BS’D

The Sex Offender -Volume VI (2008)

Civic Research Institute (CRI) Publishers

Kingston, New Jersey

 

Chapter 4

Paradoxical Interventions

for the Treatment Resistant Offender

- Theory and Practice -

 

By Eliot P. Kaplan, PhD, LCSW, CAS

Email: ParadoxDoc@gmail.com

 

Overview…………………………………………………………………………..            4.1

Introduction ……………………………………………………………..……….            4.2

Diagramming Change ……………………………………………….………….            4.2

The Solar System …………………………………………………..…..………            4.3

Advanced Attachment Theory ……………………………………….….……..             4.5

Healthy Personality System – HP System ………….………..……….………            4.6

Traumatized Attachment ………………………………….……………………            4.6

Sexual Harm Personality System – SHP System ………..……………….             4.7

Treatment and Paradoxical Intent ……………………………….…………               4.8

Win-Win Double Binds ……………………………………………………….              4.9

Interventions and Techniques ………………………………………………            4.9

Case Example -Treatment Resistant 12 Year Old - SHP System …             4.10

Conclusion ……………………………………………………………………….             4.13

OVERVIEW

Although research indicates that paradoxical interventions have a higher success rate than other methods for treating various types of oppositional and resistant client populations (Horvath & Goheen, 1990; Shoham-Salomon, Avner, & Neeman, 1989), there is no mention of the method in sex offender literature. In general, many clinicians consider the approach to be counter-intuitive and implementation too provocative for an offender population.  While the method is known for its rapid and seeming “miraculous” results, the main problem has been the lack of an organized theory to explain its mechanism. This chapter seeks to resolve these questions and concerns. By presenting a concise theoretical understanding of the method, it is hoped that clinicians will gain confidence to begin employing this powerful approach.

 

INTRODUCTION

To comprehend paradoxical interventions, it is first important to take a step back and define the concept of “change.” Interestingly, while psychological treatment is based on the idea of influencing change, there is relatively little consensus about its exact definition and what it entails. Often depending on one’s “orientation”, change is considered to occur behaviorally, cognitively, or emotionally. In general, most treatment approaches accept idea that change takes time and is a process that occurs gradually. While clinicians recognize that it is not uncommon for clients to make exponential leaps, this type of change is not addressed in the literature, because there is no framework to explain how or why this process might occur. As a result, current treatment methodologies are often presented and geared toward the expectation that change is gradual and that progress occurs in a logical, linear, and step-by-step manner.

Paradoxical interventions are known for influencing exponential leaps.  However, the problem has been in identifying a theory that supports this view. This is further compounded as such interventions often seem counterintuitive and are therefore difficult to explain using step-by-step logic. As a result, without a solid theory to support the method, the tendency within the field has been to relegate paradoxical interventions to the “fringes” of treatment. For many clinicians the complicated nature of exponential change seems to be an unsolvable mystery.  

It is the purpose of this chapter to demystify the nature of exponential change. In order to understand paradoxical interventions, we must first identify a viable framework regarding the process of change and how we might diagram it. To accomplish this, we will capitalize on the science of orbits-gravity phenomena. The orbits-gravity paradigm represents the core theoretical model for astronomy, biology, chemistry, and atomic physics (Capra, 1975; Hawking, 1998). Until now the model has been incorporated in all areas of science, except for psychology. By using the model to explain psychological phenomena, we allude to a conceptual overlap between psychology and the major sciences. The orbits-gravity model allows us to diagram the concept of exponential change. It is through this model that it becomes possible to explain the intent and goals of paradoxical interventions. 

While most clinicians have accepted the theoretical assumption that change occurs gradually, it is easily understood that a model for exponential change is particularly advantageous when treating those who cause sexual harm and other volatile behaviors, where time is of the essence. It is the goal of this work to offer a concise and viable theory so that clinicians can feel comfortable accessing the power of paradoxical interventions and exponential change.

 

DIAGRAMMING CHANGE

The orbits-gravity model is based on the concept that orbits and gravity act as a single and unified system that functions in a state of equilibrium. As a system in equilibrium, gravity is the central stabilizing force that dominates the movement, rate, and range of repetitive orbits of energy. When the gravity of any given system is altered, it impacts the orbits and equilibrium of the entire system.

