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Photo Credit: Jem Yoshioka

Do you (or someone you know) resist therapy? Is the resistance almost toward anything a therapist may be saying or doing? Have you questioned this resistance? Resistant clients are complicated. As a therapist, I have seen resistance in children, adolescents, parents, caregivers, and adults. It is a very draining reality for most therapists. In fact, some mental health, behavioral health, or personality disorders cause clients to be more resistant than others.

For example, individuals with borderline personality disorder, delusional disorder, or depressive disorders may exhibit more resistance to change, therapeutic ideas, techniques, or suggestions made by the therapist more than individuals with another type of disorder.

This article will discuss resistance and some of the ways you (or someone you know) may be resisting change, progress, or healing.

Resistance is a term mental health professionals use to describe a group of clients who refuse to learn, grow, change, or progress in therapy. Resistant clients are some of the most challenging because any suggestion a therapist may offer (including family or friends), will be ultimately ignored. For some people, resistance has cost them their marriage, their material possessions or income, their mental and emotional health, and even their relationships. It is my belief that resistance occurs because it serves some kind of purpose for the individual. As a result, I list about 15 ways you (or someone you know) may be displaying resistance:

  1. You ignore suggestions: Good therapists make suggestions to help clients weigh the pros and cons of a decision or consider alternative ways of viewing or doing something. Suggestions allow the control to remain in the hands of the client and not the therapist. But if you are rejecting or refusing to consider suggestions made by your therapist, it is going to be difficult to progress. The purpose of therapy is not so much to vent, but to try new ways of thinking and behaving. The ultimate goal is to “do life” on your own.
  2. Once you leave, it all goes out the window: Good ideas, deep conversations, and inspired thinking can all occur in the safety of your therapist’s office. Once you leave the office, however, the good ideas you had, the depth of the conversation you had, and your inspired theories are all gone as if they never occurred. For some clients this can happen when their lives are too overwhelming or chaotic to maintain proper perspective. But for other clients, this may be a sign of resistance. Forgetting everything your therapist said to you and everything you may have thought is only going to keep you in therapy longer. In fact, for some clients, this is exactly what they want.
  3. You intellectualize sessions: Intellectualizing sessions and staying “in your head” is a subliminal way to avoid accountability, uncomfortable emotions or thoughts, and change. It is so much easier to think things through and try to make logical sense out of them than to explore emotions, admit hurt feelings, and accept emotions. In the long-term, therapy will fail because therapy is not all about grand ideas and/or blocking emotions.
  4. You refuse to explore your emotions and thoughts: As stated above, therapy is supposed to focus on both thoughts and emotions and being able to accept or work through what is occurring in your life. If you stay “in your head” each and every session, you can guarantee you will remain in the same place until you are ready to take a leap of faith. It is very hard but worth it in the end.
  5. You spend the majority of time talking about less important matters: I’ve had clients who would spend about 20 or 30 minutes talking about their weekend, a holiday, a birthday, a shopping spree, their new dog, or an engagement and wedding plans. I’ve had teenagers talk to me for 15-20min about a pair of new shoes, a trip, or a new friend. The conversation was a way to distract attention from deeper topics such as being physically or sexually abused, being bullied, facing a divorce, or some other traumatizing event. This is acceptable for some sessions, especially if you need a break from difficult topics. But if every session is spent like this, there is a deeper problem occurring.
  6. Each session is different: Some clients will distract and try to draw attention away from the main issue by coming to therapy each week with a different problem or a new subject. It is okay to spend a few minutes talking about a new problem or concern you may have. But if the entire session is focused on a new problem or concern, week after week, you may be resisting something.
  7. You rely on your therapist a lot: Therapists can be great support, especially when life makes us feel alone, afraid, or uncertain. For many clients, primarily adults, their therapist can be similar to a friend, a family member, or a mentor. The therapist-client relationship can develop in such a way that bonding may occur. But if you are relying wholeheartedly on your therapist for emotional support, there may be a deeper issue occurring. Some examples include: transference/counter-transference, fear of becoming more independent, fear or uncertainty, attraction, etc.
