RSD can look like ‘resentment’ towards the therapist

If a prospective client is draining your energy with a million questions before they can commit to a single session, an unconscious pattern of resentment towards authority or power figures could be in play. Resentment towards the practitioner is very informative and tells a lot about the person's experience with power figures in early childhood.

This becomes even more apparent during the client journey, when a client reaches an impasse in their therapy. Often, there is an undercurrent of refusal that they may not even be aware of, which results in ‘two steps forward, ten steps back’ that breeds resentment towards the practitioner. What could likely be happening behind the scenes for these clients is an unconscious resistance against receiving support because they were shamed for asking for it previously. When past experiences around receiving help didn’t provide the autonomy or agency they needed, they develop a masochistic reflex – that is, a survival strategy (preserving the autonomy of the Self) – and reject the help they want so they avoid being rejected for being ‘needy’ or ‘defective’. This kind of pattern can lead to the trauma response of hyper-independence, or reveal a neurological sensitivity to rejection: Rejection Sensitivity Dysphoria (RSD).

Dealing with the various layers of refusal from clients is frustrating and draining for the practitioner. Not only is the practitioner expected to hold space for a needy but resentful client, they then have to process their own thoughts and emotions around the difficulty in holding space for them. Experienced practitioners are able to draw on various self-enquiry techniques to examine what the person’s behaviour is bringing up in themselves.

The practitioner might reflect, ‘When this person keeps asking for my help, but rejects everything I suggest, am I trying to prove myself in some way?’

‘Am I trying to save them?’

‘Do I feel I have to keep helping them simply because they keep asking?’

‘Do I need to refer this client to another practitioner/suggest a different modality?’

Perhaps, even, ‘Am I worried about my reputation if they are dissatisfied by the way I have handled them?’

While this method of self-enquiry is useful, there is another way.

Practitioners can ascertain quickly and easily what's going on by paying close attention to their body sensations. If you can, suspend your automatic response to reflect, and instead, notice what sensations are arising within you. A desire to push them away? An impulse to run? To cry? A familiar feeling? Does your body move in any direction, no matter how subtle? And if so, does it seem to be moving TOWARDS or AWAY from your client?

What usually accompanies the client’s pattern of refusal is deep mistrust and resistance to being helped to protect them from losing their autonomy. It's an old pattern of protecting their autonomous self, probably developed around 2 years of age, when the child's developing boundary was not respected or allowed by their early caregivers.

Mistrust leads to pushing away connection

They’re not creating drama, rather, their trauma keeps bubbling up to the surface, and they are mostly likely feeling resentful due to an inability to break the cycle despite reaching for help dozens of times. Their resentment festers because surrendering to being helped feels really unhelpful; and sometimes, it elicits such a sense of vulnerability that allowing in help feels like surrendering to death. Working through the different layers of this pattern and being present to what arises is essentially the entire body of work you will do with this type of client.

I know this push-pull dynamic of asking and refusing help can seem confusing, perhaps counter-intuitive, so I’ll explain some more. In the past, accepting help from anyone perceived as more powerful than them inevitably led to their power being taken away. This happened repeatedly as a child when they were learning to express their boundaries, and at a critical ego developmental stage (between 18 months to 3 years). Everyone's ego needs to feel some power, and at this critical developmental stage, power is delicate, tenuous, and not yet internalised. So, to manage the impossible situation where each time they asked for help they lost precious power, they resolved to resist help by 'killing off' their life force energy. It seems a little warped, but they chose the lesser of two evils – annihilating their life force before someone had a chance to annihilate their ego by taking their power away. They decided it was better to ‘die’ than give someone else the satisfaction (power) of ‘killing’ them. The result was that they 'killed' themselves by closing down their aliveness and shutting themselves off to help and support.

If you interact with someone like this in your practice and feel a response deep within your own being to wake them from their daze, to issue some tough love, or shake them in frustration, you might be re-enacting your client’s childhood dynamic. Clients are adept at recruiting practitioners to re-enact their patterns so they can find a way through and out of their pattern.

The key to managing clients who are caught up in their own cycle of refusal is to separate your own thoughts and emotions from their projections onto you. The time you spend supporting the client is not the time to dig into your own responses – the client’s unconscious material needs to be held until they have more capacity – as much as they may resist receiving that guidance and support from you. From a client perspective, the practitioner holds the power in the client-practitioner dynamic because they have the knowledge and the means to help the client. This translates (for the client) to authority over them and activates their unconscious response to refuse that help.

An aware practitioner who has done their own work on this dynamic can hold their client in compassion while together they gently explore the client’s resistance and mistrust towards more powerful others. Outside of session, the practitioner also takes the time to process their own responses to ensure that they are not taking on the client’s introjections or bringing their own responses into the session, but rather supporting the client to see their own power reflected in the practitioner.

Read more about working with clients here.

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