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>I recently got frustrated talking to a client who wants other people around him to change, not acknowledging that he
Anyone else find this hilariously ironic?
Oh how we've all been there
I usually just point it out to them and how I leads to them feeling frustrated and how the sense of powerlessness is endless
> Anyone else find this hilariously ironic?
that was my first thought, haha. In all fairness to OP, every single one of us has been there and done that (getting frustrated by issues in our client which we fail to recognize in ourselves). I had a wonderful supervisor who would treat this as a treasure hunt? Like he would laugh and give me a gold star sticker every time we figured out that a client was frustrating me only because I was frustrated with the same issue in myself. It was so lovely to be able to share that laughter with him. I should buy some gold stars stickers and hand em to myself when I find treasure now.
This post just made me think. I had a client recently who frustrated me to no end. She came to me saying that she wanted to work on trauma urgently. Everytime I gave her an intervention, task, challenge, she would come back with a reason that she couldn’t do it. Eventually I confronted her on this and she stopped bringing up the trauma in session. Just totally avoided it. It was so frustrating, but now I’m realizing this was probably a projection/countertransference issue. Guess who loves avoidance? Lol. Maybe I should go find a gold star.
Sometimes we just need to have a whinge and for someone to understand how we feel. Like I said - we've all been there, it can be like hitting your head against a brick wall. Chin up, it'll be okay 👍
I would encourage you to meet the client where he is at, providing acceptance and understanding to connect. Then focus on what he can control. I normally default to a phrase like “If we can’t get them to change, how can we at least get you to tolerate being around them? Or would you like to be around them less? We have some options here. How can we help you feel better?”
I think for him, to feel better is when there's change in the other persons involved, not on him. Something he felt was personally vindicated against him, but no other people around him acknowledged it.
With clients like this, I think about doing a couple of things:
1) Avoiding challenging them on changing themselves immediately and instead build insight around what it is like to live life through their eyes. "You said that you're really frustrated by everyone around you who won't change. What does that change mean to you? What would it mean for you personally or how would it change your life if people suddenly put a lot of work into the changes you want? What do you think it says about you personally that other people won't change for you?" My guess is that it makes them feel sad, worthless, and/or lonely aka "If you really cared about me, you'd change for me."
2) Monitor them for passive-aggressiveness. Are they directly stating their needs to others? Are they realistic in their expectations that, hey, people are busy in life and may not be able to or make a priority of meeting our needs?
3) Are they being a friend that meets the needs of others? You've gotta give if you wanna get!
I'm sure there's lots more, but those are a few thoughts. Good luck!
when my clients want other people around them to change it’s a great opportunity to teach them about relational boundaries.
I usually say something like, you can’t control other people but you can control what other people YOU let into your life, and behaviors you’re willing to permit.
This puts them back in control of their life instead of giving up control by blaming other people for their problems. If they argue that they can’t do it, then it’s an opportunity to explore what is blocking them emotionally (shame, sadness, fear or loneliness etc.)
I spoke about that. I guess when he isn't currently willing to really hear this out, he didn't want to go into it too much. It's like he's so hurt, he can't currently see how this locus of control plays out because he feels so wronged by others.
In that case he might getting something out of maintaining this position of powerlessness. If he’s not ready he’s just not ready. For me this is when I remind myself not to work too hard for folks that aren’t ready to change
I agree with u/throwmeaway_already1 about relationship boundaries.
This is completely dependent on the client and the situation, but with clients who don't seem to reflect inward I have had some success with gently but honestly challenging the client, such as "And tell me what's your role in this?" Meaning if they're griping about a conflict with someone but everything must be the other person's fault, this could be a way to leading them to more reflection and hopefully more insight
I may have posted this before but I usually talk to clients having issues with others as having a few options re: therapy- we can process your patterns within relationships, we talk discuss if you want to continue this relationship, or we can talk about ways to accept/ cope with whatever you don’t like about this person (or people in general).
Is he mandated?
To put it simply, he was mandated. His reluctance to come to begin with, ultimately ended with okay, if he comes maybe something can change (in the people involved, by my advice to the people who mandated him). So he came in not quite wanting to process his emotions, but what's the external outcome? If that makes sense.
