In the last track we discussed the three shields of
saying no, having passion, and believing to avoid burn-out.
In this track we will
be discussing the role of client denial and resistance to the basic protocol for
educating a battered woman and how this can affect a therapist.
know, when a woman makes the decision to return to her battering partner, it may
be one of the last decisions she ever makes. By this I mean, of course as you
know, all too many women are killed by their battering partner. The Bureau of
Justice Statistics indicates that the percent of female murder victims killed
by their intimate partners is as high as 30 percent.
In my first session
with Josie, a 21-year-old pregnant woman, I felt it was particularly important
to discuss the basics regarding her safety. You will see how this discussion of
safety can lead to therapist burn-out. Josie was in the hospital two times within
the same month after being severely beaten by her husband Paul. The first visit
was for minor bruises and sprains, but this time she had two swollen eyes and
a broken wrist. She stated in our first session, "When I was at the hospital,
I still feared for my life. I was afraid Paul had followed me there and would
come crashing into the room. When the nurse notified Security, he followed her
to the hospital and was found outside the emergency room door smoking a cigarette
with two ambulance attendants."
5 Areas of Client Resistance
As I go through the five basics I
used to educate Josie regarding her safety, note the role that Josie's denial and resistance plays in this first session. The track that follows this will provide
you with a technique not to deal with your client's resistance, but to provide
three steps that you may use when dealing with your own arrogance. The five areas
of client resistance are:
1. Resistance to Information Regarding Dangers
of the Cycle of Abuse
As you know, what was a punch in the side today
may quickly become a push down the stairs tomorrow. I stated to Josie, "It
sounds like the injuries for your second visit to the emergency room were much
worse than your first. Do you think Paul's violence is becoming more intense and
cumulative as time goes on?" Josie's reaction to this first protocol of providing
information about the cycle of abuse, indicated her denial of the escalating danger she and her unborn child were in. Josie's stated, "No, I think he just had
a really bad day the last time he beat me. It's not usually that bad. I could
never leave him, though. I just can't imagine trying to raise my baby without
him around. I would do just about anything to keep this relationship from ending."
2. Resistance to Information Regarding Housing Options
options were presented Josie was resistant to leave her home and Paul, and denied
her situation. She stated, "I just can't bring myself to tell my sisters
or parents about what's been happening. I really don't think they'd understand,
and it isn't really all that bad. And I'd be too embarrassed to go to a shelter. Those women have it so much worse than me; they'd just think I was weak for going
there. I mean, I really have no choice but to stay at home with Paul." As
mentioned, the next track will relate client resistance to therapist arrogance.
3. Resistance to Information Regarding Child Implications
denied the dangers and lethality of her situation to both her and her unborn child
and resisted the information I was providing. Josie stated, "Paul hadn't
ever hit me in the stomach before, but I'm sure he didn't mean to hurt the baby.
I'm only four months pregnant. He probably just forgot because he was so angry
4. Resistance to Information Regarding Feelings of Guilt
I asked Josie if she felt that she was to blame for the abuse
and Paul's anger. Have you found, like I have with Josie, that a battered woman
often denies her problem and danger by blaming herself? Josie stated, "It's
all so silly really, that this whole thing ever happened. I fell asleep on the
couch while I was folding laundry, and when Paul got home he exploded with anger
that he had to dig through the pile of laundry to find his sweatpants. If I had
just stayed awake long enough to fold everything and put it all away it wouldn't
have happened at all."
5. Resistance to Information Regarding the
As I explained to Josie her options about filing charges,
advocacy, Child Protective Services, community agencies, and Law Enforcement,
she seemed resistant to charge the man she loved with assault. Josie stated to
me, "At first I was certain that I would press charges against Paul. I gave
consent for photography when I was at the hospital. The fact that he was now attacking
my unborn child made things seem really bad, worse than ever. But, once I got
home he was so sweet and apologetic, I just knew that the legal stuff would only
make him mad again, so I dropped it."
Think of a battered client
you are currently treating... Have you found that your attempts to educate him
or her of their dangers are met with resistance and denial, as with Josie? As
with many battered clients, this denial can allow the battered client to become
so disillusioned that she will die for love rather than leave her battering partner.
Think of the last Josie you treated. Did you, or do you, experience feelings of
frustration or perhaps anguish following the session that might be a precursor
to burn-out for you?
In this track I have explained the five areas of education
regarding: the Dangers of the Cycle of Abuse, Housing Options, Child Implications,
Feelings of Guilt or Blame, the Legal Process, and Evaluating Relationships. I
have also given examples of the resistance and denial that takes place with many battered clients as they hear this information. Is it beneficial for you to turn
the CD off and think of a battered woman you are currently treating? Is there
one of these basics that you may have forgotten? Or, do you need to do some emotional
releasing regarding their denial, which may be striking a personal cord for you?
As mentioned earlier, the next track will discuss a technique I use concerning
a client's resistance and denial. However, this technique may surprise you, because
it is not a technique for the client, but rather a technique for the therapist.
I use the technique to avoid the Trap of Arrogance.
Peer-Reviewed Journal Article References:
Aviram, A., Westra, H. A., Constantino, M. J., & Antony, M. M. (2016). Responsive management of early resistance in cognitive–behavioral therapy for generalized anxiety disorder. Journal of Consulting and Clinical Psychology, 84(9), 783–794.
Urmanche, A. A., Oliveira, J. T., Gonçalves, M. M., Eubanks, C. F., & Muran, J. C. (2019). Ambivalence, resistance, and alliance ruptures in psychotherapy: It’s complicated. Psychoanalytic Psychology, 36(2), 139–147.
Westra, H. A., Aviram, A., Connors, L., Kertes, A., & Ahmed, M. (2012). Therapist emotional reactions and client resistance in cognitive behavioral therapy. Psychotherapy, 49(2), 163–172.
Online Continuing Education QUESTION
What are the six areas of domestic violence education, when met with
client resistance, which may be fostering burn-out for you? To select and enter
your answer go to .