From One Therapist to Another
Updated: Jul 28, 2019
Common Expressions of Ambivalence in Psychotherapy: Lack of Skills
In this series of posts, I have been focusing on relabeling resistance as ambivalence and noting the common ways that ambivalence shows up in psychotherapy. It is important to identify ambivalence as soon as possible when our clients appear stuck to enable the appropriate strategies for resolving ambivalence.
At times individuals are ambivalent about change simply because they perceive themselves as lacking the skills to bring about the change. This is the easiest form of ambivalence to resolve. Once it is determined that the difficulty is a lack of skills, providing skills should resolve the ambivalence. Some individuals, however, are hesitant to admit that they can’t do something, especially if they believe that most people can, or that they should already know how. Unless this is assessed early in the process, the therapist is likely to attribute the lack of progress to resistance.
Carrie sought therapy for career counseling. She took the Strong Campbell Interest Inventory, which confirmed her desire to go into sales. She made a plan with her therapist to write a résumé and to begin looking at job opportunities. Several weeks went by, during which she had “resisted” doing her homework. Conversation in therapy sessions centered on what had happened during the week that distracted her from writing her résumé. Finally, Carrie exclaimed that she was procrastinating because she had never written a resume before and didn’t know how to get started. The therapist had made the assumption that this well-spoken, apparently bright client had the basic knowledge to do this.
It is easy to assume that when a client doesn't do what they say the want to do from week to week, that they are being resistant or lack motivation As therapists we often will also search for a deeper meaning for the apparent resistance. Therefore, when giving homework assignments, it is important to simply ask if the client knows how to get started on the homework or can predict any reason that it might not get done.
My book A Clinician’s Guide to Pathological Ambivalence: How to Be on Your Client’s Side Without Taking a Side can teach you how to address this and other forms of ambivalence in psychotherapy by developing skills to work directly on resolving ambivalence and rewriting old narratives. I would love to hear from you. Please scroll down to the bottom of this page (past the banner of recent posts) to leave a comment.