Case Study: Facing a Fear of Confrontation in Couples Therapy

When Couples Issues Hit Close to Home, Moving Forward Means Putting Aside the Fear of Confrontation

Ellyn Bader and Peter Pearson

Throughout my childhood, my parents carefully avoided open conflict and taught me to do the same. To this day, I prefer to sidestep conflict whenever possible, but that’s not an option in couples therapy. We frequently need to confront our clients, and putting aside a fear of confrontation—not to mention a fear of losing clients—we must risk the possibility that one partner, or perhaps both, will become openly angry with us.

When I first saw Joe and Jill, they’d been in a power struggle for 10 years. They’d seen several therapists and gotten nowhere. Their fights were escalating, most intensely about Jill’s weight. She hated Joe for nagging her to diet, and by now was angry enough to consider having an affair, partly to demonstrate that she didn’t need to lose weight to be attractive to men, and partly to get revenge on Joe for attacking her self-image.

As soon as their struggle became apparent, my first thought was, “I’m the wrong therapist for this couple. How will I avoid imposing my own issues and fear of confrontation on them?” Throughout my childhood, my mother had constantly pushed me to lose weight, and I’d despised the pressure she'd put on me.

I knew untangling Joe and Jill’s struggle would take skillful confrontation, yet the prospect of confronting them directly on the issue of weight made me shudder, and I secretly hoped they’d shift their focus to something else. They didn’t.

I tried to delay the issue by offering to teach them some skills for talking about tough topics before they embarked on this problem. That worked for a little while, but Joe remained focused on Jill’s resistance and how selfish he thought she was. “She wants me to think she’s beautiful,” he said, “but I think she’s pretty self-centered if she won’t make any effort to be attractive to me.”

By now, Jill was crying. “Why can’t you love me as I am?” she wept. I knew it was show time. I could no longer postpone the issue because of my fear of confrontation, but how could I intervene without tangling them up in my own issues? I was deeply aware of my desire to rescue Jill.

“Jill, will you ask him what your weight symbolizes, and what he thinks should happen once he’s asked you to lose weight,” I said carefully, and then took a baby step toward confrontation.

“You’ll lose weight,” Joe cut in. “You know, buckle down and get it done. And it symbolizes your selfishness.”

Many partners make incessant angry demands without realizing their own part in what’s going on. Joe kept suggesting that Jill was lazy and selfish for not doing what he wanted, as if it had no connection to his own attitudes and behavior. As a slightly overweight female therapist, I wasn’t sure I could handle this situation without his concluding that I was simply siding with Jill.

The session was heating up. Clearly, resolving this struggle was going to involve more accountability from each of them. Although I wanted Joe to take more responsibility, this tug-of-war couldn’t really all be about his wife’s perceived refusal to lose weight. At the same time, I’d need to light a fire under Jill to get her to acknowledge her own part in what was going on.

It wouldn’t be easy, but I had to put aside my fear of confrontation to get them both to face an issue freighted with psychological meaning for me. Many years ago I’m not sure I could have found the right mix of gentleness and strength, but at least for this hour, I could feel the difference that 25 years of couples work made in my own clarity and sense of inner direction.

Topic: Couples

Tags: emotionally focused couples therapy | having an affair | resistance | therapist | therapists

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Wednesday, February 26, 2014 8:13:53 PM | posted by Psychotherapy Networker
You can download the full free report by clicking on the link in the middle of the blog post: Couples Therapy: Why So Many Therapists Try to Avoid It

Wednesday, February 26, 2014 7:47:26 PM | posted by PlymouthAlice
How do we get to the rest of the article? There is a clear power struggle in the relationship.....I can't comment on the content because I don't know how the therapist actually intervened "with gentleness and strength." The article ends at the climax of the session....confusing.

Wednesday, November 20, 2013 4:43:38 PM | posted by Lauren Anzaldo
Interesting that the author didn't actually delve into the actual confrontation other than the one "baby step"--since that's what the article was about.

Monday, November 18, 2013 3:24:45 AM | posted by dee hein
Lol I would focus on how loving Jill is for staying with such an abusive man. Seems however that the therapist felt they lacked an amount of confrontation. I would doubt that is the problem and if the therapist's goal is to facilitate confrontation, why not just put up a divorce shingle. We capitalize on your pain. Seems all three are.fabulous at causing grief for the other. But the quintessential I have a twenty five year jump on threatening people, that auta seal the coffin.

Saturday, November 16, 2013 3:48:58 AM | posted by Facing a Fear of Confrontation in Couples Therapy | pakehamack
[...] Facing a Fear of Confrontation in Couples Therapy [...]

Thursday, November 14, 2013 7:05:20 PM | posted by Tom Caplan
When clients are arguing in session I use this as an opportunity to listen to what they are actually saying to each other behind the drama. I then use the Needs ABC Model (Routledge) to suggest what I hear them saying about their unmet relational needs. This almost always brings them back to a more peaceful discussion.