Resistance to Beginning Therapy
Resistance to beginning psychotherapy is both natural and understandable. For each person it can take a different form.
One form of resistance stems from the belief that therapy is for people who have significant problems or are highly impaired. This had truth many decades ago. The field of psychotherapy, however, has evolved to treat a wide spectrum of individuals from those who are severely disabled to those who are simply wanting personal growth or to become more actualized as people (i.e., improving athletic performance).
Some people hold the belief that seeking psychotherapy is a sign of weakness and that one should manage their own emotional problems. In my view, it takes far more courage to disclose or expose one’s psychological problems and emotional vulnerabilities than to hide them. In regard to managing one’s own emotional problems, most of us have a bevy of specialists to help us in multiple areas of our lives whether a physician, auto mechanic, accountant, or computer specialist. When it comes to our own psyche, outside assistance is particularly important as we can never fully see ourselves as others can.
Another hesitation in initiating therapy is the belief that our own problems, in comparison to others, are minor and insignificant and not deserving the attention of a therapist. Our struggles and emotional pain are important at any level… simply because they are ours. Any devaluation of our pain and problems reflects a devaluation of ourselves. This does not mean that it is not important to appreciate what we have as compared to others who are less fortunate. Having perspective is important, however, if we devalue our own problems we leave ourselves sitting in isolation with our emotional pain. We are also at risk for adding guilt and shame to the mix for being unappreciative and a complainer.
Some people believe that the therapy process will be about blaming others, particularly parents. The therapy that I conduct, does not focus on the intent, motivation, or love of parents. I believe that every parent does the best job they can given their life experience and what tools they have acquired. However, psychotherapeutic change does require an understanding of the relationships that have shaped us as people, even though we ultimately have to take responsibility for what is now inside of us. Our self-experience is subjective and therefore fluid. Knowing what we had to do to navigate our childhood will bring forth the awareness that we now have a choice in how we experience ourselves and navigate the world today.
For many, sharing sensitive material about ourselves and expressing feelings to an unknown person can be difficult or daunting and can prevent someone from initiating psychotherapy. If we have been emotionally hurt in the past we will naturally be cautious and wary about entering any new emotional relationship including one with a therapist. It has been my clinical experience that a primary form of resistance to therapy is the fear of exposing oneself and being re-injured. Re-injuries within the therapy relationship can occur and include being unsupported, judged, or criticized. The quality of the psychotherapist’s training, experience and his or her level of attunement will, of course, minimize these occurrences. It is important to note, however, that there is no perfect relationship without misunderstandings, unintentional slights or injuries. If this does happen in the therapy relationship a good therapist will guide in the processing of what has happened (including the taking responsibility and apologizing for unintentional errors). The person in therapy will experience the empowerment of seeing and feeling firsthand that he/she can advocate on his/her own behalf and participate in the process of repair. These moments actually strengthen the therapeutic bond.
Another concern centers on the fear that therapy will bring forth unwanted feelings or thoughts that will overwhelm us. Naturally, if we have spent many years suppressing or unconsciously repressing feelings or thoughts that we feel would be upsetting or destabilizing to us, we will have ambivalence about entering a therapy relationship where these feelings or thoughts will surface. It is important to note that a skilled therapist is trained to help the person in treatment understand, first and foremost, the purpose and validity of their self-protective measures (suppression or repression). It is then the psychotherapist’s task to manage the timing and pace of what an individual brings forth and to help with the assimilation of any painful feelings and thoughts. An important awareness to acquire in this process is the differentiation between the past, when those thoughts and feelings were overwhelming, and the present with all of our resources that we now possess.
In the course of therapy, there are times when a resistance to change itself comes forth. Even though our present lives and circumstances may be difficult and painful, they are at least familiar. With any change, whether it is the ability to feel or express a new feeling, to begin to assert ourselves with others, or disclose more deeply in an intimate relationship, we are entering a new playing field and this can bring with it anxiety and fear. It is important for the therapist to examine with the individual in treatment any ambivalence or fears surrounding change.
Some individuals have a concern that therapy will be a long-term process over which they will have no control. It is my belief and practice that it is the individual who initiates therapy and thus it is always that person’s choice to end the process. Individuals and couples will participate in therapy as long as it is valuable to them.
Finally, it is important for the therapist to explore with the person in treatment any fears and resistances that may come forth at the onset of psychotherapy and during its course.
Copyright © 2013 Bruce A. Howard, Ph.D. All rights reserved.