A case illustration of resistance from a cognitive perspective

Brian, a 36-year-old, single, white male, entered cognitive therapy in response to a depressive episode, precipitated by the loss of a job. In addition to his Major Depression, the client met diagnostic criteria for Dysthymia and Personality Disorder Not Otherwise Specified. The first three sessions focused on Brian's unemployment crisis and related dysphoria, as well as his passive-avoidant approach to life. Brian collaborated with the therapist in formulating a treatment plan and quickly found a new job, whereupon he abruptly withdrew from therapy. Shortly thereafter, Brian contacted the therapist in a renewed state of “crisis,” and returned for a fourth session. The therapist attempted to draw a link between Brian's passive-avoidant style and his vulnerability to problems such as those he was currently experiencing. The client had difficulty understanding the therapist's thread of logic, became somewhat defensive and combative, and did not return for further sessions. © 1996 John Wiley & Sons, Inc.