April 28, 2023
By: Dr. Maeve O’Leary-Barrett, Clinical Psychologist
A couple of years ago, my colleague Dr. Alissa Rubinfeld wrote a blog post about ambivalence (I Want To Change….I Think!?), normalising the fact that we can often be torn between opposing feelings in therapy. For many people, although there is a part of us that wants to change and reduce our suffering (that’s often why we’re in therapy in the first place!), there can be another part of us that has a hard time imagining doing things differently. I wanted to continue exploring the value of paying attention to ambivalence, centering around another common issue that brings people to therapy, namely difficulties in relationships.
Feeling connected to other people is key to our well-being, so it makes sense that when things are “off” in our relationships, we can feel a whole range of negative emotions. Clients may come to therapy describing difficulties feeling close to other people; perhaps they worry about others’ judgment; perhaps they experience a lot of conflict with others. I typically work with clients to try to understand the nature of their difficulties (“What’s going wrong? Are there any patterns we can notice and make sense of?”). And then comes the inevitable moment of “So what now? What would change look like?”. As I often say to clients, relationships are a dynamic and we only have control over our portion of it. Which means that, if you want things to change in your relationships, then you only have the capacity to work on your side of things. We will try to identify some goals together in therapy (“Do I want to work on being more assertive? Communicate more openly with other people? Distance myself from certain relationships that are not healthy for me?”) And, importantly, we will also make space for the part of them that might be afraid or reticent about doing things differently. Because part of our job as psychologists is to help clients shine a light on all the parts of themselves, including the parts that may feel darker or less “productive”. For many clients, having a space to name and acknowledge what gets in the way of change is a vital step to getting unstuck. As Dr. Rubinfeld names in her blog, many people can feel ashamed when they feel stuck in therapy, and may even stop coming to appointments because of this. But it is a normal part of the change process. If it were so easy to do things differently, you would have done so already!
Here are some examples of barriers to change in relationships that clients have named to me:
All of these concerns will likely make sense in the context of what the client has experienced during their lifetime. And part of our role as psychologists is to help them to pay attention to and understand their stuckness, and perhaps to consider the following points.
Understanding your ambivalence is meaningful.
Deepening your understanding of what is going on for you has a lot of value. It can be very disconcerting when you feel like you don’t understand why you are stuck (“I thought I wanted to be more open with people. So why am I not doing it?”) Gaining insight can help you to move forward.
Ambivalence is common, and it is powerful.
Prochaska, Norcross, and DiClemente1 (1994) found that people need to feel significantly more positive than they do anxious in order to pursue change. They discovered that people are often more ambivalent about their goals than they realise. This makes sense. Even the smallest habit change can be trickier than we anticipate. Therapy can help us to pay attention to the parts of us that are holding back.
Understanding your process.
The journey to change is sometimes slower and more difficult than expected. It can be discouraging and confusing to feel that you’re not progressing as you would have liked, even if your goal is clear. The Stages of Change model2 recognises the fact that there are several stages that one goes through (starting with “pre-contemplation”) before being ready to make concrete changes, but that each stage can build on the preceding one, and that each has value. Gaining insight into where you are at (versus where you might think you “should” be) is important in helping you understand your behaviours and become conscious of parts of you that might feel more hidden.
It is important to become familiar with the “push and pull” within you and to consider it as something normal, to be expected, rather than something that is a sign of anything bad. As Dr. Rubinfeld says so beautifully in her blog , “Ambivalence is not something to be ashamed of, but rather a representation of an internal conflict perhaps worth becoming more familiar with.”
1Prochaska, J.O., Norcross, J.C. & DiClemente, C.C. (1994) Changing for Good. William Morrow and Company: New York, pp 174-176.
2Prochaska, J., & DiClemente, C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.