My patients plateau or resist — why does good work still fail?

You built real skill. You can design the right intervention and deliver it well. Then the patient stalls, or pushes back, or quietly does nothing — and you feel like you lost. Look at what you are actually measuring. You built your sense of competence on their response, not on your own effort. That is the mistake. Their will was never yours to direct. This is not a technique problem. You likely know enough technique already. This is a question of where your job ends and their life begins.