Five Strategies for When Therapy is Stuck

Bypassing the Limits of Feelings, Judgments, and Language

Steve Andreas (/author/bio/3053/steve-andreas) • 3 Comments

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We’ve all had moments, sometimes entire cases,
when the therapy seems stuck, our wheels
spinning in the mud, unable to get any traction.
Nothing we say breaks through the client’s
dogged negativity, convinces her to take even a
small step forward, or gets her to look more
directly at her own self-destructive behavior. At
these times, the tightness in our bodies can lead
to thoughts like “Is this why I went through years
of graduate school? Maybe I should get a job as a Walmart greeter!”

When therapy goes wrong, it’s typically because we’ve entered our clients’ negativity trances
with them, joining them in their myopic misery. In this mutually reinforcing state, neither client
nor therapist can see beyond the small, cramped space of the stalled interaction. Focused
entirely on the bad feelings generated by the problem at hand, we lose our capacity to use our
skills to expand life’s horizons, oblivious to other possibilities for change—other ways of thinking
and responding.

Once caught in such a trance, we need to break the spell, broaden our vision, and open
ourselves to possibilities outside it. These goals may present a formidable challenge, but
meeting it can be easier than you think, particularly with practice. To determine whether you
are, in fact, in a trance when treatment has stalled, ask yourself the following questions, and
consider the added suggestions for mobilizing your—and, more importantly, your client’s—
capacity for more creative thinking.

The Feelings Trap

Are you focusing too much on the client’s feelings and too little on the triggers that elicit them?

Many of us have been taught to focus on exploring clients’ feelings. That’s what therapists do,
isn’t it? Of course, it’s important to know what the pertinent feelings are, validate them, and, if
clients are puzzled about them, dissect their distinctive meanings. However, rather than
continuing to circle around the bottomless drain of feelings, it’s usually useful to nd out what’s
causing the feelings and intervene there.
So the rst principle of moving stuck therapy along is to recognize that feelings aren’t an
ultimate reality, but just important signals, much like the warning lights on a car’s dashboard.
What’s important isn’t the light itself, but what causes the light to go on. If the oil light in your car
refuses to go o , there’s no point in studying the light; you need to put oil in the engine and see
whether the light goes o . Clients’ feelings are useful signals o ering you instant feedback
about the e ectiveness of therapy, but your interventions themselves need to be directed
elsewhere.

One woman I saw had been in therapy for more than a year exploring her unhappiness with
nearly every aspect of her life. When she walked into my o ce for the rst time, her tense and
pained face, her shallow breathing, and her slumped shoulders announced her misery before
she’d said a word. After sincerely acknowledging her quite obvious distress, I took a more
objective “scienti c” attitude of curiosity. How did it happen that she was dissatis ed about
everything? I asked. Was she a perfectionist with such high standards that the real world couldn’t
meet them? Or had she just been having incredibly bad luck?

A little exploration revealed that she had a terrible way of making decisions. Even a decision
about what to order for lunch in a restaurant became an ordeal. Since random choices almost
never t her real preferences or values, she was usually unhappy with them.

I rst taught her a more e ective way of making decisions that were in alignment with her
preferences. I rehearsed her in imagining picking out a meal, a dress, and a movie that would
satisfy her tastes and give her pleasure, emphasizing an internal voice asking, “What would I
like?” She was still unhappy with many of the decisions she’d made previously, but now she had
an e ective way to review them and extricate herself from them and the bad feelings associated
with them.

The Judgment Trap

Are you or your clients distracted and distressed by judgments about their problems?

As if having bad feelings weren’t bad enough, many clients criticize their bad feelings, making
them feel even worse. “You shouldn’t feel bad!” “You’re being a silly goose about this.” “Can’t you
be a man and ‘suck it up’?” Any judgment adds yet another layer of trance, distancing clients
even further from their problems and any possible solutions.

Whenever a client describes his or her feelings as “bad,” it can be useful to point out that these
feelings are e ectively good. Like pain or the trouble light on your dashboard, they signal that
something needs attention. Clients who don’t have these feelings might fail to heed the
underlying issue and su er further consequences. People born without pain receptors
continually damage their bodies because they lack vital feedback. Even just changing a
description from “bad” to “unpleasant” can redirect attention from trying to eliminate the feeling
—as addicts and many others do—to solving the problem that causes it.
Escaping the Tyranny of Language

Are your communications directed too much toward clients’ conscious, verbal understanding and too
little toward their unconscious responses?

It’s easy to get caught up in consciously describing or discussing a problem, thinking mistakenly
that this will help solve it. But if you direct your attention only or mainly toward clients’ words,
you’re usually wasting your time, because the most relevant information is being communicated
in voice tone, tempo, movements, facial expressions, posture, breathing, and other unconcious
means. One of my teachers used to say, “Verbal report should be treated as unveri ed rumor,
unless accompanied by nonverbal con rmation.”

