“I’ve just made a huge mistake.” That was my thought in the middle of a couples therapy session. I had just described the way one partner was speaking to the other as unacceptable. I could see that my words had affected him. And I immediately imagined what would happen next: I would never see him again.

At the same time, I could not imagine remaining silent. What was happening in front of me was damaging their relationship. I felt that something needed to be said, with no certainty about how it would be received.

He did eventually return, this time for individual therapy. We were able to explore this relational pattern in greater depth. Looking back, I think the way I saw him mattered a great deal: I recognised how hurtful his behaviour was, but I could still see his qualities, his commitment and his capacity to act differently.

His return moved me. It does not prove that I was right, but it allowed us to continue our work together. I revisit that session because it changed how I practise. A few years earlier, I would probably have found it much harder to intervene in that way.

Care can also feel uncomfortable

For a long time, I associated care with leaving a session feeling better than when you arrived. That concern remains very much part of my work. I want the people I meet to find a place where they can breathe, feel recognised and recover a little confidence.

I have had to make room for less comfortable moments within that understanding of my profession. Hearing that the way we defend ourselves hurts someone we love can unsettle us. Recognising our part in a recurring argument can temporarily deprive us of the comfort of being entirely right.

I can accept working through that discomfort if we can make sense of it together. The person must retain their place, their freedom to respond and the possibility of saying that we are moving too quickly. How painful a session feels tells us little, on its own, about how useful it is.

The couple doing more and more of the same

From a systemic perspective, a relationship can find a form of stability even in suffering. We call this homeostasis: certain interactions help maintain the system’s familiar way of functioning, even when everyone says they want to move beyond it.

One partner complains that the other never talks. The other withdraws because they feel constantly attacked. The more they withdraw, the stronger the complaints become. The stronger the complaints become, the more they withdraw. Each can explain precisely why they react as they do. What becomes harder to see is the loop they are maintaining together.

The work of Watzlawick et al. (1975), within the Palo Alto school, invites us to examine attempted solutions that end up contributing to the problem. We insist, explain more, stay silent for even longer. We do what seems necessary without always noticing its effect on the other person.

Therapeutic confrontation can make this loop visible. It can begin with a fairly simple observation: when you withdraw, your partner’s requests become more insistent; is that also what you notice? There is no need to create a shock to introduce something new into the conversation.

What my reaction also tells me about myself

In The Art of Confrontation in Therapy, Ellyn Bader (2026) describes an intervention after which a couple never returned. Exhausted, she had reacted to a husband’s humiliating remarks about his wife’s body. Reflecting on the session, she recognises how her own mother’s criticism of her weight had fuelled her anger.

I value an experienced therapist being willing to share such a moment. It helps me examine my own participation in what happens in a session. We can notice something that deserves to be named and intervene in a way that makes continuing the work more difficult.

The concept of resonance, developed by Mony Elkaïm (2004; linked article in French), gives this question another dimension. Our feelings also speak of our own history, but they can take on a function within the therapeutic system in which we participate. What position are we coming to occupy? Could our reaction confirm what this person already expects to experience in relationships?

I therefore try to treat my feelings as something to explore. If I feel driven to condemn, that deserves my attention: what is touching me personally, and what position am I taking in this encounter? Might my reaction reproduce a scene that is already familiar to the person? Sometimes this question stops me from speaking too quickly. At other times, it helps me find words closer to what I am trying to say.

Naming behaviour without reducing the person to it

In the session I described at the beginning, I was convinced of this person’s commitment to his relationship. I could see his generosity, the efforts he was making and his ability to work towards a shared project. I could also see how the frustration of feeling unsupported could become criticism that damaged the relationship.

Those qualities mattered to me. They were genuinely part of how I saw him, even when his behaviour troubled me. That is probably what enabled me to speak to him with such conviction.

This experience brings to mind Guy Ausloos’s (1995) “méchante connotation positive”, which might be rendered as “the tough positive connotation”. The movement involves expressing what has been difficult for us, then looking within that same situation for a resource for the work. François Balta (2011) offers an account based on La compétence des familles (in French).

In the video, I use the example of a family whose members keep interrupting one another. I might tell them that the session was difficult for me, that I could no longer find my place in the conversation. Then I might add that I also see their involvement, the importance each gives to what is being said and their wish to find solutions. We would then have something to build on. But that reading needs to be sincere, and they must be able to tell me what they think of it.

