The moment a client begins to resist, progress often comes to a crashing halt.
But with the right strategies and a little creativity, we can usually get people back on course.
For instance, when Marsha Linehan, PhD encounters resistance, she often starts to chip away at it by asking one key question.
In the video below, Marsha will share a few simple strategies that can keep clients moving forward. She’ll also share one key question that gets at the heart of resistance.
Take a look – it’s just about 4 minutes.
How do you work to break through resistance? Please leave a comment below.
I am not a therapist but a mom who has been desparately trying to get my son to stay in therapy for the last 7 years or so ..ever since he was 13. I found most therapists just choose to give up, saying that therapy cannot help if a person is not willing. And my son says therapy will not work for me because it hsnt worked all these years! Thank you Dr Linnehan- you are sort of my lifeline now. I read your autobiographical book – will read it a second time. I hope my son will be able to access DBT
Very interesting! You’re right, we kind of have to do a little song and dance to move forward. Liked your hell story.
Please help. My trauma is so bad
great article
It is a good example that I will keep in mind. Thank you.
For resistant patients, I use the analogy of a skinned knee. I ask the patient if they are riding a bike & fall off onto a dirty, graveled area, skinning & dirtying their blood-infested knee……how would they care for it? I ask them to give me a process they follow to nurse & support that knee. The patient will go through the typical first aid procedures of caring for that knee. I, then, tell them, “yes, it sounds like you would wash & cleanse out that knee first & possibly put an antiseptic on it decreasing possible infection.” I then ask them if they would ever think of just putting a band aid on without washing the wound thoroughly. In surprise, they say “oh no! It could lead to further problems.” I go further to equate this with discussing painful things in their life & how talking about them allows airing & cleansing properties which, in turn, promotes healing. Stuffing problems under the carpet will not work……that’s putting a band-aide on a “dirty knee.” That’s why, and I might add, solution-focused brief therapy won’t work with resistant patients as the problem is more deep-seated and the therapy process takes longer.
Thank you
I find working with resistance challenging. Most people with resistance has strength and it is positive and may be a good prognosis . The question is how the client can use the strength for themselves and not against themselves. I am trying to have participants gain awareness of the internal material they resist to touch or feel. I found that using art materials have the client paint, draw or do a sculpture will help to mirror back the issue that provoke very strong feelings that they resist to feel. It is a safe way because the art they make seams like “not me” but once they discover the issue they have it out in the ‘air’ and they start to address it. ( I hope I manged to explain)
Love the analogy of climbing out of hell. I will start working on my own “sales” pitch! Thank you.
it is about choice : for one own self that can be difficult to do for the client under some circumstances . “Shame” comes from being afraid angry and sad when the clients gets frustrated about being judged or not validated. How can a client overcome the fear of being shameful , it can be a struggle .
Thank you for your reminder of the importance of authenticity, practical examples, and your analogy of pain and hell. I think it is a great visual to use with clients!
I’ve used my personal experience at times to help others work through difficulties with resistance of sadness and grief.
Yes I reiterate how hard it can be, unpacking the issue’s, it’s a work in progress all the time as the waves of grief continue.. However, I’m very aware to ensure the therapy
is fairly and squarely about the client. Also to ensure the client knows and feels supported by myself in their journey to move onward and upward
Thank you for your insights. I appreciate the analogy to hell and the ladder ?
I agree with all what is said here about how it feels like to be in hell and at the same time having a hand to hold on to to get up because it is an important transition in shifting the client belief as being alone with their problems. Acting as a guidance counselor for years i have been able to showing them that there is a fine line between being a friend and a coach; and to my clients I often reiterate that it is all possible and to feel lifted up and that’s part of the process of therapy .
“Do you feel that you need to yell in order to be heard?” Many years ago, that was the best question a therapist ever asked me. I kept feelings walled off until they erupted in misplaced anger. His recognition of my reality was the invitation I needed to speak and walk through the pain, learn it was safe to name what I needed, and grow trust that I would be heard and respected. He gave a soft response to my distress instead of pushing me away. I still think of that moment and work to be that way with my students.
Thank you Denise, I agree with all what you have described, and walking side by side with the client can build trust and confidence. Hearing what is not being said and what is (or not) well received is crucial. “He gave a soft response to my distress….instead of pushing me away” is at the core of getting to the heart of their resistance.
In my own experience with therapy and facing a pain from my childhood I resisted “going there”, while at the same time I desperately wanted to open it to the empathetic therapist I trusted. He simply said, “it will be better for you if you do get it out”. To me that meant, it really IS ok to talk about it here, now, they Want to work with me on it. It felt good to be encouraged to talk about it, – – that was new to me. . .I never had anyone who wanted to hear me. “Stuffing” had to be my only option.
I speak as a client not a therapist.
My problem is how to do the hard work?
Walking up a hot ladder with hot feet is fine but from my experience so far ‘doing the work’ doesn’t seem only to be about taking one step after the other?
Where am i going wrong?
Thank you Ruth, and Marsha, these are real pearls. So generous and so helpful to practitioners. The encouragement you give us is worth a lot.
Thank you Ruth, and Marsha, these are real pearls.