The phrase “treatment-resistant” is sometimes used in higher levels of care—such as intensive outpatient programs (IOP), partial hospitalization programs (PHP), residential treatment, or inpatient settings—when someone hasn’t responded to multiple treatment approaches.
But what that label can communicate to the person receiving it is something very different.
I’ve had clients enter care and say things like:
“I’m probably a lost cause… but I’m trying again just in case there’s still a chance.”
Others have been told they may have treatment-resistant depression (or another diagnosis), and it can land like a verdict—something permanent. Something shameful. Something that means relief might not be possible.
And that can be deeply discouraging.
💚 Here’s a thought—rooted in the experiences of several clients once labeled “treatment-resistant” who are living and thriving right now:
Clinically, what is often labeled as “resistance” is not defiance or failure.
It is often protection—a nervous system doing exactly what it learned to do in response to trauma, chronic stress, overwhelm, or survival-based patterns.
Resistance is not refusal.
It’s communication.
It may be telling us that something about the pace, approach, setting, or modality doesn’t yet feel safe, accessible, or truly attuned. And when the nervous system doesn’t feel safe, even the most well-intended treatment can feel impossible to absorb.
For loved ones, this can be especially painful. You may see how much someone wants relief—and still feel helpless watching them struggle.
🌿 If care hasn’t been helping, it may be worth exploring:
Fit: Is this the right provider and therapeutic relationship for you?
Focus: Are you working on the right goals—or are you being asked to “cope” with something that needs deeper healing?
Trauma: Are there unaddressed or unlocked trauma responses driving symptoms beneath the surface?
Modality: Would a different approach be more supportive (EMDR, somatic therapy, IFS, Brainspotting, neurofeedback, etc.)?
Integrative support: Are there nervous-system and mind-body supports that could strengthen treatment—such as mindfulness, breathwork, movement, sensory regulation, sleep support, nutrition, or creating a safer environment?
Sometimes, progress happens not because someone finally “tries harder,” but because the support finally meets the need.
💚 Encouragement:
If you or someone you love isn’t responding to care, it does not mean nothing will help.
It often means the body and brain are asking for a different kind of support—one that is more personalized, trauma-responsive, and nervous-system informed.
There is still hope.
And you are not a lost cause. 💚
#TreatmentResistance #NervousSystemCare #TraumaInformed #UtahTherapistCommunity #IntegrativeMentalHealth