Their survival instincts pose many questions:

• Will therapy mean facing powerlessness, manipulation, and humiliation?
• Is it better to trust or to avoid trusting?
• Is it better to submit to the therapist’s conditions or run the other way?

Even when clients sincerely want something different for themselves, they cannot control the triggering of instinctive survival defences, nor the fact that each survival response is inherently in conflict with another. It is at this stage that we, as therapists, face resistance and / or stuckness. Whether resistance manifests as a passive aggressive ‘no’ to every therapeutic intervention, as unchecked self-destructive behaviour, a struggle for therapeutic control, or desperation for help alternating with resistance to accepting it, the underlying dilemma is the same. Should the client commit to therapy or flee? Combat the therapist’s every effort? Or submit by coming to sessions but not fully participating?

New approaches and interventions drawn from Sensorimotor Psychotherapy, Internal Family Systems, Structural Dissociation Model and mindfulness-based therapies can transform what it means to work with resistance and stuckness in such situations. In this online course, Dr Janina Fisher draws on these approaches to explain how to de-code resistance and help clients become aware of their therapy-related conflicts and hesitations as a normal aspect of trauma treatment. She explains how we can better identify the triggering aspects of psychotherapy and positively reframe stuckness and resistance as adaptive strategies – allowing us to acknowledge and share the clients’ dilemmas. Using theoretical constructs, videos and clinical case vignettes, she:

• Highlights how we can effectively navigate the threat of closeness and the threat of distance
• Explores how we can befriend resistance, using negotiated settlements with defender parts

Course Schedule:

• What do we mean by Resistance and Stuckness?
  • Depression, shame, self-loathing
  • Chronic suicidality or self-destructive behaviour
  • Belief that nothing will work
  • Difficulty coming to or being present in therapy
  • Struggles for control of the process

• Therapy as a threat, not a refuge
  • Phobias of vulnerability
  • Phobias of closeness or being visible
  • Phobias of abandonment and distance
  • Trauma-related fear and mistrust

• How manifestations of stuckness and resistance reflect animal defenses
  • Survival responses and strategies
  • Introduction to the Structural Dissociation Model
  • Understanding resistance and stuckness as defensive, not offensive

• How we interpret resistance may increase, not decrease it
  • Triggering aspects of psychotherapy
  • Decreasing the ‘threat’
  • Positively re-framing stuckness and resistance as adaptive
  • Acknowledging and sharing the dilemma: the client wants help but not at the cost of vulnerability

• Using the therapeutic relationship
  • Navigating the threat of closeness and the threat of distance
  • Making use of the “social engagement system”
  • Therapeutic benefits of laughter and playfulness

• Helping clients deconstruct inner conflicts and struggles
  • Making use of the Structural Dissociation Model in therapy
  • Helping clients understand internal conflicts as struggles between parts
  • Using the language of parts to articulate and highlight contradictory behaviour
  • Honouring the parts who defend by resisting

• Increasing client ability to observe trauma-related patterns
  • Introducing mindfulness as a therapeutic tool
  • Increasing curiosity and interest
  • Using psychoeducation to challenge existing beliefs and patterns

• “Befriending” the resistance
  • Letting go of our need for the client to change or engage
  • Facilitating empathy for parts who defend and parts that feel injured
  • Re-framing resistance and stuckness as “the parts,” not the whole of the client
  • Cultivating compassionate internal relationships

• Creative solutions for old and obsolete survival strategies
  • “Negotiated settlements” with defender parts
  • Internal soothing and comfort for hurt and fearful parts
  • Therapeutic support for resistance and acceptance of stuckness
  • Creating a sense of “we” that includes the parts who collaborate and the parts who resist as well as the therapist

• Healing the wounds of the past
  • Providing ‘missing experiences’ of healthy attachment
  • Therapy as a play space: balancing permissiveness and structure
  • “Being” the therapeutic relationship instead of talking about it
  • Enjoying the struggles rather than resisting them

Goals:

• Identify the effects of traumatic experiences on attachment formation
• Discuss the role of implicit memory in post-traumatic symptoms
• Describe manifestations of animal defense survival responses
• Differentiate common conflicts between survival defences observed in relationships
• Summarize the aspects of psychotherapy that evoke defensive responses in traumatized clients
• Describe the association between client resistance or stuckness and trauma-related survival defences
• Discuss ways of evoking curiosity in stuck or resistant clients
• Articulate the role of ‘re-framing’ the symptoms in trauma treatment
• Utilize Sensorimotor Psychotherapy interventions to help clients notice resistance without shame
• Summarize the structural dissociation model for understanding resistance
• Utilize parts-related interventions to help clients resolve their resistance and/or stuckness

© nscience 2021 / 22