Introduction: Working with a Resistant Client

In the realm of psychotherapy, one of the most challenging scenarios a therapist can encounter is the resistant client. Resistance in therapy refers to the behaviors, attitudes, or thoughts that clients use, either consciously or unconsciously, to oppose the therapeutic process. Fred J. Hanna defines resistance as, “The patient’s efforts to obstruct the aims and process of treatment” (Hanna, 2001, p. 20).

Understanding the roots of this resistance in clients desiring change and employing effective strategies to manage it is crucial for fostering a productive therapeutic relationship and achieving positive outcomes.

Desire to Change

While some are compelled by courts and family to get therapy, many go to therapy because they deeply desire change. The literature on the resistant client largely refers to those that choose therapy as a means to improve their lives. Those that go to therapy for reasons other personal desire for change is a different subject. They are in what Carlos DiClemente refers to as the precontemplation stage (Murphy, 2024). Working with these clients requires an entirely different approach beyond the focus of this article.

Desires are rarely pure. We do not always desire completely independent of others wants and desires. Along with desires to change also comes desires for comfort. Comfort and change clash on many fronts. These battles often take place in the hidden corners of our minds, deep beneath the surface of consciousness. The whole concept of wishing to behave and feel in ways that we seem to repeatedly fail at suggests some opposing demands. If there were no internal resistance to change, we would likely make the changes without the aid of a therapist.

Deborah Anna Luepnitz, a psychoanalyst in private practice in West Philadelphia, wrote that everyone who seeks therapy brings “a desire for and a resistance to change–a yes and a no” (Luepnitz, 2008, p. 79).

The conflicting desires collide in dynamic fashion in the therapeutic process. Therapy is an overt attempt at change. Resistance is often covert behaviors to maintain status quo. As these two forces collide, futures wait.

What Constitutes Resistance?

Resistance can manifest in various forms, ranging from overt behaviors to subtle attitudes.

Hanna explains:

“Resistance can also be quite creative. Sometimes people seek therapeutic change through misguided means and inaccurate knowledge, and in the process appear to be resisting change at all costs. The truth may be that they are trying to improve but are using the wrong knowledge base and methods, as in the case of abusing drugs or joining a cult. That so much of human change turns out for the worse is often for this reason” (Hanna, 2001).

Maladaptive behaviors are resilient to change. Individuals employ these ill fitting behaviors often to satisfy a hidden agenda. It is essential to first identify the behaviors signaling resistance, acknowledge their existence, and understand they represent a motivation for some hidden purpose.

Common signs of resistance include:

• Missing or arriving late to sessions
• Minimizing or dismissing the importance of issues
• Deflecting topics during discussions
• Engaging in passive-aggressive behaviors
• Exhibiting a lack of engagement or participation

Recognizing these signs early is essential for therapists to address resistance effectively.

Resistance is the Normal Stance in Therapy

Client resistance is a common occurrence in psychotherapy because the very nature of therapy involves confronting deeply ingrained patterns of thinking, feeling, and behaving that, while potentially maladaptive, offer a sense of familiarity and safety. Change, even positive change, can be anxiety-provoking and disruptive to one’s established equilibrium.

Clients may resist because they fear the unknown outcomes of therapy, worry about the emotional discomfort of facing difficult truths, or unconsciously protect themselves from perceived threats to their self-image or established coping mechanisms. Societal stigma surrounding mental health can contribute to a client’s reluctance. The vulnerability inherent in sharing personal struggles also contributes to their reluctance to fully engage in the therapeutic process. This makes resistance a frequent challenge for therapists across various theoretical orientations.

Both cognitive psychotherapy and psychoanalytic therapy, despite their differing theoretical frameworks, acknowledge and address the common difficulty of client resistance.

Psychoanalytic Theory

Psychoanalytic theory, originating with Freud, views resistance as an unconscious defense mechanism employed by the ego to protect itself from anxiety-provoking unconscious material. Therapists using this approach aim to identify and interpret these resistances to bring unconscious conflicts into conscious awareness, facilitating insight and resolution.