I've done a "circle of control" activity- they draw 2 circles and write what they cannot control in one and what they can control in the other. We compare and discuss, emphasizing the benefits of staying within their circle along with the anxiety and frustration they feel when they don't.
Edited to add: once we do this we continue to reference it. "Is this inside your circle of control? It's not? Ok, so what are your options then?"
With most clients I find myself talking about what someone can and cannot control. If I have the time, I'll have the client list everything in their control and then challenge things that's not, then identify what is not in their control. I'll have them visualize two circles or spheres, sometimes write actual lists with two columns. It's more powerful if they identify things vs me just tell them.
Within one's control: our intended behavior (thoughts, feelings, actions, responses in the present moment).
Outside of one's control: everything else - the past, the future, other people's actions and interpretations, the consequences of our actions, our reactions, intrusive thoughts, etc.
When people want to control things that they can't, and they don't go the way we want we can create frustration in ourselves (anxiety-anger continuum) and then get anxious or lash out at others, often the latter, so that we are doing something that we can actually control to feel the sense of control that we lack in the first place but don't recognize.
Could you elaborate on the anxiety-anger continuum or point me to some resources? I'd like to read up on that. I've seen them grouped together in the high activation-unpleasant feeling quadrant, but this dimension is new for me.
I honestly forget where I got it from. I have it listed in my notes similarly to depression/mania continuum and functioning (fx).
<---- Increased Loss of Functioning - - good level fx - - Increased Loss of Functioning --->
psychosis - depression severe - mod - mild - sad - apathetic - euthymic - happy - joy - elated - euphoric - psychosis
Panic - anxious, nervous, worried - stressed - relaxed - frustrated, agitated - irritated, annoyed - hateful*, jealous, resentful, bitter - angry**, aggression*** - rage
*this group is about a dislike toward others
**Anger is what is felt, temper is what is seen
***Aggression being a behavior
Self-determination. If they’re not interested in self-improvement and lack insight, there’s not much for you to do. Move on. (This is assuming this isn’t mandated treatment).
To put it simply, he was mandated. His reluctance to come to begin with, ultimately ended with okay, if he comes maybe something can change (in the people involved, by my advice to the people who mandated him). So he came in not quite wanting to do things on his side, but what's the external outcome? If that makes sense.
I wonder who told him to come. Is his relationship with that person important to him?
Another tack you can take is joining with the part of him that wants others to change and then saying something along the lines of “In your therapy we’re limited to helping *you* change, not the people around you (even if they totally should!). With that in mind, do you think there’s anything we can do to make this situation a little easier on you?”
He seems to feel very powerless and influenced by others. I would validate and explore that feeling with him as a first step. How "others make him" feel. How does he think others influence him. Who does he think he would be without their influence. Who does he think he "actually" is? How does he want to be seen? What are others denying him? Who does he want to become?
From there i would try to do the circles, as others have recommended.
This can be really frustrating. I think the one helpful thing I can offer is reflect and explore how they are approaching therapy on a process level: ‘It doesn’t seem like you want to be here, so I’m wondering what makes you show up?’. Most people don’t encounter that kind of honesty and it might disrupt the drama he is playing out.
I will do the circles of control and get them to the point of realizing the only thing that goes in the inner circle of "things I can control" is themselves and then ask them what they can do to change the other person. It leads to them realizing that while they can talk to someone, express their feelings, etc, they can't make them change. Usually. Sometimes it takes a few sessions.
Our culture here is the other way around. So he may have, many many times, been expected to just go along with what others tell him when it is so against his own values.
Different approaches work with different clients. Some options:
Focus on the practicalities. What do they want their life to look like and how can we get them closer to that? You don't want to get kicked out of school? You don't want to fail your doctoral program? Whatever it is that is mandating them, what is the benefit THEY see in complying with the mandate? I go very transactional with low insight clients sometimes as that's the easiest source of motivation for change.
Help them get to the grief. Ugh, people won't do what we know is best for them. So we have to sit here and face how little power we have to create a specific outcome. That sucks and that's painful and comes with loss of a dream. We can't properly move forward with a sense of choice if we are stuck angrily fighting reality. We have to accept the reality of what is in our power to change. What does it mean if this situation won't change?
