Therapy Blockage

#blocks #impasse #resistances #Gouldings #Martens #transactionalanalysis #psychoanalysis #injunctions #therapistpersistence

I recently attended a webinar titled “Doing Highly Effective Therapy”, led by Dr. Mark Widdowson (whom I admire so much!). Among the many valuable takeaways, one that really stayed with me—something I intuitively knew but hadn’t articulated this clearly—was the Dodo-Bird Effect: that all well-intentioned therapists are, broadly speaking, equally effective. As I’ve noticed over the years, while learning from different schools of psychology, many concepts may have different names, but they overlap significantly, all aiming toward the same goal: the client’s well-being.

At one point, I was describing possible reasons for therapy blockages (here and here). From a Transactional Analysis (TA) perspective, internal blockages can generally be described as impasses—internal conflicts between the Child ego state (with its own agenda) and the Parent ego state, where internalized rules and parental messages live. These often operate unconsciously and are reflected in how we behave and relate—including within the therapeutic relationship.

The therapist may be perceived by the internal Parent as an "opponent" who is "teaching the Child nonsense or dangerous alternatives." Without alignment between the three ego states—Parent, Adult, and Child—any therapeutic contract is at risk of being sabotaged. Even if the client cognitively knows what’s happening ("I know I’m listening to that parental message, and I don’t want to!"), progress can stall.

One of the therapist’s key roles here is to collaborate with the client to resolve the impasse, identify the distorted or limiting beliefs of the internal Parent, and work to make these beliefs irrelevant or no longer obstacles in the Here and Now. In short, to get the Parent’s buy-in 😊.

Similarly, psychoanalysis addresses therapy blockages and offers guidance on resolving them. For example, W. Martens (1993) highlights that therapy can stall when the therapist is unconsciously perceived as a parental figure by the client (or “patient,” as termed in psychoanalysis). The emotional response in therapy (in the Here and Now) then mirrors the one from the past (There and Then).

The therapist's role is to identify this unconscious association and consistently offer a different experience: "Only through the gentle persistence of the therapist—continuously exposing themselves to being seen as the Parent, while helping the client distinguish between Then and Now, and modeling a different way—can change gradually occur."

Therapeutic blockages are often frightening—for both client and therapist. But, as with everything that unfolds in the therapeutic relationship, they are actually valuable indicators of how the therapy should continue.