- Maria Andersen
How can the concept of resistance be understood and in what way can the therapist work with this in psychotherapy for the benefit of the client´s ability to change?
The focus is on the client´s ability to change and improve, because the function of resistance is to protect the individual from change that can threaten the psychological balance and function, regardless of how dysfunctional this balance is. Resistance is activated in therapy through the anxiety connected with change and can be maladaptive in its protection and maintaining of the status quo of dysfunction. No resistance is thereby a sign that the therapy is not progressing, as it is not affecting the client enough to elicit anxiety and thereby resistance. Thereby the therapeutic approach must be concerned with managing the level of resistance, so that this does not limit the effectiveness of treatment by being so overshadowing that no change can occur, or too small which also means that the client is not currently in a change-process.
The thesis is theoretical and the scientific theoretical approach is hermeneutic. I draw mainly on psychodynamic theory and supplement with other schools of theory. I start my study by investigating the psychological research field of resistance; the research methods, the relevant findings and I make suggestions as to further areas of research. I also account for my literature search in the attempt of scientific transparency.
In the thesis I account for the nature of resistance and find that it can be both unconscious, preconscious and conscious as well as an intra- and interpersonal phenomenon. The difference between resistance and psychological defense is also accounted for, alongside whit an explanation regarding how resistance can be recognized in therapy, what will influence resistance in psychotherapy, and whether or not it is an adaptive phenomenon for the individual. All of the different categories of resistance is also accounted for, including character-resistance, resistance of the therapist, resistance as a trait of personality and Freud’s five classifications. Furthermore, I examine how resistance can be defined, but find that the field of resistance needs a new up-to-date definition as the existing ones seem to be outdated. Therefore, I gather all of the knowledge I find throughout the thesis and accumulate this. Thereby formulating my own unifying description of resistance as a concept and practice-phenomenon.
The two main discussions each focus on their part of the problem statement. The first discussion will therefor focus on the understanding and views on resistance, hereby examining the discourse, language and theoretical use of the concept, and whether or not the concept should be renamed or rebranded to escape negative associations. The second discussion focus on how to work therapeutically with resistance. Here I use Gabbards scale of interventions to discuss when a supportive - or expressive intervention style is beneficial, in regards to managing the level of resistance. I also discuss resistance-work in regards to Motivational Interviewing and Intensive Short Term Dynamic Psychotherapy, and try to understand why these two, so different, approaches are both therapeutically effective. The discussion will also examine what the ideal level of resistance is, and bring forth some empirical findings, that state the importance of matching the intervention-style with the client’s level of resistance. On the basis of these findings, I lastly discuss when an expressive and supportive approach seems favorable and how to asses this. Both discussions end in a summation. A further summarizing discussion is brought to further discuss part one and two of the thesis as well as critically evaluate the thesis.
The thesis ends in a conclusion, that will bring an independent unifying description of resistance in order to answer the first part of the problem statement. Part two is answered by bringing forth knowledge about how to work on the basis of, directly with and in proportion to resistance and resistance-levels in psychotherapy. I also expand the summarizing description of resistance, to include a perspective on how to work in regards to resistance.
Keywords: resistance, definition, psychotherapy, Steven de Shazer, Gabbards scale of interventions, Motivational Interviewing (MI), Intensive Short Term Dynamic Psychotherapy (ISTDP).
|Udgivelsesdato||2 jan. 2017|
|Emneord||Modstand, Definition, Psykoterapi, Gabbards interventionsskala, Steven de Shazer, Motivational Interviewing (MI), Intensive Short Term Dynamic Psychotherapy (ISTDP)|