Couples Therapy Is An Art —Confrontation

There are a lot of misconceptions about couples therapy. I get questions like, “Do couples just sit on your couch, hold hands and talk about their feelings?” or “Do they just yell and scream at each other the whole time?” (The answers are no and no). This is why I deeply appreciate thoughtful ways people can get a glimpse into what couples therapy is actually like— shows like Couples Therapy on Showtime or Esther Perel’s podcast Where Should We Begin. And then, came this piece from Daniel Oppenheimer called “How I learned That the Problem in My Marriage Was Me.” It’s his account of eight sessions of couples therapy with renowned therapist Terry Real, who conducts live trainings for therapists and coaches to observe and learn from his approach.

What I loved about this honest and raw piece is how Oppenheimer sheds light on what powerful couples therapy actually looks and feels like. If you read carefully, this article is as much about Oppenheimer’s realizations regarding his contributions to the toxicity in his marriage as it is about the art of couples therapy.

Here, I specifically want to talk about the art of confrontation, an area in which Terry Real is a master. He calls it “joining through the truth”—connecting with clients through honest, loving, and firm confrontation about their behavior. As couples therapists, we’re often taught to be validating and neutral, yet when one or both partners act in ways that clearly undermine a healthy relationship, we have an obligation to help them see and own their behavior.

As couples therapists, we’re often taught to be validating and neutral, yet when one or both partners act in ways that clearly undermine a healthy relationship, we have an obligation to help them see and own their behavior.

What Oppenheimer’s article indirectly highlights are the subtle elements that make confrontations powerful—what happens before, during, and after a confrontation. The therapist’s presence and energy in the session are key. Some of this can be intentionally cultivated (such as warmth, calm, and steady confidence), while other aspects are intrinsic to the individual therapist. For example, Terry Real is a white man, a well-known author, speaker, trainer, and celebrity therapist. Those factors inevitably shape how clients engage with him on a subconscious level—“We’re having a session with the best therapist!” or “He reminds me of a wise man I’d want to learn from.” These elements, while not easily replicable, should still be acknowledged when considering the dynamics of confrontation in therapy.

Before the Confrontation: Laying the Groundwork

Before a confrontation, there is rapport-building—that crucial process of connecting with each partner, letting them know they are seen, heard, and understood. Where many couples therapists get stuck is staying in this phase indefinitely. But I don’t believe you can validate your way through unhealthy marital dynamics. Validation is important, but at some point—whether in a session or in well-balanced moments throughout the work—it must be followed by challenge.

My stance from the first session with any client is clear: I see you, I get you, and I’m going to challenge you. Clients know that I bring my authentic therapist-self into the work and won’t suddenly pull the rug out from under them. This builds trust—not just in me as their therapist, but in the therapeutic process itself.

But I don’t believe you can validate your way through unhealthy marital dynamics.

The Role of Humor in Confrontation

Another crucial element in confrontation is humor—and I don’t mean jokes. I mean wit, clever touches of levity that make confrontation more digestible. As my mother always said, It’s as much about how you say it as it is about what you say. Humor is a conduit for connection—connection to our shared humanity—which allows the client to feel, I get it, this shit is hard, and yet I have to tell you that what you’re doing is not okay.

Used wisely, humor counterbalances serious confrontations. It doesn’t replace the firm, fact-based confrontation itself, but it can soften the impact, helping clients stay open rather than shutting down in defensiveness.

The Confrontation: Delivering It with Clarity and Warmth

The moment of confrontation must be delivered clearly, grounded in facts, and firmly—without losing warmth. Letting the confrontation land requires an ability to sit in the tension of uncertainty. You’re not just counting to ten; you’re reading your client’s nonverbal cues, breathing, and remaining calm. That requires a steadiness grounded in knowing that you, the therapist, are ready for anything.

One common mistake I see therapists make is backtracking after a confrontation—following it up too quickly with a reassurance like, “…but it’s not your fault.” This can be a missed opportunity. A client needs to feel the weight of their behavior and what’s at stake. Our job is not to convince them or to soften the truth to the point where it loses its impact. Let it land.

After the Confrontation: Integration

Finally, the after—checking in with the client:

“How did that land?”

“I’m watching you take it in.”

“I appreciate your willingness to let some of it impact you.”

Some degree of defensiveness is natural—especially at first. After all, it’s not easy to have a stranger hold up a loving mirror and ask you to take a hard look at yourself. But this is one of the kindest things a therapist can do. Clients won’t have healthy, fulfilling relationships until they learn to recognize what they’re capable of in their worst moments, be in relationship with that part of themselves, and develop the ability to respond from their “wise adult” self.

As therapists, we model this wise, nurturing parent—the one with firm boundaries and warmth. This is one of the many brushes we use in the art of couples therapy.

Want to Learn More?

We will explore confrontation and many other aspects of couples therapy in my upcoming course: Integrated Growth Approach: A Masterclass in Attachment & Differentiation for Couples Therapy.