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How to tackle my perceived "resistance to change" in therapy?

How to tackle my perceived "resistance to change" in therapy?

My talk-therapist (lets call her Dr D) has become frustrated with me, and declared me to be repeatedly resistant to change, even occasionally combative. I am inclined to reject the claim when stated as strongly and as generalised as that. However, I understand there is a recurrent pattern in my behaviour and judgements over my life and over the year of seeing Dr D which could be reasonably interpreted that way.

My homework from Dr D is to think about why I am resistant, presumably in order to open up options to remedy that obstacle. But I am at a loss how to proceed. I expect that if it was that easy to uncover in a fortnight, then I would have found at least some of the needed clarity at some point in my previous multiple decades of talking, writing and reading about my maladjusted life.

I have done extended work on my mental illnesses and personal struggles, and intermittently seen variously positive or disappointing results from professionals, programs and peer support groups. I have suffered discouragement with and/or skeptical rejections of SSRIs, SNRIs, CBT, DBT, non-directive psychodynamics, Twelve-Step programs, mindfulness meditation, EFT, the healing power of the Holy Spirit, etc etc.

I have accumulated multiple candidate ideas about what is critical for some change, many of which I have shared with Dr D. She seemed to dismiss most of them as either too abstract and academic, or too situation-specific, or too much about distancing from my own emotions and experiences, or too depersonalised to give me any way to take responsibility.

For an example, I have had chaotic sleep patterns for years. I recently started trialling a new medication, requiring me to establish a consistent routine rising, eating then dosing before 8AM in order to avoid problems with the medication suppressing my appetite or later interfering with my sleep. Applying myself to this, I chose to work first on my morning routine.

Unfortunately I did not concurrently tackle my browsing-social-media-til-after-1AM habit, which meant my earlier rising produced sleep debt and fatigue that muddled the potential benefits of the medication. In settling for that partial approach, I tended to see it as doing the best I can with my limited self-control and attention. Dr D apparently sees it as me sabotaging the medication trial, or as yet again blaming the professionals for not giving me an infallibly easy and complete solution. Presumably I should be taking more responsibility and doing my own problem-solving to get on top of both my sleep and my medication in a way that works for me.

So, is there some single deep choice or reason that explains me not being fully enthusiastic and engaged about trialling the medication? One that also serves to throws light on my alphabet soup of past discouragements and rejections above? It seems unlikely.

Should I be trying some recovery workbook exercises like those built abound finding your place on the "stages of change" model aka James O. Prochaska's Transtheoretical model?

Writing a one-act play about splitting myself into an enthusiastic active persona versus a passive negative persona and having them talk it out?

Analyzing some calculus of pros and cons, maybe including the imagined rock-bottom catastrophe that would make any imperfect remedy seem worth trying?

Something else? What?

6 replies

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In response to: How to tackle my perceived "resistance to change" in therapy?

Re: How to tackle my perceived "resistance to change" in therapy?

I can't comment too much on your specific dillemmas, @7cough9 , but I must say that the commentary of your therapist struck a nerve with me. I must emphasize that what I'm about to offer is no doubt heavily skewed by my own terrible experiance in therapy.

But one key question I would ask is: "Are you resistant to all change? Or just the particular changes that your therapist is trying to drive you towards?"

I was often criticized in therapy for being afraid, or finicky, or resistant, or difficult (probably a half dozen other labels as well)... But I had good cause to be, as it was apparent from very early on that my therapist had very differant goals for my life then I did. She was an enemy, not my friend, so it was typically very necessary for me to resist her, or I would've ended up with an even worse life then I have now.

But notice how she used insults to try to bully me into following her bidding? Trying to make me ashamed for not submitting to her will. It reminds me of that recurring theme in the "Back To The Future" trilogy, where all anyone had to do to get Marty to go against his better judgement was to call him "chicken". He couldn't abide being called "chicken", so his bullies would always use that insult to coerce him into doing what they wanted him to do.

Insults, particularly accusations of cowardace, or being troublesome/burdensome are very powerful coercive tools; and the mental health industry knows this very well.

Hence, I think it is important to establish whether or not you truly believe your therapist's instructions are likely to be a path to the life you want; or if she's just trying to bully you down a road that you know is not where you want to go.

Remember, it is her job to serve your ends, not your job to serve hers. You shouldn't feel pressured into making her job easier, if the job she's trying to do is anything less then getting you where you want to be.

Resistance To Change

On the subject of being resistant to change... I know a lot of people toss that phrase around like an insult. But personally, I don't believe there's anything inherantly wrong with that, because a lot of change is bad and ought to be resisted.

