Transforming Trauma-Related Resistance and Stuckness

 

Trauma treatment is invariably complicated by the fact that almost every kind of traumatic experience involves incompetence or cruelty perpetrated by other human beings.   The result is that, thereafter, human beings no longer feel safe:  they feel threatening.   To seek help may bring initial relief for clients but also raise doubts:  Is it better to trust or avoid trusting?  Is it better to submit to the therapist’s conditions or run the other way?  Seeking help may evoke unconscious hypervigilance, fear, or pulling back.   What we label “resistance” may actually reflect inherent trauma-related conflicts activated by all forms of treatment and all types of therapist.  

Whether resistance manifests as a passive aggressive ‘no’ to every therapeutic intervention, as unchecked self-destructive behavior, a struggle for therapeutic control, or desperation for help alternating with resistance to accepting it, the underlying dilemma is the same.  

Coming to therapy is a cry for help, requiring vulnerability.   Being offered help is associated with powerlessness, humiliation or abuse, evoking flight, fight, freeze and submit responses.  Even when clients sincerely want something different for themselves, they cannot control the triggering of instinctive survival defenses, nor the fact that each survival response is inherently in conflict with another.   Should the client commit to therapy or flee?  Combat the therapist’s every effort?   Or “submit” by coming but not fully participating?

In this workshop, we will explore the complex relationships between these internal trauma-related conflicts and resistance in psychotherapy. Using techniques drawn from Sensorimotor Psychotherapy, Internal Family Systems, and other mindfulness-based psychotherapy models, participants will learn how to de-code resistance and help clients become aware of their therapy-related conflicts as internal, not interpersonal struggles.   Then we can help them address resistance as a normal aspect of trauma treatment.   We have a chance to become part of the solution instead of part of the problem.  

 

DAY ONE

1. What do we mean by Resistance and Stuckness?

  1. Depression, shame, self-loathing
  2. Chronic suicidality or self-destructive behavior
  3. Belief that nothing will work
  4. Difficulty coming to or being present in therapy
  5. Struggles for control of the process

 2. Therapy as a threat, not a refuge

  1. Phobias of vulnerability
  2. Phobias of closeness or being visible
  3. Phobias of abandonment and distance
  4. Trauma-related fear and mistrust

 

3.  How manifestations of stuckness and resistance reflect animal defenses

  1. Survival responses and strategies
  2. Introduction to the Structural Dissociation Model
  3. Understanding resistance and stuckness as defensive, not offensive

 4. How we interpret resistance may increase, not decrease it

  1. Triggering aspects of psychotherapy
  2. Decreasing the ‘threat’
  3. Positively re-framing stuckness and resistance as adaptive
  4. Acknowledging and sharing the dilemma:  the client wants help but not at the cost of vulnerability

 5. Using the therapeutic relationship

  1. Navigating the threat of closeness and the threat of distance
  2. Making use of the “social engagement system”
  3. Therapeutic benefits of laughter and playfulness

  

DAY TWO

1. Helping clients deconstruct inner conflicts and struggles

  1. Making use of the Structural Dissociation Model in therapy
  2. Helping clients understand internal conflicts as struggles between parts
  3. Using the language of parts to articulate and highlight contradictory behavior
  4. Honoring the parts who defend by resisting

 2. Increasing client ability to observe trauma-related patterns

  1. Introducing mindfulness as a therapeutic tool
  2. Increasing curiosity and interest
  3. Using psychoeducation to challenge existing beliefs and patterns

 3. “Befriending” the resistance

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

 4. Creative solutions for old and obsolete survival strategies

  1. “Negotiated settlements” with defender parts
  2. Internal soothing and comfort for hurt and fearful parts
  3. Therapeutic support for resistance and acceptance of stuckness
  4. Creating a sense of “we” that includes the parts who collaborate and the parts who resist as well as the therapist

 5. Healing the wounds of the past

  1. Providing ‘missing experiences’ of healthy attachment
  2. Therapy as a play space:  balancing permissiveness and structure
  3. “Being” the therapeutic relationship instead of talking about it
  4. Enjoying the struggles rather than resisting them

 

Learning Objectives: