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.
This approach is very useful. I use it for clients/patients who grew up with a mentally ill parental figure. I psycho-educate using the findings from my (easy to read) research entitled: “Lives Unseen: Unacknowledged Trauma of Non-disordered, Competent Adult Children Of Parents with a Severe Mental Illness” and ideas from brief articles I’ve authored on trauma and grief. People interested can just Google my name.
Thank you Dr Marsha Linehan! Suzette Misrachi
All great ideas above and below in comments. All shall get me through the day, through the work with clients as I start with myself and continue same with clients through the week. They love stories.
As a story teller I now see these unique hardships have helped me grow in empathy and share when appropriate. The results are enormous. We need to honor our own heritage. What is old becomes new again, learned from my Native Americans clients, my own heritage and wise professors over the years.
These comments helped me remember the many things we have learned over the years from our studies. All those on these webinars are great reminders as they help some of the missing links. Years of training by so many in our field has been our own personal and professional growth. This was a another wonderful tool for that toolbox to keep the client moving forward.
Without these pearls of wisdom we might not grow. The subconscious is a great place to start as we educate clients regarding the nervous system and how to use their unique emotional nervous system barometer. Thanks for the tips as these are great motivational tools when we are feeling deflated for whatever new reason that arises.
Was beginning to think I liked Hell and that can be tragic. Education has been what keeps me vital, new information as it surfaces, especially the new interuterine studies, so many wonderful tools are highly needed to connect all that has gone before, so nothing gets lost.
In past workshops rarely did we receive special tools. The wonderful professionals here share their tools and the wealth within our industry. Thanks, Marsha and every one else on these webinars. Nothing gets done if we are stagnate in our own education.
“The value of giving up resistance” is a key thought here and if that can be understood by the client movement can begin. The difficulty is having sufficient reason for going forward and stepping beyond resistance which is really a form of control…..deciding to step forward is also an active form of control and if that is linked to a sense of self worth progress can begin…I like to link that to the Inner child and the necessity of advocating and going forward to take her/him to safety….its another part of self which often draws a greater sense of empathy and willingness to act…
The soul or spirituality must be added to mindfulness to really make it work. We are not only mind and body also the soul and spritual way should be addressed
For pre-natal traumas, in my work with Womb Twin Survivors, I use symbolic demonstrations to help “tell” the story so they can feel resonance and then own it, or correct it to match their truth. It brings them out of the vagueness of womb trauma into feeling it in their body memory (where it sat while the brain was developing) so we can then bring it into the now-brain for cognition and release.
Thank you
In my work with normal not complicated grief caused by the death of a loved one, i begin with an outcome and gently take the client back and forth into the painful story for short periods.
Breathing deeply throughout the journey
until both stories collapse into one and the client is open to a new story.
Grief work takes time and patience but in the long run is healing.
I use a similar analogy-You have to go through the fire to get to the other side.
Thank you for that. Great advice.
This matches my way of working where I often help client reflect on the bigger picture and through it explore all their existing options. Helping them acknowledge their stuckness sometimes by simply pointing out ‘you’ve tried that way time and time again and know it leads to the same outcome- what do you have to lose by attempting a different tactic?’ This often helps the client gain a moment of clearer perspective where even if they don’t seize the moment they would at least experience a taste of the freedom and maybe power which could come with the realisation that they do indeed have other options.
In most cases I have found that the clients return with reports of a positive shift in their process or situation.
There are quite a few therapists resisting the ideas of Marsha’s metaphor of the ladder out of Hell.
I was able to get something done that I hadn’t been able to do in months. For myself, this was the most effective thing to overcome resistance that I’ve heard.
I suggest you please just try it, they might like it, even though you might not at first, and most importantly…it could actually help you both.
By persevering and showing them that l will not give up on them.
When strong resistance arises in a client, I let them know that their subconscious mind is doing its best to protect them from deep emotional pain, but that the only way to do that is to keep the symptoms they really want to be free of. Then I tell them that the fear of the pain, as well as knowing how powerful it is, keeps it buried like infected tissue, festering and creating problems for them. Then I tell them that the subconscious mind doesn’t really understand time like the conscious mind does. It doesn’t realize that, while uncovering that deep pain will feel worse than the symptoms the client is struggling with, the pain will come and go: it will pass. The subconscious mind believes it will be there forever, but by ventilating it and giving it some room instead of keeping it buried, It will be really intense at first, but then it will pass.