Returning to my patient, I could not reproduce my exact words. The intention was something like this: I see your ability to give, to commit and to keep going over time; I also see that the way you express your frustration today is hurting your relationship. Could we use that strength to try something different?

The distinction between disqualification and confirmation (article in French) helps us understand what is at stake here. Behaviour can be named, discussed and changed. Words that reduce someone to that behaviour risk depriving them of precisely that possibility.

I want to be able to recognise a person’s worth and tell them that what they are doing, at this moment, is unacceptable. Holding those two positions together feels demanding. Yet that is where I want to work.

Building on what the person can already do

Before risking words that challenge someone, I need to see what we can build on afterwards. In this patient, I saw a capacity for commitment. I hoped we could use it to find another way for him to make himself heard. In other people, it might be perseverance or the care they show their loved ones.

If I can no longer see anything but faults, confrontation risks becoming a release of my own tension. I may then add disqualification to a relationship that already contains a great deal of it.

I associate therapeutic courage with that commitment: daring to say what we observe, then remaining available for whatever those words bring about. The title of Gérard Salem’s (2006) book, Le combat thérapeutique. L’art de guérir par le conflit, prompted me to reflect on the place of disagreement in care. I discussed it with André de Chateauvieux in a podcast episode (in French).

This question also arises when I work with experiences of betrayal or infidelity. Some moments in the work are painful. We need to be able to go through them within a sufficiently containing framework, with a shared understanding of what we are seeking. Each person remains entirely free to decide the future of the relationship, as I discuss in Do we really have to forgive to heal? (article in French).

The patient, too, can say: “That is unacceptable”

This matters greatly to me: relational courage also concerns the person seeking therapy. If an intervention leaves you feeling belittled, reduced to a label or attacked in your identity, you can say so.

“What you just said hurt me. I feel as though you are judging me, and I need us to talk about it.”

This is one possible way of putting it, not an obligation. Challenging someone to whom you have entrusted your suffering can be difficult. You can also take a step back or seek another opinion.

For my part, I need to be able to hear that response. My intention to do good does not give me the final say on what the other person experienced. It is my responsibility to listen, revisit what I said and acknowledge that I may have been mistaken. That, too, is a way of caring for the relationship.

Situations involving violence or coercive control also require specific attention to safety. An interactional understanding must not dilute responsibility or push someone into a confrontation that would expose them to greater danger.

Being authentic, and remaining open to being changed

In the video, I say that silence can damage a bond. I mean the silence that allows reproaches, interpretations and hurts to settle in without anyone being able to discuss them. Silence has other functions, too: sometimes it allows us to think, catch our breath or protect ourselves. It deserves to be understood in context.

That session gave me greater freedom to say what I feel needs to be named. It also reminds me of what I ask of authenticity in my work: acknowledging what affects me, speaking from my own position and remaining attentive to how the other person receives me. The qualities I name must be ones I truly perceive. My disagreement must be able to become part of a conversation.

Resonance helps me continue this work on myself within the encounter itself. My history is present, alongside the expectations and experiences of the people I work with. What I feel may teach us something, provided I remain curious about what I do not yet understand.

When I think back to this patient, I recognise that my fear of losing him could have prevented me from addressing something that later helped us move forward. I want to keep that freedom to speak, together with the doubt that accompanies it. And to be able to hear, when someone responds, something that changes how I see them in turn.

I explore this further in the French-language video I thought this patient would never come back.

References

Ausloos, G. (1995). La compétence des familles : Temps, chaos, processus. Érès.

Bader, E. (2026, July/August). The art of confrontation in therapy. Psychotherapy Networker. https://www.psychotherapynetworker.org/article/the-art-of-confrontation/

Balta, F. (2011). La méchante connotation positive : Structure générale [Training handout, GPS 2011-07]. https://www.frbalta.fr/pdf/GPS-2011-07.pdf

Elkaïm, M. (2004). L’expérience personnelle du psychothérapeute : Approche systémique et résonance. Psychothérapies, 24(3), 145–150. https://doi.org/10.3917/psys.043.0145

Salem, G. (2006). Le combat thérapeutique : L’art de guérir par le conflit. Armand Colin.

Watzlawick, P., Weakland, J. H., & Fisch, R. (1975). Changements : Paradoxes et psychothérapie (P. Furlan, Trans.). Éditions du Seuil.