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!