Review
BibTex RIS Cite

Psikoterapide Direnci Anlamak ve Dirençle Çalışmak

Year 2016, Volume: 3 Issue: 3, 10 - 25, 01.09.2016
https://doi.org/10.31682/ayna.470691

Abstract

Farklı terapi yaklaşımlarına göre tanımı değişen bir terim olan direnç, kısaca psikoterapide değişime yönelik bir karşı çıkma olarak tanımlanabilir. Her terapi sürecinin bir gerçeği olması ve terapinin sonucunu etkilemesi sebebiyle direnci anlamak önemlidir. Geleneksel olarak direnç, danışana ait bir özellik olarak görülür ve tedaviyi engelleyen bir faktör olarak kabul edilir. Buna rağmen, direncin son dönemdeki kavramsallaştırmaları onu danışanın bir özelliği olmaktan çıkarıp terapist ve danışanın ortak şekilde katkıda bulunduğu ve terapi süresince devam eden bir süreç olarak tanımlamaktadır. Ayrıca, direncin tedaviye bir engel teşkil ettiği yönündeki inanışın giderek değiştiği ve direncin vaka formülasyonu ve danışana göre şekillendirilmiş terapötik müdahaleleri planlamada kullanılabilecek önemli bir bilgi kaynağı olduğu yönündeki fikrin yaygınlaştığı görülmektedir. Bu makalede, direncin kavramsallaştırılması ve psikoterapide dirençle nasıl çalışılabileceği bir vaka örneğinden yola çıkılarak anlatılacaktır. Bu vakayla yürütülen psikoterapi çalışmasına dayanarak yazar, direncin bu süreçteki kaynaklarını ve tedavi amaçlarına ulaşmayı kolaylaştırmak için kullandığı müdahaleleri tartışacaktır

