so obvious that it’s not just resistance on the part of the person I’m talking to, but also on the part of me being in tune or empathizing with the person I’m talking to.
    I can see that in therapy that timing and pacing would have a huge role in fostering resistance or encouraging cooperation. I like what you have to say Tommy about letting the client lead and we’ll just help along the way.

    • Sabrina Johnson
      3:12 pm, 12.04.09

      I have noticed it too, Elizabeth. Weird isn’t it? I especially notice when meeting new people, the cohort for example. I just realized that the one thing I am incredibly uncomfortable with, meeting new people, is going to be a part of what I do for the rest of my life. What was I thinking?

  3. Kevin Burnette
    1:48 pm, 12.03.09

    RESISTANCE IF FUTILE!!

    I hope you enjoyed this flagrant Star-Trek reference in your post…hater!

    Check out the you-tube video.
    *LOL*
    Kevin

  4. Kevin Burnette
    8:01 pm, 12.03.09

    Man…that video was hard core…Is that guy a dynamic speaker or what *LOL*

    On one level, I do think that resistance is to a large degree a product of inadequate rapport and insight. Not discounting that a therapist can be taken by surprised, but, as noted in the other comments, if the therapist has proceeded cautiously, put some tentative feelers out there to gauge client’s reactions to things, then they ought to have a pretty good idea, before they ever start down a path with the client, whether the client is ready to go down it. If a therapist puts stuff out there that they know good and well that the client isn’t ready to hear yet, then resistance is definitely their fault…unless, a bombshell is dropped on a client for strategic reasons….which brings me to question # 2:

    I think that basically any paradoxical intervention is an example of Milton Ericson’s horse story.

    you guys Live Long and Prosper!

    • Sabrina Johnson
      3:10 pm, 12.04.09

      Nice! And I wouldn’t say I am a hater, just not a fan. :) lol I do hope you and Dr. Milholland will not hold that against me…

  5. Dean Pye
    4:34 pm, 12.06.09

    I was seriously blown away by the horse story. I knew I had heard it before, and I’m not 100% on all of the details to the story from some random guy on youtube, but if it is true that Milton Erickson came up with that idea at a young age, it is pretty genius for an 11 year old. I certainly do see that as a way of working with resistance that is inherent in a client in some situations. However, I prefer seeing most examples of resistance as being a part of that client-therapist relationship. It is easy to blame the client for being “resistant” to our amazing interventions or our perfectly crafted interpretations, but it seems a bit more “systemic” to consider our own influence in increasing resistance in a client system. Not to say that there are not resistant clients, but it does seem more balanced to see your own hand in the client’s resistance.

    • Sabrina Johnson
      11:01 am, 12.07.09

      Why Dean, it seems as if you have developed a systemic worldview this semester. :) You bring up an interesting point that we are part of a system in the therapy room!

  6. Kelsey Waskow
    10:49 pm, 12.06.09

    As I was reading this post, I thought about how resistance can be seen across the board regardless of what profession you choose to be in. As a teacher, third-grade student’s exhibited resistance mostly based around having to change how they did some particular task to show improvement. In the corporate world, employees could show resistance towards their coworkers or bosses suggestions. I think it is typically both the one trying to resist as well as the opposing force that is at fault, including in the thearpist/client relationship. I think that it is essential for the therapist to be aware of the speed with which the client is moving, so that they do not bring up an element to change prior to the client’s being prepared to do so. At the same time, I feel like the client sometimes consciously (some may even call it stubbornly)promote resistance in themselves. Like you said Sabrina, change is scary, and we must be aware that our clients may do their best to keep it at bay.

    • Sabrina Johnson
      11:05 am, 12.07.09

      Great points, Kelsey. I also found it difficult to place blame on either the therapist or the client as far as resistance goes. Of course we will meet more or less resistant clients, but as trained therapists we should learn to manage both such that clients see less of a need to feel resistant. If seems to me that both parties play a role in resistance.

  7. Scott Rampy
    11:17 pm, 12.06.09

    Perhaps I’m going to confuse the issue further in an attempt to answer the question. (I can see your eyes rolling now but bear with me) :)

    It seems to be that, whether purposefully or not, resistance is an action taken by the client when faced with the occasion of a (Note: not “the”) therapist-client relationship.

    Some points I would like to make about that statement. A client is only resistant if there is something to resist in the first place. If the client does not perceive a challenge, what is there to resist? The very occasion of “A” trying to help “B” may imply to B that B has a problem and A can fix it. Put yourself in B’s shoes. Perhaps A’s very attempt at helping causes B to feel inferior or incapable, especially when faced with A’s apparent capability. This type of dynamic takes place not only in the therapy room but also between friends, parents/children, church members, etc. It isn’t hard to think of a scenario in which we’ve seen this take place.

