Understanding the Psychology of Refusal Through Defense Mechanisms | Kokokari Psychology Column

There are clinical situations where a client refuses the therapist's involvement. Why can't they accept it?

The Psychology of Refusal

There is always a reason or meaning behind a resistant reaction.

For example, what about the possibility that the therapist's choice of words and the client's level of understanding are not aligned? Learned helplessness might be triggered, leading to a depletion of agency. Could cognitive abilities be diminished due to a mood disorder like depression? People with personality disorders may have biases in how they perceive things.

When applying clinical psychological interpretations, the focus changes depending on the school of thought.

Cognitive Behavioral Therapy considers it to be because "schemas (beliefs, values) are being threatened." Schemas dislike contradictions. People generally tend to want to reject information that shakes their own values.

In psychoanalysis, it is considered to be because "the client's mental maturity has not reached that point yet." Since they are aware that they are being told something correct, the state of not accepting it, or being unable to accept it, becomes uncomfortable. Because it is uncomfortable to leave discomfort as it is, the mind tries to protect the ego through various strategies. These are defense mechanisms.

Defense Mechanisms

Defense mechanisms are means of protecting the mind from unpleasant emotions. They were proposed by the psychologist Freud. Defense mechanisms related to refusal include repression, rationalization, and displacement.

Repression protects the mind by locking away unpleasant impulses or experiences in the unconscious so that they are not consciously perceived. For example, there are times when you cannot recall a shocking event even though it clearly was one. This is because the mind has judged that you cannot face the event directly and has locked it away in the unconscious layer through repression. It is also evidence that the mind is working well to maintain mental health; however, if repression is habitually performed, it can manifest as pathological symptoms, personality traits, or personality structures, appearing as various maladaptive symptoms.

Rationalization is a defense mechanism that justifies one's actions with logic that is convenient for oneself. By thinking that grapes hanging too high to reach are "sour grapes anyway and cannot be eaten" (Aesop's fable "The Sour Grapes"), one protects one's mind from being hurt. In job hunting, there are cases where people do not send resumes to companies they highly desire because they are afraid of being rejected. By not acknowledging the fear of rejection and thinking that the company surely wouldn't suit them, they protect their mind.

Displacement is a defense mechanism that redirects emotions aimed at one target toward another. Although one realizes it is their own problem, acknowledging it would hurt their self-esteem, so they blame others or their surroundings. Simply put, it is shifting responsibility and taking it out on others. For example, directing anger felt toward a parent onto the therapist falls under this. In psychoanalysis, displacement that occurs during training is sometimes interpreted in the context of "transference."

The Therapist's Attitude Toward Refusal

Therapists are human too. When refused, they may feel unpleasant or have the urge to strike back. While that is a natural reaction as a person, letting it out innocently in a clinical setting makes one unfit to be a therapist. It is best to ponder the reasons and meanings behind the client's resistant attitude, make an assessment, and be able to take the following approaches.

An Attitude of Waiting
This is the attitude of waiting until the client is in a state where they can accept it. It is the interpretation that intense conflicts that cannot be dealt with without employing defense mechanisms are swirling within the mind. In the concept of readiness, it is believed that there is a timing for when a person becomes able to do something, and that no matter how much you give them before that period, it cannot be fulfilled. People change. While paying attention to the changing tides, wait firmly.

Guaranteeing the Difficulty
The client is trying to do self-transformation now that they wanted to do but couldn't until now. Let us stand on the premise that they are doing very difficult and tough work. Do not forget the attitude of showing appreciation.

Returning to the Initial Goal
In the case of counseling, it is good to have the client state in their own words "what they want to achieve here" during the initial interview. When hitting a difficulty, it is because one can return to the point of why they are taking on such a difficult challenge and that it is something they desired themselves.

Persuasion Techniques
There will be times when persuasion is necessary. Persuasion techniques such as foot-in-the-door (sequential request method) and door-in-the-face (concession induction method) are useful.

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There are two important things regarding a client's refusal. First, to be armed with knowledge and theory. As long as things are happening within the scope of your assumptions, you will be able to deal with them calmly with a certain sense of security. The other is to temporarily let go of knowledge and theory in the clinical setting and face the client in front of you with a blank slate. People are diverse and varied. I would like to approach this with trait theory rather than typology.