When Helping Doesn’t Help

by David Burns

As therapists, we want nothing more than to help people who are suffering—help them feel better as soon as possible and help them, after therapy, live more emotionally satisfying lives. But that usually requires helping them change—change their dysfunctional patterns of thinking, self-destructive behaviors, and self-defeating ways of relating to others. Since just sitting with them and commiserating with their misery, week after week, month after month, may not result in any tangible change, most of us naturally want to engage in more active forms of helping. So we try to persuade our clients—compassionately, gently, kindly, patiently—to engage in this and that tool, technique, exercise, or homework assignment, which we know would help, if only they’d just try it.

Of course, many clients do follow our helpful suggestions, and the resulting changes can often be rapid and dramatic. But what about those who seem to do everything in their power, subtly and not so subtly, to undermine our help? We make suggestions, explain proven techniques, reason with them, advise, cajole—to no effect. Regardless of their heartfelt renditions, session after session, of how miserable they are, how much they need our help, some clients simply won’t, or can’t, accept the help we’re offering.

We’ve all dealt with clients like this—the ones who “yes-but” us and consistently “forget” to do their psychotherapy homework. They may insist that we don’t understand, that we’re not helping—and the harder we try, the more adamant they become. Too often, therapy with these clients ends in a stalemate. The client drops out, feeling no better than when he first arrived, and the therapist is left feeling baffled, inadequate, frustrated, even defensive and angry, perhaps blaming the client for being “resistant.”

Ah, resistance! Haven’t we all, at times, blamed our clients for it, suggesting that they secretly don’t want to get better and are, in some way, purposely sabotaging us? But what if the problem is really with us, that we’ve become so single-minded in our attempts to be helpful, that we tend to ignore the aspects of our clients’ inner ecology triggering the resistance? And what if the negative thinking patterns, feelings, and behaviors that keep them stuck have powerful, unconscious advantages serving vital, even life-preserving purposes? Finally, what if their resistance to change reveals something positive, beautiful, and even healthy about them—something that we’ve overlooked? If so, we might want to view resistance from a radically different perspective.

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