Rolling with Resistance

Rolling with Resistance in Sessions 

Dear Supervisees,

Rolling with resistance can be considered a strategy, as its an active approach (purposeful) in processing what may be occurring in the therapeutic room or rather what isn't. First, let me start off by noting that resistance may look different across the board. In fact, some in the field may or may not interpret clients' behaviors as resistance in accordance with their theory or model of choice. Nevertheless, overall, resistance essentially is when someone does not seem to be open to something. Yes, this is vague, but that's exactly the problem. The something can be resistant to an idea, a person, a thing; it can be anything. In therapy, however, there are too many variables to consider before labeling anyone as resistant. For instance, for those that may appear to be resistant perhaps its situational (mood), or contextual (not yet comfortable with the idea of therapy perhaps its new to them or perhaps they have had some past poor experiences or simply the therapeutic alliance hasn't been built yet), or even perhaps due to medical or psychological conditions (anxieties, depression, bipolar, schizoaffective, etc.), or due to the content (perhaps the topic is a touchy subject).

Another key point to consider is culture and diversity implications, considering how clients' culture and diversity manifest itself in their demeanor and reaction that may appear as resistant but isn't. Also, consider your own world view lens' implication; that is how might your own beliefs, experiences, culture, and diversities filter what you are seeing and hearing accordingly. And lastly, consider why or rather how is this supposed resistance an obstacle to change and achieving the client's wanted outcome.

So now what to actually do if indeed the clients seem not as open, perhaps some reservations or challenges, you wouldn't need to challenge it necessarily, but instead, roll with it. Now of course this method will not maybe be taken with many theories or models, but the idea here is that at least perhaps coming from an MFT training and postmodern approach the clinician might be more concerned about what he or she can do differently, as there is no need to address for instance at least not directly, why they are resistant to X Y Z but instead perhaps focus on how to understand where the client is emotionally and mentally and quite frankly simply get a better understanding of what they may want and need from that session, which should be in line with therapy goals. Now some of you may be thinking this approach can potentially ignore the more significant problem in not addressing the root of the resistance. In no way considering everything I said would you not gain some deeper insight on what can be some potential contributions to the supposed resistance, remember in some cases, it might not even be resistance, which is a part of the point here. You should ask yourself why you might think X is resistant and how is that an issue if at all to the therapy work.

You may argue that you can't move forward with a resistant client, stuck if you will, who doesn't want to do the work. And I would say to that, well again you don't have to deal head-on the current supposed resistance but instead focus on the basics and that's the therapeutic alliance to create a safe space where the client feels respected and heard and if you explore what they may need you will be able to come back around essentially and with some clarity, as potentially by now the client might have let their guard down more or if you take an SFT stance you would say the solutions may have nothing to do with the presenting problem.

So, in summary, be patient with the therapy process (it's not a race), do a lot of active-reflective listening (allow the client to feel heard) and circular questions (asking alternative views, understanding context and sequences, exceptions, etc.) to get a better understanding of their needs and wants, and lastly stay attuned to your client (do not impose what should happen in therapy-be flexible) and reassess what might be more useful to them. Some of you may not know what circular questions are or circular causality, stay tuned (Subscribe to the blogs and vlogs for clinical interns) as I will have shortly have a blog and/or vlog on these topics.