References

  • Arkowitz, H. (2002). Toward an integrative perspective on resistance to change. Journal of Clinical Psychology, 58(2), 219-227.
  • Basch, M. F. (1982). Behavioral and psychodynamic psychotherapies: Mutually exclusive or reinforcing? In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 187– 196). New York: Plenum.
  • Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.
  • Björklund, F. (2000). Defense mechanisms and morality: A link between isolation and moralization. Scandinavian Journal of Psycholology, 41(1), 55-61.
  • Bischoff, M. M., & Tracey, T. J. G. (1995). Client resistance as predicted by therapist behavior: A study of sequential dependence. Journal of Counseling Psychology, 42(4), 487-495.
  • Burns, D. D. (1999). Feeling good: The new mood therapy. New York: Quill.
  • Butler, M. H., & Bird, M. H. (2000). Narrative and interactional process for preventing harmful struggle in therapy. Journal of Mental and Family Therapy, 26, 123–142.
  • Dryden, W., & Neenan, M. (2011). Working with resistance in Rational Emotive Behaviour Therapy: A practitioner’s guide. Routledge: East Sussex.
  • Dewald, P. A. (1982). Psychoanalytic perspectives on resistance. In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 45– 68). New York: Plenum.
  • Ellis, A. (2002). Overcoming resistance: A rational emotive behavior therapy integrative approach. New York: Springer.
  • Engle, D., & Holiman, M. (2002). A gestalt-experiential perspective on resistance. Journal of Clinical Psychology, 58(2), 175-83.
  • Fenichel (1946). The psychoanalytic theory of neurosis. London: Routledge and Kegan Paul.
  • Gabbard, G. O. (2009). What is a ‘’good enough’’ termination? Journal of American Psychoanalytic Association, 57, 575-594.
  • Hartman, D., & Zimberoff, D. (2004). Corrective emotional experience in the therapeutic process. Journal of Heart-Centered Therapies, 7(2), 3-84.
  • Holmes, C. A. V. (2005). The paradox of countertransference: You and me, here and now. New York: Palgrave Macmillan.
  • Maroda, K. (2010). Psychodynamic techniques: Working with emotion in the therapeutic rela-tonship. New York: Guilford.
  • McWilliams, N. (1994). Psychoanalytic diagnosis: Understanding personality structure in the clinical process. New York: Guilford Press.
  • Meichenbaum, D., & Gilmore, J. B. (1982). Resistance from a cognitive-behavioral perspective. In P. L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 133-156). New York: Plenum Press.
  • Messer, S. B. (2002). A psychodynamic perspective on resistance in psychotherapy: vive la résistance. Journal of Clinical Psychology, 58(2), 157-163.
  • Mitchell, S. A., & Black, M. J. (1995). Freud and beyond: A history of modern psychoanalytic thought. New York: Basic Books.
  • Newman, C. F. (1994). Understanding client resistance: Methods for enhancing motivation to change. Cognitive and Behavioral Practice, 1, 47-69.
  • Newman, C. F. (2002). A cognitive perspective on resistance in psychotherapy. JCLP/In Session: Psychotherapy in Practice, 58(2), 165-174.
  • King, S. M. (1992). Therapeutic utilization of client resistance. Individual Psychology, 48(2), 165-174.
  • Lampropoulos, G. K. (2001). Bridging technical eclecticism and theoretical integration: Assimilative integration. Journal of Psychotherapy Integration, 11, 5–19.
  • Lazarus, A. A., & Fay, A. (1982). Resistance or rationalization? A cognitive-behavioral perspective. In P. L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 115-132). New York: Plenum Press.
  • Leahy, R. L. (2003). Overcoming resistance in cognitive therapy. Guilford: New York
  • Lorand, S. (1967). Clinical and theoretical aspects of resistance. Psychotherapy and Psychosomatics, 15(2):162-178.
  • Otani, A. (1989). Client resistance in counseling: Its theoretical rationale and taxonomic classification. Journal of Counseling and Development, 67, 458-46.
  • Patterson, C. H. (2000). Understanding psychotherapy: Fifty years of client-centered theory and practice. Ross-on-Wye: PCCS Books.
  • Safran, J. D., & Muran, J. C. (2000). Negotiating the Therapeutic Alliance: A Relational Treatment Guide. New York: The Guilford Press.
  • Schlesinger, H.J. (1982). Resistance as process. In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 25– 44). New York: Plenum.
  • Silverberg, F. (1990). Working with resistance. Journal of Contemplative Psychotherapy, 7, 21–34.
  • Sultanoff, S. M. (2013). Integrating humor into psychotherapy: Research, theory, and the necessary conditions for the presence of therapeutic humor in helping relationships. The Humanistic Psychologist, 41, 388–399.
  • Turkat, I. D., & Meyer, V. (1982). The behavior-analytic approach. In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 157-184). New York: Plenum.
  • Wachtel, P. L. (Ed.) (1982). Resistance: Psychodynamic and behavioral approaches. New York: Plenum.
  • Watson, J. C. (2006). Addressing client resistance: Recognizing and processing in-session occurrences. Retrieved October 22, 2014 from http://counselingoutfitters.com/Watson.
  • Wessler, R., Hankin, S., & Stern, J. (2001). Succeeding with difficult clients: Applications of cognitive appraisal therapy. New York: Academic Press.
  • Yalom, I. D. (1980). Existential psychotherapy. New York: Basic Books.
  • Young, J.E., Klosko, J.S., & Weishaar, M. (2003). Schema therapy: A Practitioner’s guide. New York: Guilford Publications.
  • Zepf, S. (2011). About rationalization and intellectualization. International Forum of Psychoanalysis, 20, 148-158.

Understanding and Working Through Resistance in Psychotherapy

Year 2016, Volume: 3 Issue: 3, 10 - 25, 01.09.2016
https://doi.org/10.31682/ayna.470691

Abstract

The term resistance has a variety of definitions based on different therapy approaches; but it briefly
indicates an opposition to change in psychotherapy. The term resistance was first used by the psychoanalytic

model in the early 1900s. Today, it is possible to find as many models of resistance as the theories of

psychotherapy. It is necessary to understand resistance because it is a fact of every clinical situation; that is

there is always a certain amount of client opposition in psycho-therapy; and resistance affects the treatment

outcome.

