Encountering resistance in clients can be disheartening because as therapists we want our sessions to be effective and our clients to make the best use of their time (and money!). The first thing to remember when you have a silent and resistant client sitting in front of you is don’t panic, this is all part of the process.
I have encountered resistance in many forms in my therapy practice. I have had clients ask me about my life, change the subject, evade the issue by sharing a lot about something else, or conversely by going very quiet. Lots of therapists have reported clients evading their main issue until the last minutes of a session, leaving no time to properly process what they have said. This is all very normal and you can become skilled in helping clients break through their resistance so they can engage most effectively in healing.
Resistance, like many defense mechanisms, is an often unconscious psychological response that has its beginnings in the amygdala, the almond shaped part of the brain that is well known for the part it plays in fear conditioning. We develop defense mechanisms to help us mitigate feelings of anxiety or upset that can arise from harmful or unpleasant stimuli. Our defense mechanisms are primarily our friends - they help keep us safe and happy, and protect us against things that are upsetting.
Problems arise when we forget that whilst resistance and silence may once have been very effective at keeping us safe, they can become unhealthy or maladaptive mechanisms that hold us back. Understanding this you may wonder how then to get a client to open up. Below I have outlined three ways in which to approach this.
First of all, remember that therapy is a collaborative enterprise. Yes, engaging resistant clients in therapy is part of our task as mental health professionals, but responsibility also lies with the client, and they will have their own work to do in order for them to most effectively use their therapy time.
As a therapist I find it helpful to follow these three steps:
Accept the Resistance
An important thing to remember is that resisting therapy is normal! Wanting to avoid questions that are difficult or uncomfortable is a very common defense mechanism. Perhaps we developed this trait in order to not be mistreated when we were young. Perhaps we learned to distract our parents or teachers to avoid their disappointment. Normalising the behaviour, by talking congruently about what is happening, can be powerful for the client as they may have some belief that they are bad or unusual for being resistant.
Resistance is to be expected. It is much more uncommon that I have a client come to sessions without any resistance, totally open, and willing to do the work. But as normal as it is, silence and resistance do not serve the client well. I gently remind clients that the goal of therapy is to really push through these defense mechanisms so we can talk and heal. I find it useful to remind them that they are the expert on their experiences, and that I can’t offer them helpful tools if they can’t or won’t share with me what is really happening.
Fostering a Sense of Safety
You can help your client to foster a sense of safety and security by encouraging them to track their thoughts and become aware of their fear-based thought patterns, and then show them how to challenge that thinking.
Challenging such maladaptive thinking, and shifting your focus from danger to safety, can start to reverse the hold that self-generated fear has. You can help your client to feel empowered to do this by encouraging them to identify opportunities to get in touch with positive, supportive, protective things in their lives such as:
What should you do if your client is not talking in therapy?
Tolerating silence comes naturally to some people but others find it intolerable and feel compelled to fill the silence. It could be very beneficial for your clients if you can become skilled and comfortable in this area. I have found sitting with silence through mindfulness meditation in my own time invaluable for me as a therapist in terms of managing silence in counselling sessions. Mindfulness meditation is also something I practice with my clients in sessions. It can be very helpful in terms of developing emotional regulation skills.
Your silence, when used properly, may very effectively hold an empathic space in which your client can become mindful of what is arising in the here and now, and work through their thoughts and feelings.
It may also make your clients very nervous or anxious. I always feel it’s a good idea, and sometimes very helpful and liberating for the client to be open, honest, and congruent about what is happening within the counselling relationship, and what is happening in the session.
One very effective tool I have used with clients who find talking challenging is to ask them to keep track of their emotions and thoughts in between sessions and write them down. They can bring the document with them to session and read it out - this may be key in how to get a client to open up.