American Association for Physician Leadership

Operations and Policy

Dealing With Rebellious Resistance

Robert Hicks, PhD

May 8, 2020


Abstract:

Uninformed resistance occurs when people are oblivious to the need to change. As I discussed in my previous article “Addressing Uninformed Resistance to Change,” uninformed resistance is symptomatic of the precontemplation stage, as defined in Prochaska’s Transtheoretical model of change.(1,2) Overcoming uninformed resistance requires that information be provided to others in a way that increases their awareness about a needed change and the advantages of making that change. Rebellious resistance, however, is another matter altogether.




Uninformed resistance occurs when people are oblivious to the need to change. As I discussed in my previous article “Addressing Uninformed Resistance to Change,” uninformed resistance is symptomatic of the precontemplation stage, as defined in Prochaska’s Transtheoretical model of change.(1,2)

Overcoming uninformed resistance requires that information be provided to others in a way that increases their awareness about a needed change and the advantages of making that change. Rebellious resistance, however, is another matter altogether.

Rebellious resistance differs from uninformed resistance in that the individuals generally are aware of their behavior and its potential or real negative impact on themselves or others but still refuse to acknowledge that a change is needed. Miller and Rollnick(3) maintain that this happens for two reasons: (1) the person has a substantial investment in the behavior for some reason and is unwilling to give it up, or (2) the person’s personality is such that he or she is resistive to change — even if it is in his or her best interest.

In general, rebellious resistors are outspoken, tend to argue and rationalize their behavior, and deny that they have any reason to change. The objective when dealing with this type of person is to have a quiet conversation about the value a change might provide without escalating resistance. The goal of a quiet conversation about change is to facilitate a discussion about the benefits of making a change while diminishing the possibility of an escalation during that interaction. The following guidelines, which are consistent with those practices recommended for any coaching conversation, will help.

Resist the Righting Reflex

The righting reflex is the urge to correct another’s misconceptions or course of action so as to set things right from your point of view. It is an automatic and spontaneous habit that often prompts others to resist rather than be open to a different perspective. Specifically, in the case of rebellious resisters, instead of eliciting a recognition of the need for change, the righting reflex causes them to defend the status quo and diminishes the prospect that they will accept the need to change.

Remember: Recognition that change is needed must come from within, not from outside pressure. In other words, for change efforts to endure, they must be driven by intrinsic motivation. Telling people what they should do may provide extrinsic pressure and generally causes resistance that dampens intrinsic motivation.

Use Reflection

Reflection involves restating what you hear the other person saying but in your own words. Your reflection cannot include an implicit “right or wrong” judgment about what the person has said; it must be perceived as a neutral response. Using reflection with resisters sends a signal that you are listening to others’ point of view and encourages dialog rather than argument.

It’s important not to react to arguments against change; merely reflect back the resister’s words as you heard them (e.g., “So what I hear you saying is that the way you interact with people might be a little aggressive, but it’s not something that should bother them. Is that basically correct?”). As an aside, you may also reflect back to them any spontaneous statements that indicate change may be a good thing for them. This adds motivational fuel to any potential change effort.

Emphasize Personal Choice And Control

Psychological reactance occurs when an attempt at social influence is perceived as threatening one’s autonomy, one’s ability to form opinions, or one’s freedom to do what one wants to do.(4) The intensity of the reaction will be directly proportional to the importance the individual places on the choices that are eliminated or threatened. Therefore, since rebellious resistance is a product of the substantial investment people have in their current behavior, pressing them to recognize the need for change will likely result in psychological reactance.

To avoid this possibility, deflect the reactance by making statements that emphasize their personal choice and control over what happens (e.g., “Obviously, it is ultimately your choice as to what you want to do. And you may decide not to do anything at all. I guess if I were in your shoes, I might want to consider how a change might help me.”).

Suggest In the Form of A Question

Making suggestions in the form of questions is a subtle way of offering your opinion about what a person might do while minimizing the possibility of triggering psychological resistance.(5) For instance, you might say to a person who doesn’t recognize his aggressive behavior with others as a problem, “Have you thought about the fact that you may be stronger than other people and, therefore, your directness has more of an effect on them than you realize? What would be the harm in trying a different approach?”

By presenting a suggestion in this manner, you are offering an opinion that may be helpful, but you also are giving the other person room to consider what you are saying without feeling as if you are trying to tell them what to do or how to think. When used in the context of dealing with a rebellious resister, you reduce the chances that the person might become defensive.

Summary

Confronting rebellious resistance is difficult; however, attempting to deal with it by arguing with or pressuring the other person invites failure. When you encounter rebellious resistance, avoid direct confrontation by working around the edges of the resistance until it is dissolved. In other words, have a quiet conversation about change that might induce the other person to consider that a change might be needed.

Resist your need to be right; let resisters know you are listening; emphasize that they have autonomy and, ultimately, it is their choice as to what they want to do. Finally, when you do have a suggestion, frame it as a question to be considered rather than as your opinion.

References

  1. Prochaska JO, Norcross JC, DiClemente CC. Stages of Change: Prescriptive Guidelines. In Koocher GP, Norcross JC, and Hill 111 SS (eds.).
    Psychologists’ Desk Reference, 2nd ed. New York: Oxford University Press, 2005, pp. 226–31.

  2. Hicks R. 2019. Traveling the Stages of Behavioral Change. Physician Leadership Journal. 2019;6(1):68–70.

  3. Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. New York: The Guilford Press, 2002.

  4. Silvia PJ. Deflecting Reactance: The Role of Similarity in Increasing Compliance and Reducing Resistance. Basic and Applied Social Psychology. 2005;27:277–84

  5. Hicks RF. Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals. New York: Routledge, 2014.

Robert Hicks, PhD

Robert Hicks is a licensed psychologist, a clinical professor of organizational behavior, and founding director of the Executive Coaching Program at the University of Texas at Dallas. He also is a faculty associate at UT Southwestern Medical Center and the author of Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals (2014) and The Process of Highly Effective Coaching: An Evidence-based Framework (2017). robert.hicks@utdallas.edu

Interested in sharing leadership insights? Contribute



This article is available to AAPL Members and Subscribers of PLJ.

Log in to view.

For over 45 years.

The American Association for Physician Leadership has helped physicians develop their leadership skills through education, career development, thought leadership and community building.

The American Association for Physician Leadership (AAPL) changed its name from the American College of Physician Executives (ACPE) in 2014. We may have changed our name, but we are the same organization that has been serving physician leaders since 1975.

CONTACT US

Mail Processing Address
PO Box 96503 I BMB 97493
Washington, DC 20090-6503

Payment Remittance Address
PO Box 745725
Atlanta, GA 30374-5725
(800) 562-8088
(813) 287-8993 Fax
customerservice@physicianleaders.org

CONNECT WITH US

LOOKING TO ENGAGE YOUR STAFF?

AAPL providers leadership development programs designed to retain valuable team members and improve patient outcomes.

American Association for Physician Leadership®

formerly known as the American College of Physician Executives (ACPE)