EP21 Topical Panel 08 - Resistance - Robert Dilts; Nancy McWilliams; Michael Miller; Cloe Madanes

Clients generally understand what they need but fail to comply with their own directives and those of the therapists. Resistance will be analyzed from three different therapeutic models.

Learning Objectives

1. Describe resistance from each of the three models
2. Given the patient, indicate three possible orientations to the client resistance

Outline:

Introduction and Panelist Backgrounds

• Rick Miller introduces the panel on “Resistance” with Robert Dilts, Nancy McWilliams, William Miller, and Cloe Madanes.

• Panelists are recognized for their work in NLP (Dilts), psychoanalytic psychotherapy (McWilliams), motivational interviewing (Miller), and strategic family therapy (Madanes).

Robert Dilts on Resistance in Motivational Interviewing

• Resistance is shaped by the therapist’s response; it’s an interpersonal, not intrapersonal, issue.

• Introduces "sustain talk" (client defending status quo) and "discord" (conflict with therapist).

• Recommends active listening, empathy, and apologies to reduce resistance and build collaboration.

Nancy McWilliams on Psychoanalytic Views of Resistance

• Resistance is a self-protective internal process, not simply client defiance.

• Full engagement in therapy doesn’t mean absence of resistance—it’s often unconscious.

• Therapists should use patience and compassion to help clients face painful realities.

Robert Dilts on NLP and Generative Change

• Resistance may signal ignored aspects of a person’s internal system (“holarchy”).

• Uses the principle of complementarity: every behavior has a positive intention.

• Suggests curiosity and acceptance to uncover and work with the intention behind resistance.

Cloe Madanes on Strategic Family Therapy

• Resistance often stems from relational and family dynamics.

• Shares case of a resistant, court-ordered client whose breakthrough came from reconnecting with his grandmother.

• Highlights the power of family involvement and reframing through rituals like meditations.

Panel Discussion Highlights

• Panelists avoid using the term "resistance" with clients—focus instead on understanding behavior contextually.

• Strategies include addressing lateness or missed sessions by exploring meaning rather than confrontation.

• COVID-19 has influenced how resistance shows up; family roles and dynamics remain central to engagement.