It's only when a person is presented with a reliably positive change that "resistance to change" may potentially be a problem. But if you merely resist a change because it would not serve you well, or because you are sceptical of it's ability to serve you well, then I can't see how that's a bad thing.

If you are merely resisting a change because you are sceptical of it's supposed merits, then that likely indicates that you've learned the hard way to be cautious, as previous changes have proven harmful to you. I know that's where my highly sceptical nature comes from. Extensive personal experiance has demonstrated to me that change has a very high tendancy to be unfavorable; especially when that change has not been deliberately designed to benefit me.

So I guess that's the question: "Are you only resistant to the changes that you are sceptical of?"

Take, for example, your sabotaging of your medication regime. Could you be resisting that because you don't genuinely believe the medication will do you any good?

Has your therapist ever presented you with any instructions that you genuinely believed would be a route to a significant improvement in your life? If so, were you resistant to those instructions?

Perhaps the only change you are resistant to is unhelpful change. If that's true, your quite normal. 😉

With regards to your late-night social media habit... I believe that a lot of ISPs these days offer services that allow you to disconnect your internet automatically on a certain schedule - e.g. to force the family kids to participate in "family time", ect. I believe that many modern Wifi routers can also be configured to disconnect the internet on a certain schedule.

So, if you want to kick your late-night browsing habit, maybe your ISP can help you set an automated schedule that disconnects your internet at midnight, ect.?

In response to: How to tackle my perceived "resistance to change" in therapy?

Re: How to tackle my perceived "resistance to change" in therapy?

Always they have a reason why this didn't work, or that. Always they know how to help, but then they don't. You sound very astute to me, @7cough9. And resisting change to yet another direction sounds wise to me. There'd have to be good reason for me to comply with such advice. I cannot offer advice because I'm still trying to find what works for me.

But, as for sleep, I sometimes have got up and played games on the computer – which sounds counterintuitive, I know – but I've played until I tire myself out. Or I read. I usually have a cup of tea, any kind but often camomile, and then when I get back to bed, I manage to fall asleep. It has worked for me. Other times I've just lain there and satisfied myself with resting. Whatever works for you.

Sending best wishes.

In response to: How to tackle my perceived "resistance to change" in therapy?

Re: How to tackle my perceived "resistance to change" in therapy?

I’ve heard it said that behaviour change is easier when one thinks about ones own values and how our behaviour, both current and desired, fits into those values. For example, for many years, I avoided doing exercises, because I associated them with painful childhood therapies that I had to undergo for my physical disability, and admitting I needed special exercises made me feel less normal, something I value.

Now, I do my special exercises because doing them makes me less of a burden on my parents, something I value, and it makes me feel stronger and more capable.

Maybe thinking about what you’re valuing when you’re doing what you’re doing and what you want to start doing could help?

In response to: How to tackle my perceived "resistance to change" in therapy?

Re: How to tackle my perceived "resistance to change" in therapy?

In your example, it might have been more people-based to create a medication schedule that was compatible with your sleeping patterns. Generally, the best way to avoid "sabotage" is good old fashioned collaboration. Thing about system-based vs people-based is, systems are made of people (who are also made of systems).

I like the stages of changes. I do find that at most times people bridge at least two stages at any given time. Like, one foot in planning while the other one moves from consideration to action. Like on a ladder or a hike. I also like the Jung/Campbell "hero's journey" (better than the subsequent 12 steps, at least) both as a self-help guide and as creative writing framework.

A practitioner citing resistance to change suggests someone with a behavioural rather than a Rogerian approach. I had perhaps a comparable experience. It led to three developments.

1. I discovered my condition (AVPD ("avoiding disease")).

2. I adopted a kind of self directed( ACT (because accepting and committing addresses both sides of avoidance)).

3. I got another psychiatrist (Gestalt-school (nice and holistic, which is totally my speed)).

As options, I'd recommend any combination of the above (if you're feeling them).

In response to: How to tackle my perceived "resistance to change" in therapy?

Re: How to tackle my perceived "resistance to change" in therapy?

Hi there,

I'm also seeing a therapist and have trialled a few before him.

I wander if being so direct or critical is helpful always, as Dr d was.. I know ppl respond to different styles, but when we have a tendency to be hard on ourselves....do we need new routes to self-blame?

Maybe it's hard for people to sit with that conventional treatments do leave a lot to be desired.

The system is broken, not us.

I just wanted to say hi and hope Ur doing OK today.

In response to: Re: How to tackle my perceived "resistance to change" in therapy?

Re: How to tackle my perceived "resistance to change" in therapy?

Resistance to change is not the same as resistance to 'growth'. You may have

outgrown Dr D.

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