Cognitive Pearl #016 Kislev 26, 5775 December 18, 14

A client comes for treatment. He does his homework. He actively participates in treatment. Yet, remains stuck. He is still immobilized, avoidant, enraged, or whatever the presenting problem is. We seek guidance from colleagues. We try this and we try that. Sometimes, we blame the client with our professional jargon and slang: ‘the client is resistant’, ‘there is some form of secondary gain’, ‘there is some form of personality disorder’, ‘he needs treatment with medication’, or the worst, ‘he’s a borderline’. The effective cognitive therapist however doesn’t rely or take comfort in nicknames, even those which are very impressive sounding and can be found in very impressive books. We are always a bit suspicious of diagnoses not only because they are inexact but also because they are static and fixed, something that rubs us the wrong way because we see the client as trapped in a transactional and social system that hypnotizes him into a state of immobilization. Instead we take the failures and the resistances and deteriorations as useful information that illuminates the invisible parts of the trap.