What is Resistance?

Resistance refers to behaviours, thoughts or emotions that reduce engagement with therapeutic tasks or slow change. Rather than a problem to punish, resistance is useful clinical data about fear, protection, identity, loss, or relational patterns.

Common Types of Resistance

• Avoidant Resistance — skipping sessions, diverting topic, procrastination on homework.
• Active / Overt Resistance — arguing, rejecting therapist suggestions, confrontational stance.
• Passive Resistance — silence, minimal answers, superficial agreement without change.
• Cognitive Resistance — intellectualising, counter-arguing, rigid beliefs (“therapy won’t help”).
• Emotional Resistance — intense shame, anger, or emotional numbing that blocks processing.
• Transference/Relational Resistance — recreating past relational patterns with the therapist (mistrust, dependency, idealisation).
• Systemic Resistance — family, cultural or workplace forces that obstruct change.
• Motivational/Ambivalence Resistance — wanting change but fearing the cost (loss of identity, relationships, role).

Why Resistance Appears — Typical Functions

• Protects from overwhelming emotions or trauma.
• Maintains a valued part of identity (e.g., “I am strong because I cope alone”).
• Preserves relationships or roles that give meaning (even if unhealthy).
• Signals mismatch of pace, technique or therapeutic alliance.
• Reflects cultural or systemic pressures against change.

Clinical Implications

Unaddressed resistance can cause stalled progress or dropout. When approached thoughtfully, it reveals core fears and stuck points and can deepen engagement. Clinicians should view resistance as an invitation to explore—not a failure.

Practical Strategies to Work With Resistance

• Normalize & Validate: Name avoidance or friction and validate its protective purpose.
• Collaborative Curiosity: Ask open, non-judgemental questions: “Help me understand what happens for you when…?”
• Motivational Interviewing: Explore ambivalence, elicit change talk and roll with resistance.
• Adjust Pace & Intensity: Break tasks into smaller steps and offer choices.
• Behavioural Experiments: Use concrete tests to challenge rigid beliefs safely.
• Address Relationship: Repair alliance ruptures, explore transference gently and transparently.
• Involve Systems: With consent, work with family, employers or cultural supports to reduce external sabotage.
• Set Clear Boundaries: Define expectations about attendance, safety and homework compassionately but firmly.
• Use Supervision: Seek supervision to manage countertransference and complex enactments.

Short Case Example

Client: 34-year-old female avoids discussing a sexual assault and misses sessions on weeks with triggers.

Therapist Approach: Therapist normalised avoidance, used motivational interviewing to explore readiness, collaboratively designed a very small homework (5-minute imaginal exposure) and provided stabilization techniques. Over time the client attended consistently and began gradual trauma processing.

Therapist Scripts & Phrases

• “I notice we change the topic when this comes up — that’s understandable. Can you tell me what feels risky about talking about it?”
• “I hear you’re not ready for that exercise. What small step might feel manageable this week?”
• “Sometimes therapy feels threatening because it asks us to change things that are familiar. Would you like to explore what you might lose and what you might gain?”

When to Change Approach or Refer

• Persistent non-attendance despite engagement efforts.
• Increasing risk (suicidality, severe substance use) requiring crisis intervention.
• Severe dissociation or instability — prioritise stabilization or phased treatment.
• Repeated impasses despite well-tailored strategies — consider alternate modality or specialist referral.

FAQs