Feeling stuck in therapy can be frustrating for both the client and the therapist. Stuckness appears when the therapy process is unable to move forward and surrounding feelings are difficult to access. Both clients and therapists can feel stuck. When a therapist is stuck it can feel as though you are not meeting the client’s goals and feel disconnected in the therapeutic relationship. Therapist may feel impatient or worried that the client will abruptly terminate. This is a result of the client hitting their perceived capacity at that moment causing them to shut down as a defense mechanism to indicate they have hit their maximum. Clients may say, “I don’t know” a lot, feel resistant in the room and/or may struggle with being present with the therapist.
A client may have had a breakthrough in treatment, which may lead them to an overwhelming state that causes them to be at a standstill in therapy. Clients may hold onto the fear of moving forward as a result of going deeper into their past and experiencing feelings without the tools they used to used to numb feelings, such as eating disorder behaviors. Another indicator of stuckness can be portrayed by the client’s need to put on a front that they are “fine” and better than they actually are at the moment. If the therapist is unable to perceive this underlying message, the client can easily fall back into old patterns, which can result in leaving treatment and/or relapsing.
How can clinicians work with clients when they are stuck? Use the stuckness and the therapeutic relationship that you have built with the client together and be transparent. Is it just the therapist who feels stuck? Does the client feel what the therapist is feeling? How do both the therapist and the client perceive the energy that is in the room? Self-disclosure can be helpful in this instance as the client may not be able to identify what the energy is that is causing the disconnection in the relationship. By allowing the client to know what the therapist feels is going on they have the opportunity to process and explore what is causing the client and therapist to be stuck.
As an example of this, one of my clients has been stuck in the therapy process for a couple of weeks. She struggles with constant negative thoughts about her body image and her worth as a person with no hope that it will improve. After a couple of sessions not feeling confident in my ability to help this client, I directed our attention to the stuckness. Asking questions about where she felt she was in this process and if she felt the same energy I did. The client discussed how she had felt stuck for a couple of months, but avoided talking about it because it meant she was a “bad” client or that I would be frustrated with her. Exploring the stuckness with the client and sitting in it allowed us both to identify what was underneath it all: the fear that she will always be depressed and will never be comfortable in her own skin. This turned into one our better sessions and helped her to focus on what she needed to do differently. As for clinicians, a lot can come from of a session like this by just identifying that the stuckness is present. It allows for a new look and can be the cornerstone for change!