15 Paradoxical Interventions - An Overview

“The handle of the axe which chops down the forest comes from a tree in the forest itself” (Sanhedrin 39b). 

1) No-Frills Predicting and Forecasting – Using previous observed repetitive behavioral cycles / pattern(s) to forecast and predict future events;

2) ‘l’ll Bet You!’ – Who are you calling “predictable?!” 

3) Prescribing the Symptom – Instructing the client to engage in symptomatic behavior;

4) Permission and Positive Reframing – Advising client of the ‘benefits’ of doing his symptomatic behavior;

5) Scheduling and Planning  - Scheduling where, when, how, and with whom the next ‘event’ will occur;

6) Cognitive Ordeal – Creating an ‘logical’ ordeal around the client’s rigid perceptions and reasoning;

7) Practice Makes Perfect - Encouraging client to ‘improve, practice or exaggerate’ symptoms;

8) Colluding and Advice - Giving advice to expand client’s ‘business model’;

9) Achievement Awards and Mementoes – The client’s ‘achievements’ are honored through awards, certificates, greeting cards, mementos, etc.  

10) Contracting for Success –formalizing a written contract that details what client and therapist responsibilities in order to maintain the status-quo;

11) Bribery and Payoffs- cash incentives to continue symptomatic behavior;

12) Copycat Mirroring – Clinician ‘takes on’ or imitates client symptoms’;

13) Role-playing Made EZRole-plays that purposely support status-quo behavior;

14) ‘Home Sweet Home’ Inoculation – Couples and families become inoculated to each others symptoms and triggers;

15) Flunky Therapist – Admitting incompetence for the client who complains that his therapist is not perfect;


Working With The Treatment-Resistant Client - Paradoxical interventions are geared specifically toward addressing  the treatment-resistant client. While it seems that there is no shortage of ‘resistant behaviors’, the basic goal of any paradoxical intervention is surprisingly simple and single minded; the intent is to enhance trust. This is accomplished by ‘strengthening the therapeutic alliance’ and dissolving underlying and often unconscious aspects of ‘abandonment trauma.’

‘Strengthening the alliance’ and ‘reducing trauma’ are “two sides of the same coin.”  The combined result of a ‘stronger therapeutic bond’ and ‘soothing abandonment trauma’ leads to a decrease in rigid habitual reactions and an increase in free-will flexible behavior. All paradoxical interventions seek to promote relief by simultaneously addressing ‘trust /alliance’ and ‘trauma / abandonment’ issues.

Strengthening the alliance undoes the debilitating effects of historic ‘abandonment trauma’. Such trauma is the core issue that perpetuates feelings of intense aloneness, emptiness, and isolation. Until the client experiences relief around abandonment, he will be unable to sustain long-term changes in rigid ‘orbits’ of disruptive behavior.

A key factor to remember is that the childhood trauma experienced by the client is not the reality in the ‘here-and-now’ of today. Clients who have been severely abused emotionally or physically tend to carry this ‘unresolved baggage’ into the present. For this reason their current reactions and responses are often a re-creation and a re-living of past trauma. Telltale signs that the client remains in the past are evidenced by the tension of vigilent attitudes and perceptions, along with rigid behavior patterns. 

The healing process of paradoxical interventions is to create dilemmas in the ‘here-and-now’ that simultaneously highlight past trauma events, but  bring the client into the safety of the therapeutic alliance of today.  By presenting both situations side by side, the client is able to let go of past trauma and reorient himself in the present.

Paradoxical interventions work to strengthen the therapeutic bond in order to help the client experience support in the here-and-now that he did not experience at the time of his childhood trauma. In experiencing this support, the client is able to surrender into a more relaxed state. This type of surrender allows for a ‘release of tension’ and the ‘letting go’ of vigilent attitudes and defenses. With this new found ability to release old attitudes and behaviors, treatment provides a safe atmosphere to explore the flexibility of making ‘free-will choices.’ 

By strengthening the alliance and reducing isolation, interventions tend to provide a ‘comforting blanket’ that envelopes the client on conscious and unconscious levels. By providing a safe and comforting atmosphere treatment helps reduce the client’s conscious and unconscious efforts to maintain a guarded stance.

A main focus of paradoxical interventions is to ‘avoid power struggles.’  This is a hallmark of the approach, as it promotes a non-confrontational and non-threatening atmosphere. By not ‘buying into’ the client’s expectation for a power struggle, the intervention enhances the alliance in a manner that leaves the client with nothing to ‘defend against’ or ‘block out.’ In this way, the avoidance of power struggles works to promote the alliance while undermining the client’s habitual defensive and vigilent reactions.  While the presence of power struggles usually perpetuate the client’s resistant stance, the avoidance of such struggles tends to stymie the client’s attempts to analyze, monitor, and ‘figure out’ the treatment. 

Another key factor is the subliminal nature of the approach. While the client is effected on behavioral, cognitive and emotional levels, the subliminal quality of the intervention is able to influence the client without the need to convince, instruct, or reward. While such interventions clearly induce change, they are not the result of overt directives. In a subliminal manner shifts in behavior occur as an indirect result of the clinicians actions. In this way, paradoxical interventions act in a subliminal manner that serve as a catalyst for change rather than overtly attempting to influence change.

As a result, the method influences the client to make spontaneous behavioral / energy shifts that occur without planning or forethought.     

www.ParadoxPsychology.com              EPK Revised: 1-12-12