Confrontation: Is it Art or Science?

What do you think about when you think about confrontation in couples therapy? Is it something you do a lot? Or rarely?  Does thinking of a specific confrontation make you scared or anxious? Or, perhaps creating a well-crafted confrontation leaves you feeling enthusiastic and excited?

Do you dread confronting an angry partner for fear that you will be attacked or aggressively challenged? Do you worry that an untimely or poorly worded confrontation will result in a permanent rupture or at least a significant disconnection in a relationship that you have carefully built? Is your anxiety strong enough that you avoid making a confrontation that you know is important to make?

Confrontation is much more of an art than a science. Effective confrontation requires careful attention to nonverbal cues as well as context and interpersonal dynamics. The skills required to make effective confrontations are honed over the lifetime of being a psychotherapist. Some confrontations are very forceful and some of the most effective confrontations are very gentle.

My 1986, 2nd edition Random House Webster’s Unabridged Dictionary, gives the following definition of confrontation, “a technique used in therapy to recognize shortcomings and their possible consequences.” I was very amazed to find this and thought, “what an eloquent definition!” Recognizing shortcomings and the consequences of not changing is so central to our work.

I thought about so many common problems we see: Addiction, Infidelity, Conflict or Intimacy Avoidance, Escalated Hostility, Passive-Aggressiveness, Lies, Deception and Overworking and I realized that it would be impossible to do successful couples work without confronting the consequences of these behaviors. So many partners in struggling relationships rationalize their lack of accountability and their minimal efforts while excusing themselves for acting in ways that devalue their partners.

Without becoming skillful at challenging regression, violations of trust, indirect hostility, addictive thinking and behavior or lack of commitment, our couples work would just skim the surface. Our desire to avoid feeling anxious or insecure may lead us to shy away from refining the art of confrontation. Sadly, everyone loses when we “wimp out.”

Or, sometimes we start to make a powerful confrontation and before we know what’s happened, an artful client has wiggled away from our carefully crafted words. Then we get distracted or overwhelmed and either forget to go back to it or are uncertain about the best way to return to our challenge effectively. And in couples therapy, this process is even tougher than in individual therapy because we must reflect on the impact of our confrontation on two people, not just one.

Consider for yourself…  do you want to learn more about confrontation? What types of confrontation are hardest for you? When is confrontation easiest? Do you agree that confrontation is a big part of couples work?

And, comment below – do you think confrontation is more necessary than it may appear to be at first?

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Vivian Baruch
Vivian Baruch

Terrific Ellyn & Pete!!!! Looking forward to your insights & what you’ve learnt over the years about this topic. I’ve been concerned about how a prioritization on attachment over differentiation in work with couples can actually collude with the narcissistic or entitled partner & fail to address the core issues in their interactional pattern. Without sufficient, targeted & skillful confrontation (which I’m constantly stretching myself to learn), we as therapists replicate the dynamic in the couple & render ourselves powerless, making the therapy ineffectual at best and harmful at worst.

Tom Johnson
Tom Johnson

I agree that strategically-timed confrontation can be useful in creating some disequalibrium in one partner and or in the relationship that help lead to positive change. One would need to be careful about being unilateral in the confrontation that would risk a perception of favoritism. I would say that being confrontive with someone who is already angry would be most challenging for me.

Greg Rowe
Greg Rowe

I think one of the reasons I’m so grateful for the couples training is that it is helping me become more confrontative – in geneal. Being confrontative seems far easier with a couple than an individual. By design it brings me out of my reserve and forces be to be more ‘Hands on’ – hence I speak my piece more readily than I have been used to doing in individual work. If I am working hard challenging/prodding these two really defended people in the room to speak their truth it’s only natural that I express mine (when it’s therapeutically appropriate of course!)

Salomon Nasielski
Salomon Nasielski

Yes, and how !!! If a client “wiggles away” from my confrontation, I may shout loudly “Hey, this is not answering my question ! If you’re not going to answer my question, then tell me first ‘I won’t answer this’, and then proceed. Now, what do you say ?” And I sit prepared for a possible next confrontation, pointing out the contradiction between coming to me for help and choosing not to answer some of my questions.
Yesterday, I confronted a husband, who felt shocked when his wife admitted, with a bright smile, that she totally forgot their long discussion around their couples rules. I asked him to start organizing his response to her obliviousness, starting from his own feeling of being shocked, and left alone.
Please, Ellyn and Pete, keep going with your so enriching and stimulating questions ! This offered me the opportunity to share the above. Thanks so much !!!

Stephen C. Gill
Stephen C. Gill

To Ellyn & Pete:

This is a phenomenal topic. I have two comments: one; confrontation can apply to the passive, “it’s no my fault or responsibility for his/her problematic/controlling/passive-aggressive… behaviors, patient as well as to the overtly abusive partner. And two: Confrontation should come from a place where the therapist is authoritative and not authoritarian.

Thank you for opening up this discussion.

