This is the 2007 version. Click here for the 2017 chapter 13 table of contents.

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 struggling against unwanted mental events is often ineffective. As described in Chapter 9, there is a children's game in which people are instructed not ot think of a white bear, or a red monkey. The result (to the amusement of children experiencing this for the first time) is the complete inability not to think about the "forbidden" topic. Urging a person not to have unpleasant thoughts may be equally counterproductive.

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 a paradoxical intention 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.

What is "negative practice"?

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

How do Zen masters use something similar to paradoxical intention?

Zen masters have been using techniques similar to paradoxical intention for centuries. They seem to urge the novice student of Zen in one direction, while intending that the student snap back in the other direction. Zen teachers use outrageous statements, contradictions, and impossible demands. They startle beginning students, break up their preconceptions, and open them to new ways of thinking. This may explain such odd phenomena as a book on Zen Buddhism titled, If You Meet the Buddha on the Road, Kill Him! (Kopp, 1976).

How might exposure be a factor?

Reactance or "pushing back" is one explanation of successful paradoxical therapies, but there is also an entirely different mechanism that might also be at work. As we will discuss presently, sustained exposure to anxiety-producing stimuli in a safe environment (such as a therapist's company) can reduce anxiety and fear. This is extinction of a CER or conditional emotional response can produce a therapeutic result in itself.

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