Resistance in psychotherapy: Conclusions that are supported by research

Abstract

Theoretical literature is contradictory in most areas, but virtually all theories agree on the existence of patient resistance. Furthermore, these theories propose similar views regarding the implications, and effects of resistance. However, theories differ widely in both the assumed causes of resistance and the methods of dealing with resistant patients. Common to various theoretical definitions is an assumption that resistance is both a dispositional trait and an in-therapy state. While the focus of this article is on resistance as a general phenomenon, the vast majority of research has given particular attention to a special class of resistance that is the reaction against the sense of being controlled by others. This “reactance” is manifested in oppositional, angry, and uncooperative behavior. In both its general and more specific forms, resistance bodes poorly for treatment effectiveness. However, nondirective and paradoxical strategies have been found to be quite successful in overcoming resistant and reactant states. In addition, matching low-directive and self-directed treatments with potentially resistant patients tends to attenuate the negative effects of resistance traits. © 1996 John Wiley & Sons, Inc.