Fear of change in therapy

Have you ever driven past a new housing estate with a big sign that says ‘If you lived here, you’d be home by now’?
Starting therapy is a bit like that. Most clients who come to see me have had their problem for some time. They’ve lived with it, or around it, or just avoided whatever situation made it worse. To re-frame the sign, if they’d had therapy a year ago, they’d have solved it by now. So what stopped them?

Fear of change

It’s well known, among those that deal with stress, that change can be stressful whether it’s perceived as a positive or a negative event. Moving house is widely accepted as one of the most stressful things you can do, and it often doesn’t matter whether you’re going from a hovel to a palace or the other way around. It’s the process of change itself that people find difficult.

Why is the prospect of change difficult?

Therapy is all about change - it’s why our clients come to see us. So what is it about change that could also be inhibiting the results, or even stopping them from contacting you in the first place?

  • The risk of failure. What if the therapy doesn’t work? Say they come to a therapist to quit smoking, and then they don’t quit? What will their family and friends say? What about the time and money they invested? Maybe it’s easier not to try.
  • They don’t feel strong enough. If your client suffers anxiety or depression, in particular, they often also experience mental and physical fatigue. Doing anything new is difficult because the ‘thinking parts’ of the brain which deal with language, planning and memory are adversely affected as well, so the prospect of changing long-term habits feels like too much effort.
  • Fear of what’s involved. People worry about what the therapy will ask of them emotionally and practically, and what they will have to face. Some assume they will have to reveal - or discover – hidden trauma that they might have preferred to remain hidden.
  • Fear of success. If you have a flying phobia, for example, you know if the therapy is successful your family will want you to go on holiday with them. So if the therapy is successful you'll have to do the very thing you've been avoiding all these years, which is a scary prospect.
  • Wondering if it’s worth it. If your client has never been, confident, slim or a non-smoker they may wonder if it’s worth the effort to achieve their goal. They struggle to imagine life the way they'd like it, and the status quo is familiar even if it’s not particularly comfortable. 
  • Fear of other people’s attitudes. If people find out you’re having therapy, will they think you’re ‘weird’, ‘crazy’, ‘weak’ or even ‘laughable’? If you’re overweight and want to trim down, for example, will you have to go to a gym class where everyone else is slim and will mock your lack of fitness? 

How can you help your clients deal with change?

Am I blaming the client for their failures here? No, absolutely not. Some of the processes I’ve mentioned could be completely unconscious and the client may not be aware of them. Even where they are aware, your client has legitimate reasons for their fears.

Some of those reasons might stop some people from signing up with you at all. That’s tricky to deal with because you don’t know who they are. But you can assume they exist and make sure that your website and other literature addresses their concerns.

Offer plenty of information about how you work and what’s involved. Offer to answer questions or concerns without a ‘hard sell’. Stress that you offer a confidential service and that your therapy is client-led. Reassure people that life following therapy can be good, but at the same time be honest about whether you are the best person to help, and what the chances of success are.

Once your clients actually become clients, it’s easier.

  • Don’t ignore or dismiss the client’s concerns about change, talk about them openly and look for solutions within the therapy, even if you feel you’ve been ‘side-tracked’ from the original problem for a while.
  • Emphasise that they’re choosing change to make life better, not because there is something intrinsically wrong with them.
  • Set reasonable and realistic goals in terms of achievement and time frame. 
  • Make sure you know why the client wants to change, and how exactly what they think this will do for them. Keep them focussed on those positive outcomes.
  • Don’t expect change to happen at the same speed for each client – work at a rate the client is comfortable with. Chunk down the goals into smaller steps if that’s easier, and build in rewards for each step the client succeeds in taking. 
  • Ensure that you work with the client’s likes and dislikes as much as possible – if your weight loss client dreads going to the gym, for example, find something else to keep them active.
  • Planning is fine, but it needs to be mixed with a certain amount of flexibility - treat every client as an individual.
  • If things aren’t going to plan, discuss this with the client. Why do they think this is? What is getting in the way of progress - and what would help them overcome it?
  • If a client has multiple issues, it's often best to tackle one at a time. All at once can be overwhelming, and increase the likelihood of failing. If you’re not sure where to start, ask ‘If we could change just one of these, which would make the most impact on your life?' 
  • Consider including some work on confidence, especially around dealing with change, in your therapy, no matter what the presenting problem is.


Author: is an experienced hypnotherapist and hypnotherapy trainer. She is the author of Their Worlds, Your Words and has co-written the Hypnotherapy Handbook, both of which are available from Amazon.
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