Resistance to change – does it exist?

Is resistance a trait or state?

Resistance is a word that gets bandied around a lot in relation to client work. I often hear people talking about how resistant their client is, resistance of the client to taking on new ideas, or resistance of the client to engaging in a therapeutic or working relationship. It is interesting how we can position ourselves in relation to these ideas. We can see resistance as a trait (something within the person) or as a state (something the person is responding to). As you and I know, how we construct issues impacts hugely on the way we respond to them. So does resistance reside solely within the client?

I think not. I have been drawn to social interaction theory that views resistance as a “… negative interaction dynamic between the therapist and the client” (Otani, 1989, p.459). I would also add after therapist ‘or the context that the therapist works in’. If we accept this position, then we would automatically consider two aspects of change: 1) What are we doing within the relationship to develop resistance; and 2) what is the context for the interaction that the client finds themselves in. In this blog I will deal with the former, in the next, the latter.

Have a look at the list below and see some of the things that we can do to develop resistance in the client. Tick off the ones that you have been guilty of. If I am honest with myself then I know I can tick quite a few.

  1. We lead the change and try to push, cajole, or bully the client in a direction of change – we are right out-front.
  2. We have more investment in the change than the client does.
  3. We ask questions that the client does not get or understand – we know what we mean but the client is trying to figure out where we are coming from.
  4. We move too quickly for the client rather than at the client’s own pace.
  5. We don’t empathise with the client’s position.
  6. Our agenda is hidden, rather than explicit.
  7. We don’t appreciate the context of the client – if change was that easy then the client would have already probably embraced change.
  8. We are lost and rather than stopping, decide to keep going – this only builds anxiety in the client.
  9. We use language that is incomprehensible to the client.
  10. We are off our game, tired or not feeling well.
  11. We don’t respect the client’s autonomy to make their own decisions.
  12. We don’t work in a collaborative manner with the client.

How did you get on? I know I have to really attend to the person in front of me and tune into their wavelength in order to not be the one responsible for developing resistance. The motivational interviewing field, along with those working in brief therapy and solution based therapies, know too well of the ‘righting reflex’. This occurs when the worker takes more responsibility for change than the client does by establishing arguments for change and trying to convince the client of the wisdom of change. As we all know, if the client argues for change, then this builds intrinsic motivation which is longer lasting that extrinsic motivation.

In the next post I will explore the context that impacts upon presentation by clients to us. You can then decide on whether resistance is a state or trait. You may have already sorted that one out. Love to hear your thoughts.

 

Sources: Otani, A. (1989) Resistance management techniques of Milton H. Erickson, M.D.: An application to nonhypnotic mental health counselling. Journal of Mental Health Counselling, 11(4), 325-334.

Published on Tuesday, May 22nd, 2012, under Motivational Interviewing, Practice tips and techniques

5 Responses to “Resistance to change – does it exist?”

  1. Rick Maurer says:

    Ken –

    What a delight to read this post. “I know I have to really attend to the person in front of me and tune into their wavelength in order to not be the one responsible for developing resistance.” Yes, yes, yes.

    I work in organizations with people are attempting to lead change. My belief is that resistance (as well as support) occurs in the dance between us. Often the notion that I might actually be creating the resistance I’m getting is eye-opening to people.

    I identified three levels of resistance:
    I don’t get it.
    I don’t like it.
    I don’t like you.

    Most resistance I’ve seen between people and within groups falls into a combination of those three categories. The good news is that what we need is the opposite of each of those items. People need to get it. Like it. And trust us.
    I like forward to reading more of your posts.

    Rick Maurer

    • Ken McMaster says:

      Rick, I enjoyed your lovely summary of the real challenges. As we all know change is a real challenge. If it was that easy we would have done it. I am interested in how hard we make change for ourselves and also what we do as helpers to work with clients to create movement.

  2. I like the idea that if the client is resistant, the therapist’s role is to see what they are doing that is getting in the road of the client’s ability to embrace change. I am very influenced by systems and complexity thinking, which shifts the focus from the individuals to the relationships and the processes. I have been using the term dynamic co-creation to talk about the fundamental flow of life. Anything we do is an interaction between us and the outside. I am defined by the outside, the outside is defined by me in an ongoing dance. It’s dynamic and ever changing. What is right for one moment might not be right in the next moment. It’s like surfing. Ken, you once described me as a philosopher – I guess it’s showing.

    • Ken McMaster says:

      Victor you are so very right that the dance of life is how we interact with the world around us. Our brains are hard-wired for danger and I know that when I go to therapy (yes it does happen) that my threat radar is on even with therapists I deeply respect. It is about being able to come through the experience in one piece and maintain my own mana (respect). When I am working with someone I don’t want to be obstructive of change so the I need to be mindful of my own process and reactions to the person or people who are with me at that moment in time.

  3. Marianne Lammers says:

    I agree with the notion that it is the therapists’ stance to the problem behaviour that determines how the client reacts to the problem. I work in a prison environment and from my perspective there is no way we can ever hope for client acceptance of the problem behaviour if the client in any way feels being judged for what they have done. Only total acceptance of the person makes it safe enough for the client to look at what behaviour needs changing, as clients’ feelings of shame when being judged will only activate their defense mecahnisms; thereby creating resistance to change. This is my view at this moment in time and I welcome further discussion if I need to review my stance. Marianne

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