Erich Fromm wrote:

“Psychoanalysis is essentially a theory of unconscious strivings, of resistance, of falsification of reality according to one’s subjective needs and expectations (transference), of character, and of conflicts between passionate strivings embodied in character traits and the demands for self-preservation” (Fromm, 2013).

Cognitive Psychotherapy

Cognitive psychotherapy, on the other hand, often views resistance as stemming from maladaptive thought patterns or beliefs that hinder the client’s willingness to engage with cognitive restructuring or behavioral changes. Accordingly, cognitive therapists might directly address resistance by identifying the underlying negative thoughts or fears associated with change. They work collaboratively with the client to challenge and modify these thoughts. This process aims to increase the client’s willingness to participate actively in the therapeutic process.

Albert Ellis explains that if you wish to use REBT to make inroads against your clients’ resistance, your task is “to discover their core IB’s (irrational beliefs), have them agree that they actually have them, then help dispute these dysfunctional convictions until they minimize them” (Ellis, 2002).

Why Does Resistance Occur?

Resistance can stem from numerous factors, often deeply rooted in the client’s past experiences, fears, and defense mechanisms. Some common reasons for resistance include:

Fear of Vulnerability

Fear of vulnerability is a significant contributor to client resistance in therapy because the therapeutic process inherently requires individuals to confront and explore deeply personal and often painful aspects of themselves. Sharing these vulnerabilities with a therapist can feel incredibly risky and uncomfortable.

Albert Ellis wrote:

“One of the most prevalent forms of resistance stems from clients’ fear of disclosure. They find it uncomfortable to talk about themselves to give the gory details of some of the ‘shameful’ situations they got themselves into, and find it ‘too’ hard to confess these thoughts, feelings, and actions” (Ellis, 2002).

Clients may fear judgment, rejection, or the potential for past traumas or insecurities to resurface, causing significant emotional distress. This fear can be particularly intense if the client has a history of negative relational experiences where vulnerability was met with criticism, abandonment, or exploitation. Consequently, the prospect of opening up and being truly seen can trigger a powerful protective response aimed at avoiding this perceived threat.

This fear of vulnerability often manifests as resistance in various ways. Clients might avoid discussing sensitive topics. They might intellectualize their emotions to create distance. They could become overly agreeable to prevent deeper exploration. Some may even miss appointments to sidestep the discomfort of confronting their inner world. These resistant behaviors act as a shield, preventing the client from fully engaging in the therapeutic process and potentially hindering their progress.

See Emotional Vulnerability for more on this topic

Asserting Autonomy

The fundamental human need for autonomy, the desire for self-governance and control over one’s own life and decisions, can significantly heighten resistance to therapeutic interventions. Clients enter therapy often feeling a lack of control over their problems or emotions.

When a therapist suggests specific interventions, techniques, or perspectives, it can inadvertently be perceived as another attempt to direct or control them, triggering a defensive reaction. This is particularly true for individuals who have a strong need for independence or who have experienced past situations where their autonomy was violated (Brehm, 1966). The feeling that someone else is telling them what to do, even with the intention of helping, can feel disempowering and lead to a pushback against the therapist’s recommendations.

Marshall Rosenberg wrote that human beings tend to resist any kind of demand because “it threatens their autonomy.” Individuals have a strong need for choice. Tyranny evokes an emotional reaction even when “it’s internal tyranny in the form of a should” (Rosenberg, 2015).

This perceived threat to autonomy can manifest as resistance in various forms. Clients might overtly disagree with the therapist’s suggestions, question their expertise, or express skepticism about the effectiveness of the proposed interventions. More subtly, they may passively resist by agreeing to interventions but not following through with them outside of sessions, minimizing their importance, or finding reasons why they won’t work for their specific situation.

This resistance serves to reassert their sense of control and protect their autonomy in the face of what feels like an external imposition on their personal agency.

