Sometimes the very people who seek healing unknowingly become the biggest obstacles to their own progress.
I’ve noticed something weird over the decades with occasional clients. I wonder if you’ve experienced this too.
The very clients who make the biggest song and dance about coming to therapy are the same ones who don’t turn up! They tell you on a call or over email how stoked they are about coming to therapy, how they can’t wait to get going, how much they need therapy, and so on… but “the lady (or man) doth protest too much”, it seems.
It’s got to the stage where I can tell pretty accurately if someone is going to bail before the first session.
Enthusing about something may be not a prelude to doing that thing, but a replacement for it.
If someone is really serious, they just do the thing they are really serious about. They don’t feel the need to convince you, themselves, and anyone who’ll listen that they are indeed sincere.
But even among some who do turn up, there are ways they may unconsciously block the action of your therapy.
We can sometimes do wonderful things for clients – relieve trauma, lift depression, and so on – but only if they let us.
We and they need to remember that ‘going to therapy’ isn’t necessarily the same as actually receiving therapy.
There in body…
I may ‘go to dinner’, but if I refuse to order from the menu or swallow my food, or if I stuff the dinner contents into a bag under the table, I’m not really having dinner.
Likewise, we might say, “Hey, it’s great that Bob/Sally is going for therapy!” but if they’re acting like me at that dinner, it’s essentially a waste of time and money.
As a boy at school I certainly went to chemistry lessons. I was undoubtedly there in body. My mind, though, was seldom in attendance. It flowed freely among a thousand different fantasies. Few, if any, were chemistry related.
We don’t just want our clients there in the therapy room. We want them present, so we can do more than just meet physically.
A real meeting of minds
Therapy, like most human endeavours, is collaborative, a meeting of minds. But sometimes the very people who seek healing unknowingly become the biggest obstacles to their own progress.
I’ve written before about resistance in therapy and how to overcome it. Methods such as actually encouraging the resistance can work well with very contrary clients.
But here I want to suggest further ways some clients might block the action of therapy, offer examples, and suggest how we might deal with these specific self-imposed blocks.
First off, though, there is a trap that, no matter how empathetic you are, some clients may have you falling into.
It’s not about blame
It might be more comfortable to inwardly blame the client if our wonderful therapy doesn’t seem to work so marvellously with them.
Of course, it’s human nature to inwardly or even outwardly get frustrated with clients who seem to block every one of our attempts to help them. But I certainly have to remind myself sometimes that, heck, they may just not be ready for therapy or – heaven forbid! – we might need to change our approach and become a more flexible practitioner.
So therapy not working is by no means necessarily to do with the client ‘blocking’ the effects of what we are trying to do for them. Sometimes (though rarely, I’ve found), the personality combination may be all wrong – in which case we might not take on a client and refer them to someone else.
So firstly we need to discern, partly through intuition grown from experience (as with my predictive ability to discern when an overenthusiastic client will morph into a no-show!), whether the derailment or block to progress really is due to the client not opening their hand to take yours, or whether progress isn’t happening for some other reason.
And if it is… what next?
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Understanding is key
To cure, you first need to diagnose.
Understanding how clients block therapy – and how to respond therapeutically – can be the difference between stagnation and transformation. I want to suggest common forms of resistance and provide strategies to gently yet effectively work through them.
Now I think we’ve all seen the following type of client …
Type one: Minimizing or intellectualizing emotions
One of the most common defence mechanisms is staying in the head rather than the heart. This is the MO of what we might call the overanalytical client.
A boy dissected a fly to find out how it worked, analyzed it to death, and then found it had no life in it at all. He had all the parts… but where was the fly?
A similar process occurs in therapy. This may be because the client is rather ‘left brained’ naturally, or perhaps because past therapy of an overly analytical kind has conditioned them to think that all therapy is supposed to be incredibly analytical.
This kind of client may know all the psychojargon, and yet the life they are living isn’t adequately meeting their emotional needs. They seem somewhat too detached from their own life and feelings.
The trouble with overanalysis is that it tends to tie people up in knots and take the life out of therapy. If everything is analyzed, wider patterns of immediate experience may be missed and humour may evaporate. And along with that evaporation goes perspective.
Emma, a 32-year-old marketing executive, came to therapy after a breakup. She spoke articulately about her attachment patterns and referenced psychological terms with ease.
However, whenever I asked how she felt about the breakup, she deflected with analysis: “It’s likely an avoidant-attachment dynamic, which makes sense given his [her erstwhile boyfriend’s] trauma history.” Emma’s ability to intellectualize her pain was shielding her from feeling it – and that was certainly an adaptive response.
This may sound strange, but while thinking is a wonderful tool, it’s not necessarily the right tool for every part of life. Sometimes we need to intuit, feel, and shut up the chattering mind for a while. This is one reason practitioners use hypnosis.
