Therapy and Therapists factor
It is absence of rapport between therapists and client. Failure to recognize that client is avoiding a higher order anxiety; thus an overweight client might fear that after the weight loss a new readjustment may be occur dealing with social and sexual anxieties.
There are some secondary benefits that clients hold on to although the discomfort is in their way. Frequently clients prefer not to get well because they do get benefits by being incapacitated.
Resistance could be created by incorrect use of the technique, which needs to be applied for the given client- this may be due to lack of experience or training on the therapist’s part. Beginning therapy without the client’s understanding or accepting the rationale for that particular therapy. Giving assignments or homework related to the client’s goal which are not relevant or understood by the client. Assignment given to the client is too time consuming and the therapist’s lack of sensitivity in recognizing it.
Environmental and other External factors:
A deliberate sabotage from other family members, in addition to dealing with the agoraphobia of the client, the therapist may choose to involve family members who might be fostering unhealthy dependency relationships.
The therapist may be confronted with direct gains from not getting better. For instance, clients who are experiencing chronic pain and are on disability may consciously or unconsciously hold on to the affection for they do bring about reward. In such cases the therapist needs to establish a differential diagnosis.
The client may have some ‘hidden agendas’ that could prevent treatment from progressing satisfactorily. For instance, getting a spouse into therapy, which may lead to one, could then break the marriage. Motivation is, when a client is referred by a family member or a physician, he may not really value the desired outcome of the therapy to give it the necessary effort. The client may be feeling very strong about self fulfilling prophecy and negative expectation. Thus a client may come to therapy to prove that his belief of not being able to succeed is correct one. Sometime a client will exhibit low frustration tolerance, which then lead to self defeating behavior.
Some of the manifestations of resistance can be seen through the rationalization for delaying the receiving of help. For instance a client may express all kinds of reasons, such as the therapeutic process is too expensive, too long and so on. The therapist needs to be aware that the resistant client is offering him a very important fund of information, namely it sets up a pattern for the interpersonal relationship between the client and the therapist. Resistance is often ‘caused’ by the inability of the therapist to get into ‘sync’ with the client. The client comes in with a certain set of beliefs, one of those being that he is so disturbed, or so sick or so uncomfortable or so miserable that nobody can help him. The therapist may have his own set of beliefs that it is important for him to succeed with any client.