Therapeutic skills UvA Lecture notes

RESISTANCE


- Not always conscious;
- Can be redirected (adjusting own reaction/attitude);
- Says something about the interaction;
o Try to look at it as an observer (e.g. someone who never shows up but always
calls when in crisis);
o What is the function of the behaviour?
o Are you contributing to / facilitating to it?
- Gives diagnostic information




Boundary transgressing: go at cost of own safety or personal boundaries.
- Recognizing resistance: conscious/unconscious avoiding of certain subjects.
o Cynicism, anger, silence, ‘I don’t talk about that’, contradictions (lies?),
minimizing, hesitance, changing the subject, vagueness/evasiveness, true
reason for coming not mentioned, coming late.
o ‘As long as client answers, no resistance’  NOT true!
- When?
o At the beginning (initial);
o Resistance/hostility that develops/emerges;
 During session;
 Over course of time (loss of belief in efficiency, symptoms get
worse).
o Resistance can also return.
- Which emotions/reasons/needs underly the resistance?

, o Shame? Fear of not being able to handle it (when sharing)? Fear of shocking the
other? Fear of stigma? Distrust? Testing clinician (power/distrust)? Anger?
Fear of change? Loss of autonomy?
- How do I deal with it?
o Empathetic and accepting;
 (non-) verbal joining;
 Reflective listening;
 Formulating positively/affirmation.
o Rolling with it;
 Leary’s Rose;
 Judo;
 Situation clarification;
 Offering choices.
- What does not work?
o Convincing, get into a discussion, ignoring, etc.
o Pitfalls:
 Responding (too) quickly/comforting;
 Making commitments/promises you cannot keep;
 Giving advice;
 Overworking.




- Adjusting your reaction in such a way
that the other person gets out of balance.