How to help our patients shift gears when “stuck”

In counseling work, it’s common to see folks who are stuck doing the same thing, follow the same strategies (often fight/flight/freeze), but expecting a different outcome. They are “stuck” in a bad state, but are unable to “shift gears”.

As an “outsider” looking in, it can be awfully frustrating to see the status quo.

So how can we help them to shift that, with the least resistance?

1. There may a temptation to tell people what to do, but this may not be fruitful or well received despite our best intentions. There may be much resistance or defensiveness.

2. Validate, support, and wait until a time when they can come to the conclusion, that what they are doing is going to be “hopeless”, and make a shift themselves. Validation and support can be a “safe option”, but it can take a long time, and may not resonate completely with the patient’s personality style.

3. Or we can try to “fast track” option 2. In Acceptance Commitment Therapy ACT, we can try “creative hopelessness”. It’s about creating a sense of “hopelessness” about the current agendas and position, and pivot that to “hopefulness” about the future, through acceptance of what is IS, and assertiveness towards a more value driven life despite the challenges.

We aim to facilitate people’s position from “I want to change”, to “I need to change”, to “I must change”, and then to “I can change”.