Sheila Rauch, PhD: “Rolling with Resistance” – How Providers Can Help Those with PTSD Start to Heal

One thing that I’ve learned is really to be conscious about rolling with the resistance, which if you’re a therapist, you know that’s a motivational interviewing term. But basically it’s the idea that when you’re hitting up on a patient saying “no, I’m not going to do this”, instead of trying to push them and say “yes, you have to do this”, it’s really saying “okay, well, let’s examine what’s going on, why is this a stopping point for you, what’s your goal, what do you want to get out of this?” and helping to collaboratively plan with them what that next step is going to be. I would say that that’s really the biggest skill that I learned is how to approach and then how to step back when the patient needs a little bit of step back. If I’m in a session that someone is experiencing a lot of affect, I am giving them all kinds of reinforcement because those are the best sessions we can have. The more that people let themselves go there and feel those emotions, the more benefit they’re going to end up getting out of this treatment. So, it’s kind of interesting when you’re an exposure therapist, when the patient is crying and having a tough time, of just being able to be present with them and say “I can see this is hard, you’re doing a wonderful job.” This is the work that we need to do to move to the other side of this trauma and just being able to be present while people are having a hard time. That is something that lots of mental health professionals have a hard time with at first, especially if they haven’t had the experience of seeing patients benefit from exposure-based treatments. They can be uncomfortable with that because we don’t go into mental health because we like to make people feel bad. We want people to feel good. But what you learn pretty quick is by letting themselves go there and experience it for a short term, they get these long-term benefits that are life changing. BrainLine is powered in part by Wounded Warrior Project to honor and empower post-9/11 injured service members, veterans, and their families.