Therapy clients who resist change

Therapy clients who resist change
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As a hypnotherapist, you will likely notice that some people prefer a predictable and foreseeable routine, whilst others need variety and resist monotony. So, why can some people cope well with change, yet others resist it intensely? This blog will explore some of the most common factors in resistance to change and how hypnotherapists can help clients become more able to cope with change, both in their day-to-day experience of life and in any therapy contexts.

Resistance to change can be seen in the hypnotherapy session in a number of ways. Firstly, it may be that your client simply doesn’t turn up for their therapy session in an effort to avoid changing. Or, they may attempt to talk around the subject for the whole session, in an attempt to avoid discussing the most significant issue. Should therapy progress, resistance may also emerge more passively, such as by not engaging in homework tasks and activities. At the start of your work with a hypnotherapy client, it is good to check for hypnotic susceptibility, as an individual’s need for control and resistance to change can sometimes show up at this stage. If resistance is suspected, using a series of tests may give more information, such as some of the Stanford Hypnotic Susceptibility Scale tests (see our video on this).

Our ability to cope with change tends to be an individual personality trait, yet it could also be argued that it is a learned behaviour. From a ‘nature-nurture’ perspective, this ability (or lack of ability) may have both genetic and upbringing-environment components. Where a child has a secure base (secure attachment), they can explore independently, knowing they can return to a place of support and safety. Where a child develops in a setting with rigid adherence to strict routines, a lack of social freedom and an expectation of passive obedience, they may not develop skills in taking the initiative (thus influencing their ability to flexibly adapt to change). This can be compounded where there is a lack of any form of secure attachment. Other attachment influences include the effects of disorganised attachment, where children develop in a setting with a lack of organised support (e.g. no rules, unpredictable parents, lack of consistency). This can lead to poor decision-making skills in later life and often limited ‘self-soothing’ abilities, poor stress management and even weak social skills. Such family influences will carry though into early socialising, schooling and higher education, as ways of responding become habitual.

Another personality influencer may be our core values. There is a significant difference between someone who values stability and consistency, and someone who likes adventure and challenge. People tend to develop habits within their personality and value traits. This is fine where people are considered as individuals. However, there can be an imbalance where an individual is attempting to fit into a culture, lifestyle or political environment (workplace, family) which has different values and attitudes in regard to how they manage change.

Whilst childhood would seem to have a notable influence for some people’s ability to cope with change or be resistant to change, it can be questioned whether age is also a factor. Although it might be perceived that younger people are less ‘set in their ways’, they tend to have less life experience and may lack skills to ‘go with the flow’ using the wisdom that comes from more mature people having experienced and coped with change many times in the past.

It is generally recognised that people tend to prefer to do what they always do. This is not surprising, as our habits give us security and comfort. Effectively we are programmed towards balance or ‘homeostasis’ (a state of equilibrium). The basal ganglia in our brain has an important role in our routine habits, and our habits do make us more efficient. If we had to work out how to do something on every occasion that we wanted to do it, we would have little productive time available for anything else. Just think for a moment of your day so far. How much of it has been carried out with habitual behaviours, using limited mental effort? It is just easier to do what we always do, than find another way of doing it. This inertia to act can slow down the potential gains of therapy if not addressed effectively.

Acceptance of, or resistance to change can have behavioural, cognitive and emotional components as well as being influenced by personality characteristics and traits. Certainly, characteristics such as extraversion, agreeableness and openness to experience tend to be associated with people who are more comfortable with change, whilst neuroticism tends to be more commonly associated with resistance to change, as do traits associated with ‘routine-seeking’ and ‘short-term thinking’, the latter preventing exploration of what life would be like with the proposed change in place. This may have a notable influence in the therapy setting when engaging in future pacing and mental rehearsal relating to suggestions and change work focused around new behaviours, thinking strategies or emotional responses. More time may be needed and greater attention given to facilitating active engagement in order to more effectively establish a tangible connection to a new way of responding.

There are some conditions where change can be more difficult to work with. For example, low mood and depression can make change harder or slower, as it can feel more of (or too much of) an effort. People with ADHD or issues with focus, or attention, may also have difficulty in focusing sufficiently to make decisions and to follow a new routine consistently. It can help here to work with a buddy or support system/group, have between session follow-ups, or utilise an MP3 or self-hypnosis strategy alongside the standard hypnotherapy sessions.

In addition to considering whether any conditions may have an impact on a client’s ability to cope with change, their emotional perspective and attitude to change is also a significant factor. Fear is a common component of many aspects of resistance to change, including fear of leaving a comfort zone, fear of the unknown, fear of getting it wrong and fear of loss of control. For clients with a fear of leaving their comfort zone (we have a great blog on this) it can be helpful to give (or recommend) the book: ‘Who moved my cheese?’ and give clients simple tasks to help them learn to move from their comfort zone into their ‘optimal zone’, whilst not overloading them.

A fear of the unknown is perhaps one of the most common causes of resistance to change. Clients may consider that there is a risk that a situation may get worse, or they may have the viewpoint, “Better the devil you know, than the devil you don’t”, thus holding themselves in a state of discomfort to avoid potential greater discomfort. There are often faulty thinking strategies here and cognitive distortions, such as imagining the worst (catastrophising), compounded by a lack of trust, whether in others or themselves.