    Perhaps a better answer is that the action of a client’s resistance rests in the occasion of therapy, exacerbated or diminished by the therapist-client relationship: the client’s perceptions of the therapist, the client’s perceptions of the therapist’s perceptions of the client, the therapist’s perception of the client, and the therapist’s perception of the client’s perception of the therapist. There, was that clear?

    I mentioned above the client’s perception of a challenge – without which resistance is meaningless. Perhaps this is the clinical location where the split between directive and non-directive therapy emerged? Based on this proposition, it would seem that the directive therapist would encounter much more resistance than the collaborative, non-directive therapist.

    • Sabrina Johnson
      11:21 am, 12.07.09

      *eyes rolling* Leave it to Scott… whatever that means :)

      I think you make valid points, Scott. I can certainly see how where all the perceptions of each other and perceptions of perceptions of perceptions can affect the client’s perception of the challenge. No, but seriously I can certainly see what you are saying with that. I see that everywhere there are relationships, which is everywhere. For example, as a cohort we all have perceptions of each other, and also perceptions of others’ perceptions of us (or so we perceive them to be). This can affect how we interact in class or outside the university at social events. Although we will not be hanging with our clients socially, we will definitely be able to see this played out in the therapy room as we try to bring about change in regards to the client’s presenting problem.

      However, I do wonder if our culture affects your proposition that “direct” therapists will encounter more resistance than “non-direct” therapists. By that I mean our American mindset of independence and “don’t tell me what to do.” Also, I have yet to see a “non-directive” therapist in any of our models.

      Also, I wanted to comment on your A and B equation. I can see how a client may feel inferior or incapable in the therapy relationship; however, I feel that Dr. Goff’s advice to us this semester will greatly decrease that feeling. She has told us numerous times before about how some clients will look at us and wonder what we have we can do to help them with some of us who have not been married, are not single, have not been divorced, have no kids, have no teenagers, have not had this, have not had that… etc. etc. If we advise them that they are the expert in their story and their experience and we have education and empirically validated (don’t use that language) theory to offer, they might be more inclined to listen and less inclined to resist.

      We certainly do play a part in the resistance of a client. Thanks, Scott Rampy!

  8. Morgan Myrick
    6:29 pm, 12.08.09

    Well….I spent six years as a manager in retail so I have to agree with Kelsey that resistance is a part of every profession! I always try to tell people I’m right and they’re always resisting the urge to believe what I’m saying!!!
    Seriously though, resistance is something that I have started to really notice in all of my different relationships. Friends trying to date people they shouldn’t, family members not letting their children grow up, etc. I am seriously starting to worry! I have realized though that resistance is directly linked to fear. The issue isn’t really about the change in most cases, it’s about change and fear of the unknown. When people are resisting therapy or intervention, I would be tempted to think there is a deeper underlying problem that needs attention and would probably try to focus on what their real needs are. Of course if everyone would just listen to me this process would be a lot smoother!

  9. Tara Stephens
    7:25 pm, 12.10.09

    In general who is more to blame for resistance: client or client-therapist relationship?

    Personally, like others above, believe that resistance is a natural part of life. I often find myself resisting friends, family, and other people simply because I subconsciously want to be independent of them and not doing what they suggest gives me a false sense of that. Resistance is natural in life, but I do believe that in therapy resistance is at fault of both parties. The therapist should be aware of their client and their current readiness in regards to how quickly they are ready to progress. If the therapist pushes too hard, naturally any person would resist to protect themselves. But, your client’s are naturally going resist because change is scary! Wanting to remain the same is natural and easy therefore we resist the change our therapist is promoting.

    What was your reaction to the horse story in the video? Do you think we can use resistance to our advantage in therapy; if so, how?

    I loved the story about the horse. People’s creative juices amaze me sometimes. Theoretically I do think that we can use resistance to our advantage, I think that will look different for each individual client and situation, but isn’t that what strategic therapy is all about?

    What are some ways in which we can avoid resistance in therapy?

    By putting our own therapist agendas aside and walking along the client with their best interest at heart, we will be able to reduce a bit of the resistance that we might have faced by trying to force our own wants on them. Also, on the same subject, by explaining and being honest about your motives (I don’t think full disclosure of therapy is necessary or helpful at times) and desires for the client in regards to therapy and where you see it taking them could help the client to jump on board to the changes they want to see in themselves.

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