Anyway, how might we deal with the emotional intellectualizer?
What to do about it
Gently reflect what you notice:
“You’ve given a very thoughtful explanation of what happened, but I wonder how it felt for you at the time?”
Encourage slowing down, connecting with bodily sensations, and using grounding techniques to stay present with emotions rather than escaping into analysis.
I asked Emma to access some of the actual feelings of pain – just a sample – then I suggested she really home in on that feeling, not as an analysis of it but as an experience of it. Then we could start transforming painful feelings into more positive, hopeful ones – not by talking about them, but by experiencing them in a controlled and safe way.
As I said, this is much easier to do when you know inner-work approaches such as mindfulness and hypnosis, as these approaches are intrinsically experiential not analytical.
It’s worth noting that this is the opposite of the approach we need to take for many clients who do need to get distance on their feelings and develop narratives around them rather than simply being swamped by them. Different types of people need different approaches.
And sometimes it’s the client’s relationship with you, the therapist, that becomes a block to their progress.
Type two: Performing for the therapist
Michael always arrived early, assiduously maintained eye contact, and enthusiastically agreed with everything I said – which I admit was pretty enjoyable at first!
But over time, it became clear that while he was saying all the ‘right things’, his words started to ring a bit hollow.
He was so enthusiastic and positive about me and my therapy that it seemed he just wanted me to like him. He spoke of not wanting to waste my time and kept apologizing if he felt he had talked for too long or not been clear about something.
Wanting to be liked is all very well, but if it’s always the number-one priority then it can start to have just as many therapy-blocking effects as someone reflexively being continually contradictory.
You might find there is passive agreement without engagement. So the client may nod, agree, and seem open – and yet between sessions, little shifts. They may fail to complete agreed-upon homework or avoid taking therapeutic insights into real life.
If something hasn’t worked in therapy – if one of my prized interventions has made not the slightest impact – then I want to know about that.
Chronic people-pleasing, often a manifestation of low self-esteem, blocks honest and open conversation, and that can be a serious problem in therapy. Therapy becomes another performance rather than an authentic endeavour.
It pleases me when someone doesn’t just try to please me.
What to do about it
Describe what seems to be going on sensitively. I said to Michael:
I notice you often seem very aware of what I might want to hear. I wonder what it would be like to talk from a less caring-what-the-hell-I-think perspective!”
Building relational safety is essential. They may need reassurance that messiness is not only allowed but welcomed.
Both within and outside of therapy, Michael was often unable to state his dissatisfactions assertively and set boundaries, and as a result he often felt depressed and frustrated.
So we may need to use strategies to help our client actually absorb our reframes and carry out our behavioural tasks.
Bit by bit Michael was able to care less what I thought, and also be himself regardless of what others thought. Once this block had been removed, or at least diminished, progress became rapid.
Mind you, some clients would rather talk about other people than themselves!
Type three: Avoidance through externalization
Jasmine, a 40-year-old teacher, spent much of therapy venting about her husband’s shortcomings: his emotional unavailability, his parenting style, his lack of appreciation, even his poor fashion sense!
Whenever the focus shifted to her internal world, her needs, her fears, she redirected back to him. Exploring her difficulty in accessing her own emotions revealed a long history of caregiving for others, where her own needs were ignored or punished.
But this nurturing element had slowly morphed into a kind of learned helplessness in which she’d come to feel as though she were simply a puppet on a string, her wellbeing at the mercy of the moods and actions of others.
To continually blame others for the state of our lives is to hand power away. And externalizing to this degree can certainly block the effects of therapy.
These kinds of clients may:
- Constantly vent about others’ behaviours
- Seek validation of being ‘right’ in conflicts
- Avoid reflecting on their own emotional patterns or contributions to problems.
They may focus excessively on others (partners, parents, coworkers, the government…) as the source of their distress, effectively externalizing responsibility for change.
What to do about it
Join them where they are, but gently shift the spotlight:
- “It sounds like that argument was really frustrating.”
- “Can we take a moment to explore what you felt during that experience?”
- “Did you handle that in the best possible way?”
- “How would you have liked to have reacted to that?”
Invite curiosity about their internal world, rather than staying stuck in external narratives.
I suggested to Jasmine that we couldn’t completely determine what her husband did, how he dressed, and what he said. But we could work on how she felt about things. Who knows, a change in her might help him too – but it was her who was here for help.
It might be interesting and certainly relevant to know how your client’s mother, father, husband, wife, cat, or dog feels about what’s going on in their life – but ultimately we are working with them.
I deal with more ideas around clients who overly externalize causes to their problems here.
Some clients, though, are so full of continual immediate ‘drama’ that it can be hard to actually see what might be needed longer-term with them.
