Showing up to therapy does not mean just coming to a session. There are topics that some people want to talk about and vent, and there are topics that are suppressed within us that are uncomfortable to uncover in therapy. It is natural to have resistance, uncover sensitive issues, and relive our past or insecurities that have caused us unpleasant feelings. To grow, therapy requires us to revisit painful and uncomfortable parts of ourselves, our past, present, and potential futures. Often, people may think of therapy as just having a safe space to vent. While venting is part of releasing frustration and other methods, there are other aspects to therapy. When we vent, we often talk about things we feel we need to discuss. Therapy also includes talking about the uncomfortable, uncovering the hurt from our past, and understanding that it is better to help us move forward with our goals, live in the present, and be ready to cope with what may happen in the future.
What does the process of therapy look like?
At the beginning of therapy, the therapist and client are getting to know one another. The client often spills and shares a lot about themselves and situations, including initial goals and expectations of therapy. It can be emotionally exhausting, especially for someone who is not used to going to therapy or has not spoken about what has been bothering them. During these initial few sessions, usually around six sessions, the therapist and client develop a clinical professional relationship. After the initial sessions, the therapist and client will work on goal setting, finding coping skills, practicing and maintaining healthy coping tools and skills, and checking in on what has happened in the past, the future, and how they are handling the present.
Terminating the therapeutic process is best when the client and therapist notice progress from the client on their use of coping skills, how they can maintain in the present, and when they have been honest and communicative about their feelings about the process. This process is different for each person and can sometimes be several months to years to a more continuous lifelong process, depending on the person’s needs.
Therapy is a process that requires consistent meetings weekly or multiple times a week. Consistency creates accountability and builds rapport and trust between the client and therapist. Consistency also allows the meetings to build off one another; too much time between sessions can make the sessions feel like a catch-up instead of developing skills and moving further with the work building off the previous session.
Why do we have resistance to “showing up” for therapy?
There are many reasons why one may resist showing up for therapy. Sometimes, there is hesitation in disclosing based on someone’s fear and shame. Feeling there is something to be ashamed of, fearing what others’ reactions may be. There can also be resistance based on hopelessness if someone feels they could never change or have been going through something for so long that there is no point in it. Resistance can be based on their past feelings and experiences, if therapy did not go well before, if they have not been able to progress, if they have not been able to trust someone; all of these factors contribute to that hopelessness that manifests as resistance in therapy.
Mandated therapy can look very different; if someone is required to attend therapy due to recent behaviors such as anger management, then resistance can be expected throughout the process, and one may feel they want to do the bare minimum to fulfill therapy requirements.
When does resistance usually occur to “showing up” for therapy?
Resistance can occur at any time throughout therapy. Usually, in the beginning, if the therapy is voluntary and not mandated, there may be motivation and excitement about the process. In the beginning, when there is a lot of spilling or explaining about your life, stressors, goals, and expectations, there is a lot to talk about and to cover, and you can feel temporarily relieved to get something off your chest. After this period, when therapy starts to become more complicated when things seem to be temporarily better, you may think, okay, that is all I needed and not continue to work on the roots of the problems you are facing. It can also happen when you do not notice change and are frustrated by the lack of progress. Sometimes, when we set high expectations for ourselves, we want the more significant problems solved but neglect to acknowledge the smaller goals we have accomplished.
Common signs of resistance to therapy can be missing sessions, arriving late to sessions, making small talk during sessions, withdrawing or distancing yourself, second-guessing the process, denying challenges and difficulties, and not completing or avoiding homework or working on tools outside of session. Other signs of resistance can include feeling defensive or argumentative during sessions, feeling a lack of connection with the therapist, or feeling a lack of progress. For each person, resistance can manifest in different ways; often, this shows up as feelings of frustration, fatigue, lack of motivation, hopelessness, and hostility.
Challenge resistance to therapy
If you find yourself withdrawing, avoiding, or only discussing comfortable topics in therapy, it’s important to acknowledge these feelings. The first step is to be honest with yourself and your therapist about your discomfort or resistance. Therapy thrives on open communication. Consider journaling about your resistance and feelings during the therapeutic process. Reflecting on your emotions can be a powerful tool to overcome resistance and heal.
If you are a therapist, this may be an opportunity to challenge your client and acknowledge your sense that they are resisting therapy. Overcoming resistance can look different for different mental health specialists. Rational-Emotive Behavior Therapy leans into discomfort and resistance that they may see their clients displaying and lets it drive their curiosity to treat clients. REBT believes that humor can help address avoidance with clients; this is best when you have a rapport with the client. Using humor can help us make the process more human and relay to your client your observations of resistance in a lighter way. As a therapist, your role is to identify and address resistance in a supportive and non-judgmental manner. Motivational interviewing can be a positive tool for therapists when challenging resistance to showing up for therapy. Motivational interviewing involves reflective listening, leaning into empathy, and eliciting motivation for goal setting and change. When we can empathize, find sources of a client’s motivation, and work together to increase that motivation, we can help our clients even at their lowest points.
It’s possible resistance from the therapist to commit to showing up for their clients for therapy. When a therapist has a client they do not know how to move forward with, they may avoid uncomfortable topics. Therapists can also have countertransference with clients, meaning they can be emotionally triggered by an experience, past, symptom, or behavior a client may be expressing based on their own experiences, symptoms, or behaviors. If you are a therapist noticing resistance in yourself, seek support from your fellow therapists, continue group supervision, or find a cohort of peers you can talk to ethically about your feelings as a therapist. Cases are proven to help you be a better therapist for your clients and help relieve us from moving toward burnout.
Therapy is a commitment; it can be emotionally taxing and requires us to discuss uncomfortable parts of ourselves and our past. Resistance will happen sometimes to some of us undergoing the therapeutic process. We are human and can all benefit from self-reflection and honesty throughout the process to help us achieve our goals.