I use a very powerful and elegant technique to resolve the subconscious source of emotional pain and dysfunction, so the passage of that deeper pain almost often takes place in seconds. I never tell them that it will be that fast, but it usually is and we both wonder at that fact afterwards.
I’d like to know your technique Alfred. Would you share it here! Elaine
Thank you for sharing. Please share your technique as well.
Thank you,
Barbara Altman, LCSW, DCSW
Resistance is just a word that can have different meaning for each and everyone. So I would ask:” How do you know that you have resistance? Where do you feel it in your body?”
Coming away from labelling is key in my work with clients, connecting them to their bodily sensations. I find this kind of approach very successful. After all emotions are ALWAYS linked to bodily sensations!
The same goes for the fear of facing their scariest Trauma. It’s always getting them out of their head and into the body. Sometimes first I’ll suggest doing some TRE in order to build more resilience before addressing those painful memories and often the problem resolves even without addressing them!
Marsha’s ideas and stories are very useful. I usually use paradoxical interventions with high resistant clients
In ”Death of resistance’ Steve De Shazer one of the pioneers of Solution Focussed Brief Therapy said there is no such thing as resistance, only the wrong question. SFBT is like a dance with the client leading the worker, if the worker looses step with the client it is the workers responsibility to find it again not the clients.
Thank you/ Some excellent points here. Telling the right story at the right time can be very effective. And I really like the thought that the patient needs to understand, and believe, that you can understand their pain. For many patients I see, I’m reminded of the old spiritual, “Nobody Knows the Trouble I’ve Seen”. It’s hard for them to believe that anyone has ever experienced pain at the level they are feeling. And so frequently, as Marsha Linehan points out, their answer is to avoid the pain–to shut down and do their best to feel nothing. But that doesn’t work either. I like the story of the hot ladder out of Hell. I’m going to remember that one! Thanks again.
I find these podcasts very short but some useful tips to work with clients.
I am an EFT coach-not a therapist. EFT makes resistance easy to break down because you can take down each snippet causing blocks. Eg. I start by tapping Even though I don’t want to think or feel about it, you can’t make me, I am convinced it will be too painful…(and the rest of the EFT tapping process) Then I break down an even that seems to be a big one with the same feelings and first to come to mind in EARLY years for them. I ask them to describe the story and as soon as they show any signs of discomfort, we stop right there with that feeling. Eg. A client had a horrible event at a family friend’s summer camp where her father beat her. She started telling me the story….I was getting into the car (and how do you feel right there–trapped) so we started tapping on Even though I feel trapped because we can’t talk or laugh in the car with dad… When you use tapping to break down a single BIG episode into freeze frames and take it down in stages, it’s amazing how an event clears out of both the mind and body! In one of two hours or tapping, you can clean up a major event that might’ve started the entire pattern that keeps the client stuck. I’ts like pulling out the bottom of the house or cards. Then the rest of the “pattern” falls apart. It’s amazing!
Another thing-I loved this approach. Especially the part when you tell them you are going to help them through the pain and up the ladder. That’s what I needed in my own personal therapy and when I finally trusted someone enough to help me I was able to climb it. Thank you for sharing such a valuable and insightful video.
Excellent video. I’m always hesitant to share my own story of going through my own emotional pain. How do I know when it is appropriate and when it isn’t?
Hi Dee. If I feel comfortable to share a story of my own experience with a client, I always ask myself – is sharing this story going to benefit me or the client?
If sharing the story will help the client – then I feel I am on safe ground. If I feel I am just indulging myself and sharing my experience for my own pleasure – then I don’t share that story.
I have found self disclosure to be very helpful for clients – they can relate to you, they feel you understand and that is really useful.
I hope that helps. 🙂
In a group setting we encourage the client to make friends with the sad or hurt little child or young person inside and show compassion to them through writing drawing and / or verbally exploring the feelings. I find this helps them to be more compassionate to themselves as adults, and therefore more able to push through the resistance talked about above. Interesting to read of so many different approaches, really depends of who you are supporting and their level of fragility, I guess.
