Interpretation and Confrontation

Interpretation as construction of meaning

Interpretation is the act by which the therapist offers an explanatory hypothesis about the latent meaning of the partner's behaviors, dreams, or fantasies.

It goes beyond what the patient consciously knows, giving new meaning to his or her experience.

To be effective, it must be rigorously based on the material provided by the patient and on clinical theory, avoiding at all costs that the therapist projects his or her own personal experiences or values.

A good interpretation connects the past with the present, or the symptom with the hidden conflict.

For example: "Perhaps the anger you feel when your wife is late is not only because of unpunctuality, but because it reminds you of the feeling of waiting and uncertainty you experienced in your childhood".

The goal is not to be right, but to offer a perspective that unlocks understanding and allows the couple to see their conflict in a new, deeper light.

Confrontation to generate insight

Confrontation is an active technique that brings the patient "face to face" with his own contradictions, resistances or defensive behaviors that he himself does not recognize or avoids.

Unlike pointing, which is more descriptive, confrontation is more direct and seeks to challenge the barriers to change. Its ultimate goal is to "realize".

For example, if a patient constantly complains that his partner does not speak to him, but every time his partner tries to speak he interrupts her, the therapist must confront this dynamic: "You say you want to be heard, but I notice that you interrupt your wife every time she opens her mouth. How do these two realities fit together?".

This intervention forces the individual to examine his or her own responsibility in maintaining the problem, breaking out of the role of passive victim.

Ethical difference between confronting and attacking

It is crucial to distinguish clinically between confrontation and aggression. Therapeutic confrontation is carried out from empathy and the desire to help, never from the therapist's frustration or the desire to punish.

It is not a matter of "cornering" the patient to make him confess, but of showing him a mirror of reality that he may prefer to ignore.

A poorly executed, hostile or premature confrontation can damage the therapeutic alliance and increase defenses.

The therapist must gauge whether the patient has sufficient ego strength to tolerate the truth at that moment.

The underlying message should be, "I am showing you this because I believe you are capable of seeing it and handling it for growth," not "I am showing you this to prove you wrong."

Summary

Interpretation offers an explanatory hypothesis about the latent meaning of behaviors or dreams. It gives new meaning to the experience by connecting the past with the symptom of the present today.

Confrontation brings the patient face to face with contradictions or resistances that he/she does not consciously recognize. It seeks to generate "awareness" by breaking the role of passive victim in the face of current problems now.

It is vital to distinguish ethically between confronting and attacking in order not to damage the therapeutic alliance. The intervention must be made from empathy, calibrating the strength to handle the truth revealed soon.