I agree with you about the 'feel-good, mothering-type' therapists. That is not what I was meaning at all. Wishy-washy empathy which just says basically 'I know what you are feeling, I feel your pain...' etc goes nowhere and is certainly not for me.

The therapist I have in mind is both extremely empathic *and* confrontational. The reason is, that if someone really knows what you are feeling, there is no escape! Someone who is merely confrontational can be hoodwinked, and I can and do use avoidance tactics to some extent on such a person, even unconsciously. But someone who can *really* resonate with what I am feeling, that person I cannot hoodwink, cos he knows what I am feeling, and can sense my bullshit.

So I don't see empathy and confrontation as two opposite ends of a spectrum, although I agree they are often seen that way. I think they need to go together. Empathy without confrontation is just 'feel-good' as you say; confrontation without empathy is against pretty much everything I believe in, and would not be effective with me, for sure. But put them both together, and you have by far the most effective therapy or dialog I have come across.

I am happy to give you the name and url of the actual therapist I have in mind, by private correspondence, if you are interested, but he only operates in England. He certainly is not just 'fulfilling his own needs...' as you say, and he does *not* keep 'folks for the long-term', on the contrary, he is often extremely effective in just one or two sessions with real head-cases.

I agree with you that the 'whole field is extremely tricky...'