Things You Learn in Therapy
Things You Learn in Therapy
Ep 103: Harnessing the Power of Confrontation for Personal Development and Effective Communication with Dr. Deborah Miller
Confrontation doesn't have to be a clash; it can be a gateway to growth and understanding. Discover how to harness this power with myself, Dr. Beth Trammell, and Dr. Deborah Miller, as we dissect the essence of confrontation in therapy and its transformative impact. This isn't about fostering conflict; it's about creating change with compassion. Throughout our discussion, we unpack methods to address behaviors that might block a client's progress, and we demonstrate, through role-play, the art of using soft, curiosity-based language as a catalyst for insightful revelation.
As we transition from the therapy room to everyday life, learn how the delicate art of confrontation can enrich your personal relationships. Dr. Miller and I dissect the balance between challenging behaviors and maintaining a non-judgmental stance. We explore the use of humor to defuse tense moments and the necessity of choosing wisely which patterns to confront for nurturing personal growth. So, if you're a therapist, a leader, or anyone aiming to polish your communication skills, this episode is brimming with wisdom to help you approach those moments of truth with grace and skill.
This podcast is meant to be a resource for the general public, as well as fellow therapists and psychologists. It is NOT meant to replace the meaningful work of individual or family therapy. Please seek professional help in your area if you are struggling. #breakthestigma #makewordsmatter #thingsyoulearnintherapy #thingsyoulearnintherapypodcast
Feel free to share your thoughts at www.makewordsmatterforgood.com or email me at Beth@makewordsmatterforgood.com
www.bethtrammell.com
Hello listener, welcome back. I'm your host, dr Beth Tramiel, and I am really excited about this topic and while it is something that I think kind of happens in everyday life, I'm not sure that we ever get real training or teaching or or even spend a lot of time talking about it. So I'm really excited about this episode with my dear friend and colleague, um, fellow Red Wolf. I know what. I don't know what our states like chirp chirp.
Speaker 1:I know I don't think so I don't know what Red Wolves do, but I don't think so. I don't know what red bulbs do, but I don't think it's that.
Speaker 2:We're going to work on that. We'll workshop that.
Speaker 1:So, anyway, okay, my friend and colleague, dr Deborah Miller, is here with us to talk about confrontation, and in the therapy room, and maybe even outside of the therapy room. So I'm excited about this. So, deb, here's how it goes. You introduce yourself and tell us one fun thing about you.
Speaker 2:I'm Deborah Miller and I am a professional. I have a professional life. I am a professional with a life. I'm an associate professor at IU East in psychology. I'm the chair of the department right now, so that's fancy.
Speaker 1:Very.
Speaker 2:Very, and also I do clinical practice. I've done lots of different things over the years, from individual counseling to assessment. Right now I focus more on assessment than individual counseling, but I do a little bit of each. One fun thing about me I guess people are always surprised and interested to know that my husband and I have a little band and I sing and he plays the guitar and that's a fun thing we do together, I wouldn't say to keep the spark alive, but you know it keeps us creative and connected and doing a hobby that we both enjoy. So that's fun.
Speaker 1:Yeah, it is fun and you, you're great. I have heard you sing and watched your little band. You call it a little band, I'm not sure.
Speaker 2:It's little, it's just me and him.
Speaker 1:We have a little band.
Speaker 2:We're not little people, but you know me and him.
Speaker 1:We have a little band. We're not little people, but you know, yeah, but it's really amazing. I love that. It's something that you do to stay connected. You know, I think in relationships it's, I mean, the older I get, the the longer I've been in relationship. It's like man, life just keeps going and then if you don't have kind of a targeted thing that you do together, you we also know lots of therapists and training. We are obviously well connected to other therapists as well, and this issue of confrontation comes up a lot, and so I invited you and a few other folks to come on. Actually, I'm going to have multiple episodes on confrontation, because I think getting different takes on how to do confrontation is good and important, and so we're going to talk a little bit about confrontation from a professional perspective, right, and through the lens of a therapist. But I think it will probably also parallel other fields also, right, professional confrontation is a skill that I mean. I can't even think of a profession where you don't need healthy confrontational skills. Can you think of?
Speaker 2:No, I mean I can think of more examples of leaders I've encountered who do not have good confrontation skills and so things just go wrong. You know, like it's, it's not good because they're they can't, they don't know how to address difficult topics or things that need to be said. So I can't think of anything where you wouldn't need confrontation skills. Yeah, yeah.
