The Art of Confrontation

Twenty years ago, late on a Friday afternoon, I was feeling drained and exhausted after a long day of seeing clients. I only had one couple left to see: John and Susan—and I certainly wasn’t looking forward to it. John tended to be incredibly domineering, unmercifully rude, and obnoxious toward Susan. He frequently told her she needed to lose weight and act sexier around him. Our sessions often felt volatile, and many times when John went on the attack, I could barely get a word in.

Here we go again, I thought to myself as the two walked through the door, sat down on my couch, and John almost immediately went into attack mode. After hearing him complain yet again about how Susan “needed to hit the gym,” I couldn’t hold back.

“You know, John, if you keep talking to Susan like this, she won’t want to have sex with you at all!” I blurted out in a not-so-neutral tone. John sat in stunned silence, and quickly changed the topic.

Two days later, I got a phone call from Susan. “John is furious after that last session,” she told me. “We won’t be coming back.”

Susan’s words hit me right in the gut—and sat with me for a long time. I really blew it, I thought to myself—and I knew I had. I’d been tired and not thinking clearly, but I’d also let countertransference get the best of me. As a child, my mother used to nag me about losing weight and would drag me to weight specialists. I knew I was still angry at her, and I’d directed this anger at John.

Certainly, there must’ve been a way to challenge John, to confront him without evoking defensiveness and losing him entirely. But how?

***

As one of the early founders of modern couples therapy, I’ve been working with partners for over 40 years. And if you see as many couples as I do,  you know how the work can get heated. Sometimes partners come to sessions locked in patterns of unrealistic expectations, as John was, while others are entrenched in cycles of hostility, deception, betrayal, or emotional withdrawal. Often, neither partner fully recognizes the role they’re playing in sustaining the dynamic, and even when they do have some awareness, they struggle to change it.

This is precisely where the therapist is called to step in and explicitly call out negative thinking and behavior. Confrontation becomes part of the work—not as aggression or correction, but as a way of interrupting entrenched relational cycles that the couple can’t see from the inside.

But for so many therapists, confrontation feels dangerous. We hesitate, waiting for the perfect phrasing or the perfect moment. We worry about rupture or losing the clients. We tell ourselves that good therapy means showing restraint, or that insight will emerge without pressure. But what’s often underneath this is avoidance, which always comes at a cost.

Over the years, I’ve come to see confrontation not as something to fear, but as one of our most powerful clinical tools. When used skillfully, it doesn’t damage the therapeutic alliance; it deepens it. It creates moments of clarity that polite reflection alone cannot. It’s a way to nudge partners toward the healthy relationship they’ve been seeking all along.

Rethinking Confrontation

When I first started doing couples therapy, I thought confrontation was synonymous with conflict. It felt like something that would escalate tension or threaten the therapeutic relationship. Over time, that view shifted completely.

I came to realize that skillful confrontation isn’t conflict—it’s more like holding up a mirror to a system that’s malfunctioning, calling attention to the beliefs and behaviors that are keeping clients from growing. It fosters awareness and lets clients know they have a choice, rather than simply letting their unconscious reactions take the lead.

At its core, confrontation isn’t an act of aggression, but an act of care. It’s a refusal to let destructive dynamics like unspoken resentments and emotional avoidance continue unchecked simply because they’re familiar. It’s especially valuable when working with highly dysregulated couples, whose negative patterns have become so ingrained that they’ve become oblivious to their toxicity.

Confrontation forces partners to wake up, forcing them into honest conversations that demand they pay attention to the issues keeping them trapped. I’m a firm believer that honesty is a cornerstone of a loving relationship, and without hard, honest, confrontational conversations, there is atrophy; partners disengage, and fall out of love. Conversely, confrontation helps partners get clear about their vision for the future of their relationship, and the new behaviors it will take to bring that vision to fruition.

It’s worth noting that there are situations where confrontation becomes necessary rather than optional, like when there’s a chronic failure to take responsibility for bad behavior, repeated patterns of deception or betrayal that have eroded trust, significant deficits in conflict or relational skills, and persistent denial about the impact of one partner’s behavior on the other or the family system.

