Bum Rap!

As a powerful intervention that has defied definition, the paradoxical method has been subject to conjecture and criticism. The lack of understanding that has clouded ‘how and why’ interventions work has resulted in unfounded accusations that highlights the degree the method continues to be misunderstood. While achieving amazing results in the hands of skilled clinicians, the many years that the method remained unexplained have ultimately taken its toll.  As a result Paradoxical Intervention approach has gained a ‘bum rap’.

Among complaints that have been leveled are that the method is “manipulative”, “provacative”; “nothing more than “reverse psychology”; and can easily “backfire”!

Before addressing these issues it is important to offer an analogy. We recognize that someone who dangerously wields a sharp knife can easily cut and seriously injure someone. However that same knife in the hand of a skilled surgeon can be a tool for healing. It is therefore understood that we don’t outlaw all sharp knives simply because there are people out there that have trouble controlling their impulses. 

Paradoxical interventions are similar to a ‘sharp knife’. For someone who is unclear about the intent of the method, it can easily become a tool that is clinically destructive in a manner that undermines the therapeutic alliance, or it can be a tool that enhances the alliance to promote exponential growth. 

One of the key elements of understanding paradox psychology and paradoxical interventions is to let go of a treatment focus based on “changing behavior”. This is one of the basic ‘paradoxes’ of paradox psychology. While other methods focus on the ‘surface’ element of changing behavior, in reality it is the shift in “attachment” or the “therapeutic alliance” that is the ‘active ingredient’ that causes behavior to change.

As it turns out, those that complain about the ‘dangers’ of doing a paradoxical intervention, are focused on “behavior change” as the prize. Their focus is not on enhancing or strenthening the ‘client-clinician alliance’ but rather on their personal ego in feeling that they “caused the client to change”.

In fact when the client senses the clinician’s ego as being primary to “making the intervention work”, it is then that the intervention comes across as manipulative, and provactative. In those situations it is not surprising for the client to react in a way that “calls the clinician’s bluff” resulting in an intervention that “backfires”.

As noted elsewhere a true paradoxical intervention is always focused on enhancing the therapeutic alliance. It is through a shift in the alliance that behavior change comes as a natural secondary outcome.