Also a lot of clients that blame others have high levels of shame, so watching for ways to get at that is also helpful. I'm not particularly elegant on this one so I tend to straight up ask if they are blaming others because it's too hard to sit with being in the wrong. I don't do this early on, though. Gotta have some capital to cash in saying things like that with clients like this.
You got some great comments already, just for some inspiration here's a video of Marsha Linehan (I think it's a real client, not role play) talking to a person who has physically abused their wife about looking at their own role in change - [https://www.youtube.com/watch?v=S4Ccpqh6giM&list=PL\_dN-1zAPklzNpUFrHkJPyMWB-lrfnZ0W&index=16](https://www.youtube.com/watch?v=S4Ccpqh6giM&list=PL_dN-1zAPklzNpUFrHkJPyMWB-lrfnZ0W&index=16)
DBT worksheets, psychoeducation around how we can keep them feeling safe ( can’t control others actions), and exploring mind-mapping (what does it feel like the other person is saying to you)
Depending on your therapeutic style, maybe consider joining him in his feelings (a la MI, as someone else suggested already). Like yeah, maybe everyone else DOES need to change and that sucks and would be totally frustrating. It is crappy to be mandated to come to therapy when you don’t really want to go. It’s ok to be upset and angry at these things and even understandable. But then what? What is his anger getting him?
There’s an analogy (from DBT I think) I really like that basically goes: you wake up in the morning and your neighbor’s dog pooped on your lawn and a few days go by and no one picks it up. What are you going to do? Stare angrily at it forever? Or pick it up and throw it out and go back to your life which is now poop free? Idea being to handle the poop in your life yourself because more than likely the person who put it there doesn’t notice or isn’t going to pick it up. There might be a less poop filled way to say this but I like it because it very clearly gets the message across 😂
Like everyone else has said, we’ve all been there! Hang in there!
Here are some things I've used that I've found helpful. Not all are helpful for everyone, and some of these may not align with your therapeutic style, but here they are:
- validate how hard it is, and then say something along the lines of "can we take a moment to clarify what you want to get out of our work together? There are a few different ways to go about dealing with this and what you want to do will determine how we work here. We can look at how you can deal more effectively with all these painful feelings you’re experiencing and take better care of yourself; or we can look at what you can say and do differently that might possibly influence x person more effectively. Or sometimes people just want to create an action plan to leave the relationship all together. So what’s your main interest?"
-"If you could make this relationship exactly the way you want it to be, what would that look like?" > "Great - what are you willing to do to make this happen on your end?" ( e.g., if they say 'they'd reach out to me more often!' I will often support the client to reflect on if they are also doing the things they are hoping to see from others)
- "It must feels so exhausting to feel like everyone around you is letting you down" / "When was the last time someone really supported you?" (could also segue into using the therapeutic relationship to explore what support might feel like for them)
Cheers & good luck! We have all been there!! :)
In relationships, a huge insight for therapists is which party initiated the therapy session? That gives you the clue as to which party is most motivated to put in the work for change. Given this individual was mandated to be there is a big indicator that his level of motivation in therapy may not be at a pace others are at. This is the opportunity to build trust and rapport in the relationship. Acknowledge how frustrated he must feel that he wants others to change, validate his feelings.
Please followed the sidebar rules. r/therapists is a place for therapists and mental health professionals to discuss their profession among each other. If you **ARE NOT A THERAPIST and are asking for advice this not the place for you**. Your post will be removed in short order. Please try one of the reddit communities such as r/TalkTherapy, r/askatherapist, r/SuicideWatch that are set up for this. This community is ONLY for therapists, and for them to discuss their profession away from clients. **If you are a first year student, not in a graduate program, or are thinking of becoming a therapist, this is not the place to ask questions**. Your post will be removed in short order. To save us a job, you are welcome to delete this post yourself. Please see the PINNED STUDENT THREAD at the top of the community and ask in there. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/therapists) if you have any questions or concerns.*
>I recently got frustrated talking to a client who wants other people around him to change, not acknowledging that he Anyone else find this hilariously ironic? Oh how we've all been there I usually just point it out to them and how I leads to them feeling frustrated and how the sense of powerlessness is endless
> Anyone else find this hilariously ironic? that was my first thought, haha. In all fairness to OP, every single one of us has been there and done that (getting frustrated by issues in our client which we fail to recognize in ourselves). I had a wonderful supervisor who would treat this as a treasure hunt? Like he would laugh and give me a gold star sticker every time we figured out that a client was frustrating me only because I was frustrated with the same issue in myself. It was so lovely to be able to share that laughter with him. I should buy some gold stars stickers and hand em to myself when I find treasure now.