But there’s another indication that confrontation is necessary: stagnation. When couples repeat the same arguments without meaningful progress, what looks like communication is actually just spinning the wheels. At this point, dysfunction has become normalized, routine for partners but intolerable to an outside observer. Confrontation becomes the mechanism that disrupts this false stability, a catalyst for change and growth.

The Six Types of Confrontation

Over time, I’ve come to understand confrontation as existing along a continuum of intensity rather than as a single technique. Each level serves a different function, and each can be used flexibly depending on the couple’s capacity in the moment. The work often begins at the lowest level of intensity and moves upward only as needed.

Soft confrontation. The first level is what I call soft confrontation, which you might use early in therapy or as you’re getting to know your clients. This involves gentle curiosity and early attempts to bring patterns into awareness without increasing emotional arousal. A therapist might use soft confrontation by asking why the couple believes they’re in therapy, or by gently noticing a pattern such as one partner withdrawing while the other pursues.

They might say, “I notice that when you withdraw, your wife starts making more demands of you. Have you noticed that too?” If the client is receptive, you might add, “I wonder if you’ve noticed that your withdrawal may play a part in her asking for more from you.”

This intervention is designed to create space for reflection. Even just doing a little psychoeducation, like sharing a framework for relational development (I’ve developed one called Stepping Stones to Intimacy with my husband, Peter Pearson) can function as soft confrontation, allowing couples to recognize their own stuckness.

Empathic confrontation. The second level is what I call empathic confrontation, where emotional experience is named more directly. This often involves identifying underlying feelings that are obscured by more reactive emotions. Anger may be reframed as loneliness, or criticism may be understood as attachment longing.

To use empathic confrontation, you might say to a partner, “You sound very lonely in your parenting role. It seems like you’re looking for more collaboration, more togetherness. I wonder if you could speak more about your loneliness and less about your anger?” Or, “Could you speak about what felt hurtful before you got angry?”

Sometimes the therapist’s own emotional response can be used to highlight what’s happening between the couple.

Not long ago, I was doing therapy with a husband and wife, the former a very perfectionistic company executive. At one point in our session, I told him, “I’m feeling a lot of dread right now that I might not get this right. And I wonder if I’m the only one here feeling this.” I turned to his wife. “Do you ever have this experience with your husband?”

Gentle but tough confrontation. The third level, gentle but tough confrontation, is firmer, but still contains warmth. It targets blind spots directly, but without shaming or escalating defensiveness. The tone is calm and matter-of-fact, and content is clear. It often names the gap between what a client wants and what their current behavior actually makes possible.

I used a gentle but tough confrontation recently while working with a couple in which the husband had started opening up and describing emotions he’d hidden for years, and his exasperated wife just rolled her eyes.

“I’ve had enough of this,” she said. “I want someone who adores me. I deserve that. If he can’t do any better than this, I’m out of here.”

“Many people want that,” I responded. “But only a few get it, especially after decades of marriage and kids. Unless you allow your husband to be more open—to do more of what he just did—he will live with resentment, which will never allow the kind of loving partnership you’re looking for to unfold.”

She was silent for a moment. Then, she exhaled, looking at me with an expression that said, I don’t like what you just said, but I get it.

Indirect confrontation. The fourth level is indirect confrontation, where the therapist speaks to one partner, but what’s being said is actually meant for the other. This approach is particularly useful in couple dynamics where there’s high reactivity or avoidance.

I used this in one session where the husband was often passive and disengaged in treatment. His wife was highly verbal with lots of complaints. “Megan,” I said, “when you have so many issues with Marcus each week, you’re actually making it easy for him to hide. I wonder what would happen if you left more space for him to show up?” You actually make it so easy for him to not work on himself.

By addressing one person, the therapist can highlight dynamics that involve both partners without triggering immediate escalation. Indirect confrontations often  address systemic patterns or chronic resistance in real time, like how one partner’s over-functioning enables the other’s withdrawal.