See Autonomy for more on this topic

Distrust or Mistrust

Distrust and mistrust form a significant barrier to the therapeutic process and can strongly contribute to client resistance. Clients may enter therapy with a pre-existing lack of trust stemming from past negative experiences with authority figures, previous failed attempts at help, or a general wariness of opening up to others.

This inherent skepticism makes it difficult for them to believe in the therapist’s genuine intentions or the potential for therapy to be beneficial. They might fear being judged, misunderstood, exploited, or having their vulnerabilities used against them, leading to a reluctance to fully engage with the therapeutic relationship and its potential for growth.

This lack of trust often manifests as resistance through various behaviors. Clients may be hesitant to share personal information, offer vague or superficial responses, or actively challenge the therapist’s interpretations and suggestions. They engage in behaviors that test the therapist’s reliability. They could be inconsistent with appointments or withhold crucial details. This resistance acts as a protective mechanism, preventing the client from becoming emotionally exposed in a relationship they don’t yet feel safe in.

Fear of Change

The human psyche often seeks stability and predictability, finding comfort in the familiar, even if those familiar patterns are ultimately detrimental. This inherent need for the “comfort of sameness” can lead to significant resistance in therapy because the therapeutic process is fundamentally about facilitating change (Murphy, 2019).

Ellis explains:

“A number of clients resist therapeutic change because they strongly feel that they are unable to modify their disturbed behavior-that they are hopeless and unable to change” (Ellis, 2002).

Conflict Between Desire for Change and Comfort of Sameness

Clients, while consciously seeking help, may unconsciously fear the disruption of their established routines, identities, and ways of relating to the world.

Harriet Lerner wrote:

“Two things will never change: the will to change and the fear of change. Both are essential to our well-being and to the preservation of our relationships. We all move back and forth between our desire to learn, risk, experiment, and grow—and our anxiety about doing so. Change brings loss in its wake, even when it’s a change we truly and deeply want to make” (Lerner, 2005).

The prospect of the unknown, even if it promises improvement, can trigger anxiety and a desire to cling to what is known, regardless of its negative consequences. This fear stems from the potential loss of a familiar, albeit problematic, equilibrium, and the uncertainty of navigating a new, untested way of being.

See Fear of Change for more on this topic

Defense Mechanisms

Defense mechanisms, operating largely outside of conscious awareness, serve as the primary psychological motivators for resistance to therapeutic treatment. These unconscious strategies are employed by the ego to protect the individual from overwhelming anxiety, painful emotions, and internal conflicts.

When the therapeutic process begins to touch upon these sensitive areas, defense mechanisms are automatically activated to maintain psychological equilibrium and prevent the individual from experiencing distress. This protective function, while helpful in certain situations, becomes a barrier in therapy as it prevents the client from fully engaging with the very issues they need to address for healing and growth.

Ann Freud wrote:

“The ego becomes active in the analysis whenever it desires by means of a counteraction to prevent an inroad by the id. Since it is the aim of the analytic method to enable ideational representatives of repressed instincts to enter consciousness ,i.e. to encourage these inroads by the id, the ego’s defensive operations against such representatives automatically assume the character of active resistance to analysis (Freud, 1986).

Erich Fromm explains that for Freud, “self-knowledge means that man becomes conscious of what is unconscious; this is a most difficult process, because it encounters the energy of resistance by which the unconscious is defended against the attempt to make it conscious” (Fromm, 2013).

Manifestations of Defense Mechanisms as Resistance in Therapy

Defense mechanisms manifest as resistance in numerous ways. For instance, denial might lead a client to minimize their problems or refuse to acknowledge their impact. Intellectualization can create a detached, analytical approach to their feelings, preventing genuine emotional engagement. Projection might cause a client to attribute their own unwanted feelings or thoughts to the therapist or others, avoiding self-reflection. Displacement could lead to the client focusing on less threatening issues instead of the core concerns.

When the prospect of pain looms, well practiced and unconscious mechanisms typically follow to save us from the painful realities of confronting ourselves. These protective mechanisms actively work against the therapeutic goals, hinder self-awareness, emotional processing, and behavioral change.

