What’s resistance?
What’s resistance? Resistance is based on personal automatic ways of reacting in which clients both reveal and keep hidden aspects of themselves from the therapist or another person. These behaviors occur mostly during therapy, in interaction with the therapist. It is a way of avoiding and yet expressing unacceptable drives, feelings, fantasies, and behavior patterns. Examples of causes of resistance: resistance to the recognition of feelings, fantasies, and motives; resistance to revealing feelings toward the therapist; resistance as a way of demonstrating self-sufficiency; resistance as clients’ reluctance to change their behavior outside the therapy room; resistance as a consequence of failure of empathy on the part of the therapist. Examples of the expression of resistance are canceling or rescheduling appointments, avoiding consideration of identified themes, forgetting to complete homework assignments and the like. This will make it more difficult for therapist to work with the client, but it will also provide him with informatio the client, but it will also provide him with informatio
State and trait resistance (situational and characteristic)
Resistance is an automatic and unconscious process. According to Van Denburg and Kiesler, it can be either for a certain period of time (state resistance) but it can also be a manifestation of more longstanding traits or character (trait resistance).
In psychotherapy ‘state resistance’ can occur at a certain moment, when an anxiety provoking experience is triggered. ‘Trait resistance’ on the other hand occurs repeatedly during sessions and interferes with the task of therapy. The client shows a pattern of off-task behaviors which makes the therapist experience some level of negative emotion and cognition against the client. Therefore the maladaptive pattern of interpersonal behavior and the therapist’s response interfere with the task or process of therapy.. This ‘state resistance’ is cumulative during sessions and can best be stopped to develop through empathic interventions from the therapist’s part.
Outside therapy ‘trait resistance’ in a client is shown off by distinctive patterns of interpersonal behavior. Often caused by typical patterns of communication with significant others, like family, friends and partner.
How do therapists handle resistance in psychotherapy?
Nowadays many therapists work with resistance as a way to understand the client better. They emphasize the importance to work with the resistance and not against it. This is because working against the resistance of a client can result in a counterproductive relationship with the therapist. You could say that the more resistance is showed, the less productive is the therapy. Working with the resistance provides a positive working relationship and gives the therapist information about the unconscious of the client.
A therapist can use countertransference as a tool to understand the clients resistance. The feelings the client evokes in you (as therapist) with his/her resistance will give you a hint what the resistance is about. E.g. A very directive client can make the therapist feel very passive. When the therapist pays attention to it’s passive feelings, it can make him/her understand this behavior of the client as resistance coming from fear of losing control.
Important to the question of treatment planning are research studies that have looked at resistance traits as indicators and contra-indicators for different types of interventions. Beutler, Moleiro and Talebi (in press, as described in ) reviewed 20 studies that inspected the differential effects of therapist directiveness as moderated by client resistance and found that 80% (n=16) of the demonstrated that directive interventions were most productive among clients who had relatively low levels of state or trait-like resistance, while nondirective interventions worked best among clients who had relatively high levels of resistance. These findings provide strong support for the value of resistance level as a predictor of treatment outcome, as well as treatment-planning. In these studies cognitive behavioral therapy has been used as a prototype for directive therapy and psychodynamic, self-directed, or other relation oriented therapy have been used as a prototype for non-directive therapy.
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