A confrontation therapy is a certain procedure in the context of a psychotherapeutic treatment, in which the patient is directly confronted with anxiety-triggering situations or factors. This is intended to achieve that the anxiety can be reduced. Confrontation therapy should only take place under expert supervision.
What is confrontation therapy?
Confrontation therapy is a specific approach to psychotherapy treatment in which the patient is directly confronted with anxiety-provoking situations or factors. Experts use the term confrontation therapy to refer to a component of psychotherapeutic treatment that is used, for example, when the patient suffers from anxiety or obsessive-compulsive disorders. Especially the symptoms of anxiety disorders are usually triggered by one or more factors, which can lead to a panic attack. In confrontation therapy, the patient is specifically confronted with exactly this triggering factor (alternatively, it is therefore also called “exposure”). It takes place under therapeutic supervision and is intended to achieve a weakening or even complete abatement of the fears/compulsions. Confrontation therapy is not a stand-alone therapy, as the name might suggest, but always just one part of a more comprehensive treatment. Studies have shown that therapists can achieve great success with anxiety patients using such confrontation techniques.
Function, effect, and goals
People who suffer from an anxiety disorder are not infrequently restricted in their daily lives. Certain stimuli cause them to have anxiety and panic reactions of varying severity. These stimuli may be either rather nonspecific situations (large crowds, confined spaces) or very specific triggers (spiders). Depending on the severity of the anxiety disorder and the likelihood of encountering the particular trigger, anxiety patients suffer from their disorder to varying degrees. If they seek a psychotherapist for this reason, the psychotherapist can conduct confrontation therapy in consultation with the patient. In the course of this intervention, the affected persons are specifically exposed to the triggering stimulus; in other words, they have to face what scares them the most. Beforehand, a detailed conversation takes place in which the therapist slowly prepares the patient for what is about to happen. This means that first the stimulus is discussed and appropriate pictures or videos are viewed, for example. Each step is carefully coordinated with the patient. An abrupt or surprising approach by the therapist could make the anxiety disorder even worse. The last step is direct confrontation. During the whole time, the therapist is present and has a positive effect on the patient. The goal of confrontation therapy is to show the sufferer that their anxiety has limits. Anxiety patients often believe their anxiety can escalate to “infinity” and eventually lead to their death. If they are confronted with the trigger, they notice after a while that the fear does not increase, but initially remains the same and then even weakens. Experts refer to this as “unlearning” the fear, in which the patient realizes as a final consequence that their fears were unfounded and that they will no longer suffer from them in the future.
Risks, side effects and dangers
Statistically, confrontation therapy often achieves good results. However, it also carries some risks for the sufferer. For example, if the exposure is stopped in the middle because the patient cannot bear the situation, this may lead to a worsening of symptoms. Self-esteem can also suffer significantly if confrontation therapy fails. At worst, the anxiety disorder intensifies as a consequence, making treatment much more difficult. It is therefore of great importance for the success of the therapy that the patient endures the confrontation to the end. Last but not least, success also depends significantly on the therapist or on the relationship between patient and therapist. The anxiety disorder can only be weakened or eliminated with the help of confrontation therapy if comprehensive treatment takes place beforehand or concomitantly. The preparatory sessions are also of great importance.A therapist who does not adequately prepare his patient for confrontation runs the risk of only exacerbating anxiety disorders. Confrontation therapy should therefore only be carried out if the patient agrees to it and there is an appropriate relationship of trust between the two parties.