An interesting take on how to get a client to move out of their resistance. My understanding of working with resistance comes from the Motivational Interviewing perspective. Within this approach, the client’s “resistance” is seen more as an ambivalence, being stuck or lack of motivation towards change. If the client is at the contemplative stage or higher in their relationship to the “problem”, then the salesperson approach could be beneficial in giving them a map of what to do or where to go regarding their interior and therefore potentially help them find their own motivation for change. I like the “ladder out of hell” image which for some clients, once they resolve their ambivalence towards change with our help, can then feel validated in their experience and then use this image to help them gain some traction in the necessary work of facing certain emotions. I’m not sure however the salesperson approach will work with every client who’s displaying resistance. In my experience, it really depends on where the client is in relation to the perceived problem. If there is an expressed readiness for the benefits of getting beyond painful emotions, then the salesperson approach can be useful. If there is lingering resistance, if the client is not ready to move out of where we think they should be, then I think we need to proceed carefully/slowly and not so much emphasize the value of facing certain emotions but taking the necessary time in helping them resolve their fears towards change in general. Questions like: “What would it mean for you to face your sadness at this time”? “What resources would you have to draw upon if you were going to face these emotions”? And of course, getting them to consider: “What can you imagine will happen if you don’t face these emotions”? Sure, we as therapists can lay it out of them and sell the new behavior as Dr. Linehan suggests, as a way of persuading them towards change however, if it comes from us, if we are the ones providing the motivation/reasons for change, (as the experts/salespeople) then I think the possibility for their reactance/relapse is much more likely. In my experience, when encountering any resistance, it is often more useful to spend the time getting the client to explore their own relationship to one of life’s certitudes, and that is that everything changes; whether we are ready for it or not. What Dr. Linehan says is true, there is only one way to stop pain from running one’s life, and that is to go through it! For the clients who are ready/motivated for this work, part of the job is giving them the map. For those who are not, we mustn’t put them in the same treatment category as those who are clearly ready, willing and able to go down that road.
I really like this approach Jack as it is more about collaborating with the client and using some thoughtful open-ended questions to get at their own reasons for changing or not changing however the case may be at the time and then helping them move forward when they are ready.
When Marsha suggested we explain to the client the value of their engaging with the issue –
I must admit to feeling some resistance !
Because, in my experience, rational arguments satisfy the speaker much more than the listener.
Depending on rational argument was arguably a big factor in Hillary Clinton losing.
I was much more comfortable with Marsha’s suggestion that we try to inhabit the client’s world, willing to people alongside them in the ‘hell’.
And, I suggest, alongside, as they climb up the ladder.
( after all, professional sales people utter more questions than statements. They realise that they have two ears and one mouth!
I really liked Marsha’s belief in telling the client, this is going to be difficult, not easy. A beautiful truth.
Thank You.
Thank you. I like the hell analogy and have a client who could benefit from this approach.
A helpful and very clear and brief input. Thank you.
I used to practice as a probation office in the UK many moons ago and ‘clients’ did not attend voluntarily. There was a lot of resistance as you might imagine. My task was made easier if I was able to ‘sell’, as you put it, the value of becoming a client instead of an offender.
Bill O’Hanlon’s and the TA question – what stops you [doing x] – proved very helpful as it enhanced the choice of – as you say – staying in hell or moving out, even though it is a hard journey.
That was great – thank you! I would be happy to use the hot ladder method having first gained my client’s trust that I would be with her on the ladder all the way. I have also been able to unstick clients by asking if they think they’d be able to look at their avoidance as a type of experiment – then we gradually get around to their pain as the cause. Have found it helps if they speak about the trauma in the third person, then graduating to being able to tell their own story, the first person, when they feel safer showing emotion.
Thank you again for these great ‘insights’ – love ’em!
I find a mindfulness approach, asking about their experience as they are resisting, can help move past it. Part of what is calling for recognition is the need to resist. Cognitively combatting that need doesn’t feel right to me, particularly since it won’t reach the preverbal aspects of the client needing to be met and held.
Ah, good. Kind of exploring the resistance. Maybe also using meta-cognition. Just let the resistance be, not attack it. I like the expression “the need to resist” because this is how I experience it. Can you suggest some further reading on that?
I like the hell analogy.
Sometimes highlighting the pain of staying as you are contrasted with the alternative of a better future provides some compelling momentum.