Speaker 1:So when I think about confrontation in the therapy room, right, I think most people have probably a negative initial reaction to this. Even just this word, confrontation, right, and so that probably doesn't set us up for success to get started in doing it. Well, Right.
Speaker 2:I mean just thinking about if you describe someone as confrontational, that's not a way you want to be described, right, but it is absolutely, I think, from my perspective, thinking about therapy and what facilitates change in the therapeutic process. Confrontation is probably one of the most important skills you can have as a therapist, and you know we say confrontation, but really what we're talking about is pointing out inconsistencies or pointing out blind spots that people may not be aware of that they have without judgment, without you know, without engaging their defenses.
Speaker 2:Right, you know, in a way that's helpful, but it's just observing, noticing and verbalizing the inconsistencies that you're seeing in a client.
Speaker 1:Confrontation doesn't mean conflict.
Speaker 2:Exactly.
Speaker 1:Yeah, Because I think that that is something that we might kind of put these two terms together right To your point, like we might just think all confrontation is conflictual and actually confrontation in the therapy room is very powerful and very healing.
Speaker 2:Yeah, and sometimes I guess it could.
Speaker 2:There could be a conflict involved between you and a client that needs to be confronted, but more often confrontation is just pointing out things that it triggers inside yourself and what you're afraid you'll trigger inside the other person if you bring up a certain topic.
Speaker 2:I don't want to hurt their feelings, I don't want them not to like me, I don't want there to be an argument or a fight, whatever it is that you don't know how to process maybe. So it's understanding the underlying emotional content of the confrontation that I think is really essential. And from a therapeutic standpoint, like, while confrontation is a really key piece to the change part of therapy, it goes hand in hand and can't exist without a really strong therapeutic alliance where there's a lot of safety, trust, unconditional positive regard, right, and you've built up a really a pretty good understanding of what's making your client tick and you know the factors from their past that might be informing their current behaviors and decisions, so that you can confront their behaviors with compassion and understanding and kind of help them explore with sensitivity and compassion those areas where you know like they're doing things that are pretty inconsistent maybe with their values or their goals and they just can't see the roadblocks to success, to getting past those things. Does that make sense?
Speaker 1:Yeah, yeah, yeah. So if I am a early clinician or kind of a beginning counselor who understands that, it's hard for me because I want my clients to like me. It's hard for me because I don't want to make my clients too uncomfortable, or what happens if they don't come back. I think what I'm hearing you say is that confrontation really relies solely on the foundation of the relationship first, right, and so we do have to build rapport, we have to build the relationship so that the client feels safe, and it is okay to sort of step into some hard topics before session 12, right? You know what I mean.
Speaker 1:I feel like there's this like, yeah, we got to build this foundation of a relationship, but that doesn't have to take six sessions, right? I guess maybe that's part of my question for us to talk about. I think about some sessions that I had where even in the first session, it was sort of like well, that doesn't sound like the goal that you have is matching what you were saying earlier for listeners to help them understand this. How do we rely on this foundation of the relationship, but it doesn't have to take time, isn't the only factor? Right? Right, but then how do we help people understand what those factors are.
Speaker 2:I think it's also, you know, your approach to the confrontation that's going to make people feel safe and secure with you and strengthen your alliance in the, you know, like, like it's all just a big bundle of things, so you can't come out guns blazing before you know and just saying no, no, no, no, no, wait, wait, wait, wait.
Speaker 2:You know, like, very insensitively, you have to like finesse it and use your personality and your own skills of how you understand people, work and how you'd want to be approached in a therapeutic session by someone who has maybe something difficult to say about your behavior or what you're doing.
Speaker 2:And I really do think that that is part of building a strong relationship, because honesty is the foundation of trust, right? So if somebody, some people, know when their behavior is somewhere inside them, they know when their behavior is inconsistent in some way, they know that if their goal and value is X but they're doing Y that doesn't support that goal and value, they have a sense of that. And if you, as their therapist, never have that insight and communicate with them about that, I don't think they're going to trust you as much as if you know you're willing to point out your observations in a caring, compassionate way. You know you're willing to point out your observations in a caring, compassionate way. So, yeah, it's like all this thing that's wrapped up together. The relationship and confrontation exist simultaneously and they build off of each other and must have each other to function properly.
Speaker 1:I am, you know, just thinking about specific examples of common reasons that you know you may use confrontation. You kind of talked about pointing out those inconsistencies, and so can you think of some examples where using confrontation makes a big difference. Using confrontation makes a big difference.
