Confrontation can be a friendly comparison of views. I see confrontation as a regular but unobtrusive technical maneuver that, without drawing attention to itself, assists in the elaboration of content. Its form in the actual therapeutic dialogue or interchange is expressed thus: “It seems to me that…and I wonder how it seems to you.”
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Confrontation in the Analysis of the Transference Resistance
Unlike interpretation, social confrontation is designed to induce internal conflict. It is the difference between saying “This is the third session you have wasted this week,” and “You are once more reacting as if only bad can come from our work together.” Tis analysis of transference anxieties has proved to open the way to reaching and engaging with the very hardest of the so-called hard to reach.
Confrontation, Countertransference, and Context
Confrontation draws upon empathy. Countertransference distortions are likely when we find ourselves angry, disappointed, exasperated, especially frustrated, or jealous. Confrontations can also be contaminated by fantasies of being the magic healer, rescuer, shaman, sage, or parent.
The Uses of Confrontation in the Psychotherapy of Borderline Patients
It has been useful to us to define confrontation as a specific technique for dealing with avoidance defenses. Because borderline patients rely heavily on these avoidance mechanisms, we have found confrontation to be necessary in their treatment. At certain difficult times it is needed as part of the therapist’s effort to help his patient regain an experience of security and avoid actual dangers toward which he is inclined.
The Misuses of Confrontation in the Psychotherapy of Borderline Patients
When it happens that the patient observes his therapist struggling with his own countertransference fury, he has the opportunity to learn how another person can master murderous rage. If the therapist fails in his struggle, the patient may then comply helplessly as a victim of an attack, and his view of the world as untrustworthy is further confirmed. In this mutual struggle the patient can learn that neither he nor the therapist need destroy each other in spite of mutually destructive urges.
Therapeutic Confrontation from Routine to Heroic
Confrontation here is viewed as being done not electively but by the demands of the particular case after adequate assessment of all variables involved. It is heroic in that it is a measure reserved for situations that require other than ordinary treatment.
The Purpose of Confrontation
A majority of patients will respond to confrontation to a greater or lesser degree in a positive way, though certainly, there are those who will not give up their narcissistically determined entitlement. Our attempts to give the patient a new choice in his way of life are worthwhile and often effective.
Confrontation in Psychotherapy
Describes the varieties of confrontation in psychotherapy, its meanings to patients and therapists, its indications and its dangers. (637 pp.)
