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Confrontation techniques in Adlerian psychotherapy.

The characteristics and purposes of confrontation techniques have been variously described by different authors. Devereux (5), a psychoanalyst, perhaps the first to write on the subject, defines confrontation as "a device whereby the patient's attention is directed to the bare factual content of his actions or statements, or to a coincidence which he has perceived but has not, or professes to have not, registered." The purpose, says Devereux, is to "indl;lce or force the patient to pay attention to something he has just said or done" in order to open up new avenues for examination and to increase awareness. Wolberg (17, p. 429) points out contradictions to the patient and asks him why he so behaved. He then examines the patient's response to the confrontation. Ruesch also uses confrontation to "confront the patient with the facts" and describes it as containing "an element of aggressiveness, and ... designed to produce shock ... usually demonstrates discrepancies between intent and effect, between word and action" (14, p. 194)' Berne likewise defines confrontation as "pointing out an inconsistency" and suggests its use in three specific situations: when the patient tries to deceive the therapist, when the patient "plays stupid," or when he does not perceive the inconsistency himself (3, pp. 235-236). Dreyfus and Nikelly describe the technique in existential language: "Two of the most important kinds of human relatedness which frequently occur during psychotherapy are encounter and confrontation ... Confrontation involves being faced with a choice regarding one's own existence. The therapist confronts the client with an aspect of the latter's world, and the client must choose whether or not he will respond and what the response must be" (7, pp. 18-19). Garner (9, 10) more than anyone has described the various kinds of patient material on which confrontation may be focused. One may choose one of many "conflicts" as object of a direct, authoritarian statement, sometimes a command. No matter what the focus of the statement, Garner then adds, "What do you think or feel about