The Making of a Therapist by Louis Cozolino

Author:Louis Cozolino
Language: eng
Format: epub
Publisher: W. W. Norton & Company

CHAPTER EIGHT

It’s Scary to Go to Therapy

The Paradox of Client Resistance

I had a lot to learn before I could figure out how much I had to learn.

—A SUCCESSFUL CLIENT

ONE OF THE MOST DIFFICULT aspects of being a new therapist is learning how to deal with client resistance. Most of us make the mistake of thinking that resistance is like a rain delay—something to wait through before we can get started. Nothing could be further from the truth. Working with and working through resistance are key therapeutic skills. Many of the answers to a client’s difficulties are woven into the resistance he or she brings into the therapy relationship. With time, we gradually learn to decipher the important information embedded within resistance.

Beginning therapists often first identify resistance in the content of what a client says. Content resistance is reflected in emotional difficulties around certain topics. Strong emotions or gaps in the discussion are often the first indications that “something is going on in there.” A client may always look sad when he mentions his sister, another may talk a great deal about her father but never mention her mother. Sometimes a client will say, “I don’t want to talk about that,” and go on to another topic. These are all examples of content resistance.

With increased experience, therapists begin to recognize what is called process resistance. Process resistance is embedded in personality, coping styles, and defenses formed during development. Our brains are shaped through adaptation to experiences and, in turn, organize our adult perceptions in line with what has come before. In this way the past becomes the present and future, or, put another way, we create what we expect to find. A prime example of this is the transference relationship, through which the client experiences the therapist as a significant person (or persons) from the past.

New therapists often get their first view of process resistance in situations of setting and collecting fees, missed appointments, and early termination. These are arenas in which a client will “act out” his or her resistance. It is up to the therapist to understand and name the acting out, as well as discover the underlying emotional processes motivating the behaviors. It is particularly difficult for beginners to confront these situations, and it takes time to gain the confidence needed to overcome the discomfort of making process interpretations. It is easier to avoid discussing missed sessions or bad checks than to have frank discussions about the thoughts and feelings motivating them.

It is scary to go to therapy, and ambivalence is the norm. Just making the decision to go can be nerve-wracking, let alone making the appointment and sitting in the waiting room anticipating the therapist’s arrival. Wild and unfettered enthusiasm is often a well-practiced form of resistance. By the time I walked into my first session, I was a giddy mess. The voices in my head kept telling me things like “the therapist will think I’m crazy,” or “he’ll think my parents did a bad job,” or, worst of all, “he’ll tell me I’m too screwed up to be a therapist.

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