See Defense Mechanisms for more on this topic

Strategies for Managing Resistance

Effectively managing resistance involves a combination of empathy, patience, and strategic interventions. Here are some strategies that therapists can employ:

Building a Strong Therapeutic Alliance

A strong therapeutic alliance plays a crucial role in overcoming client resistance by creating a safe, trusting, and collaborative environment. When clients feel understood, accepted, and respected by their therapist, their inherent fears of vulnerability, judgment, and the discomfort of change are significantly reduced.

The alliance, characterized by mutual trust, empathy, and a shared understanding of the therapeutic goals and tasks, provides a secure base from which clients feel more willing to explore difficult emotions and challenging patterns. This sense of safety and connection directly counteracts the anxieties that often fuel resistance, making it more likely for clients to engage openly and honestly in the therapeutic process.

Part of the process of building this alliance comes from how the therapist views the client. Hanna explains that from this perspective, “it is wise to reframe difficulty and resistance as a form of self-protection rather than subtly or not so subtly implying that such clients are being stubborn or misguided” (Hanna, 2001).

Building Trust and Safety Within the Therapeutic Relationship

Within a strong alliance, therapists can more effectively address resistance when it arises. Instead of viewing resistance as defiance, the therapist can approach it with curiosity and empathy, exploring its underlying causes with the client. Lawrence Heller explains that as a therapeutic alliance strengthens, “these clients will discover that not only will the therapist not hurt them, but that the therapy can be a haven of safety” (Heller & LaPierre, 2012).

The established trust allows the therapist to gently challenge resistant behaviors or thought patterns without the client feeling attacked or misunderstood. Furthermore, a collaborative alliance fosters a sense of partnership, where the client feels like an active participant in their own healing journey rather than being dictated to. This empowers the client, respects their autonomy, and makes them more willing to consider new perspectives and experiment with different behaviors, ultimately leading to a reduction in resistance and greater therapeutic progress.

See Therapeutic Alliance for more on this topic

Identifying Resistant Behaviors

Helping a client identify their own resistant behaviors is a crucial step in lessening their strength because it brings what was often an unconscious process into conscious awareness. Many clients engage in resistant behaviors without fully realizing they are doing so or understanding the underlying reasons. These behaviors, such as consistently changing the subject, minimizing problems, or missing appointments, can feel automatic and outside of their control.

By gently pointing out these patterns and exploring the feelings and thoughts that precede them, the therapist helps the client develop a greater understanding of their own actions and how these actions are impacting their therapeutic progress. This newfound awareness begins to dismantle the automatic nature of the resistance, making it less of an invisible barrier.

Ellis suggests using cost-benefit analysis often motivates clients’ “unconscious resistance to change, makes it fully conscious, and thereby interferes with it.” He explains that by encouraging them “to do clear-cut cost-benefit analyses in writing, and by their making themselves much more conscious of the harm they are wreaking, their changing becomes more likely” (Ellis, 2002, p. 70).

Effective identification of resistant behaviors requires preparation. It involves lowering some of the frightening underlying reasons. These reasons originally motivated the creation of protective mechanisms.

Fromm explains:

“Knowledge of this kind requires that most repressions within oneself are lowered in intensity to a point where there is little resistance to becoming aware of new aspects of one’s unconscious. The attainment of a non-judgmental understanding can lower aggressiveness or do away with it altogether; it depends on the degree to which a person has overcome his own insecurity, greed, and narcissism, and not on the amount of information he has about others” (Fromm, 2013).

Recognition Creates a Sense of Control

Once clients can recognize their own resistant behaviors, they gain a sense of agency and the potential for choice. Instead of feeling like they are passively being acted upon by an internal force, they can start to see these behaviors as patterns they engage in, often for understandable reasons. This shift in perspective empowers them to consider alternative ways of responding in therapy and in their lives.