Type four: Chronic crises and ‘firefighting’ sessions
Carlos, a 28-year-old grad student, arrived at each session with a sense of emotional drama. He was a lovely client but the kind who could drive you to drink faster than your in-laws arriving unannounced with luggage.
You may have spotted clients or other people in your life like this. One week it was a conflict with a friend, the next it was an academic panic, then a housing issue. Then it was that someone had said something he didn’t know how to take. He was a self-described “drama queen”!
When asked about deeper topics like family or early life, he’d wave them off with “There’s just no time for that right now – I’m barely staying afloat!”
It’s important to make the distinction that while Carlos was constantly plagued by some kind of crisis, he wasn’t at crisis point. This is a different situation altogether, in which other services may need to become involved.
When talking about these types of clients, who have a fresh ‘worst thing ever’ to regale you with each week, I hesitate to call their issues ‘dramas’, because that makes them sound concocted. Carlos’ crises were real, but they also served as a block to us focusing on his longer-term therapeutic goals.
The client for whom each session seems to require ‘firefighting’ at the expense of focus on wider, longer-term goals may be someone who often has exaggerated or overly emotional reactions to events or situations. They may have histrionic personality disorder or be emotionally labile for some other reason.
Sure, they may receive secondary gains such as a sense of excitement and more concentrated attention from other people, but the crisis can seem real to them, even if it’s short lived and the next day it’s forgotten.
What to do about it
Validate the distress, then invite a shift:
“It seems like every other week brings something overwhelming. I wonder if there’s a deeper pattern underneath this we could explore together?”
In Carlos ‘ case the deeper, longer-term goal became him reacting less immediately and severely to what were often not really huge setbacks at all.
I suggested that a burglar alarm really doesn’t need to go off at every shift in the weather or gust of wind, and that analogy really stuck with him.
So rather than just focusing on each specific setback and wasting his time and money just talking about his landlord or some professor at college who seemed to have been a bit off with him, we focused on him learning to care less and stay calmer. Carlos actually had to learn to get out of touch with his emotions more of the time.
You can consider introducing structure or boundary-setting in sessions to protect space for longer-term themes. I stated firmly to Carlos that we needed to work on the bigger picture, and just that idea seemed to help him calm down.
Finally, some perfectionistic clients actually block the effects of therapy by wanting success too badly.
Type five: Perfectionism and fear of ‘failing’ therapy
Some clients feel shame about not progressing ‘fast enough’. They want to do therapy ‘right’ and may be self-critical when progress feels slow.
Signs to watch for might be:
- Apologizing for setbacks
- Judging themselves for not being ‘better’ already
- Telling you they worry about what you think of them or that they don’t want to waste your time
- Comparing their progress to others (real or imagined).
Nigel, a high-performing lawyer, approached therapy like any other work project. He kept a notebook of goals, asked for reading recommendations, and measured progress weekly.
Don’t get me wrong, those are really useful strategies for many clients to keep on track, but if someone can’t help but treat therapy as one more thing they have to be ‘good at’ then the resulting anxiety can actually backfire and stall progress.
After a difficult session where emotions surfaced for Nigel, he apologized: “Sorry I wasn’t very articulate today. I should be doing better by now.”
Therapy itself had become another arena for perfectionism – one that needed to be gently reframed as a space for imperfection and self-compassion.
What to do about it
We can normalize the nonlinear nature of healing. Reframe setbacks as valuable data. Use a compassionate lens:
“What if this moment isn’t a failure, but an important part of your process?”
I suggested to Nigel that sometimes our sessions wouldn’t “seem to make much sense” but often it was those sessions in which the most progress would be made. This helped lift the self-imposed pressure to analyze and understand in limited terms what was going on. I said:
“Sometimes people don’t know which key it was exactly that opened the door… all they know is the door opened, and they went through to some better way of experiencing life.”
He actually found that the way he approached most other aspects of his life wasn’t necessary or useful in my therapy with him.
But ultimately we work with, not against, what our clients are like.
We don’t need to resist resistance
Resistance is not failure. It’s a force we can align with and use for therapeutic gain. As therapists, the key is to notice these blocks and respond with compassion.
Ask yourself:
- What purpose might this resistance be serving?
- What unspoken fears are at play?
- How can I create safety around the very thing they’re avoiding?
Therapy thrives on trust, safety, and attuned responsiveness. When we honour a client’s resistance as meaningful, not merely obstructive, we create the conditions for transformation.
Elegantly Sidestep Resistance with Flexible Reframing Skills
Psychological flexibility is a hallmark of an effective therapist. The ability to see things from multiple perspectives gives practitioners the agility to help clients step out of their limiting beliefs. Having written a book on reframing, Mark now delivers an online course, Conversational Reframing, to help practitioners become expert at freeing clients from their self-maintained prisons.
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About Mark Tyrrell
Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.
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