Tough confrontation. The fifth level is tough confrontation. This is rarely delivered before you’ve built a relationship with a client. Here, the therapist intentionally introduces discomfort in order to prevent avoidance. After all, anxiety can be motivating! The goal here isn’t to punish, but to increase clarity and decrease minimization. Behavior is described in a way that makes it difficult to bypass or rationalize, especially when clients persist in deflection.

An example might be saying something like, “Are you willing to give your partner what you want so badly from him?” or, “Do you realize how big the thing is that you’re asking for?”

Bombshell confrontation. The sixth and most intense level is what I call bombshell confrontation. This is reserved for moments when denial structures are deeply entrenched or when destructive behaviors haven’t  shifted despite prior interventions. It might be used in cases where there’s been repeated lying, addiction, or partners are incessantly demanding. It’s best used only after all other types of confrontation have failed, since it’s a lot harder for a client to hear a bombshell without anger or defensiveness if it comes dramatically and unexpectedly.

I once used bombshell confrontation with a female partner who’d developed a habit of cheating on her husband—and then repeatedly lying about it. In the midst of all this, she also said she wanted to have a baby with him.

“He was making me feel so alone,” the wife said. “I thought he hated my guts.”

“Are you telling me,” I replied, “that because you thought he hated your guts, that it was okay for you for lie and hide for two years?”

“No, but it’s the context I was coming from,” she said.

“I’m going to say something tough,” I replied. “And I want you to hear this: you may not have time left with him to get back to where things were. He’s nearly done, and so much of what you’ve said today is about you and your experience. While that matters, if you two are going to move forward, you’ll need to take a real deep look at what made it okay for you to lie and hide for the last two years.”

These statements often articulate consequences or future trajectories that the client has been avoiding. When used well, they don’t escalate conflict; they crystallize reality.

The Therapist’s Responsibility

Effective confrontation depends less on technique than on the therapist’s internal state. Before doing any confrontation, I assess my own regulation, my motivation, and my level of clarity. I center myself, asking, What’s my affect and mood right now? Confrontation that arises from frustration tends to create defensiveness, but confrontation that arises from grounded observation tends to create reflection. Before I begin, I also want to have some idea of how far I will be pushing.

Timing is equally important. The therapist must consider each partner’s current emotional capacity, the strength of the therapeutic alliance, and the likely impact of the intervention before speaking. I also expect pushback. Pushback isn’t a sign that the confrontation has failed; it’s often part of the process.

Last, know that some confrontations are built over time. You can always dial up confrontation—to increase discomfort or reveal deception, regression, destructive behavior. It’s much more difficult to dial it down.

Of course, it’s not always the therapist who is doing the confronting. In some cases, it’s more effective for one partner to confront the other. You can assist with this by encouraging the confronting partner to trust their judgment and instincts or keep describing the problem. Meanwhile, you’ll want to make sure they don’t come from a “gotcha” or one-up position, which isn’t constructive. However, if safety or emotional regulation is compromised, then the therapist should be doing the confronting.

Ultimately, confrontation is uncomfortable. But it can be delivered skillfully, with your intentions made clear—whether it’s to help save a relationship, save a partner, ensure one partner or both partners’ health, challenge addiction or raise concerns about the wellbeing of children. The aim isn’t to win an argument or establish authority, but to increase the couple’s capacity to see themselves and each other more clearly and motivate them to build new emotional capacities.

Beyond Problem-Solving

Many couples enter therapy with a strong desire for immediate problem-solving. They want relief from conflict, reduction of distress, and a return to stability. While problem-solving has value, it’s rarely sufficient for deep relational change.

The deeper work involves helping couples shift from a reactive, problem-focused stance to envisioning a new, better future for their relationship. When couples begin to imagine themselves not just as people trying to fix what’s broken, but as partners building something new together, the entire therapeutic process changes. The relationship no longer becomes a battlefield, but a foundation for something greater. Confrontation becomes easier to receive because it’s no longer experienced as blame, but as something that unlocks a shared future. In this way, confrontation isn’t a lack of compassion, but one of its purest expressions.