PARADOXIC INTENTION: what it is, examples and how to apply it

Seeking psychological help is a way to mitigate the suffering suffered by people with psychological problems. When a person goes to the psychologist, they go with the hope of finding effective solutions to their problems. Psychologists must be prepared to meet the demands of our patients and reduce and / or eliminate the psychological suffering for which they come.

But can you imagine that the psychologist guides the patient to maintain the problem and even aggravate it? This situation can knock down the patient's expectations and surprise them. Should the psychologist implement this strategy, it would not constitute malpractice on the part of the professional, but is framed within an intervention technique called intention paradoxical.

Keep reading this Psychology-Online article in which we talk about paradoxical intention: what it is, examples and how to apply it.

Index

1. What is paradoxical intention
2. Paradoxical intention as an element in other psychological techniques
3. How to apply paradoxical intention

The paradoxical intention technique was originally developed in the context of logotherapy from Viktor E. Frankl for the treatment of phobias.

It is a type of intervention that has been shown to be useful for patients who are resistant to change. This technique can be striking for the patient, since the therapist, instead of promoting the remission of the problem, is going to encourage its continuity and even its worsening.

The American Psychiatric Association defines paradoxical intention as that psychotherapeutic technique in which the patient is asked to magnify his symptoms so as to distance himself from them and be aware of the low probability that the catastrophic consequences you anticipate will occur.

• For example, consider a person who has insomnia and he can't sleep. In order to fall asleep, use resources such as changing posture, turning the pillow, wrapping up, getting dressed... However, although you consider that you are solutions will help him reach his goal, the reality is that he still cannot sleep, which can generate anxiety and thus distance him even more from reconciling the dream.

If the attempts to solve the problem are what properly maintain the problem, ask the patient If you stop issuing these solutions and keep the problem, you will abandon precisely these Attempts.

• In our example, if we ask the person to stay awake, he will stop using all these resources to be able to sleep and even her anxiety will decrease.

Paradoxical intention is, by itself, an intervention technique. However, we can find paradoxical elements in other techniques such as exposure techniques. In these techniques, used for the treatment of anxiety disorders, the patient is exposed to the feared stimulus, which can be paradoxical.

• For example, in the case of phobia of heights the patient will be asked to stay at a certain height for a long time.

When trying to control anxiety, it can also happen that a certain paradoxical anxiety appears, that is, that in our attempt to reduce our anxiety levels precisely the opposite occurs and this is elevate.

The paradoxical intention technique follows a series of steps at the time of its application that, based on Díaz, M.I., Ruiz, M.A. and Villalobos, A. (2012) we explain below:

1. Problem assessment

In the first place, the psychologist will carry out an evaluation of the behaviors that are being tried to control and / or avoid. The result of this evaluation will account for what are the answers and / or solutions that the patient tries to give to the behaviors and how are you maintaining this problem. It will also provide data on its topography such as its frequency, intensity or duration.

• In our example about insomnia, the psychologist will assess under what circumstances it appears and what mechanisms it leads to. hold the patient to sleep (bring pleasant thoughts to mind, change posture, turn on the television, etc.). Remember that these mechanisms are contributing to the maintenance of insomnia.

2. Symptom redefinition

In this second stage, the symptom will be redefined and it will be given a positive value.

• In our example, we can tell the patient that staying awake offers advantages such as being able to read in bed.

3. Paradoxical change and conceptualization of change

This phase will consist of directing the patient to a paradoxical change based on the complaints that he manifests. Although there are several methods, the most used is that of the prescription of symptoms in which ask the patient to be the one who causes the symptoms or behaviors that he is trying to avoid.

• Following our example, we are going to ask you to stay awake.

Then the therapist will rephrase and reallocate the effects of the paradoxical intention. We will check if the technique has worked correctly and / or we will ask ourselves what could have gone wrong if the result was not what we expected.

4. Schedule of relapses and end of treatment

The therapist must predict and schedule relapses if they occur. Finally, the next step will be to end the treatment once the technique has been explained to the patient and they have been told how to apply it autonomously.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Paradoxical intention: what it is, examples and how to apply it, we recommend that you enter our category of Clinical psychology.

• Díaz, M.I., Ruiz, M.A. and Villalobos, A. (2012) Chapter 12: other intervention techniques in Cognitive Behavioral Therapy. In Díaz, M.I., Ruiz, M.A. and Villalobos, A. (2012) Cognitive Behavioral Intervention Techniques Manual. Bilbao: Desclée De Brower.
• Michael Ascher, L. and Turner, R.M. (1979). Paradoxical intention and insomnia: an experimental investigation. Behavior Research and Therapy, 17 (4) 408-411 https://doi.org/10.1016/0005-7967(79)90015-9