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Paradoxical Therapies

In a book titled Paradoxical Strategies in Psychotherapy (1986), Leon F. Seltzer described how reverse psychology could be useful in producing therapeutic change. Normally clients expect a psychotherapist to tell them not to dwell on their troubles, not to feel anxiety, not to think bad thoughts.

Seltzer points out that this might be counter­productive. In the section on reverse psychology in Chapter 9 (Motivation) we discussed the children's game mentioned by Dostoevsky among others. Children are instructed not to think of a white bear or red monkey.

The result is a complete inability not to think about the forbidden topic, to the amusement of children experiencing this for the first time. Urging a person not to think of something just puts it into their consciousness and makes them think about it.

What is "paradoxical intention"?

Sometimes a therapist achieves a better result by encouraging a client to practice a troubling thought or emotion. Paradox­ically, this can lead to a reduction in frequency of a troublesome thought or behavior.

Shortly after World War II, Victor Frankl introduced paradoxical intention as a treatment of phobias. He urged clients to deliberately stir up their fears and to practice the behaviors that caused them anxiety. For some clients, this robbed the anxieties of their power.

Even earlier, Knight Dunlop coined the term negative practice. In the 1920s, he described practicing an unwanted response to make it go away.

What is "negative practice"?

As Dunlop put it, he advocated "the practice of a response for the purpose of breaking the habit of making the response." This strange approach sometimes works to eliminate repetitive twitches of the head or neck called motor tics.

Most people try to eliminate a motor tic by trying to suppress it. Sometimes willpower fails and the twitches continue despite all conscious efforts to suppress them. On the other hand, trying to make the tick occur, practicing it, will sometimes make it go away.

The ordinary hiccup shows the futility of directly opposing an unwanted impulse. Struggling against hiccups typically does not make them go away; it makes them continue.

However, when people forget about having the hiccups, or put their attention onto something else, then the hiccups tend to go away. Even more interesting: hiccups sometimes go away if a person is challenged to produce them.

That may not work more than once, because it seems to depend partly on novelty or surprise, but it is worth trying (and very amusing when it works). When somebody complains of hiccups that will not stop, command that person to produce a hiccup, right now!

Often that stops the hiccups. Whatever is happening in that process, it seems very similar to the intent behind paradoxical therapies. At the least, this strategy changes the relationship between conscious will and the intruding neural event, and sometimes that is enough to break up a stalemate.

Many therapies, including paradoxical therapies, have that element in common. They bring a troublesome thought or emotion into transaction with conscious­ness. Much of Jung's approach (such as personifying aspects of the unconscious) was aimed at the same thing.

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Reference:

Seltzer, L. F. (1986). Paradoxical Strategies in Psychotherapy. New York: Wiley.


Write to Dr. Dewey at psywww@gmail.com.


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