Resistance is Fertile

One of the biggest questions in modern therapy is how to most-effectively work with what’s known as a “resistant” client.  The idea of resistance is a simple one that belies a complex reality: some clients wont respond well to what the therapist is doing, and progress will be slow or nonexistent.  It’s a little hard for me to write about any of this - resistance, progress - without throwing quotes on every other word, but since that looks awful in print please assume I view all of this askance.  It’s worth noting that the question of resistance is a question that has only shown up in the modern era of therapy; Freud and the analytic gang not only weren’t worried about “resistance”, they didn’t have even have a concept of it.  Why is that?

Therapy used to be a very, very, very long process.  Therapeutic analysis was expected to take 5 or more years.  The idea of resistance didn’t exist then because it didn’t have to - moving slowly was how it was done, as the analyst and their patient were working together to make a comprehensive map of a completely uncharted domain.  A patient coming to session and complaining that they didn’t think analysis was working, that nothing was changing, was just as valid as lauding the process for its incredible efficacy.  To the analyst’s eye, both reactions to analysis were considered the same: defense mechanisms designed to keep analysis away from all the most tender stuff.

In modern therapy, a lot of effort is placed on how to work within the confines of insurance company strictures.  Many insurance companies wont pay for more than 8 or 13 sessions.  Needless to say, this has an effect on how therapy is practiced at every step of the way.  Even in situations where therapy is paid for out of pocket, the narrative of what therapy is and how it can and should work has changed.  People are looking for positive results, and quickly.

It’s worth noting: there is nothing wrong with this.  Therapy is expensive, time consuming, and difficult; expecting to gain something from it seems fair to me!  The question is not about what’s appropriate to expect, but about how to gauge whether expectations are being met.  When we classify clients as resistant, we are forgetting or ignoring that therapy is a process that tasks us to see the whole client.  We are missing the forest for the trees, and the work that we are able to do suffers for it.

When working with clients, I am constantly trying to remember that most of what they are showing me is what they have been trained to show me.  As Kurt Vonnegut points out in Breakfast of Champions, people like to agree with each other.  Being agreeable feels good to us and keeps our society working.  Unfortunately, this can make it hard to be disagreeable, which is an unavoidable state every now and then.  It’s really important if a person is going to get what they want out of this life to be able to express themselves, even when what they’re expressing is an unpopular opinion, and our natural preference for being agreeable can make that a very difficult thing to do.

In therapy, I make sure to tell my clients in our first session, and remind them in a lot of session after that, that it’s important to tell me when I piss them off.  Or make them sad.  Or am ignoring them.  Basically, I try to make sure they know they can tell me when I have disappointed or upset them and that it won’t negatively affect my regard for them.  This is important - it may be the most important service I can offer them.  I want them to know that they are free to resist, slow, or not enjoy the therapeutic process in any way they want to so long and as long as they keep showing up it will keep working.  Resistance is fertile.

The point being, one thing therapy can do for you is give you a chance to show off your most unlikeable self.  Which, if you ask me, is an incredible gift!  It is beyond nourishing to know that you can go somewhere and be a complete schmuck, and be loved for it all the same.  Showing the parts of yourself which are most unwelcome in society - which are often the parts that feel most shameful - allows for a complete paradigmatic shift.  Can you imagine feeling loved and accepted not just for your wit, your charm, your intellect, but also for your mediocrity, your depression, your misery?  Acceptance is one of the best things I can offer my clients, and I could never offer it if they don’t show me what to accept, so how can I call that resistance?