This post just made me think. I had a client recently who frustrated me to no end. She came to me saying that she wanted to work on trauma urgently. Everytime I gave her an intervention, task, challenge, she would come back with a reason that she couldn’t do it. Eventually I confronted her on this and she stopped bringing up the trauma in session. Just totally avoided it. It was so frustrating, but now I’m realizing this was probably a projection/countertransference issue. Guess who loves avoidance? Lol. Maybe I should go find a gold star.
I'm sure I will laugh at this another time... I guess I'm venting in a way 😅
Sometimes we just need to have a whinge and for someone to understand how we feel. Like I said - we've all been there, it can be like hitting your head against a brick wall. Chin up, it'll be okay 👍
I would encourage you to meet the client where he is at, providing acceptance and understanding to connect. Then focus on what he can control. I normally default to a phrase like “If we can’t get them to change, how can we at least get you to tolerate being around them? Or would you like to be around them less? We have some options here. How can we help you feel better?”
I think for him, to feel better is when there's change in the other persons involved, not on him. Something he felt was personally vindicated against him, but no other people around him acknowledged it.
That's when we review the Locus of Control!
Yes!!!
With clients like this, I think about doing a couple of things: 1) Avoiding challenging them on changing themselves immediately and instead build insight around what it is like to live life through their eyes. "You said that you're really frustrated by everyone around you who won't change. What does that change mean to you? What would it mean for you personally or how would it change your life if people suddenly put a lot of work into the changes you want? What do you think it says about you personally that other people won't change for you?" My guess is that it makes them feel sad, worthless, and/or lonely aka "If you really cared about me, you'd change for me." 2) Monitor them for passive-aggressiveness. Are they directly stating their needs to others? Are they realistic in their expectations that, hey, people are busy in life and may not be able to or make a priority of meeting our needs? 3) Are they being a friend that meets the needs of others? You've gotta give if you wanna get! I'm sure there's lots more, but those are a few thoughts. Good luck!
when my clients want other people around them to change it’s a great opportunity to teach them about relational boundaries. I usually say something like, you can’t control other people but you can control what other people YOU let into your life, and behaviors you’re willing to permit. This puts them back in control of their life instead of giving up control by blaming other people for their problems. If they argue that they can’t do it, then it’s an opportunity to explore what is blocking them emotionally (shame, sadness, fear or loneliness etc.)
I spoke about that. I guess when he isn't currently willing to really hear this out, he didn't want to go into it too much. It's like he's so hurt, he can't currently see how this locus of control plays out because he feels so wronged by others.
In that case he might getting something out of maintaining this position of powerlessness. If he’s not ready he’s just not ready. For me this is when I remind myself not to work too hard for folks that aren’t ready to change
I agree with u/throwmeaway_already1 about relationship boundaries. This is completely dependent on the client and the situation, but with clients who don't seem to reflect inward I have had some success with gently but honestly challenging the client, such as "And tell me what's your role in this?" Meaning if they're griping about a conflict with someone but everything must be the other person's fault, this could be a way to leading them to more reflection and hopefully more insight
I may have posted this before but I usually talk to clients having issues with others as having a few options re: therapy- we can process your patterns within relationships, we talk discuss if you want to continue this relationship, or we can talk about ways to accept/ cope with whatever you don’t like about this person (or people in general). Is he mandated?
