The confrontation in psychology: what it is and what is its usefulness

The confrontation in psychology: what it is and what is its usefulness

The psychological intervention is a process of building a change (acceptance of a duel, overcoming an infidelity, strategies for personal growth, etc.) that affects the three pillars of study of psychology: thought, emotion and behavior.

Intervention techniques in psychology

To achieve the objectives that a patient proposes in therapy, we will necessarily work on these three points, using tools and knowledge that can be focused more towards one or the other depending on the difficulty that arises.

For example, one of the most used and most effective techniques in the cognitive behavioral therapy is the known cognitive restructuringwhose Work focus is cognition / thinking, which seeks to modify (restructure) through the observation of irrational and generalist beliefs that the patient may have, to later transform them into ideas that are more adjusted to reality.

In Gestalt therapy, the focus is on body sensation and emotion, so that the body posture and facial expressions are used to delve into something that may have been mentioned, so that the gestalt psychologist accompanies the patient in the process of becoming aware of that postural or expression change and the relationship that keeps With the subject treated.

Again in cognitive behavioral intervention, one of the most common treatments of Obsessive-Compulsive Disorder (OCD) It has a strong cognitive component when establishing a good psychoeducation about the disorder and one modification of beliefs and attitudes that the patient may have, but also includes a good emotional management of anxiety linked to the ritual itself and the perception that the patient may have of himself, and strategies directed directly to the behavior, such as slowing or postponing the compulsion with the aim to eliminate it.

What is confrontation and what is it for?

The confrontation is a psychological resource that works between thought and emotion.

Referring to two highly known authors in our field, Ellis He called it "Socratic technique", as it focused on challenging the patient's beliefs, while Rogers I knew it as a "reflection of feeling", due to the search to find the emotions linked to the verbal expression of the person.

In other words, confrontation is a very useful tool in the therapeutic process because it helps the person to give another approach to the situation they are going through (in which they may have been “stuck”). When the person manages to position themselves differently with respect to their problem, they are usually much better able to find behavioral alternatives as well..

However, it is a technique that must be used very carefully, and each psychologist must gauge how and with what patients can use a confrontation.

This is because not only does it generate an increase in awareness about the problem and a possible change at the cognitive level, but it can also generate an emotional impact for which the person may not be prepared and with whom I don't know very well how to deal.

For that reason, it is recommended that the questions and statements of a confrontational type are not given in the first sessions of psychological intervention, since the therapeutic alliance is not yet solid enough so that the person, if he suffers an impact, relies on the psychologist to talk about how this confrontation has affected him.

If we use it intensely since the beginning of the therapeutic relationship, we are very likely to create a feeling of "attack" towards the patient and this provokes rejection towards the figure of the psychologist and, therefore, towards the therapy.

Three practical examples

Below, I present three examples of confrontational interventions based on one's experience.

These confrontations have been divided according to the level of impact they sought to cause and the degree of "subtlety" with which they were raised. It is worth mentioning that this classification, in the present case, is completely subjective and is based on the personal criteria underlying the knowledge of the given patient and the therapeutic relationship created.

Any of these interventions, outside the context in which they occurred and with any other patient, could be classified in a different way:

Case 1

Low impact level, subtle confrontation: Patient manifests need for control in different situations and contexts. It refers to always looking for a location in those places where you go where you can visually "watch" everyone.

Confrontation: What would you think if we both continued what remains of the session with our eyes closed?

Case 2

Intermediate impact level, direct confrontation: Patient manifests (on several occasions) accusation of his environment about his hostile, aggressive, jealous and manipulative character. He shows an attitude slightly according to what has been described, although he is always kind in therapy.

Confrontation(after several sessions): Do you think there is something that you have usually told me that corresponds to a hostile, aggressive, jealous or manipulative character?

Case 3

High impact level, direct confrontation: Patient says he is in a relationship with a man who tends to abandon his partners when he gets tired of them and fears that the same thing will happen, although he refers to such a level of infatuation that it is unfeasible to end the relationship.

Confrontation(again, after several sessions): Could you tell me what differences you see between your relationship with your partner and past relationships that he has told you?

The objective of a confrontation is always to find that the person can approach the situation, at least, from two points of view and that, therefore, with two alternatives can choose.

It is essential to mention that it is not the psychologist's responsibility to judge or argue (neither in favor nor against) based on our personal beliefs, since the psychologist should never push in any direction.

However, as professionals in the field of health we can consider that we are with the patient before a room with many doors. The patient may only be looking at one, so our job will be to illuminate the place a little more so that he can see if there are two, three or one hundred more.

In any case, it will be the patient who finally decides which door he wants to open to continue moving forward.