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eJOURNAL OF THE INTERNATIONAL CHILD AND YOUTH CARE NETWORK (CYC-Net) – ISSN 1605-7406

ISSUE 33 OCTOBER 2001 •  CONTENTS •  HOME PAGE

practice

One child care worker’s approach to resistance in adolescents

Brian Stock

NOTE: One of the most pervasive myths about good child and youth care is the idea that the competent practitioner is able to "break through" the resistance of the client. From this perspective, resistance is seen to be something that gets in the way of progress and, from here, many of our most coercive, intrusive and manipulative techniques become justified. In our experience, it takes a certain courage for a practitioner to challenge this belief since such a challenge is often taken as an act of resistance by those who supervise and monitor front line practice. Once the issue of authority is understood, however, the basic wisdom of such a challenge becomes painfully obvious.

In this short article, Brian Stock demonstrates the courage and the insight to articulate and defend such a challenge. He offers the more enlightened view that resistance is something to be understood and embraced as an integral part of the adolescent experience. Our inability to take this position is often embedded in our own unresolved control issues and contextualized in social structures that reward subservience to objects of authority. Caught up in our own needs for competence and control, we are unable to understand or enter the confusing world of adolescence and, ironically, we find ourselves colluding the familiar struggle for power. The more threatened we become, the more we attempt to exert control and, of course, the more we invite challenge and resistance.

Brian documents his case well, using clear citations from the literature as well as examples drawn from personal experience. In our day-to-day encounters with children and adolescents we all become "objects" through which our clients can address their own issues. By understanding this process, we can become stronger in who we are while allowing the young person to enter into his or her own experience of Self. Thanks for the reminder, Brian.

— Introduction by the Editor of the Journal of Child and Youth Care, Vol.3 No.4, in which this article first appeared.

Resistance and change
The need for authority or control seems to be pervasive in child care work with teenagers in placement. It is seen all the way down the hierarchy, from the government down to the child (Simon, 1971, P. 5). Society wants authority over its institutions; the institution needs control of its workers; the workers need control of the clients or client groups, and all need control in terms of their own goals and destinies.

Each system and/or sub-system within society also feels the lack of authority over its own destiny. This is so because "in order to exercise certain privileges, liberties, or freedoms, one must give up something and accept rationally defined limits imposed by the society" (Yelaja, 1971, p. 39). The institution has monetary limits imposed; the worker lacks input in treatment goals; the adolescent feels that he has his freedom limited (Irvine, 1964, p. 15).

Whenever any system or any part of a system stands up for its needs, two things generally occur: confrontation and resistance. This is because standing up for oneself involves examining of "the boundaries of freedom and the limits of authority" (Yelaja, 1971, p. 35). I define confrontation as any intervention that challenges the status quo, and resistance as "all behaviors, feelings, patterns or styles that operate to prevent change" (Anderson & Stewart, 1983, p. 206).

For therapy to occur, there must be confrontation, "a phase of aggression and destruction" (Perls, Hefferline, & Goodman, 1977, p.273), in which old thoughts, patterns and feelings are destroyed and transformed into new thoughts, feelings, patterns, and actions. Simply put, this is the stage between what we are and what we are to become (Latner, l974,p. 186). This process is one of thesis, antithesis, and synthesis.

In any therapeutic milieu, therefore, confrontation is inevitable for it involves a redefinition of authority, either externally, i.e., from system to system, or internally, i.e., within the sub-system.

Given that confrontation is unavoidable, the question becomes: must it always be accompanied by resistance with conflict? The answer is yes and no.

Resistance to change in general and resistance to being influenced in particular always occurs when individuals, groups, and systems are required by circumstances to alter their behaviors" (Stewart & Anderson, 1983, p.1). We have all experienced resistance of the sort where conflict is inevitable. Trying to get the phone company to correct an error in billing can be a most frustrating task, for example. The point is that conflict is not always necessary.

Resistance occurs because people have to live with each other, and this means limiting liberty, denying opportunities, and inevitable restraint (Yelaja, 1971, p. 37; Irvine, 1964, p. 14). Resistances are also based on each particular individual’s viewpoint and are, at first, important aspects that we create to meet felt needs (Latner, 1974, p.l86). We each have our own interpretation of the facts and events that we have shaped, are shaping, or will shape to create our own unique world (Bateson, 1980, p. 70). This is particularly important to consider when referring to therapy and authority.