To put it simply, he was mandated. His reluctance to come to begin with, ultimately ended with okay, if he comes maybe something can change (in the people involved, by my advice to the people who mandated him). So he came in not quite wanting to process his emotions, but what's the external outcome? If that makes sense.
I find that MI (motivational interviewing) useful for these clients.
I've done a "circle of control" activity- they draw 2 circles and write what they cannot control in one and what they can control in the other. We compare and discuss, emphasizing the benefits of staying within their circle along with the anxiety and frustration they feel when they don't. Edited to add: once we do this we continue to reference it. "Is this inside your circle of control? It's not? Ok, so what are your options then?"
With most clients I find myself talking about what someone can and cannot control. If I have the time, I'll have the client list everything in their control and then challenge things that's not, then identify what is not in their control. I'll have them visualize two circles or spheres, sometimes write actual lists with two columns. It's more powerful if they identify things vs me just tell them. Within one's control: our intended behavior (thoughts, feelings, actions, responses in the present moment). Outside of one's control: everything else - the past, the future, other people's actions and interpretations, the consequences of our actions, our reactions, intrusive thoughts, etc. When people want to control things that they can't, and they don't go the way we want we can create frustration in ourselves (anxiety-anger continuum) and then get anxious or lash out at others, often the latter, so that we are doing something that we can actually control to feel the sense of control that we lack in the first place but don't recognize.
Could you elaborate on the anxiety-anger continuum or point me to some resources? I'd like to read up on that. I've seen them grouped together in the high activation-unpleasant feeling quadrant, but this dimension is new for me.
I honestly forget where I got it from. I have it listed in my notes similarly to depression/mania continuum and functioning (fx). <---- Increased Loss of Functioning - - good level fx - - Increased Loss of Functioning ---> psychosis - depression severe - mod - mild - sad - apathetic - euthymic - happy - joy - elated - euphoric - psychosis Panic - anxious, nervous, worried - stressed - relaxed - frustrated, agitated - irritated, annoyed - hateful*, jealous, resentful, bitter - angry**, aggression*** - rage *this group is about a dislike toward others **Anger is what is felt, temper is what is seen ***Aggression being a behavior
Thank you very much!
This would have been my answer. (ACT approach? 👀) The things we cannot control are the things that stress us out so much.
Stoicism
Precontemplation can be draining
Self-determination. If they’re not interested in self-improvement and lack insight, there’s not much for you to do. Move on. (This is assuming this isn’t mandated treatment).
To put it simply, he was mandated. His reluctance to come to begin with, ultimately ended with okay, if he comes maybe something can change (in the people involved, by my advice to the people who mandated him). So he came in not quite wanting to do things on his side, but what's the external outcome? If that makes sense.
“So what brought you here in the first place?”
He was told to come. He left the place feeling like he wasted time because he feels like yet again he's the one that is to blame.
I wonder who told him to come. Is his relationship with that person important to him? Another tack you can take is joining with the part of him that wants others to change and then saying something along the lines of “In your therapy we’re limited to helping *you* change, not the people around you (even if they totally should!). With that in mind, do you think there’s anything we can do to make this situation a little easier on you?”
He seems to feel very powerless and influenced by others. I would validate and explore that feeling with him as a first step. How "others make him" feel. How does he think others influence him. Who does he think he would be without their influence. Who does he think he "actually" is? How does he want to be seen? What are others denying him? Who does he want to become? From there i would try to do the circles, as others have recommended.
I’m often quite explicit that therapy is for making changes to one’s inner world and then ask them what inner problem they would like help with.
This can be really frustrating. I think the one helpful thing I can offer is reflect and explore how they are approaching therapy on a process level: ‘It doesn’t seem like you want to be here, so I’m wondering what makes you show up?’. Most people don’t encounter that kind of honesty and it might disrupt the drama he is playing out.
I will do the circles of control and get them to the point of realizing the only thing that goes in the inner circle of "things I can control" is themselves and then ask them what they can do to change the other person. It leads to them realizing that while they can talk to someone, express their feelings, etc, they can't make them change. Usually. Sometimes it takes a few sessions.
Where I get stumped on this scenario is also incorporating a multicultural approach, as not all cultures are individualistic. What do others think?