By understanding the function of their resistance, clients can begin to explore whether these behaviors are still serving their best interests or if they are now hindering their growth. This conscious recognition and understanding are key to weakening the power of resistance and fostering a more engaged and productive therapeutic process.

Exploring the Root Causes of Resistance

Exploring the roots of resistance in therapy can significantly weaken its hold by bringing unconscious patterns and underlying motivations into conscious awareness. Often, resistance stems from past traumas, negative experiences, deeply ingrained fears, or unmet needs that the client may not fully understand or recognize. These roots operate outside of conscious awareness, fueling defensive behaviors that hinder therapeutic progress.

By collaboratively investigating the origins of these resistances within the safety of the therapeutic relationship, clients can begin to understand the purpose these defenses once served and how they might be hindering them in the present. This process of discovery and understanding can demystify the resistance, making it feel less like an automatic, uncontrollable force.

Setting Clear and Realistic Goals

Setting clear-cut goals in therapy can significantly help a client overcome resistance by providing a tangible sense of direction and purpose. When the desired outcomes of therapy are well-defined, the therapeutic process becomes less abstract. It becomes more focused when these outcomes are mutually agreed upon. This clarity often increases the client’s motivation to actively engage. They have a clear understanding of what they are working towards and the benefits of achieving those goals.

The presence of specific objectives reduces feelings of aimlessness or overwhelm which contribute to active avoidance and resistance. Knowing the destination can make the journey feel manageable and worthwhile.

In achieving change, Anders Ericsson and Robert Pool wrote:

“One of the best bits of advice is to set things up so that you are constantly seeing concrete signs of improvement, even if it is not always major improvement. Break your long journey into a manageable series of goals and focus on them one at a time—perhaps even giving yourself a small reward each time you reach a goal” (Ericsson & Pool, 2016, p. 177).

These clear goals help clients refrain from excusing failures on lack of understanding of the objective.

Framework for Addressing Resistant Behaviors

Clear-cut goals serve as a framework for identifying and addressing resistant behaviors. When the client and therapist have a shared understanding of what progress looks like, it becomes easier to recognize when resistance is hindering movement towards those goals.

For example, if a client’s goal is to improve their social interactions, consistently avoiding discussing social situations in therapy is a clear indicator of resistance. This enables the therapist to gently highlight the mismatch between the client’s goals and their current actions, opening a dialogue about the underlying fears or anxieties driving the resistance.

See SMART Goals for more on this topic

Utilizing Motivational Interviewing

Motivational interviewing (MI) is a particularly effective approach for combating resistance in therapy because it directly addresses the ambivalence that often underlies it. MI does not confront resistance head-on. Instead, it operates on the principles of empathy, collaboration, acceptance, and evocation. The aim is to understand the client’s perspective without judgment. MI creates a safe and non-confrontational environment. This reduces the likelihood of the client feeling defensive. It also lowers the chances of them feeling misunderstood.

Feeling judged and misunderstood often triggers resistance. In MI, the therapist actively listens to the client’s reasons for both wanting and not wanting to change, validating their feelings and respecting their autonomy. These collaborative interactions fosters a sense of partnership rather than an adversarial dynamic, helping the client lower protective barriers and more likely to actively work with the therapist towards the client’s goals.

DiClemente explains that motivational interviewing “consists of strategies like reflective listening, rolling with resistance, supporting self-efficacy, and developing a change plan that allows for individual concerns and decisional considerations as well as for individual choice and responsibility” (DiClemente, 2017).

See Motivational Interviewing for more on this topic

Introducing Incremental Changes

Using small incremental changes as a technique to combat client resistance works by making the prospect of change feel less overwhelming and more achievable. Fear of significant upheaval often causes resistance. People may perceive the required changes as too difficult or daunting to undertake. By breaking down larger goals into smaller, more manageable steps, the therapist reduces the intensity of this fear.

Small changes begin a pattern of change, beginning with non-threatening movements towards a goal. Richard Thaler and Cass Sunstein wrote, “first, never underestimate the power of inertia. Second, that power can be harnessed” (Thaler & Sunstein, 2009). 