You may notice that a client will start to make some changes and then slow down or stall in their development. This could be relating to a fear of getting it wrong. For example, you may teach them self-hypnosis, yet whilst they know how to do it, they are scared of doing it wrong. You can address concerns about competence with the provision of appropriate information, skills training, and offering support. Where a client is reluctant to try something new, reframing ‘failure’ to ‘feedback’, ‘data’ or ‘information’ can help. You can even set up a task where there is no right answer or response, there is just information, as this can build confidence. You may also encounter clients where there is a lack of confidence in making the right decision. Here, some education and development of practical decision-making skills can reap rewards throughout the therapy process. Clients who previously found it easier to say no than to consider the implications of saying yes, are able to step back and make an appropriate objective assessment. For example, if a client struggles to decide whether to have a cup of tea or a cup of coffee, give them a time limit to decide (e.g. count to 3, and choose). They can learn to allocate more time and consideration to more significant decisions (and how to work out what is significant and what is not).

Finally, fear of loss of control is an influencing factor for many clients. This will often become apparent right at the start of the hypnotherapy process, and is a really good reason why suggestibility tests are a key component of a first session (as already mentioned above). It can really help therapy outcomes to identify this fear and address it early on in the process. Where someone has felt that they have lost autonomy, agency or a sense of personal power, they can wish to avoid similar discomfort by resisting the hypnotherapy/change process. This can be if the form of passive resistance, in that they don’t engage in the therapeutic work. Or it could be more direct, particularly if you hadn’t noticed this resistance and your style is naturally more direct or authoritarian, where they simply disregard your suggestions. As well as adapting your style to enhance the collaborative nature of hypnotherapy, it can be useful to teach your client coping strategies to help them look objectively at situations so they can find aspects where they do have control. For example, if they were locked in a room, they would still have control over how they stood or sat and what they looked at.

Regardless of how well your clients seem to cope with change, everyone has their own change saturation point. Some people can take a vast amount of change in their stride before reaching the point of saturation or exhaustion, whereas others have a much lower threshold. Having change in multiple areas of their life can be cumulative. Lifestyle can also have a big influence. People who are tired or highly pressured can be more irritable, even angry with a low tolerance for frustration (including a change from ‘the norm’).

As well as the above reasons that people may actively or passively resist or avoid change, people can also develop a number of faulty coping strategies when faced with change. These include:

Flee:
Avoiding anything related to the change

Fight:
They will argue against change

Flop:
They will withdraw from the change process physically/psycholgically

Freeze:
They will withhold information needed to progress change

Flap:
They will share their dissatisfaction with others

Forget:
They will avoid thinking about it until change is inevitable

Follow:
They will carry on being comfortable with discomfort (e.g. a client may stay in an unhappy relationship simply because they have got used to it)

Hypnotherapy can help in numerous ways to strengthen a client’s ability to cope with change (or conversely, reduce their need for constant change).  Hypnotherapy is superb at helping clients move beyond their inbuilt inertia and maintenance of habits, to create new ways of responding, whilst learning to cope better with change as they change. For example, if you have a client who is stuck eating certain foods, you can work on behavioural change of their habits (e.g. eat a new food each meal), cognitive change of their beliefs about those foods and new foods (e.g. helping them gain more flexible beliefs) and even get insight into the underlying drivers and contributing factors (present and past).

Behavioural responses often follow this process: TRIGGER + ROUTINE ACTION = REWARD. Positive outcomes can be achieved by recognising the trigger and keeping the same reward, but changing the routine action. This is common with a smoking habit, for example: Feeling stressed at work (trigger) + smoke cigarette outside (action) = respite from stress (reward). A hypnotherapist will help the client to replace the routine action (habit), for example: Feeling stressed at work (trigger) + take a 3 min break outside to do deep breathing (action) = respite from stress (reward).

During the consultation or throughout any part of the hypnotherapy sessions, you may also notice any of a number of psychological responses to change. This may include denial that the change needs to or will be happening or anger at themselves for their inability to be comfortable with change, or the initiator of a change they need to make. It may be that the client is lacking any ability to objectively assess the opportunity for change and feels they are in a state of crisis, whether this is due to a lack of skills, or past negative outcomes. There may also be signs of confusion about the change. If the client doesn’t understand the reason for the change, there can be resistance, particularly if they have a way of working that is familiar (even if leading to undesirable outcomes). For example, being concerned about their weight gain whilst maintaining the same diet as they ate 20 years ago when they were more active. This may have arisen from routines developed in their younger years and a lack of awareness of their present options.

Where people are an active part of their own change process, there is more engagement and less resistance. Another factor that increases engagement is an understanding of the benefits and rewards, showing that the return on their investment (of engagement with change) will leave to positive outcomes. With engagement, the client can move towards a more positive attitude towards acceptance of change. Generally, people don’t resist change that they believe is in their best interests. By helping a hypnotherapy client move through a change process they can develop a new confidence in their ability to cope with change in other aspects of their life as well, thus developing a beneficial life skill.

We hope that this blog on therapy clients who resist change has been useful for you. If you have any questions about this topic or anything else for that matter, do please get in touch, because we’re always happy to help!

– written by Dr Kate Beaven-Marks
(HypnoTC Director)

Dr Kate Beaven-Marks HypnoTC the Hypnotherapy Training Company

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