  8. You get angry and offended very easily: Some clients are sensitive and that’s okay. Other clients are sensitive because they cannot handle or cope with the truth. That’s okay too. However, when a client’s sensitivity causes ripples in the therapist-client relationship, there may be something else occurring. There are clients who become very angry with their therapist because they cannot accept that their therapist understands them so well or can spot manipulation. Very rarely do my clients get angry with me. But when they do, I am prompted to explore why and for the most part, it is often because the truth is not easy to accept. It hurts.
  9. You ignore your progress or potential to progress: Resistance to progress or change could occur at the very moment you see yourself changing or growing. If you change or grow, you will no longer need your therapist or you might begin to see your therapist less frequently. For some clients, especially clients with traumatic histories, mood disorders, or borderline personality disorder, progress and growth means the therapeutic relationship (i.e., the emotional support, friendship, or comfort-zone) will be terminated. This can be scary.
  10. You get stuck on small things to waste time: Because termination of therapy can be frightening, some clients set out to sabotage their progress by intentionally stalling, setting themselves back, or by attempting to deceive the therapist into believing symptoms are worse than they really are. Wasting time may include: getting stuck in therapy because of a minor mistake made, getting and staying angry with your therapist, rescheduling multiple sessions or not showing up, playing phone tag, disappearing for weeks or months, etc.
  11. You cancel sessions, reschedule, or stall: Cancelling sessions, rescheduling, playing phone tag, stalling or showing up late to sessions can all be signs of resistance. If these things happen on a frequent basis, a therapist cannot support a client in moving forward. In fact, this is often a recipe for a therapist to terminate therapy or refer a client to another therapist, especially if these behaviors are chronic.
  12. You blame or distract: Some clients blame everyone else but themselves and get “stuck” in a victim’s mindset. Sadly, these clients are often afraid of acknowledging weaknesses in themselves. A narcissistic personality may have a great deal of trouble taking responsibility for anything he/she may have done. A therapist who points this out or holds a client accountable may begin to see resistance. Resistance may include blaming the therapist or others, getting stuck in the victim role, accusing others, or refusing to look at the truth.
  13. You laugh and joke around to cover emotions: My mom used to quote a scripture from the Book of Proverbs in the King James or New International Version of the Bible which was: “Laughter does good like a medicine.” In other words, laughter can heal your heart and mind. Sadly, so many clients use laughter to release tension, cope with difficult emotions, or distract. Resistant clients may engage in laughter at very inappropriate times such as while discussing a traumatic history or exploring deep emotions. I once had an adolescent  client who was sexually assaulted during prom-night. Each session she would discuss bits and pieces of the assault and would end up laughing uncontrollably.
  14. You refuse to consider what could be the truth: Some clients truly struggle with the truth and will go to whatever length they can to dismiss it. Some clients struggle with a therapist giving them a diagnosis they do not want or pointing out a pattern of behavior that is embarrassing. For many of us, the image of ourselves that we have may not be the same image others see. A therapist, who has developed a relationship with a client and is familiar with patterns of behavior or interaction, will have to point out things that need attention or improvement. Some clients resist any truth their therapist may have about them.
  15. You attempt to be your own therapist and get in the way: As a 15 year old I overheard my grandmother state “if you listen more, you will make less mistakes. The more you talk the more you miss.” She was right. A humble attitude of always learning and always growing is the best route to take in this complex life. The moment we start thinking we know everything (or mostly everything) or feel we don’t need to stop and think, we are setting ourselves up for failure. Seeing a therapist is a humble step. It requires that we allow someone else, a complete stranger that we know little about and that we have decided to trust in some ways, to evaluate/assess us and give us guidance. But the moment a client starts ignoring the therapist, thinking their ideas or behaviors are “just fine the way they are,” or has an attitude of resentment toward the therapist’s expertise, resistance is likely occurring.

 

Although we are often the best “experts” on our lives because we know it better than anyone else, we aren’t always right and could stand to consider another perspective. Resistant clients intellectualize, challenge the therapist, and refuse to consider an experts view. While some resistance is understandable, opening one’s mind to other ways of existing in the world may be helpful (as long as it is not morally, ethically, or psychologically damaging). Consideration of another’s viewpoint doesn’t mean you necessarily except it either, but you should be open to it.

 

Do you know someone who may fit the above descriptions? Could you possibly see yourself? If so, what needs to change? Can it change?

All the best and Happy New Year