Recently I worked with a family where they had held on to shame and grief and anger for 20 years. This was now impacting 3 generations, from the grandmother to the children, some of whom were now grownups. I decorated a box with black paper and put all the feelings I had heard and observed in the family related to this old pain on the box. Then I took another bright box with butterflies and put all the hopeful, positive characteristics I had heard and seen on that box. I then put the two boxes on the table and asked the family what legacy they wanted to give to the children in the family.
The black box over-shadowing the butterfly one, or did they want to let the black one go and move forward with the butterfly one? A number of family members found this very helpful in deciding how they wanted to relate to each other and plan to move into the future.
fabulous! Thank you, that will work with a family I am working with where grandparent incest has become the ‘new normal’ and the children have been in therapy and are ready to move but the parents are not – and their focusing on the hurt/pain/fear is holding the children back. So that will be a wonderful way to highlight the future focus – and hopefully won’t affect another generation.
In doing bodywork, denial and not being able to face things often percolate on their own if the client feels the safety of the container. I agree, they need to know that you get exactly HOW painful this issue is for them, because if it’s glossed-over or worse, trivialized, you have lost their trust. Curiosity about the *shape and size* of the pain, and asking *What would it take to make it dissolve or fall open, or crack open or blow up or whither of it’s own accord* can help image the change and inch the process along.
I disagree with everything about this approach for every client with the exception of the most destructive acting out client.
The moment I feel myself trying to “sell” my client this is my internal signal that I have lost the empathic thread of connection. If I find myself feeling like a “car salesman” I have most certainly entered into a dark place of manipulation. In my mind a “car salesman” is in the business of convincing someone to buy something they don’t need but the seller needs to sell. This is a manipulation- the antithesis of authenticity. Without authenticity I have no real connection- much less a connection that heals.
Isn’t maintaining an empathetic connection (without necessarily buying into your clients experience of their reality) the whole point of therapy? I would argue that in order to understand my clients emotional hell I need to understand that hell. My job is to climb down there with them and maintain my sanity ( emotional boundaries) while working to understand my clients emotional reality. Then and only then have I earned the right to suggest a way out, a hand up.
The ladder itself is one made out of compassion, empathy and kindness. This ladder involves opening to a deeper understanding and acceptance with of why they have been in emotional hell.
In my experience most of the pain that keeps my clients stuck is underground or unconscious and difficult to face. Strong arming my client will most certainly backfire in this case.
Contrary to what this trainer says, most clients I have encountered don’t refuse to experience negative emotions. Rather they are unaware of the emotions that are driving the behavior that is causing the current pain of their lives. Therefore they aren’t willfully refusing to do the work of therapy and are in need of being “sold” on the idea of experiencing more pain. It follows that consciously arguing with them to experience more pain is counterproductive.
While I may confront my client with some variation of the Dr. Phill line ” how’s that working for you?” my job is to extend compassion, not selling them on more pain.
I train therapists who treat Adult Daughters of Narcissistic Mothers who are trapped in the role of the “good daughter”.
In my practice and in the training I provide -my ladder is always a suggestion, an offering from one human being to another. It is ALWAYS my clients decision to accept the hand up, therapeutic suggestion or interpretation.
In my opinion, without this approach I am one more in a long line of attachment figures who used manipulation for my own gain under the guise of ” For Your Own Good”.
It is an easy trap to fall into- particularly when we feel internal or external pressure to ” DO SOMETHING” . In my view it is almost always a mistake. There is another way.
Although I liked the concept of a ladder and at first this appealed to me I can see that it much better to join them in the hell and climb the ladder together with compassion, empathy and kindness.
I didn’t see Marsha’s explanation as forcing the client or being inauthentic – rather, the acknoweldgment that we cannot know their pain, but we can find an analogy to the pain and the dynamic or the pattern that we have learned belongs to them through our attuned engagment.
Once we understand that pattern, we are letting them know it “looks like we are at the top looking down” but really we are “here to help you climb the ladder” and “we know it is painful” but it is the only way out.
The ladder is always an option – we can’t make them climb it – Marsha is explaining how we can lead (sell it) to them as a way out of their pain = how to understand the dynamic, and giving them hope that there IS a way out, they don’t want to know we are “in it with them” how can we help them if we are?
I have had clients that have been to therapists that are so ’empathetic’ that they are in effect colluding with the client as victim, and even ones that get upset when they know the facts, and say unhelpful things like “oh you poor thing, I understand” when the clients soon tunes out and leaves therapy to look for someone ‘strong’ enough to ‘contain’ them in their pain, accept them there, but then can offer them hope.