SueMarie
SueMarie

Great topic! Generally as a society we avoid confrontation/conflict like the plaque, when it is absolutely necessary in all types of relationships for healthy dynamics within it. I find that in working with all clients what helps create understanding within our relationship in sessions is to educate at the start, on the process of therapy including @ times it will be necessary to confront issues & that no one likes “You in your face” I go on to say some examples of the more common resisitances or defences that might come up & that “THAT IS A GOOD THING & NECESSARY (i say why) part of a good outcome, & so knowing that going in, you can just choose to make a decision now, to be ok with… being uncomfortable” b/c feeling uncomfortable is part of the process…so I normalize it including the truth that as a human being, I too can have uncomfortable feelings around confronting at times but choose to be responsible & feel the feeling & do it anyway,,,,its called “growing pains”. I do this at the begining, so in most cases I have set them up to succeed & have also created better trust & therapuetic allignment at the same time. I end up with permission up front rather than blind side the clients with the first & subsequent confrontations.

Joanne
Joanne

I think I use confrontation more than other therapists due to my professional background and previous trainings. I worked as an alcohol and drug counselor in both outpatient and inpatient so doing reality checks with patients was very important. I also worked as a probation officer. I find I work better with people in denial of their addictions and inappropriate behaviors but with the ability to comprehend how their behavior is continuing to create problems for them and their relationships. I am glad you are addressing this. I tell people I am not a sugary sweet therapist. They are paying me so I will be upfront and give my opinion (which maybe wrong) and if they want a different type of therapist I will refer them to someone else.

Jerome
Jerome

Most folks don’t want confrontation. The attendant emotions are uncomfortable and ackward. I believe that just as with other powerful emotions our task as humans is to be able to carry those emotions with out hiding from them or acting out on them. This is a process, one that will go on all our lives. Confrontation with couples is a necessity to break the jam up there in. Having said this I realize that it is important to confront in a way that engenders growth and not more confrontation. Great topic.

Paul
Paul

I am comfortable confronting couples by describing to them an interactional pattern in which they both participate in ways that maintain distance and conflict, if that is considered confrontation. But when I think one individual is primarily responsible for sabataging, I hesitate to point this out due to fear of being perceived as unobjective or fear of losing the couple because of someone feeling “blamed” or “picked on”. I’d love to hear if others can relate and how they deal with it.

Lisa M. Stanton
Lisa M. Stanton

Sorry it took so long to reply, Ellyn. I regularly use “gentle confrontation” with my couples when appropriate, which I have no problem doing (must be the New Yorker in me 🙂 as long as I have valid reasons for doing so. For those therapists fearful of confrontation, it may be best to steer away from working with couples–a challenging area to specialize in.

Bonnie K.
Bonnie K.

I use confrontation regularly and quite comfortably. It is my job to tell them the truth regarding behaviors that are hurting their chances to have the relationships they crave. I believe confrontation is the deepest form of empathy. It is my job to do it in a respectful, caring, and centered way and keep my counter transference issues out of it. Since I have learned this “emperor has no clothes” approach, I am much more effective and enjoy work more. I look forward to learning more from you, Ellyn. I appreciate your work.

Carmen Cubillo, LAC, LAMFT
Carmen Cubillo, LAC, LAMFT

Thanks Ellen, nice to meet Peter and your team at recent conference. I use gentle confrontation and often in the form of curiosity or confusion. Then clients are more apt to tell me more, give more details and then I say ….Ok so you say X and then we have Y? And then I use some sort of hand gesture to put X and Y very far apart and then I wait a bit…..if client does not answer, I can further probe and ask, so how are those two compatible? or how can those exist at same time? etc… They often laugh when they see the situation….as not being congruent to what they are supposedly saying.

I have not tried the bombshell, on any couple so far. I would like to see some effective examples….I love working with couples and I am always looking for new approaches, because every couple is unique and responds differently, even thought there are certain pattern similarities, or stages of growth as you say. I would like to see couples continue in session, for longer than they do, often they leave with lots more work to go…I see in some of your examples it is one session situation, tough one ……thank you.

Rosario
Rosario

Confrontation is also necessary in couples therapy. It allows us to be attentive to how that couple moves in their disagreements, what type of dynamic is prevailing and why they do not advance in their growth and one of the members returns or remains fixed in a stage. former. I agree with Elyn about the attentiveness, care and skills we must possess for confrontation to be effective. I am eager to learn how you achieve this with the developmental therapy model. These confrontations could be strong, especially if one of the members of the couple has a mental illness.

Dr. Ellyn Bader

Dr. Ellyn Bader is Co-Founder & Director of The Couples Institute and creator of The Developmental Model of Couples Therapy. Ellyn is widely recognized as an expert in couples therapy, and since 2006 she has led innovative online training programs for therapists. Professionals from around the world connect with her through internet, conference calls and blog discussions to study couples therapy. Ellyn’s first book, "In Quest of the Mythical Mate," won the Clark Vincent Award by the California Association of Marriage & Family Therapists for its outstanding contribution to the field of marital therapy and is now in its 18th printing. She has been featured on over 50 radio and television programs including "The Today Show" and "CBS Early Morning News," and she has been quoted in many publications including "The New York Times," "The Oprah Magazine" and "Cosmopolitan."

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