Speaker 2:Depending on your approach to therapy.
Speaker 2:This one was a really hard one for me when I was starting out, if clients didn't do anything between session, like if we had talked about homework or things to try out. You know, an hour a week, we know it's not going to change their lives if they're not doing things between session. So if somebody's like, oh, I forgot to do the homework, I was really busy this week and da da da, okay, fine, free pass this week, right. But if that's a consistent thing where they're just really not engaging, then that's where confrontation is really important, because they're coming to therapy once a week but they're doing themselves a disservice by not following through between sessions. You're not going to be as effective as a therapist if you're not willing to explore with them.
Speaker 2:Okay, what is it that is really preventing you? I know everybody's busy, but if you're committing to this process, let's figure out how to get you engaged with this between sessions and doing the homework that we talk about in session. If you don't really want to do it, don't tell me you're going to, and let's figure out something that you actually really will do and that's going to be possible for you. So that's one way that confrontation is important is like the actual nuts and bolts of the therapy process. If they're not like engaged, if they're coming late to session, if they're missing sessions, if they're doing things that really are not going to support their full utilization of therapy, then that could be an appropriate place for confrontation. But it's also really hard because it's it is about. You know it's their choice to come to therapy or not, and you can give them all of the tools at your disposal and then it's their choice whether they're going to use those tools or not.
Speaker 1:I mean, I think about the client who maybe has their device and is sort of like kind of distracted frequently by their device, and I could imagine the power of confrontation to say I'm going to point out this inconsistency that you're saying you want to come to therapy and you want to be better and it feels like your phone is kind of a constant distraction for you. Here Can we sort of like role play this example?
Speaker 2:Yeah, sure, who do you want me to be?
Speaker 1:I'm picturing, like saying this to a client right, okay, so I'm noticing, and do you use that term like, do you when you're in confrontation? I've, I know I have. I don't always say that, but you know I'll say things like I've noticed, or when I think back. Yeah, I'm wondering. Soft language, yeah, and it's curiosity based language which I do think helps in confrontation.
Speaker 1:But you know, I'm picturing this person who is, you know, checking their phone once or twice, maybe three times, during session, and saying to them like, hey, you know, so I'm noticing that. You know, this phone is kind of a distraction for you today and it seems like you want to be present here but you keep being pulled elsewhere, and so I can imagine that that's hard, that's hard for you to be focused on the work we have to do here. And I can picture a person then also saying well, I'm just really busy and I just have to check this one last thing. And I can then imagine the client or the therapist who struggles with confrontation just ending the confrontation. There I get up the courage to do the initial confrontation of, hey, I'm noticing this thing. And when the client comes back with some sort of answer, I think I've heard my students, my supervisees just sort of like stop there and I'm not sure that's the end of the confrontation.
Speaker 2:No, absolutely. That's so the beginning right. It's such a beginning of the confrontation right To where they'll give you a pat answer. But your literal job as a therapist is to push beyond what is the surface right, and that is a huge skill because that is very uncomfortable sometimes. But it also I don't know if you've ever been bored as a therapist. I don't know if you've ever been bored as a therapist because things are at a surface level right, like it's nothing's going wrong, but you're not really finding much interesting to talk about because the difficult stuff hasn't come up yet, the meat of an issue.
Speaker 2:So for me and this is maybe because I don't thrive on confrontation, but I want to say it's a skill I've developed pretty well, and part of that is because I know that that's where things get really, really interesting, that's the most fertile ground for insight and change is when you maybe do the initial confrontation.
Speaker 2:They come back with their like immediate kind of maybe defensive answer. But you lead them beyond that into a deeper understanding of what's really going on, and it can be a very gentle process that isn't conflictual, right Like there's maybe a little bit of conflict because you know, as a therapist who likes to sit there and have their client be on their phone and feel like they're not listening. But then when you depersonalize that and say this is not about me and how I feel about this client, but I can use my feelings that this client is kind of like, use my feelings that this client is kind of like provoking in me to facilitate some sort of increased awareness of how their behavior affects other people and how they're like blocking their own personal growth by being distracted or disengaging by looking at their phone or whatever it is.
Speaker 1:So what would be your next step to this client?
Speaker 2:I would say, yeah, I get that, like I know you're so busy, but I also know that, like therapy is really important to you and that when you do that, I would bring in like some here and now kind of stuff where it makes me feel like you don't care about the time with me. You know, like you don't care about this, you're not engaged in the process, you're not really listening to what I'm saying and or that this isn't important to you.