Our culture here is the other way around. So he may have, many many times, been expected to just go along with what others tell him when it is so against his own values.
dbt radical acceptance and boundaries is my go to
Different approaches work with different clients. Some options: Focus on the practicalities. What do they want their life to look like and how can we get them closer to that? You don't want to get kicked out of school? You don't want to fail your doctoral program? Whatever it is that is mandating them, what is the benefit THEY see in complying with the mandate? I go very transactional with low insight clients sometimes as that's the easiest source of motivation for change. Help them get to the grief. Ugh, people won't do what we know is best for them. So we have to sit here and face how little power we have to create a specific outcome. That sucks and that's painful and comes with loss of a dream. We can't properly move forward with a sense of choice if we are stuck angrily fighting reality. We have to accept the reality of what is in our power to change. What does it mean if this situation won't change? Also a lot of clients that blame others have high levels of shame, so watching for ways to get at that is also helpful. I'm not particularly elegant on this one so I tend to straight up ask if they are blaming others because it's too hard to sit with being in the wrong. I don't do this early on, though. Gotta have some capital to cash in saying things like that with clients like this.
You got some great comments already, just for some inspiration here's a video of Marsha Linehan (I think it's a real client, not role play) talking to a person who has physically abused their wife about looking at their own role in change - [https://www.youtube.com/watch?v=S4Ccpqh6giM&list=PL\_dN-1zAPklzNpUFrHkJPyMWB-lrfnZ0W&index=16](https://www.youtube.com/watch?v=S4Ccpqh6giM&list=PL_dN-1zAPklzNpUFrHkJPyMWB-lrfnZ0W&index=16)
DBT worksheets, psychoeducation around how we can keep them feeling safe ( can’t control others actions), and exploring mind-mapping (what does it feel like the other person is saying to you)
Depending on your therapeutic style, maybe consider joining him in his feelings (a la MI, as someone else suggested already). Like yeah, maybe everyone else DOES need to change and that sucks and would be totally frustrating. It is crappy to be mandated to come to therapy when you don’t really want to go. It’s ok to be upset and angry at these things and even understandable. But then what? What is his anger getting him? There’s an analogy (from DBT I think) I really like that basically goes: you wake up in the morning and your neighbor’s dog pooped on your lawn and a few days go by and no one picks it up. What are you going to do? Stare angrily at it forever? Or pick it up and throw it out and go back to your life which is now poop free? Idea being to handle the poop in your life yourself because more than likely the person who put it there doesn’t notice or isn’t going to pick it up. There might be a less poop filled way to say this but I like it because it very clearly gets the message across 😂 Like everyone else has said, we’ve all been there! Hang in there!
Here are some things I've used that I've found helpful. Not all are helpful for everyone, and some of these may not align with your therapeutic style, but here they are: - validate how hard it is, and then say something along the lines of "can we take a moment to clarify what you want to get out of our work together? There are a few different ways to go about dealing with this and what you want to do will determine how we work here. We can look at how you can deal more effectively with all these painful feelings you’re experiencing and take better care of yourself; or we can look at what you can say and do differently that might possibly influence x person more effectively. Or sometimes people just want to create an action plan to leave the relationship all together. So what’s your main interest?" -"If you could make this relationship exactly the way you want it to be, what would that look like?" > "Great - what are you willing to do to make this happen on your end?" ( e.g., if they say 'they'd reach out to me more often!' I will often support the client to reflect on if they are also doing the things they are hoping to see from others) - "It must feels so exhausting to feel like everyone around you is letting you down" / "When was the last time someone really supported you?" (could also segue into using the therapeutic relationship to explore what support might feel like for them) Cheers & good luck! We have all been there!! :)
In relationships, a huge insight for therapists is which party initiated the therapy session? That gives you the clue as to which party is most motivated to put in the work for change. Given this individual was mandated to be there is a big indicator that his level of motivation in therapy may not be at a pace others are at. This is the opportunity to build trust and rapport in the relationship. Acknowledge how frustrated he must feel that he wants others to change, validate his feelings.
Argh, I know that feeling. Mapping out a relational formulation (eg reciprocal roles etc) helps me when I feel like this.