Traditionally, resistance has been viewed as a characteristic of the client and seen as an obstacle

to treatment. However, there has been a major change in how we view resistance today. As opposed to the

early view that resistance stems from the client, recent conceptualizations of resistance take into account

the mutual role of both the client and the therapist. Thus, resistance is seen as a relational and two-person

phenomenon rather than a negative client characteristic. Parallel to this change, therapists are encouraged

to explore their own contribution to resistance and work on their own emotions towards clients which

are not helpful in the treatment process. Furthermore, the traditional view of resistance as a roadblock

to psychotherapy has shifted to-wards a more positive view of resistance which emphasizes the richness

of information re-sistance provides about clients and us as therapists, as well as the adaptive functions

resistance may serve for clients. So, resistance is now seen as a source of information to guide case formulation and interventions designed specifically for that client. Additionally, it is now believed that resistance

may not necessarily be dysfunctional. In some cases what we call resistance might be clients’ best available

and adaptive strategy to resolve problems.

In this paper, after a brief review of the definition and theoretical models of resistance, a case

example will be used to discuss the conceptualization of resistance and working through resistance in

psychotherapy. Based on the psychotherapy work with this case, the author will out-line the sources of

resistance, as well as specific interventions she used to facilitate working to-wards the treatment goals.

The author will highlight the importance of understanding the mean-ing and function of resistance in the

psychotherapy process, the therapist’s responsibility to ana-lyze his/her contribution to resistance, and

working through resistance rather than working against it.