Speaker 1:I mean it is important to me, but I mean this phone, this phone call, like I, just it, just I. I, I had this thing that I had to do today and so, it's fine, I'm going to put it away, Okay. Okay, I'm back to you.
Speaker 2:Okay, all right, you're back to me now. But I'm wondering what this is like for you in relationships with other people. So you can take it in that direction, to be like our relationship in the therapy room is a proxy for other relationships in your life and we can use our interactions to kind of dissect the way you interact with other people and how that might be affecting your real life. Quote unquote relationships, right, generalizing what we do in therapy to other people, and so that's one way to take the confrontation. But you could also just say okay, you know, I'm noticing that maybe you're wanting to just kind of give me a pat answer right now, and I understand that. But I'm wondering if you'd be willing to maybe go a little bit deeper into this with me and just investigate maybe some of the reasons why this is. You know, the, the phone's a distraction and and what that might mean beyond.
Speaker 2:Just like, okay, I'm putting it, you know I'm putting away right now so getting their permission to go in that direction and explore further in a cure, like you said in a curious way, not in a judgmental way.
Speaker 1:I'm picturing session next week and the phone came out again and and I'm I mean I can imagine there are people that are like, well, I've already addressed it, I don't need to confront it again. And I think this comes back to what you were saying before about recognizing what it is in us that is having some sort of reaction to this. As a therapist, we're like constantly evaluating our reactions to people, to processes, to things that are happening in the therapy room, and I think if you're not constantly doing that, then you may be missing out and, honestly, you may be dangerous. I might as well just say that too. I mean, that's the truth, I think. But I'm picturing this therapist who's in front of this person who just last week we had this conversation, and we get the phone out again and do we address it again, do we confront it again?
Speaker 2:Well, that's a really interesting thing, because usually when I've pointed out an inconsistency or confronted a client about something, I will end that conversation by saying please be prepared If this happens again in future sessions. I'm probably going to point it out to you again.
Speaker 2:And not in a way like this isn't probably the end of it because this is an automatic process for you. You're not going to get this the first time. You know like this isn't maybe going to change for you immediately and so is it okay with you. If this happens again or if I notice this again, can I point it out and talk. You know we can talk about it again and kind of process through it some more and usually you know the client will say yes, if we, if the conversation has gone well with about the confrontation. So that's kind of how I head that off.
Speaker 2:If I haven't done that, hopefully I use humor a lot and have like a kind of a lighthearted rapport with clients in a lot of my relationships, cause that's just how I am, you know, as a person. There may be like a gentle, teasing kind of thing or like it doesn't have to be heavy. Hey, wait a second, we talked about that. You know, like just kind of pointing it out in a lighthearted way that will provoke maybe like a lighter hearted, joking reaction than somebody being really offended by pointing it out again.
Speaker 1:I hear, like in your approach, that you're still confronting it, but there are multiple ways of being able to do the confrontation right. Where it's like, this is kind of lighthearted and we use humor and maybe we're teasing a little or using a little sarcasm, but we're not avoiding it.
Speaker 2:Yeah, and I think that's that that word is such a huge part of my therapeutic approach is noticing places of avoidance, because those places are stagnation and places that usually are blind spots and automatic behaviors that are really unhelpful, and confrontation is like the opposite of avoidance right.
Speaker 2:Which means if avoidance is stagnation and even, like regression, confrontation means growth and progress forward. So that's, I think, even in interpersonal relationships that are therapeutic based, having a way to confront those automatic patterns that exist, but in, like your relationships with somebody. So I think, like the Gottman's say, so I think, like the Gottmans say, it's important to notice our interpersonal relational patterns within our romantic relationship and then, instead of angrily calling those things out, like the unhelpful patterns that your partner may display about X, y or Z, agreeing to like a little gentle teasing code word you may be like okay, you're doing this again, you know, like did you notice that? You know, and that comes with managing your own personal reaction to something that may be really irritating. If you can kind of like calm that first and point it out in a gentle, more lighthearted, humorous way, that's probably not going to engage the defenses of the other person really strongly.