It can be useful to approach therapy as a process similar to training an animal. You can still
employ words, but only to use your own nonverbal behavior—voice tone, tempo, facial
expressions, hand gestures, and so forth—to elicit new and di erent responses. If you want a
dog to get excited, you must get excited yourself, speeding up the tempo and amplitude of your
movements and raising the pitch of your voice. If you want the dog to calm down, you need to
speak softly and slowly. People really aren’t that di erent. If you aren’t getting a useful response
from a client, you can either wait for it to occur naturally—which could take a long time!—or you
can vary your behavior until you succeed in eliciting it.

The Power of Presupposing and Implying

Are you o ering explicit messages that would be more e ective if you presupposed or implied them?

A skill too often ignored by therapists is the ability to use language in ways that unconsciously
elicit nonverbal responses and create sudden shifts in feeling and attitude. For instance, read
the following two sentences, and notice the di erence in your response:

“You may nd it easier to imagine this with your eyes closed.”

“You may nd it harder to imagine this with your eyes open.”

Logically, those sentences are completely equivalent; however, the rst one presupposes that
the task will be easy and the second one presupposes that it’ll be hard. Most people don’t
consciously notice the di erence, but they’ll tend to respond to the rst instruction with ease
and the second with di culty.

Therapy is widely described as “the talking cure,” yet clinicians are seldom taught even the
rudiments of linguistics, the study of language itself, so they don’t learn how to detect and use
presuppositions and implications in a directed way to elicit speci c behavioral responses.

Is It Time for a Joke Break?

Have you and your client fallen into the grim trap of terminal seriousness?

Unhappy people, singlemindedly engrossed in their own misery, often regard themselves and
their predicament with deadly seriousness. Jokes and humor have the power to surprise and
unbalance people, popping them out of their negative mindset without threatening their
comfort level. Humor is an unparalleled trance-breaker because, by its nature, it changes the
perspective and alters attention.

A joke is one of the best, most enjoyable, ways to change a client’s (and your own) state to one
that’s more playful and experimental. You can use almost any excuse to introduce one: “I heard
a joke this morning, and it’s on my mind. If I don’t tell it to you, it’ll interfere with focusing on my
work with you.”

Putting It Together

When you remember that the experiences that cause feelings are important—rather than the
feelings themselves—that judgments are useless distractions, and that the mostly unconscious,
nonverbal exchanges, presuppositions, and implications embedded in your communication are
powerful means of promoting change, therapy can become a much more liberating experience
for you and your clients. But even more important than that is the understanding that your
clients, no less than you yourself, are hypnotists who weave a spell in the therapeutic hour. The
di erence between you is that the success of therapy typically hangs on your ability to
demonstrate more skill and awareness in using the trancelike qualities of human
communication to move beyond the tunnel vision that can stall therapy and prevent change and
healing from taking place.

***

Steve Andreas, MA, has been learning, teaching, and developing briefest therapy methods for over
55 years. He’s the author of Virginia Satir: The Patterns of Her Magic; Transforming Negative Self-
Talk; and Transforming Your Self: Becoming Who You Want to Be, as well as numerous articles
and videotaped client sessions.

This blog is excerpted from "Breaking the Spell,"

(https://www.psychotherapynetworker.org/magazine/article/180/breaking-the-spell) by Steve
Andreas. The full version is available in the May/June 2013 issue, Tough Customers: Is It Them or
Us? (https://www.psychotherapynetworker.org/magazine/toc/16/tough-customers)

Photo © TRAVELPIXPRO/Getty Images

Topic: Creativity (/magazine/topic/1957/creativity) | Professional Development

(/magazine/topic/20/professional-development)
 Tags: body language (/blog/archives?keyword=body%20language) | clinical creativity
(/blog/archives?keyword=clinical%20creativity) | clinical hypnosis (/blog/archives?
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keyword=communication%20techniques) | creative counseling techniques (/blog/archives?
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| feelings (/blog/archives?keyword=feelings) | humor (/blog/archives?keyword=humor) | humor
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Steve Andreas (/blog/archives?keyword=Steve%20Andreas) | therapy techniques
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Comments - (existing users please login rst)
3 Comments

Saturday, January 21, 2017 3:54:20 PM | posted by Liza J Alvarado

Good things to think about. Thank you

Sunday, January 22, 2017 9:24:21 PM | posted by AdamItinerant

Thank you. I found the dashboard light analogies useful in the explanations.

Monday, February 25, 2019 8:30:50 AM | posted by Mary

Very useful and right on, thanks! I'd also like to add remembering that the client's goals and mine
may not be the same. This can make it appear that things are stuck when in actuality that may
not be the case.