Skip to main content

Verified by Psychology Today

Depression

Are You Resistant to Therapy, or Just Seeing the Wrong Therapist?

Here are some ways to find an answer.

The first time I went to therapy, it was a disaster.

I was 23 years old, and I had just gotten out of a mediocre relationship with a miserable ending. I moved to New York to start grad school, suffered an extremely debilitating injury, and lost my grandfather—all in the span of a few months.

I started crying even before I introduced myself. I told her about my broken heart. I told her about my relationship with my parents. I was a first-year grad student at the time, and so I even managed to find poignant and meaningful connections between my broken heart and my relationship with my parents.

She looked sad. Really sad. Sad for me, and for what I had been through, and for how I was feeling.

That look, that sadness, really didn't make me feel good. And I really didn’t want to go back.

But, I didn’t want to appear to be resistant. Resistance was a word that slithered off the tongues of all of my professors that first year. There was definitely a He-Who-Shall-Not-Be-Named thing going on when someone spoke of a resistant patient. A resistant patient isn’t ready to help themselves. A resistant patient isn’t ready to “do the work of therapy.” A resistant patient disagrees with the therapist’s suggestions and interpretations.

And so, of course, I returned to therapy the following week. I spoke about how it was kind of lonely starting all over again in a new town.

She nodded at me. Sadly.

Every word of empathy, every sigh of sympathy—it all added more weight onto the invisible pile of crap and grief that I had been dragging around with me for months.

Psychologist Aaron Beck believed that those who suffer from depression are stuck in a so-called cognitive triad of automatic, uncontrollable, negative thoughts:

  1. I feel hopeless.
  2. I feel helpless.
  3. Things are never going to get better.

Yeah, Beck came up with a pretty accurate description of depression. And you know what really, truly, absolutely isn’t helpful to me when something bad happens?

That look. The one where her pupils enlarge ever so slightly in surprise and slight disbelief. That look where the corners of her mouth curve downward in sadness, and an expression of some sort of unconscious disapproval. That tilt of her head that somehow makes me feel like she is grateful that my problems are not hers in a there-but-for-the-grace-of-God-go-I kind of way.

The therapist didn’t do anything wrong. She did what many sweet, kind, well-meaning people do. But for me, this has always felt like pity. It’s as if this type of reaction just further reinforces my cognitive triad, my feelings of hopelessness, helplessness, and the belief—fear—that things will never get better.

I never went back for a third appointment, but I also never explained why. I have often thought about how I would handle the situation if it happened today, and wondered whether my reaction was, in fact, resistance, or whether the reality was that this therapist and I were simply not a good fit.

What would I do differently now? And what should you do if you are questioning whether your therapist is the right person for you?

  1. Say something. “I have noticed that when I talk about the things in my life, you look very sad. Sometimes I feel like you feel sorry for me, and that doesn’t make me feel very good.”
  2. Listen to what the therapist says next. Their reaction should be open, non-defensive, and honest. Your therapist should be open to exploring your experience, and perhaps sharing some of theirs. I would be less than thrilled with a therapist who immediately jumped in with the word “resistance,” or denied my experience of our interaction. Also, and I know this is a terrible faux pas in our field, I would have tremendous respect for the therapist who admitted that her reaction was based on something from her personal life. Perhaps she has recently lost a family member. This “disclosure” would allow me some context to determine whether her reactions were coming from me or from her.
  3. Remember why you came to therapy to begin with. And pay special attention to the "why now?" question. Often, the distinction between resistance and a bad fit with the therapist can be found here. If you have always struggled with social anxiety, and a recent break up left you feeling rejected and depressed, you might be extra sensitive to how you perceive your therapist's reactions. In this case, you might have some resistance, or hesitation, to opening yourself up to the therapist, who is a virtual stranger. Your therapist won’t always be a stranger, though, and it is certainly worth attempting this relationship.
Photo by Nik Shuliahin on Unsplash
Are you hiding from your truth by blaming your therapist?
Source: Photo by Nik Shuliahin on Unsplash

I readily admit that therapy requires the right match between a therapist and a patient, and that match is often difficult to explain. Because of this, at the end of every first meeting with a new patient of mine, I always give them the option of scheduling a second appointment.

Therapy is such a personal experience, even from that first meeting, and most of us are not good at telling people that we don’t want to see them again. Isn’t that the whole reason “ghosting” is so common?

I let the patient know even before we meet therapy is about finding the correct match, and that if I am not the right person, I will do my best to recommend someone who might be. And it makes sense for both the patient and myself to be honest in our assessment. There have, in fact, been times that I have told patients that I did not feel that I was the right fit for them—as painfully, painfully awkward as this conversation was to have.

These days, I only air my dirty laundry to people who will laugh with me—or even at me—when I am crying. These people, or My People, as I like to think of them, can be across the street or across the country. These are the ones I can call crying at any time of the day or night, and they will find a way for me to end the call laughing.

My People are smart and witty and sarcastic and not always fit for public consumption. Which is part of what makes them mine, part of what makes them perfect for me. And this type of person is exactly what I look for in choosing a therapist for myself.

To find a professional near you, visit the Psychology Today Therapy Directory.

LinkedIn Image Credit: shurkin_son/Shutterstock

advertisement
More from Lindsay Weisner Psy.D.
More from Psychology Today