The success achieved through these small steps can also build momentum and increase the client’s self-efficacy. Each small accomplishment provides a sense of mastery and reinforces the belief that change is possible.

Addressing Cognitive Distortions

Addressing cognitive distortions is a powerful therapy technique for working through client resistance to treatment because these distorted thought patterns often underlie and fuel that resistance. Cognitive distortions often create a negative bias towards change. Clients also view therapy goals through this lens.

Distortions include catastrophizing, overgeneralization, and negative self-talk. For example, a client might resist trying a new behavioral technique because of a distorted thought like, “I’ll definitely fail, so why even bother?” or they might avoid discussing difficult emotions due to the belief, “If I start crying, I’ll never stop and I’ll look weak.” These negative expectations and fears can make clients hesitant to engage fully in the therapeutic process, leading to various forms of resistance.

Ellis explains that the ability to change “dysfunctional thoughts, feeling, and behaviors is one of the essences of human constructiveness” (Ellis, 2002, p. 37).

By helping clients identify and challenge these cognitive distortions, therapists can directly address the underlying cognitive barriers to treatment. As clients learn to identify and modify their distortions, their negative expectations and fears surrounding therapy and change often diminish.

See Cognitive Distortions for more on this concept

A Few Words by Psychology Fanatic

In conclusion, client resistance, while often challenging, is a common and understandable phenomenon in psychotherapy. It arises from the intricate interplay of internal conflicts. Another factor is the protective function of defense mechanisms. Additionally, humans often feel ambivalence towards change. This is especially true when it involves confronting vulnerability and stepping outside of established comfort zones. Recognizing the multifaceted roots of resistance, from the fear of the unknown to the need for autonomy, is the first crucial step for therapists seeking to effectively navigate this complex terrain.

Ultimately, working with resistant clients necessitates a blend of empathy, patience, and skillful application of therapeutic techniques. Therapists can help clients move through their reluctance. This is done by prioritizing the building of a strong therapeutic alliance. Exploring the underlying causes of resistance is also essential. Thoughtfully employing approaches like motivational interviewing and incremental change makes a difference. These strategies lead clients towards meaningful progress. Viewing resistance not as an obstacle to be overcome, but as a valuable communication about the client’s internal world, allows for a deeper understanding and a more collaborative path towards healing and growth.

Last Update: April 25, 2026

Associated Concepts

• Self-Consistency Theory: This theory posits that individuals are motivated to maintain a consistent sense of self. This means that people strive to ensure their beliefs, attitudes, and behaviors align with their self-concept.
• Force Field Analysis: This is a diagnostic tool used to identify the forces for and against a change, developed by Kurt Lewin. By visualizing these “driving” and “restraining” forces, individuals can determine how to shift the balance. This approach helps them achieve their desired goal effectively.
• Self-Sabotage: This refers to the subconscious or conscious actions and behaviors that undermine one’s own goals, progress, or well-being. It often involves behaviors that impede personal growth. These actions can affect success or happiness. It can manifest in various forms such as procrastination, negative self-talk, or undermining one’s efforts.
• Self-Verification Theory: This theory suggests individuals have a strong need to confirm their self-concept. This means that people seek out information and experiences that validate their self-perceptions, whether positive or negative.
• Self-Efficacy: This concept refers to an individual’s belief in their ability to accomplish specific tasks and achieve goals. It plays a significant role in determining the level of motivation, effort, and perseverance a person puts into various activities.
• Motivational Orientation: This concept refers to an individual’s underlying motivation to accomplish tasks, goals, or activities. It reflects the underlying motivations that drive a person’s behavior and influence their choices.
• Progress Principle: This theory suggests that individuals derive a sense of satisfaction and motivation from making progress towards meaningful goals. This principle is based on the idea that small wins or accomplishments have a significant positive impact on an individual’s well-being. Even if they are minor, these accomplishments can boost motivation.