Speaker 1:Yeah, I love that Thinking about confrontation through this lens of just pointing out inconsistencies that's what I hear you saying, like that we're looking at patterns and then we're pointing out inconsistencies in those patterns. And I know we don't have time to talk about all the personal confrontation. But, because you brought it up Also, this thing in me that wants to say, now that we've learned this art of confrontation, it doesn't mean that we have to point out everything and everyone, you know. I mean I just feel like there are some things that are happening in the world. You know, people in relationships are really struggling because we are spending too much time caring about pointing out things that aren't really a pattern, that aren't really a horrible, detrimental thing, and we just are like, well, my voice needs to be heard, and Beth and Deb said that we should learn to confront people, and so I'm going to bring it up for the hundredth time today.
Speaker 2:Well, I mean, that is, it's different being a therapist when your job is to and, of course, as a therapist, you're not going to point out every little thing but, you're only going to point it out if it serves your therapeutic goals right, Like if it's something that needs to be addressed so that the client can grow.
Speaker 2:So in relationships with other people, you know you have to be judicious, because people are not perfect and confrontation should be used appropriately and not for every little thing. I want to be given a lot of grace in my relationships with other people. I don't want to be confronted about every little dumb thing that I do or, like you know, if it's pretty inconsequential, leave me alone, Let me live right.
Speaker 1:Let me live.
Speaker 2:Let me live. I'm not perfect, I'm not trying to be, but if it is a behavior that's impacting you or our relationship or, you know, harming something in some way, then yes, of course. Of course, talk to me about that. But if it's just that you don't like the way I chew, leave me alone.
Speaker 1:Hilarious.
Speaker 2:I don't tell my husband. I said that because that's something we will confront about.
Speaker 1:I know your issues with food and chewing. Eating noises is a real thing. I read a lot Well, I listen to audiobooks a lot and the book Radical Candor. There's a spot in that book and this isn't the main idea of the book. So I think there's's other main ideas, but the one main idea that stood with me is, um, when the author said, leave three unimportant things left unsaid every day and I think it's so true right in in our relationships. It's like is this, is this an unimportant thing that should be left unsaid? And not even just unsaid like let it out your mind. You know, I think sometimes we're like, well, I'm not going to talk about it and then I'm going to stew about it for four days.
Speaker 2:That's unhelpful too.
Speaker 1:It's really unhelpful, like let that narrative go. Anyway, I don't know how we got from therapeutic confrontation to the horrible negative narratives I have around other people chewing. I don't know.
Speaker 2:Well, you know, I think it's something that we help clients with in therapy as well, of learning how to have healthy confrontations or conflict with other people. That's a huge part of therapy and life. So, you know, as a therapist it's an essential skill, but also just as a human, to really fully engage in healthy, joyful relationships. You, confrontation is just part of that and it doesn't have to be so scary. And just part of that and it doesn't have to be so scary, and but it does take, like you said, it's, it's not something we get trained on, so we're kind of left to our own devices or modeling from other people who are probably very just as avoidant as we are about it. And it can be very scary if we don't understand, if maybe we don't have like an emotional maturity about conflict.
Speaker 2:I really, the other day I heard somebody describe emotional maturity as like, instead of having to confront someone about how they made you feel, understanding that they behaved a certain way, and then you had a reaction to that based on X, y and Z, the other person did not make you feel a certain way. You had a response to their behavior, whether their behavior was quote, unquote right or wrong. Okay, whatever it might need to be confronted or not. But the more important part is understanding why you responded that way. What is it about yourself? And I think that's a really important key thing to remember about conflict and that can really help you decide what needs to be confronted or not and especially in interpersonal relationships, understanding, okay, is this response something that's about me, or is it really about the thing that they did?
Speaker 2:And usually, a lot of times, it's about me right and so yeah, it's only my problem and that's something that I need to resolve within myself. It doesn't necessarily need to be that the person needs to change their behavior. I might need to change my internal response.
Speaker 1:Yeah, there is so much more to say. There's so much more to say Okay. So we do have the Beth and Deb show YouTube channel where we did a series on conflict. So people want to hear more, right, don't we have conflict?
Speaker 2:yes, we do.
Speaker 1:We have a few, a few videos on conflict and we have videos on a few other things, and so if folks want to kind of hear more of the dialogue between deb and I, we have our youtube channel where we um talk about good stuff you want to know. That's right, that's our tagline Stuff you want to know.
Speaker 2:Stuff you want to know, stuff you need to know.
Speaker 1:I think it's stuff you want to know. I don't know what it is. It's a really good tagline we have a good time on YouTube. So thanks for being here and I am grateful for our conversation around conflict and confrontation and all the things, and I hope that listeners gained a lot from it too. So, listener, thank you for being here, as always, and until next time, stay safe and stay well. Ciao.