Thank you for the metaphor. I also think the key is that the person feels you deeply understand his/her pain.
I like the metaphor. It makes sense. I think it works best, when people already know, that the have a choice.
i’m having a difficult time trying to find the effectiveness in taking an intellectual approach to why a client should have a feeling….in my time
feelings come when folks feel safe enuf to allow, them…resistance will melt when the time is right. . respectively, this sounds like trying to push somebody into expressing a painful feeling that they aren’t ready to express. it wouldn’t work for me, i know that. i’d lock up even tighter if i was being preached to about why i need to come out from my hiding place with stories about how i’ll suffer in hell untill…what??? in my belief, resistance serves a purpose…when it isn’t needed any more, it dissolves
maybe i’m missing something here….somehow the image comes to mind of ripping open a rose bud, rather than watering it and fertilizing it until it opens on its own.
I agree Mikki- So very well put. Resistance serves a purpose, yes. And when no longer needed dissolves ! Thank you. We don’t need to lose sight of that. To do so is harmful and arrogant and misses the point of respecting all of a clients experience. Do so and we generate more resistance.
I found that it is useful to get the patient to begin to speculate what is their. Feeling about their feelings. That can foster curiosity about less sensitive issues and over time they develop increasing ability to explore within themselves…. and begin to share and grow.
I use story-telling too, and surprise. I know that we can be masters of our selves and that confidence radiates I expect. I took a lady who’d had hip surgery aged 88 out of the hospital yesterday and surprised her first of all by saying “we’re getting out of here today, I going to take you to see a tree.” She is a very intelligent woman and she just thought that statement was hilarious, and ended up walking a mile to sit under a spreading chestnut tree and back. She thanked me over and over for such an interesting day. I will follow up with the poem Under a Spreading Chestnut Tree tomorrow. (She had threatened to kill herself on Monday – so in 5 days I turned it around)
I also like the Hell and hot ladder analogy and will definitely use it in my work. I very much agree that people need to know that we really hear the level of suffering that they are living.
Sometimes my clients have a strong, lifelong programming about not letting anyone see them cry. This is fairly common in the U.S., isn’t it? As they gradually feel safer letting themselves express sadness in varying degrees and as it naturally arises, I think they learn that it is not so scary to be vulnerable. It is something we seem to learn and re-learn to trust in industrialized cultures.
How I co-create that safety varies from person to person based on their comfort levels. Paradoxically, often just giving someone clear permission NOT to express their sadness (or any emotion, memory, etc.) until they are ready relieves a big tension and fear for them, and more openness follows.
I used to work in a hospice program. Some people grieved openly and easily and others were afraid that once they started crying they wouldn’t be able to stop. I did share my own experiences and those I had observed. Usually, there is significant change in breathing and tension in the throat and other areas when one is resisting grief. It sometimes helps to just work with it somatically: first noticing how breathing IS happening, how grief lives in them and then allowing oneself to open into breathing more fully in a natural way—an exploration, not an exercise, often with that breath comes the tears. To resist arises again, one can become curious about how that happens with guidance.
I sometimes call my clients on the day after sessions where the floodgates have opened because I have found that they always feel so much better the next day, often motivated to go out and connect with people or just feel more alive than they have in months. I call because I want to highlight the connection between their experiencing of grief and the true relief that offers to them versus what they thought would happen.
And sometimes, people just aren’t ready and I have to respect that and continue to find ways for them them to share at the level they are currently capable of sharing.
I love the respect shown in this post for clients and their process.
