NYC Psychotherapist Blog

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Wednesday, September 26, 2012

Overcoming Resistance to Change

I read a blog article by Rosabeth Moss Kanter in the Harvard Business Review Blog Network called Ten Reasons People Resist Change.  The article addressed business leaders about why many employees resist change in the workplace.  As I was reading the article, I realized that there are parallels to the kinds of resistance many psychotherapy clients experience--even though they come to therapy, at least initially, because they want to change.

Overcoming Resistance to Change

Skilled Therapists Know that Clients Often Resist Change
Skilled therapists recognize that psychotherapy clients often have mixed feelings about change.  Most of the time, clients come to therapy because there's a problem they want to change.  They know that, on some level, their lives aren't working out.  They might know that they can't keep going in the same direction.  So, they come to therapy because they want to make changes in their lives.  Or do they?

It's not unusual for psychotherapy clients to become afraid of the very change that they say they want. 

Change can represent the unknown, uncharted territory.  It raises a lot of questions and uncertainty:
  • How will this change affect the rest of their lives?  They've been accustomed to living their lives a certain way, possibly for many years, and now they're faced with making changes.  
  • What if it doesn't work out?  
  • What if they "fail" with these new changes?  
  • What if it's too much of a hassle?  
  • What if things come up in therapy that are completely unexpected?  How would they handle the unexpected?
  • What will they have to give up for this change? 
These are all questions that Rosabeth Moss Kanter writes about in her blog article about employees, and they're equally true for psychotherapy clients.

The following vignette, which is a composite of many cases with all identifying information changed to protect confidentiality, is an example of how a psychotherapy client dealt with his fears about changing the issue he came to therapy to change:

After Rick's family confronted him in an intervention, organized by his wife, to talk to him about his drinking, Rick had to admit that his life at home and at work had become unmanageable.  He knew he couldn't go on drinking the way he had been, and he stood to lose his wife, his children, and his job if he didn't change.  So, he contacted a therapist who specializes in substance abuse.

Before his first session, Rick nearly walked out of the waiting area.  His stomach felt queasy, his hands were sweaty, and his thoughts were racing:  "Maybe my problem isn't so bad.  Why do I need to come to therapy?  Maybe I can do this on my own? Maybe I can try to cut back?"

As the therapy session started and he heard himself give his alcohol history, he had a new realization about how long he had been drinking and how alcohol had affected his life, starting from his teenage years:  he almost got thrown out of college for being drunk on campus; he lost his first job because he took off too many days when he was hung over; his first girlfriend left him because she couldn't deal with his drinking; and now his wife and family were confronting him.

Of course, he knew all of these things before, but saying them out loud, at one time, had a big impact on him.  Suddenly, he realized that he had been rationalizing away his drinking for most of his adult life.  Now, in his mid-30s, he was looking back and he didn't like what he was seeing.

Overcoming Resistance to Change

Rick left that first session feeling more motivated than ever to stop drinking.  When he got home, he thanked his wife for having the intervention that was the catalyst for his seeking help.  But, later that week, one of Rick's drinking buddies called him and asked Rick to meet him and a few other friends at the bar they usually frequented.

Rick hadn't told any of his drinking buddies that he started therapy to stop drinking.  He felt too embarrassed to tell them.  He didn't want to lose face with them.  He tried to make up an excuse for not going, but his friend was very persistent.  Rick went back and forth in his mind about what to do.  On the one hand, he knew that if he went to the bar, he would begin drinking and he wouldn't be able to stop.  He knew that if he did that, he would be a disappointment to himself and his family.  On the other hand, he really liked his drinking buddies and he would miss them if he stopped hanging out at the local bar with them.

After a few minutes, he thought to himself, "What the hell, I'll go and I won't drink."  An hour later, Rick was at the bar having his usual drink and telling himself that he'd only have one.  After the second drink, he told himself that he would set the limit at three which, after all, was a lot less than he usually drank.  But by the third drink, Rick was "off to the races" and he couldn't stop.  His buddies drove him home, and he staggered into the living room where his wife was waiting for him.

Once Rick saw the hurt look on her face, he felt deeply ashamed.  He wanted to apologize, but he was too drunk to even get the words out.  The next day, he was too hung over to go to work, so he called in sick.  He felt despondent.  Later in the day, he renewed his commitment to himself and to his wife that he would stop drinking.

Overcoming Resistance to Change

During the next several weeks in therapy, Rick talked about how his life was changing now that he wasn't drinking any more.  Life was hard, and Rick wasn't sure that this was what he wanted.  Now that he was sober, he had to face the mounting bills he was avoiding, problems his son was having at school, a reorganization at work, and his wife's distrust that he would stay sober.  And, he had to do all of this without alcohol.  He realized now that alcohol had become a sort of "friend" that helped him to relax and zone out.  He wasn't sure if he liked being sober.  He thought it might be too hard to live a sober life, and he wasn't sure he wanted to do it.

During the next several months, Rick struggled to remain sober with the help of his therapist, A.A, and an A.A. sponsor.  It seemed to him that every week brought a new challenge.  He hated having to give up his drinking buddies.  But he realized that they weren't going to stop drinking and if he had any hope of not ruining his life with alcohol, he couldn't hang around with them.  So, he began forming new friendships with people he met at A.A.

Step by step, Rick began to put his life back together.  There were times when he was tempted to leave therapy because part of him wanted his old life back.  Working towards change was a constant emotional battle, going back and forth in his mind about whether or how much he wanted to change.  There were times when he went into denial and told himself that he could drink and he didn't need to be in therapy.  At those times, he battled with himself and found the strength to continue making positive changes.

Change isn't Easy
Many psychotherapy clients struggle with the changes they say they want.  Change isn't easy, especially in the beginning.  Some people have many false starts before they commit themselves to changing.

Some Resistance to Change is Normal in Therapy
Resisting change, to a certain extent, is part of changing.  It's rare that someone comes to therapy and doesn't have some mixed feelings about change.  A skilled therapist can help psychotherapy clients to sort out this resistance.  A therapist won't tell you what to do, but s/he can help you to figure it out for yourself.

Do You Want to Stay on the Fence Forever?
For some people, change feels so daunting, even change that they want, that they stay on the fence about coming to therapy for years.  Then, at some point, they might look back on their lives and regret the time they wasted.

Getting Help in Therapy
You don't have to be 100% convinced about the changes you're considering before you come to therapy.  If you think about where you are and where you want to be all at once, it can seem overwhelming.

You can look at it as a process where you take one step at a time, knowing that you can stop at any time.  It can begin with having a consultation with a therapist, knowing that you can decide at each step how far you want to go.  If you've been on the fence about making changes for a long time, don't you owe it to yourself to at least take that first step?

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.  

I work with individual adults and couples.  

I have helped many clients to make positive changes so they could lead more fulfilling lives.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.