Confrontation: On (not) Saying What We Need, Out Loud (under our breath, to ourselves).

The challenge of direct and healthy communication is a regular topic that comes up in therapy sessions (and in daily life, for all of us). Sometimes, we find ourselves mired accidentally in reality tv-worthy dramas. Unnecessary disputes result from assumptions made but never expressed. Differing opinions aren’t fully unpacked and people assume the worst of one another. Sometimes, unfortunately, there is an (un)healthy dose of silent treatment with which to contend. 

Straightforward communication is routinely avoided, even by the best communicators among us. Why does communicating present such a challenge, when we know the outcomes of poor communication are so, well, poor?

The Problem of Fear

Well, to start, confrontation is capital “S” Scary. At the heart of the matter, the fear is almost always that we will damage the relationship with the other person, or that they will no longer like us, or will view us differently. All of the following are common fears related to confrontation:

  • Fear of offending the other person, or of being offended.
  • Fear of ruining the relationship or making things awkward.
  • Fear of being perceived as overly sensitive or dramatic.
  • Fear of looking weak or unappreciative.
  • Fear of retaliation.
  • Fear of vulnerability.
  • Fear of disappointment. 

These are heavy fears, up there with being trapped in very tiny spaces or being left alone in the middle of the ocean (I mean, personal phobias, but you get the point, right?). It’s no wonder we freeze up and opt out of the difficult conversations, given the stakes! 

When we recognize the root of our fear, we can decide whether or not that fear is useful. For instance, a legitimate fear of conversing with a potentially aggressive or emotionally reactive person might help us decide a conversation is not worth having (and for that matter, whether that relationship is worth having!). On the other hand, a fear of ruining a relationship with an open and lifelong friend, while scary, might be highly unlikely and therefore less helpful. It’s worth it to take the time to explore our fears and assess their value to the situation at hand.

The Problem of Self-Confidence

Frequently, clients in session will cite lack of self-trust as the reason why they don’t speak up. Boy, do I relate to this concern. What if we say something and then change our minds? What if we are being reactive and haven’t assessed the situation thoroughly? What if we aren’t justified in our feelings? We don’t trust ourselves or our feelings, especially if we’ve been shamed historically for being overly sensitive (“Why can’t you just get over it?”) or dramatic (“It’s all in your head”) and so we grow into adults who question ourselves. 

It’s important to assess the reactions we have, sit with them, and take them seriously. Sometimes, they come from Parts of us that are reacting due to experiences we’ve had in the past, such as trauma or loss. It’s important to recognize that this does not invalidate the reactions! We can sit with them, identify where they are coming from, and then assess what they need from us. At times, we’ll be able to take care of them on our own. At times, we will decide that it’s important to speak up for them. Either way, we can be confident that there’s no way that we “should” feel, and that our emotions are okay.

The Problem of Time

Finally, practicing direct communication is frankly exhausting. In reality, if we addressed every situation in which had conflict or probably should communicate more deeply or honestly, we would do nothing but have emotionally difficult conversations all day long. For many of us, our calendars are already filled to capacity with work, family, children, friends, and all the tasks that take up everyday life. Because these things are (to varying degrees) often easier than scheduling a direct and anxiety-producing discussion, we focus on them and put our difficult conversations on the back burner, until we’ve forgotten about them, decided they were no longer important, or just “let it go.” 

We can prioritize the need to have direct conversations by how much mental and emotional space they take up. If we become angry about something and feel okay about it a few hours later, it might not be a top priority to hash it out. However, if we are up several nights in a row thinking about what we want or need to say, how we want to say it, and envisioning a situation playing out in all manner of ways, it’s likely important for us to confront the problem.

Direct and honest communication is scary, time-consuming, and takes guts. It is obvious why we so often choose not to say what we need to say, and to wait out the problem, or to avoid the conversation altogether. But often, the strength and authenticity of our relationships suffer due to this avoidance, and we cheat ourselves out of being true to our own wants and needs. 


Originally posted on my blog, Common Humanity, at Psych To read more, visit

Useful Information

Some frequently asked questions and useful answers.

Online therapy works in the same way as in-office therapy, but is done online, similar to a Skype or FaceTime conversation. Clients are able to have sessions from home, work, or any other convenient location. We meet with clients using a HIPAA-compliant secure platform.

Online therapy allows you to work with us from the comfort of home, or any private location of your choosing. For some, the screen provides an added layer of comfort that makes the challenging work of being vulnerable in therapy a little easier.

Online therapy also creates the unique opportunity for you to work with us without the constraints of proximity! The practice was born in Keene, New Hampshire, but has since grown to service clients anywhere in Massachusetts, Pennsylvania, Connecticut, Vermont, New Jersey, Florida, and New Hampshire.

Online therapy is a great option for clients that travel for work, for college students that go home during the summertime and do not want a break in their sessions, and for anyone with a challenging or inconsistent day-to-day schedule. It is an excellent choice for clients seeking a therapist with a particular specialty that they are unable to find support for locally. Some of our clients report that online therapy makes the vulnerability element of therapy a bit less intimidating.

No. For some clients with more complex symptoms or safety concerns, having a local therapist that is readily available is important in case of crisis or the need for a higher level of care. Online therapy is also a challenge for clients that do not have access to a private, quiet space to be “in session” for the hour, or for those that do not have adequate internet connectivity.

There are several reasons why we don’t accept insurance. The most important are:

Confidentiality. Insurance companies require that your information be shared with them in order to pay for services. We prefer that clients’ information is kept as confidential as possible.

The pressure to diagnose. Insurance companies require that clients are given a mental health diagnosis in order to pay for therapy. We have found that many clients benefit from therapy, but do not meet criteria for a diagnosis. Not using insurance allows clients to access therapy without being given a mental health diagnosis.

Flexibility and freedom. Insurance companies dictate the length and number of sessions they will authorize, as well as when a client is no longer eligible for the benefits of therapy. Because we do not work with insurance panels, you and we can collaborate to determine your individual needs regarding session length, frequency of sessions, and when to terminate therapy.

While we do not accept insurance, many clients choose to submit receipts to their insurance companies to receive reimbursement via out-of-network benefits. We are happy to provide these receipts for you! Please check with your insurance company for details on your benefits.



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