The requirement of confrontation is absolute in therapy when a  change in behavior is crucial to avert a crisis. This confrontation must take place in a friendly and supportive manner, and in the spirit of  collaboration, so that the patient understands that it is the      therapist’s wish to help him or her live in a new way that is more effective, productive, and gratifying. This is the type of  confrontation  that has made short-term therapy possible and can increase the efficiency of other therapies.

How can the therapist, through such confrontation, help the  patient to overcome resistance to change, which in routine psychoanalysis takes  years to “work through”? It is the acute suffering of most of  the patients who seek our help that is the main source of  motivation to   change. Resistance to change is often overcome by suffering.  Moreover, once relief from immediate pressure occurs, the patient  is   willing to examine  other areas  of  disturbed functioning  with    diminished resistance.In assessing sources of difficulty, it is essential   to confront the patient not only with the effects of  his own behavior and thinking but also with the  effects of confusing, limiting, and exploiting behavior of  others. This includes the basic limitations    embedded in the patient’s specific social and economic reality. In this  way we  can help patients deal with destructive life situations that are not exclusively of  their own making. When we help patients to  realize  what they are not responsible for, they are more able and willing to  accept their  actual contributions to existing problems.

Since all  dysfunction takes place within a disturbed system of human interaction, it is additionally essential that wherever possible we bring  family, peers, and even appropriate community members  into the therapeutic situation. In this way, not only can confrontation be       appropriately directed, but needed change in whole social units can     be effected.Individuals in these units can learn to be  therapeutically  confronting with one another.

Pointing out sources of the patient’s difficulty should be only a prelude for the confrontation of  needed change. When the therapist sees that  change is required to avoid a crisis  he, using appropriate timing and   supportive manner, will confront the patient with the needed changed activity. Changed activity will produce a new, healthier consciousness and existence. This is the only source of  inner  growth and useful insight.We know a person’s consciousness  only by its practice. Confrontation leading to changed human practice will produce the  therapeutic  “cure” —  a  changed person  with a changed consciousness.


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