Introduction

                             Eliot P Kaplan, PhD, LCSW, CAS

Dr. Eliot P Kaplan is the director of The Paradox Psychology Institute and is the author of this website.

The goals of this website are two-fold:

1)      The Paradox Psychology Institute is dedicated to the theory and practice of paradoxical interventions, and its strategic and educated use when working with the ‘treatment-resistant’ client.

2)      To offer a scientific understanding of the concept of 'change' and how this understanding can help to theoretically unify behavioral, cognitive, psychodynamic orientations -along with paradoxical interventions.

Goal 1) Paradoxical interventions are particularly important in working with the ‘treatment-resistant’ client. Independent research indicates that paradoxical interventions have a higher rate of success than traditional approaches - behavioral, cognitive, and psychodynamic methods - when working with ‘treatment resistant’ populations. These clients include:  

Ø       borderline personality,

Ø       compulsive disorders,

Ø       eating disorders,

Ø       oppositional / defiant behaviors

This work will show that it is possible to extend the list to: 

Ø       addictive disorders,

Ø       fire setters,

Ø       problem sexual behavior and aggression,

Ø       violent behavior and ideation, to name a few.

Goal 2) As will be discussed, it is through understanding the paradoxical method that we are able to define the science of 'change' and thereby offer the theoretical 'missing link' that unifies the seemingly separate natures of behavioral, cognitive, and psychodynamic orientations under a single conceptual umbrella.

Master Therapists

In this era of ‘evidence based treatment’, we hear little about the potential and historic importance of paradoxical interventions. However, it should be noted that numerous ‘master therapists’ have been associated with the implementation of the method. They include:

Alfred Adler                                           Milton Erikson  

Fritz Perls - Gestalt Therapy                   Salvador Minuchin

Victor Frankl - Logotherapy                     Virginia Satir

Research supporting paradoxical interventions:

Shoham-Salomon, Avner, & Neeman, (1989) You’re changed if you do and changed if you don’t; Mechanisms underlying paradoxical interventions, Journal of Consulting and Clinical Psychology, 57, 590-598

Horvath & Goheen, (1990) Factors mediating the success of defiance and compliance-based interventions. Journal of Counseling Psychology, 37, 363-371

Beuter, Moleiro, & Talebi (2002) Resistance in Psychotherapy: What conclusions are supported by research, Journal of Clinical Psychology, 58 (2), 207-217

A Peculiar Pre-condition

It should be recognized that almost any treatment method will be successful with the client who is motivated toward change. In terms of treatment-resistant clients, traditional approaches often express a peculiar ‘pre-condition’ before they endeavor to help such clients. That pre-condition is that the client must be willing to ‘participate, or make some minimal effort to cooperate’. In other words, these approaches ask that the resistant client should ‘agree to be less resistant’ so that treatment might be successful!

Paradoxical interventions do not rely on this pre-condition, and are therefore not invested in gaining the client’s overt agreement, or willful cooperation to ‘participate’. In general, the process of treatment engages the client around his ability to make ‘free will’ choices. By addressing the client on the subject of his 'free will', we address the deepest level of the client's 'human identity'. When done correctly, the process is able to bypass the client's cognitive state of mind (both high and low IQ), as well as the need for superficial behavioral rewards. On a core level, interventions challenge the client to take self-responsibility toward achieving personal changes.

The question we will address is: What is the ‘active ingredient’ that makes the paradoxical method successful?!