The following writing comments on neurobiology and "resistance." There is this term in the social service field of "resistance" aka difficult, which I believe to be socially constructed. Aren't we all "resistant"? Haven't we all had experiences in our life that affect our being that make us stronger, weaker, skeptical, fearful, anxious, disappointed, etc. We can not judge or label human beings as resistant when they have had experiences that have shaped them. Oppression, discrimination, labeling, lying, deceit, abuse, neglect, distrust-one needs to prove themselve and work to make them believe in goodness and truth again.
I was actually just reading an article “Neurobiology for Clinical Social Work” and it is a perfect article for this question. It touches on the changes in the field i.e. from psychoanalysis to ego psychology to object relations and self psychology, and it especially focuses on the influence of the relationship. With object relations, “interactions between child and caregiver are internalized by the child as templates for relational interactions throughout life-templates that will also shape how they experience and behave in therapeutic relationships (Applegate, 2007, pg. 241). Theorists of intersubjectivity have also identified the relationship between child, caregiver, client and clinican as co-creating( Applegate, 2007, pg. 241). It mentioned how children internalize ways of handling strong emotions that place them at risk for later psychopathology. Therefore, these strong emotions are contributing towards resistance. Aggressive impulses can be formed. Affect dysregulation with kids of parents of substance abusers, adolescent parents and children and depressed parent and children. Many children in foster care are products of substance abusers or parents with a mental health diagnosis. Neurobiology plays a role, but the helping relationship really is the key to therapeutic effectiveness.
In terms of neurobiology, the movement of emotions between individuals connects them in dynamic, reciprocal relationship. Emotion connects mind and body between individuals. When an individual’s nonverbal communication match another, synchrony happens, and we may actually feel what another person is feelingInterning in foster care for a few months, I have come across many clients who have attachment disorders and come from unstable and inconsistent “holding environments.”
I have difficulty with the idea of not liking a client. I have had very difficult clients, but I understand why they are difficult, and I meet them where they are at. I thrive off of my interpersonal interactions with people and being of service to them. I have a strong spiritual base to my work and believe in treating clients equally. I have innate empathy for my clients and understand their feelings i.e. their anger and resistance. Being able to identify with a person’s experience and again really FEEL genuine empathy can aid you in working through that resistance. It takes skills and it also takes a lot of work on yourself to really be able to help your client. Interpersonal interacts are the biggest tool for learning so constantly exploring cultures, traveling, engaging with others, and reading builds you up as a person and as a clinician makes me more mindful and insightful. You keep learning about yourself and working on yourself and this affects your relationship with the client. When you have your life’s passion, you spend a lot of time working towards how you can keep it growing.
As a clinician how do I provide a holding environment in the face of resistance?
One example, client removed from mother and has been in 4 different foster homes. There are so many social workers, psychologists, teachers that he has been verbally abusive too, and with me he demonstrated some resistance. He would answer questions with a very short response, but by the end of the session I had him engaged and talking.
I provided a holding environment by validating his feelings, active listening, and acknowledgement of his experiences and his strengths as a young boy. He has constant instability in his environment by switching homes, schools, therapists, etc and I have to show if that I am consistent with him: show up on time, keep to our sessions, remind him of our sessions, let him know I am looking forward to our sessions, give mini homework to keep him involved. Foster kids have people that come in and out of their lives, and it takes work to show them that you care and want to be involved. I proved to this client that he was in a safe, trusting environment. The relationship has a tremendous influence on a client’s perceived holding environment. If you are genuine, caring a child may just open up to you and begin to trust. Trust is a huge issue for a foster child and it takes time, but with validation and identifying how you can be of service it can be built between helper and client. Warmth, genuine, acceptance, attentiveness, concern, and responsiveness is key conveyed to the client and they appreciate you for that and your relationship grows. Identify with their emotions/feelings as a REAL person. Foster kids are treated by their label and how people can perceive them (Bad, violent, angry). Identify with what you are given. A client is screaming at you, connect with their feelings of anger and deescalate the situation. Every client is resistant on some level( they had a bad social worker, they have dealt with rejection and disappointment their whole lives, they have to deal with the system day after day, they feel your going to judge them) Prove them wrong and instead of us focusing on the resistance, focus on how to connect with them rather than the resistance. Empower your client to believe “The Power and Empowering potential of the Clinical Relationship!”
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