As a drama therapist I may begin to use externalizing langauage regarding resistance to put the client in relation to resistance. If they are open I would refer to resistance as a character and interview them as resistance. I would ask how you help this client. What strengthens you, how long have you been with this client. What weakens you. What are your hopes and dreams for this client. Then something in the conversation may allow for the opposite of resistance which could be openness, bravery…and then interview this character. Then maybe create a scene that puts them in conversation together. Not an actual scene from the persons life but begin dymbolucally so it’s less threatening. I could also ask them to do a sculpture of when resistance is strongest and what their preferred relatationship to resistance would be. Bringing the client into their body and imagination takes it out of the resistance to therapy and brings a more playful engagement. Just some ideas. Thanks, Psm
oh gosh – no the burning ladder in hell (with therapist above/on the outside) approach doesnt resonnate with me for a couple different reasons. I think its critical that the client feels you are WITH them – every step of the way. The ladder creates a visual image of they, alone, in hell, the therapist way up high, away from them. And on top of that what lies between is a very painful (just the image of grasping a burning hot ladder thats going to burn your hands can be so anxiety producing – the pain of that!). Creating a very safe space and gently guiding in to the unfelt feelings, being with them in this place (being with them is the key key part!) as they were very alone/or felt alone when the trauma first occurred) – being with them step by step to feel the blocked feelings, process the suspicious that they hold of themselves/other or the world. (as another person above mentioned with exposure therapy) building the resilience/tolerance to feeling those feelings – being WITH the client, creating an extremely safe and compassionate space for the healing and processing to take place – is SO key. When resistance appears – keeping the goal front and centre (there should be a goal of how they want to feel – clearly articulated at the beginning. Trust in the therapist will help them move towards this goal – yes have to move through painful feelings but they have company there. just my thoughts
PS – the resistance of course is fear (often terror) – so the question is how can we help move them through the fear? (by adding an image of more fear? and alone-ness? just a thought as a consideration)
Yes. I remember my own terror and times of “resistance” through my own healing process. With some kinds of trauma the option to say ‘no’ was taken away. In respecting ‘no’, I am respecting someone’s need to set a boundary, which is very therapeutic. That place inside of us that knows when we are ready, when there is a ‘yes’ for something gets repressed and disconnected when boundaries are totally disrespected through acts of sexual, physical abuse, torture and many other forms of trauma. I often see ‘resistance’ more as a person learning to trust that inner voice and reconnect with that internal compass. I don’t really know what anyone needs more than they do.
i soooo agree!
Yes, being with the client is everything.
Good points. To me the bottom line is that I am always sitting with an individual. Whatever happens must be responsive to that. There is no ‘they’ but just a ‘we’ which is also changing in every moment. Compassion, responsiveness and presence for what is arising/emerging ir primary. And that ladder might be a worthy offering to someone, if tailored to what is happening in that moment.
This can be tricky territory because resistance, as we know, is a defense. The defense is the way the person survived, sometimes horrendous and abject early childhood trauma. I had a client who told me up front in her therapy process that she could not and would not go beyond the barrier of nine years of age. I worked with this client weekly, gradually building trust and providing a safe place and a safe parental-type friendship. After about a year, the client journaled, writing most days, shared her survival strategies (she continued to live in an environment that was not nurturing). When we re-assessed progress after one year, the client reported having 2-3 nightmares per month, rather than the beginning 4-5 per week, more confidence, less free-floating anxiety, and more sense of joy in her life (ie: appreciation of nature, her writing, coloring mandalas, knitting). I may never have broken down that line in the sand she specified, but we got to talk about the barrier and why she didn’t want to go there, but in talking about the barrier she developed a coherent narrative. She just couldn’t or wouldn’t go back there and try to desensitize or reprocess the dark emotions. Maybe some day she will, but in the meantime, for once in her life, she had someone who respected her pain and her boundary around that pain.
My point is, that breaking through resistance can be about trust, timing, severity, and duration. This client was 60 years old and was surviving with equally severe, chronic physical problems. I think she is a living miracle…just that she’s alive and functioning and not in a mental ward or drugged out.
We may never get through that wall and may never want to. Breaking down resistance has to be a collaborative process. There is no one size, fits all. I think that sometimes living in hell is the devil the client knows and only the client ultimately knows whether it is better to live with him or leap into the unknown, in Marsha’s metaphor “climb” into the unknown.
I love the metaphor.
This is true. I think of clients who had major, chronic medical issues and just didn’t have the energy it takes to face some of those terrifying demons. I also don’t beleive that the ONLY way out is through. Again, we are sitting with individuals. I have seen people make tremendous changes without processing traumatic memories in direct way. I also have the deepest respect and admiration for each and every one of them.
Loved your “climbing out of hell” story! I will use that!
There is a lot of focus lately on trauma informed care and understanding resistance through a trauma informed lens. Through this lens, the client’s behavior can be understood as the way they have been able to survive traumatic life experiences. However, their behavior is not working for them anymore (and perhaps it never has but they have reached a point where it really doesn’t work for them) because it is simply keeping them in what Dr. Linehan referred to as “hell”.
