Solutions for Moving Beyond the Therapeutic Impasse

Three Strategies for Making Progress with Stuck Clients

Steve Andreas

When clients get immersed in their problem, they often suffer from a kind of tunnel vision, focused on a small range of experiences, with their bad feelings taking center stage. It’s a state that resembles a hypnotic trance: a limited, intense, internal focus of attention. When therapy gets stuck, one way of moving it forward can be to think of clients as being in a troublesome trance induced by parents, caregivers, and difficult life experiences. They’re trapped in what Buddhists call maya, the world of illusion.

When therapy goes wrong, it’s typically because we’ve entered our clients’ trances with them, joining them in their myopic misery. In this mutually reinforcing state, neither client nor therapist can see beyond the small, cramped space of the stalled interaction. Focused entirely on the bad feelings generated by the problem at hand, we lose our capacity to use our skills to expand life’s horizons, oblivious to other possibilities for change---other ways of thinking and responding.

Once caught in such a trance, we need to break the spell, broaden our vision, and open ourselves to possibilities outside it. These goals may present a formidable challenge, but meeting it can be easier than you think, particularly with practice. To determine whether you are, in fact, in a trance when treatment has stalled, ask yourself the following questions, and consider the added suggestions for mobilizing your---and, more importantly, your client’s---capacity for more creative thinking.

The Feelings Trap

Are you focusing too much on the client’s feelings and too little on the triggers that elicit them?

Many of us have been taught to focus on exploring clients’ feelings. That’s what therapists do, isn’t it? Of course, it’s important to know what the pertinent feelings are, validate them, and, if clients are puzzled about them, dissect their distinctive meanings. However, rather than continuing to circle around the bottomless drain of feelings, it’s usually useful to find out what’s causing the feelings and intervene there.

So the first principle of moving stuck therapy along is to recognize that feelings aren’t an ultimate reality, but just important signals, much like the warning lights on a car’s dashboard. What’s important isn’t the light itself, but what causes the light to go on. If the oil light in your car refuses to go off, there’s no point in studying the light; you need to put oil in the engine and see whether the light goes off. Clients’ feelings are useful signals offering you instant feedback about the effectiveness of therapy, but your interventions themselves need to be directed elsewhere.

The Judgment Trap

Are you or your clients distracted and distressed by judgments about their problems?

As if having bad feelings weren’t bad enough, many clients criticize their bad feelings, making them feel even worse. “You shouldn’t feel bad!” “You’re being a silly goose about this.” “Can’t you be a man and ‘suck it up’?” Any judgment adds yet another layer of trance, distancing clients even further from their problems and any possible solutions.

Whenever a client describes his or her feelings as “bad,” it can be useful to point out that these feelings are effectively good. Like pain or the trouble light on your dashboard, they signal that something needs attention. Clients who don’t have these feelings might fail to heed the underlying issue and suffer further consequences. People born without pain receptors continually damage their bodies because they lack vital feedback. Even just changing a description from “bad” to “unpleasant” can redirect attention from trying to eliminate the feeling---as addicts and many others do---to solving the problem that causes it.

Escaping the Tyranny of Language

Are your communications directed too much toward clients’ conscious, verbal understanding and too little toward their unconscious responses?

It’s easy to get caught up in consciously describing or discussing a problem, thinking mistakenly that this will help solve it. But if you direct your attention only or mainly toward clients’ words, you’re usually wasting your time, because the most relevant information is being communicated in voice tone, tempo, movements, facial expressions, posture, breathing, and other unconcious means. One of my teachers used to say, “Verbal report should be treated as unverified rumor, unless accompanied by nonverbal confirmation.”

It can be useful to approach therapy as a process similar to training an animal. You can still employ words, but only to use your own nonverbal behavior---voice tone, tempo, facial expressions, hand gestures, and so forth---to elicit new and different responses. If you want a dog to get excited, you must get excited yourself, speeding up the tempo and amplitude of your movements and raising the pitch of your voice. If you want the dog to calm down, you need to speak softly and slowly. People really aren’t that different. If you aren’t getting a useful response from a client, you can either wait for it to occur naturally---which could take a long time!---or you can vary your behavior until you succeed in eliciting it.

Putting It Together

When you remember that the experiences that cause feelings are important---rather than the feelings themselves---that judgments are useless distractions, and that the mostly unconscious, nonverbal exchanges, presuppositions, and implications embedded in your communication are powerful means of promoting change, therapy can become a much more liberating experience for you and your clients. But even more important than that is the understanding that your clients, no less than you yourself, are hypnotists who weave a spell in the therapeutic hour. The difference between you is that the success of therapy typically hangs on your ability to demonstrate more skill and awareness in using the trancelike qualities of human communication to move beyond the tunnel vision that can stall therapy and prevent change and healing from taking place.

This blog is excerpted from “Breaking the Spell". Read the full article here. >>

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Topic: Professional Development

Tags: caregivers | parents | psychotherapy | Steve Andreas | success | therapist | therapists | therapy | strategies | creativity | progress | stuck | solutions | moving therapy forward | tips

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1 Comment

Monday, July 13, 2015 7:44:34 PM | posted by Jeffrey Von Glahn
Someday, hopefully very soon, I'm going to write an piece titled: THE TYRANNY OF INTERVENTION. It is based on my belief that there exists a natural healing process for what I think of as psychological "injuries," and that this process works under the same conditions as the healing process for physical injuries/illnesses. Both require protection from further adverse events. Then sufficient support is required. In medicine, support is physiological in nature; while in psychotherapy it is provided by the therapist's support for the client's experiencing. This support allows the client's emotional experiencing to emerge in an unforced way, rather than in a forced manner from an unexpected stimulus. The unforced activation of emotional experiencing manifests itself in animated talking to deep crying, and none of which is retraumatizing as the client remains in control of his experiencing.