References

  • Arkowitz, H. (2002). Toward an integrative perspective on resistance to change. Journal of Clinical Psychology, 58(2), 219-227.
  • Basch, M. F. (1982). Behavioral and psychodynamic psychotherapies: Mutually exclusive or reinforcing? In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 187– 196). New York: Plenum.
  • Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.
  • Björklund, F. (2000). Defense mechanisms and morality: A link between isolation and moralization. Scandinavian Journal of Psycholology, 41(1), 55-61.
  • Bischoff, M. M., & Tracey, T. J. G. (1995). Client resistance as predicted by therapist behavior: A study of sequential dependence. Journal of Counseling Psychology, 42(4), 487-495.
  • Burns, D. D. (1999). Feeling good: The new mood therapy. New York: Quill.
  • Butler, M. H., & Bird, M. H. (2000). Narrative and interactional process for preventing harmful struggle in therapy. Journal of Mental and Family Therapy, 26, 123–142.
  • Dryden, W., & Neenan, M. (2011). Working with resistance in Rational Emotive Behaviour Therapy: A practitioner’s guide. Routledge: East Sussex.
  • Dewald, P. A. (1982). Psychoanalytic perspectives on resistance. In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 45– 68). New York: Plenum.
  • Ellis, A. (2002). Overcoming resistance: A rational emotive behavior therapy integrative approach. New York: Springer.
  • Engle, D., & Holiman, M. (2002). A gestalt-experiential perspective on resistance. Journal of Clinical Psychology, 58(2), 175-83.
  • Fenichel (1946). The psychoanalytic theory of neurosis. London: Routledge and Kegan Paul.
  • Gabbard, G. O. (2009). What is a ‘’good enough’’ termination? Journal of American Psychoanalytic Association, 57, 575-594.
  • Hartman, D., & Zimberoff, D. (2004). Corrective emotional experience in the therapeutic process. Journal of Heart-Centered Therapies, 7(2), 3-84.
  • Holmes, C. A. V. (2005). The paradox of countertransference: You and me, here and now. New York: Palgrave Macmillan.
  • Maroda, K. (2010). Psychodynamic techniques: Working with emotion in the therapeutic rela-tonship. New York: Guilford.
  • McWilliams, N. (1994). Psychoanalytic diagnosis: Understanding personality structure in the clinical process. New York: Guilford Press.
  • Meichenbaum, D., & Gilmore, J. B. (1982). Resistance from a cognitive-behavioral perspective. In P. L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 133-156). New York: Plenum Press.
  • Messer, S. B. (2002). A psychodynamic perspective on resistance in psychotherapy: vive la résistance. Journal of Clinical Psychology, 58(2), 157-163.
  • Mitchell, S. A., & Black, M. J. (1995). Freud and beyond: A history of modern psychoanalytic thought. New York: Basic Books.
  • Newman, C. F. (1994). Understanding client resistance: Methods for enhancing motivation to change. Cognitive and Behavioral Practice, 1, 47-69.
  • Newman, C. F. (2002). A cognitive perspective on resistance in psychotherapy. JCLP/In Session: Psychotherapy in Practice, 58(2), 165-174.
  • King, S. M. (1992). Therapeutic utilization of client resistance. Individual Psychology, 48(2), 165-174.
  • Lampropoulos, G. K. (2001). Bridging technical eclecticism and theoretical integration: Assimilative integration. Journal of Psychotherapy Integration, 11, 5–19.
  • Lazarus, A. A., & Fay, A. (1982). Resistance or rationalization? A cognitive-behavioral perspective. In P. L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 115-132). New York: Plenum Press.
  • Leahy, R. L. (2003). Overcoming resistance in cognitive therapy. Guilford: New York
  • Lorand, S. (1967). Clinical and theoretical aspects of resistance. Psychotherapy and Psychosomatics, 15(2):162-178.
  • Otani, A. (1989). Client resistance in counseling: Its theoretical rationale and taxonomic classification. Journal of Counseling and Development, 67, 458-46.
  • Patterson, C. H. (2000). Understanding psychotherapy: Fifty years of client-centered theory and practice. Ross-on-Wye: PCCS Books.
  • Safran, J. D., & Muran, J. C. (2000). Negotiating the Therapeutic Alliance: A Relational Treatment Guide. New York: The Guilford Press.
  • Schlesinger, H.J. (1982). Resistance as process. In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 25– 44). New York: Plenum.
  • Silverberg, F. (1990). Working with resistance. Journal of Contemplative Psychotherapy, 7, 21–34.
  • Sultanoff, S. M. (2013). Integrating humor into psychotherapy: Research, theory, and the necessary conditions for the presence of therapeutic humor in helping relationships. The Humanistic Psychologist, 41, 388–399.
  • Turkat, I. D., & Meyer, V. (1982). The behavior-analytic approach. In P.L. Wachtel (Ed.), Resistance: Psychodynamic and behavioral approaches (pp. 157-184). New York: Plenum.
  • Wachtel, P. L. (Ed.) (1982). Resistance: Psychodynamic and behavioral approaches. New York: Plenum.
  • Watson, J. C. (2006). Addressing client resistance: Recognizing and processing in-session occurrences. Retrieved October 22, 2014 from http://counselingoutfitters.com/Watson.
  • Wessler, R., Hankin, S., & Stern, J. (2001). Succeeding with difficult clients: Applications of cognitive appraisal therapy. New York: Academic Press.
  • Yalom, I. D. (1980). Existential psychotherapy. New York: Basic Books.
  • Young, J.E., Klosko, J.S., & Weishaar, M. (2003). Schema therapy: A Practitioner’s guide. New York: Guilford Publications.
  • Zepf, S. (2011). About rationalization and intellectualization. International Forum of Psychoanalysis, 20, 148-158.
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Psychology
Other ID JA77AA89HD
Journal Section Research Article
Authors

Ezgi Tuna

Publication Date September 1, 2016
Submission Date September 1, 2016
Acceptance Date October 23, 2016
Published in Issue Year 2016 Volume: 3 Issue: 3

Cite

APA Tuna, E. (2016). Psikoterapide Direnci Anlamak ve Dirençle Çalışmak. AYNA Klinik Psikoloji Dergisi, 3(3), 10-25. https://doi.org/10.31682/ayna.470691