This is brilliant. I have often focussed on the positives…of what lies ahead for the client if they face their sadness, grief, anger or feelings of shame. Providing a story of getting out of “hell” is useful for the client who cannot visualize themselves being in a better place. Thank you Marsha!
I find it really helpful at first valuate the resistance and be with it. So the client feel that is nothing wrong to be resistant. And than I explore with the client why this resistance make sense and have meaning in there life. So they can really feel and understand that resistance is something very functional for them. Than I try to find out with the client at what age this resistance served them to ” survive”. To valuate the resistance in my experience leads to a relaxation in the emotional system and to a reduction of tension in the nervoussystemfrommthat point clients feel more secure to contact their pain and suffering.
In my own work, at the point I was able to see how the resistance, which I experienced on this occasion as black hatred around my heart served me at a very young age with my father, I was asked to consider whether I still needed it. That eventually led to a deep healing catharsis.
So well said, the person needs to get out of hell but the ladder is hot. From my experience, it is so important to let the person know they are not alone (the need to know you are not alone may connect to the importance of healthy early childhood attachment versus unhealthy attachment, many people who have suffered trauma as a child also experienced unhealthy attachment with their primary caregivers.
I like the pro and con approach but that’s sometimes a too rational approach for someone who is resistant. I Like the hell analogy simply because it creates a picture. If they can retell it, they can do it.
Thank you.
I wish it were that simple. There has to be a willingness and a readiness to FEEL the pain fully. I don’t think “selling” new behaviour works, because if it did, then it wouldn’t be difficult for people to do it themselves automatically.Nobody wants to numb out difficult feelings and emotions, we do it because strong emotions are hard to take, and the more we do it the more we find it easier NOT to connect to difficult emotions.
I would say that this is a process and it’s about programming the brain to exposure. I say this because resistance can be a habit a person gets into in order to avoid an unpleasant reality and priming the brain to exposure in this case works beautifully. It’s about getting the person purposefully to bring up and sit with a painful emotion every day for a few minutes.Whatever the emotion is is not important, but best to start with an emotion that comes with less load or is easier to handle.It’s important that it is timed for a short period of time because the part of us that feels resistant needs to know that the process will end within a specific burst of time (I don’t know why this works but it does) And see what comes up. I then use the dial up method when nothing comes up. I personally did it successfully to get un-numb from emotions and to start feeling again. And it ABSOLUTELY works. The dial method is about imagining a dial with 0 for no feelings to 100 for the most intense feeling and it’s about starting from 0 and cramming up tp 100. The exercise can only be considered complete when it is possible to feel the feeling at 100 feeling the feeling intensely:almost over the top. Even if this happens for less than a second, one has the choice to go back to say 5 for example and regulate it. I find that the best thing is not to necessarily bring up a memory connected to the emotion but simply concentrate on feeling the emotion, without content first. I have found that once the resistance is comfortable with this, memories connected to the emotions (and so the resistance)will come up to be integrated. This is not something that always works super fast, but it works.With some people it takes longer wth others not so much. It depends on how much resistance the person is holding on to, or how long the habit has been going on.
thank you
Develop A VERY strong awareness of the present moment and all the potential that is a part of that moment,,,which is the only way one can move with energy and inner guidance. Eleanore
I way something similar: What isn’t felt, doesn’t change. It stays the same. Pushing it away doesn’t make it go away. It is there anyway and comes back. Turning toward the sad part of yourself (something in you) that is sad with compassion, that part of you won’t feel alone, because it has you to listen to it and why it is so sad. Once you have heard it, it can shift, change. It isn’t your enemy. You can’t speed grieving up, but you can slow it down–by refusing to be with it, without falling into it.
And yes, a little at a time. If it is too much, we can come up for air, take a break, before going back, gently.
I SAY something similar (not “way”)
This was soooooo good. Thanks for the Laddermetaphor !!!
I mainly work with the “resistant part” as i am an Ego- state -fan 😉 Once the resistant part has been honored and understaood in his protective function (which doesnt really function 😉 ) it lets the patient work up the hot ladder .
Merci encore !
I almost always ask them, “how would your life be different if you did not have these problems?” Once they describe their ideal life, I start to work providing encouragement and support for them to redesign their life. Having hope that change is possible is extremely important to “climbing the ladder that is described by Marsha in the video.