In fact, "the therapists’ theoretical orientation is the greatest determinant of what behaviors will be seen as resistance" (Anderson & Stewart, 1983, p. 206). This means that the resistance may not be coming from the client but rather from the worker. This is because just as Procrustes cut of f the legs of people who did not fit his bed, the worker may be cutting off some part of the client to fit his own theoretical bed. This is an excellent example of the use of irrational authority. If this is the case then, perhaps one should look at resistance "as a lack of understanding or clarity on the part of the therapist" (Enright, 1980, p. 1).

For a child care worker, this point of view can be difficult to accept. Issues of confrontation, authority, and resistance seem to go together when we are working with difficult adolescents, and are all part of our everyday working experience. After all, we work with a population that generally lacks self-control and needs firm emotional and social structures to guide them. On one level, their resistance seems to make sense. They are not where they want to be and they rarely come to us voluntarily for treatment, and often they have been systematically mortified (Goffman, 1961, p. 14).

Yet the issue of authority and control can be where the aims of the teenager and the worker both meet and diverge. Both sense a need for, and often demand authority. The client demands control in terms of his own personal expectations and development, and he/she generally needs control from the outside structure (Irvine, 1964, p. 15). The worker also demands the latter, but added to this is his! her need to respond to the authority of the system within which he/she works, and its expectations of authority. Authority is defined not only in terms of the client’s individual needs and differences, but also in terms of its own need with reference to yet another higher authority and its stated goals. Both the worker and the client need to respond to a structure and to obey the rules of the system, which presents its own resistance.

While confrontation remains a necessary and obvious tool, we may overuse it in order to help the client contain impulsive aggressiveness and the need for immediate gratification, not to mention the fact that it often can provide an easy and immediate solution to an authority problem. I would describe this overuse of confrontation as irrational authority; what Fromm (1971, p. 13) describes as always being "power over people."

This overuse of confrontation may be because of a misunderstanding of the client and the nature of his resistance: "Every movement the client makes is to establish an equilibrium between his personal needs and the demands of his society" (Perls, 1969, p. 46). It is at this point that the needs of the client and the worker diverge. It is here that conflict can arise simply because the needs of the worker, in his situation, may not match the needs of the adolescent as he or she perceives them.

Moving beyond conflict
The conflict need not arise, however, if the worker sees that "resistance is not just a dumb barrier to be removed but a creative force for managing a difficult world" (Polster & Polster, 1974, p. 52). In other words one has to begin with the understanding that the client is doing what he has learned to do, in order to survive the best way he knows how, in a very difficult world. It is, unfortunately this important understanding that is often missed. Conflict may also be avoided if the worker uses "rational authority (which has its source in competence" (Fromm, 1971, p. 13).

Resistance can be respected and seen in a positive light rather than merely as a reluctance to change on the teenager’s part. It is not merely a reaction to authority. In fact, as a creative and adaptive act, it implies an ability to learn and change. It maybe, Erikson (1965, p.19) suggests, "an energy of repudiation which accompanies the first steps of an identity formation" and need not be taken as a personal affront to the worker. It may be a necessary part of an adolescent’s developmental struggle and need not be taken as power struggle in the child’s relationship with the worker. Indeed, Simon (1971, p. 6) believes that good behavior that is enforced by the threat of sanction should be considered defective because it lacks voluntariness.

There does come a time, however, when the resistance does get in the way of the healthy development of the client, and, therefore, loses its value. This happens when it becomes anachronistic; when its appearance is no longer a response directly related to the present but is a continuation of the past. It is here that the therapeutic intervention must occur. The worker is most likely to be helpful if he regards the conflict as part of an ongoing, unfinished situation of the client which the client is meeting with his own self-regulation (Perls et al., 1977, p. 323).

In this case, it means accepting the resistance as part of the client’s view of his place in the world and further, accepting this as an image of man as he thinks he ought to be (Sartre, 1957, p. 17). By accepting the resistance one also accepts the client on his own terms. This also demonstrates a respect for the client’s wants and needs by creating an empathetic atmosphere conducive to therapy, and can help build the trust needed in order for further confrontation and change to occur.

