Productive Therapy artfully blends two essential ingredients: empathy and confrontation.

A client once complained about me to a friend, “My therapist is hard on me; she confronts me…” to which the friend wisely replied, “She sounds like a good therapist!”  He knew that his friend needed confronting in order to grow.

              Confrontation, easily supplanted by a steady diet of empathy, is often overlooked in therapy.  Client and therapist alike may enjoy deep understanding and gratifying “aha’s” but readily avoid the more anxiety-eliciting confrontation. 

              Empathy is wonderful, healing…  absolutely necessary to growth in therapy.  For clients to dive into searing memories of shameful betrayal, overwhelming loss or terrifying assault that they’ve carefully (and sensibly) avoided all their lives, they must trust that a therapist understands them and is for them.  They must trust that they will get kindness and support, not harsh judgment.  It is legitimately difficult to trust another person with the most vulnerable moments of our lives.  Empathy and understanding are bedrock to building the trust that invites openness about our suffering.

              But confrontation is also vital to growth.  As a thoughtful mentor once put it, if all we do with our clients is empathize, then we are simply stuck in a rut with them.  We just keep saying, in essence, “poor baby,” but never help them out of the rut.   Getting out of the rut requires the added jolt of confrontation.  In confronting, we dare to introduce a perspective that counters the client’s perspective—insight they hadn’t considered, maybe didn’t want to consider, that may be a little jarring or hard to swallow.

              Such confrontation causes discomfort and anxiety.  That’s why it’s counter intuitive in therapy:  we think of therapists as soothing anxiety, not inviting it!  But right levels of anxiety can actually be quite helpful (see upcoming  blog).  They can jostle complacency and lend impetus and energy to the work of therapy. 

              Consider…  A man comes in to a session upset about mistreatment by his boss.  Wincing, I empathize with the real hurt caused by the boss’s mean-spirited words.  I linger in the hurt with the client, unpacking other memories of similar hurt, sincerely with him in protesting the pain and unfairness he’s experienced.  There’s been a lot.

 Pivot point… Do we stay stuck in the rut?  Or is there some bigger perspective I can offer that, while risking offending him, can invite him out of the rut.  Gingerly, I say, “You know, you played a role in your boss’s harshness.”   Yes, he’s offended…   but we have history together; he trusts me enough to be curious to hear more.  And we begin looking at a pattern in this man’s choices—an unconscious pattern of extreme passivity that triggers irritation and sometimes downright harshness in friends and colleagues, subtly protecting him from a closeness that terrifies him. 

But confrontation--this uncomfortable insight—is embedded in empathy.  This man is not passive because he is a jerk or lazy or manipulative.  He’s passive because precious energy and initiative were beat out of him as a child.  A desperate choice, huge withdrawal from life was the only protection he knew.  But there’s a problem in this choice:  the passivity which protected him so well as a child is costing him dearly and unnecessarily as an adult. 

And so goes the blend of empathy and confrontation that invites healing.  Deep empathy—a non-judging and comforting understanding that tells us we are not alone in our suffering--permeates good therapy; but discerning confrontation must be boldly and gently added to the mix.  Confrontation invites a shift in perspective that leads to real change—not just “feeling better”—but substantive growth which sustains well-being.  

 Lots of empathy… a well-placed confrontation… lots of empathy...    is the essential blend that works not only for therapy but also for friendship, marriage, and raising kids. 

©  6/30/15 

*Any resemblance to actual people is coincidence and our shared humanity.