Discussions on mental health issues, treatments, and other related information. Also, opinions and stories.
Monday, May 19, 2014
What Do Counseling and Heavy Metal Have In Common?
The title, this time, does have something to do with the article!
A recent situation got me thinking about the use and necessity of therapeutic confrontation. Much of it stems from having been at a training where individuals are trained in therapeutic relationship skills. One of the techniques that is taught is therapeutic confrontation. This technique means to demonstrate discrepancies or to point out discrepancies or dissonance that a client is experiencing. I particularly like the term dissonance, as it is a musical term. When two notes that are typically 1/2 or one step from each other are played together, it sounds “off.” They don’t fit together like a typical chord and it can sound “grating” on the ears. A lot of music such as heavy metal uses dissonance as a means to excite or bring an anxious response to the crowd. If you've been to a concert before, you know what I’m talking about! People do the same thing internally. They may believe one thing, but behave in an opposite fashion. This creates anxiousness. Or, a client will feel one way about one thing, and yet go against it. I.e. An abuse survivor may be afraid of the abuser, but seek out love and affection from abusers as a means to compensate for a feeling of unworthiness or inferiority. As a counselor, we can point out the discrepancies in a following manner:
Counselor: “For the past few minutes you’ve been describing to me quite a difficult event. You reported feeling guilty for what happened and for how you responded, yet on the otherhand, you continue to do it. What can you tell me about that?”
The point is to bring the client to a greater level of awareness of their behaviors, cognitions, and affects that are not adding up. Many counselors believe pointing out the client’s flaws is a means of confrontation; however, pointing out flaws can actually increase the client’s anxiousness, guilt levels, and even cause damage to the therapeutic relationship; thus, slowing down the process with the client and inhibiting growth and change.
Therefore, it is important to learn appropriate methods of confrontation before engaging a client in their discrepant behaviors.
Motivational Interviewing can be a good method to help with confrontation. Youtube has multiple examples of what it looks like. If you have any questions, let me know! As always, it is a pleasure to chat with you all!
Dr Jamison Law