By accepting the resistance, I mean, working with the resistance, understanding as much about it as possible and involving the client in its dissolution so that it becomes a stepping stone to a new learning rather than a wall to be broken. Fagan (1971, p. 94) offers a good example of what I mean. He is working with a client who readily goes along with him until a certain point, and then the client resists by demonstrating that the therapist can do nothing to change or help him. According to Fagan, the therapist has lost control of the therapy. He/she can challenge this resistance directly, or can accept it. Admitting to the client that he! she has lost control and admitting failure is one way for the worker to bring the therapy back on track. (See also Latner, 1974, p. 184; Erickson, 1980, pp. 233—234.) In other words, the worker, by accepting and working with the resistance, advances the therapeutic process.

Perhaps one also needs to remember that resistance can be more a statement about what the worker is doing than a statement about the client (Bandler & Grinder, 1979, p. 58; Latner, 1974, p. 187). Often working with delinquent clients can raise a worker’s hidden fears of aggression, as well as a negative response to the client’s unfamiliar language and mores (Goldsmith, 1959, p. 15). This is not to suggest that child care workers should not be judgemental. They cannot help but be, for they are working from their own ethical system which can be displayed to the client in many different ways (Pilsecker, 1978, p. 54). The worker also has his! her own needs in terms of the client and in terms of the institutions with which he is involved. The point is that the workers should be aware of what they are choosing to do or, indeed, choosing not to do, in the light of the client’s needs rather than referring to their own needs. In other words, the aim here is to present ideas that will enhance the cooperative efforts of the client (Erickson, 1985, p.15). It has been suggested that this cannot be done without involving the client directly. The worker needs to understand that unless the client is inducted into the whole process he will resist healing (Anderson & Stewart, 1983, p. 4). This involvement in the process is, in itself, part of the healing process and is also away of reducing the teenager’s resistance to change because he/she has a say in what is going on. The child care worker must not forget that the teenager in placement comes to us in a state of what might be called a double bind of losing actions. The way he/she is behaving is dysfunctional in terms of his/her social growth, yet knows no other way of behaving that is "safe." He/she has had many different kinds of limits imposed from the outside until he/she was eventually ordered into placement. Generally he/she has been a recipient of authority, rules and orders, rather than a participant in the process. Allowing him/her into the process involves a change and may give room for "safe" experimentation with new behaviors. Further, by doing this, the child care worker is offering a model of openness, respect, and honesty, and it is possible that the client will learn to respond in kind (Buber, 1970, p. 67).

The case of child care
After all this is said, what we have is a fundamental philosophical and theoretical base. The question remains of how this will work in child care work practice. The following is a description of a brief interaction with a 16 year-old boy who has been in a highly structured group home setting for about one year. He had previously spent approximately two years in a psychiatric setting because of his tendency towards violent behavior. It had been reported that he was not doing well in the institution’s special school and so I made arrangements to "drop in on him during school hours.

He had just skipped art class and so that is what we discussed. He thought art was just drawing and was something only "fairies" did. I began by supporting his thesis that art was boring and feminine and I wondered out loud what the definition of art could be. He moved to lay on the carpeted floor and I joined him. Each time he would give me a definition I would agree with it and help him explore it further. We looked around the room and examined the many things that resulted from drawing; the patterns on the tiles, the designs on his clothes, etc. He decided that art was more than just patterns. (Thus, unconsciously, he was moving from the idea that art was merely drawing.) He began to give me various definitions for which I was able to provide examples, while supporting each change in definition. Each time I provided an object he realized that his definition was incomplete. As I lay on the floor perpendicular to him, I noticed that he was arranging the objects I had given him into a pattern. I began to feed him more things around the room (a pen, guitar pick, ping-pong ball, piece of kleenex, etc.). At one point he had a sense of completion and refused to add to his "thing on the floor." I liked his construction and told him so, again supporting and accepting his ideas. He told me that I was looking at it from the wrong side. I said that it was the only side I had seen and it looked alright to me, but I was willing to take another point of view because it is often helpful to do so. We exchanged places and he began to enjoy another point of view. I then suggested that we were missing his teacher’s point of view. He talked with her in my presence, and got her enthusiastic support for his project. We then went back to my office where, much to my surprise and delight, he began to draw his "thing on the floor" so that he could continue it the next day in the classroom.

