From both therapists and clients, I have heard therapeutic resistance spoken about as though it were an obstacle to therapy, or an indication that therapy will not be effective for the ‘resistant client’. The word itself appears to have a value judgement attached to it, and I think this is particularly true in the ear of the client. It is regularly heard as a criticism, a label, or perhaps even a confirmation of the hopelessness and futility which is felt internally.
If we are to define resistance in this context as an apparent unwillingness or inability to engage with therapy, it is not surprising that a therapist might feel frustrated or impatient. After all, most therapists are motivated by a genuine desire to help; spending an hour with a client who might be saying “I don’t know”, “I know this won’t help” and “nothing works” challenges the therapist’s innermost belief that client change is inevitable when, as Carl Rogers posits, certain therapeutic conditions are offered.
I wonder what a client is feeling in this situation. Fear perhaps? Despondency? Dread that the hopelessness which consumes them will again lead to rejection and loss? It really could be any of these and a myriad of other conscious and unconscious processes which paralyse the client’s psychological movement and make contact between the client and the therapist a much slower and more meticulous process than the therapist might usually experience.
As frustrating as it might feel for a therapist, I would argue that this very response from the client is a rich and fertile hotbed of information about the relationship and the client’s process which is likely to be central to therapeutic change. I see the therapist’s role at this stage of the process as one of holding and encouragement. To communicate to the client, through consistency and unconditional positive regard, the messages: “I will not reject you.” and “I trust you.”. Only when these sentiments have been demonstrated in the relationship, will the despondent client feel safe enough to explore the possibility of change.
It is my sense that everything which emerges from this period of therapy is valuable. The client’s verbal responses, physical communication and attitude to coming to therapy are all likely to provide clues about what is happening in the relationship which can be noted and brought into the room in a sensitive way. Even the therapist’s frustration and impatience may provide valuable data about the relationship, and much for the therapist to reflect on: How much of these feelings are from my own desire for deeper contact? How might they reflect the dynamics of other relationships in the client’s life, past or present? To me, this is a wonderful exploration, and fascinating!
Sometimes, a client might choose not to engage and leave counselling having made little or no progress with the issues they brought to therapy. I find myself asking whether the therapist in this situation might be left with some of the residual hopelessness or skepticism which the client brought into the room. It is certainly not easy for somebody in a helping role to feel they have not helped. As well as feeling a sense of responsibility towards the client, the therapist might feel that something of their own identity or purpose is called into question, at least internally. John Rowan (2016) reminds us to avoid becoming too focused on curing or finding a solution for a client. Not only is it not our responsibility to ‘solve’ the client’s issues, but also, as the client is the person in the best position to seek their own answers, attempting to overlay our own solutions on the process is counterproductive and seeks to meet our own needs.
When a client does leave therapy, whether or not they have chosen to engage, it is important to acknowledge that we are only the client’s journey companion for a tiny portion of their life. This is where they are now, and we cannot pretend to know where they will be ten, five, two years, or even a month from now. Perhaps they will reenter therapy at a time when they are ready to engage. Perhaps they will never reenter therapy but find other means and support to make changes in their life, or find meaning in the incomprehensible. We must respect that process and the autonomy of the client to find their own way.
Ref:
Rowan, J. (2016) The Reality Game. 3rd ed. Routledge: Oxon.
A Client First 