WORKING THROUGH WORKING THROUGH

RESISTANCERESISTANCE

Slides for Chapter 7 of text, PS375, Kaplan UniversitySlides for Chapter 7 of text, PS375, Kaplan UniversityTristram Jones, PhD.Tristram Jones, PhD.

Yes, Addiction Yes, Addiction isis like a like a LOVER!LOVER!

• ONLY WITH ALITTLE BIT OF A TWIST!ONLY WITH ALITTLE BIT OF A TWIST!

So a lot of the same neurosis So a lot of the same neurosis apply! Like Freud’s Big Tenapply! Like Freud’s Big Ten

• DenialDenial arguing against an anxiety provoking stimuli by arguing against an anxiety provoking stimuli by stating it doesn't stating it doesn't

• DisplacementDisplacement taking out impulses on a less threatening taking out impulses on a less threatening target target

• IntellectualizationIntellectualization avoiding unacceptable emotions by avoiding unacceptable emotions by focusing on the intellectual aspects focusing on the intellectual aspects

• ProjectionProjection placing unacceptable impulses in yourself onto placing unacceptable impulses in yourself onto someone elsesomeone else

• RationalizationRationalization supplying a logical or rational reason as supplying a logical or rational reason as opposed to the real reason that you were fired.opposed to the real reason that you were fired.

• RReaction formationeaction formation taking the opposite belief because the taking the opposite belief because the true belief causes anxietytrue belief causes anxiety

• RegressionRegression returning to a previous stage of development: returning to a previous stage of development: sitting in a corner and crying sitting in a corner and crying

• RepressionRepression pulling into the unconscious forgetting sexual pulling into the unconscious forgetting sexual abuse from your childhood due to the trauma and anxietyabuse from your childhood due to the trauma and anxiety

• SublimationSublimation acting out unacceptable impulses in a socially acting out unacceptable impulses in a socially acceptable waysacceptable ways

• SSuppressionuppression pushing into the unconscious things that pushing into the unconscious things that causes you anxiety causes you anxiety 

All of this adds up to: All of this adds up to: RESISTANCE!!!RESISTANCE!!!

THERE THERE ISIS A CLASSIC METHOD FOR A CLASSIC METHOD FOR BREAKING THROUGH RESISTANCE IN BREAKING THROUGH RESISTANCE IN

AOD SUFFERERS!AOD SUFFERERS!

Despite Vernon Johnson’s Despite Vernon Johnson’s (e.g., 1973) assurances…..(e.g., 1973) assurances…..

WhatWhat do all these great masters do all these great masters teach?teach?

PRESSUREPRESSURE CREATESCREATES RESISTANCE!RESISTANCE!

So what works better? Well, So what works better? Well, WORKING WORKING withwith resistance is a resistance is a

better idea!better idea!

BUT DO MILLER & ROLLNICK BUT DO MILLER & ROLLNICK HAVE THE ANSWER??? HAVE THE ANSWER???

What do Miller & Rollnick What do Miller & Rollnick suggest?suggest?

• THEY DENY THAT ADDICTSTHEY DENY THAT ADDICTS• ARE IN DENIAL!ARE IN DENIAL!• They call refusing to accept that thereThey call refusing to accept that there• is a problem is simply a “normalis a problem is simply a “normal• reaction!” They also say the behaviorreaction!” They also say the behavior• of the therapist creates the resistance in of the therapist creates the resistance in

in clients! This becomes a vicious in clients! This becomes a vicious • cycle in which confrontation=resist-cycle in which confrontation=resist-• ance= more confrontation, etc!ance= more confrontation, etc!

HERE ARE THE STAGES OF HERE ARE THE STAGES OF CHANGE THAT MILLER & CHANGE THAT MILLER &

ROLLNICK PREFER:ROLLNICK PREFER:

PRECONTEMPLATION STAGEPRECONTEMPLATION STAGE

CONTEMPLATION CONTEMPLATION STAGESTAGE

• Subject vacillates between Subject vacillates between accepting help and rejecting it! accepting help and rejecting it!

DETERMINATION DETERMINATION STAGESTAGE

• Subject may be open to accepting Subject may be open to accepting help if properly THERAPIZED!help if properly THERAPIZED!

ACTION STAGEACTION STAGE

• Subject may initiate action by herself—Subject may initiate action by herself—go on the wagon. This will be stressful go on the wagon. This will be stressful without help!without help!

RELAPSE STAGERELAPSE STAGE

• Subject may now wish to discuss Subject may now wish to discuss difficulties of maintaining sobriety with difficulties of maintaining sobriety with some help!some help!

AVOID TRAPS!!!AVOID TRAPS!!!• The confrontation trapThe confrontation trap• The question/answer trapThe question/answer trap• The labeling trapThe labeling trap

________________________________________________________________________________

Instead: Motivational Interviewing Instead: Motivational Interviewing advocates:advocates:

• Problem recognitionProblem recognition• Statements of concernStatements of concern• Intention to actIntention to act

cognitive/affective/behavioralcognitive/affective/behavioral

And use modifications of And use modifications of Rogerian therapy! (really?!)Rogerian therapy! (really?!)

•

REFLECTIONREFLECTION and and• • AMPLIFICATION AMPLIFICATION • DOUBLE-SIDEDDOUBLE-SIDED• SHIFTING SHIFTING

FOCUSFOCUS• THE TWISTTHE TWIST• REFRAMINGREFRAMING• (ALL TYPES (ALL TYPES

OF OF • REFLECTION)REFLECTION)•

•

And And PARADOXPARADOX…which is …which is essentially essentially GESTALTGESTALT, but , but

who really cares?who really cares?

VELLL—I CARE, DOTZVUN PERSONWHO GIFFS A GOOTDAMN!!! JA!

POP QUIZ TIME!POP QUIZ TIME!• ALL RIGHT,ALL RIGHT,• CHILDREN! IFCHILDREN! IF• YOU HAVE BEEN YOU HAVE BEEN

BEEN PAYING BEEN PAYING CLOSECLOSE

• ATTENTION, TELL ATTENTION, TELL TELL ME TELL ME WHAT TREAT-WHAT TREAT-

• MENT MILLER & MENT MILLER & AND R AND R ROLLNICK ROLLNICK

• RECOMMEND!!! Well?RECOMMEND!!! Well?•