I had done what the school had not. Rather than using irrational authority which created a conflict, I accepted his resistance. It then became available to be worked with and understood and I could confront his ideas without conflict or resistance.
In fact, Latner (1974, p. 188) suggests that there is no such thing as resistance, while Freud (1979, p. 327) states that resistance is violent and tenacious, lasting through the whole of treatment. I think that both of these are extremes and that the reality is somewhere in between: "Most often people are partially resistant and partially committed to change and the therapist needs to choose how to view them" (Madanes, 1984, p. 147).

I have tried to demonstrate in this paper that while authority is necessary in the work that we do, perhaps resistance with conflict is not. This was based on the thesis that resistance can be seen ma positive light rather than as a direct challenge to authority and further, that the acceptance of the resistance will involve the client in the process of its dissolution. It was also suggested that resistance may be more a comment on the therapist than a comment on the client.

It seems to me, at this point, that perhaps this method of working may not be applicable to all involuntary clients. I think, though, that it can be a valuable addition to any child care worker’s repertoire. It may certainly deserve further study and consideration.

References

Anderson, C.M., & Stewart, S. (1983). Mastering resistance. New York: Guilford Press.

Bandler, R., & Grinder, J. (1979). Frogs into princes: Neuro-linguistic programming. Moab, UT: Real People Press.

Bateson, C. (1980). Mind and nature: A necessary unity. Toronto, ON: Bantam Books.

Buber, M. (1970). l and thou. New York: Scribner’s.

Enright, J. (1980). The structure of human experience. California: Pro Telos.

Erickson, M.H. (1980). Utilizing the patient’s own personality and ideas: "Doing it his way." In E.L. Rossi (Ed.), Innovative hypnotherapy (p. 233). New York: Irvington.

Erickson, M.H. (1985). Presenting ideas. In E.L. Rossi & M.O. Ryan (Eds.), Life reframing in hypnosis (p. 15). New York: Irvington.

Erikson, E.H. (1965). Youth: Fidelity and diversity. In E.H. Erikson (Ed.), The challenge of youth (pp. 1—28). New York: Anchor Books.

Fagan, J. (1971). The tasks of the therapist. In J. Fagan & I.L. Shepherd (Eds.), Gestalt therapy now (pp. 88-106). New York: Harper & Row.

Freud, S. (1979). Resistance and repression. In J. Strachery & A. Richards (Eds.), Introductory lectures on psychoanalysis: Sigmund Freud (pp. 327—343). New York: Penguin Books.

Fromm, F. (1971). The ethics of authority. In S.A. Yelaja (Ed.), Authority and social work: Concept and use (pp. 11—16). Toronto, ON: University of Toronto Press.

Goffman, F. (1961). Asylums. New York: Anchor Books.

Goldsmith, A.O. (1959). Challenges of delinquency to casework treatment. Social Work Journal, 4(2), 14—19.

Latner, J. (1974). The Gestalt therapy book. New York: Bantam Books.

Madanes, C. (1984). Behind the one-way mirror. San Francisco, CA: Jossey-Bass.

Perls, F. (1969). Ego, hunger and aggression. New York: Vintage Books.

Pens, F., Hefferline, R.F., & Goodman, P. (1977). Gestalt therapy. New York: Bantam Books.

Pilsecker, C. (1978). Values: a problem for everyone. Social Work, 23(1), 54-57.

Polster, F., & Polster, M. (1974). Gestalt therapy integrated. Toronto, ON: Random House.

Sartre, J.P. (1957). Existentialism and human emotions. New York: Wisdom Library.

 Simon, Y.R. (1971). The bad name of authority. In S.A. Yelaja (Ed.), Authority and social work: Concept and use (pp. 5—11). Toronto, ON: University of Toronto Press.

Yelaja, S.A. (1971). Freedom and authority. In S.A. Yelaja (Ed.) ,Authority and social work: Concept and use (pp. 35-42). Toronto, ON: University of Toronto Press.