Historically paradoxical interventions have been viewed as complicated and clinically abstract. While there are numerous books written about paradox and its success with difficult cases and populations (Haley, 1963; Satir, 1964; Weeks & L’Abayte, 1982), a concise theory has remained elusive. Of the many theories offered, none have proposed the relatively simple science of orbits-gravity phenomena to explain its workings. The orbits-gravity model helps advance our understanding of psychological concepts particularly in relation to attachment and joining. The model indicates how attachment and joining, as defined through the therapeutic alliance, is the primary factor that promotes exponential change. 

            Along with providing a framework for exponential change, the orbits-gravity paradigm has other advantages:

    1. The model offers a conceptual bridge that indicates a tangible link between psychology and other areas of scientific thought.

    2. The model offers a neutral model that encompasses behavioral, cognitive, and psychodynamic approaches.

    3. The model offers a visual construct to illustrate the abstract idea of change.

    4. Although clinicians have intuitively recognized the importance of the therapeutic alliance, the model offers a scientific base to further support this understanding.

    5. The simplicity of the model allows clinicians to gain insight into the workings of paradoxical interventions, as well as its proper use when treating offenders. 

 

THE SOLAR SYSTEM      

To explore the concept of exponential change, we will enlist an orbits-gravity model based on the solar system. Figure 4.1 presents the orbits-gravity paradigm that is widely accepted as being representative of the solar system. For our purposes we will only focus on the first five planets. This model is useful to provide insight into the general workings of an orbits-gravity system. Orbits are represented by the cyclical movements of Mercury, Venus, Earth, Mars, and Jupiter; and the force of gravity, is the Sun that stabilizes the system. As discussed here, from a psychological perspective, these orbits parallel various repetitive aspects related to actions, emotions, and thoughts while the gravity represents the psychological equivalent of the force that “attaches, bonds, and joins.”  Just as the solar system is representative of a “system in equilibrium”, so too the human mind-body functions as a system in equilibrium. Thus the model offers a simple framework to explain exponential change for systems in equilibrium.

As example of exponential change, let’s say that we decided to focus on changing the orbit of Venus. If we were to follow current approaches in psychology, it is likely that we would focus our attention directly on Venus. We might try to influence Venus’s orbit using behavioral, cognitive, and psychodynamic techniques.  Following this line of thinking, we would attempt to change Venus through reward and punishment (behavioral), convincing and logic (cognitive), or possibly providing insight regarding Venus’s emotional states and history (psychodynamic).

However, the advent of the orbits-gravity model provides a forth choice to promote change.  This choice would focus on altering the gravity of the Sun. By altering gravity, we have a unique advantage of indirectly changing the orbit of Venus. This hypothesis is the central concept behind the idea for exponential change. Thus the orbits-gravity model offers a scientific framework that (1) substantiates a process for exponential, rather than gradual change; (2) shows the potential to indirectly change a targeted behavioral orbit; (3) does not depend on the orbit’s cooperation; (4) indicates a process of change that occurs spontaneously without planning or forethought; and (5) shows that for systems in equilibrium, when we shift one orbit it will have simultaneous impact on other orbits.

Figure 4.2 diagrams the impact of strengthening the gravity of the Sun. By strengthening the gravity our efforts would have an immediate and exponential impact on changing the orbit of Venus. This shift occurs despite the fact that we are not focusing directly on Venus. This means that for change to occur, we are not dependent on Venus’s cooperation. Even if Venus was set on being oppositional, if we are successful at altering the gravity, then the model hypothesizes that a shift will occur despite Venus’s initial desire to resist change. Although initially our efforts were designed to target the orbit of Venus, increasing the gravity would impact the equilibrium of the entire system. As a result, secondary nontargeted orbits would be influenced as well, and the whole system would move toward greater expansiveness and flexibility. 

Figure 4.2A shows our effort to shift gravity by shooting arrows into the Sun. These arrows indicate the process of joining and strengthening of gravity. Figure 4.2B shows that when gravity begins to alter, the orbits begin to adjust and react in a spontaneous manner. Figure 4.2C indicates the Sun in its new empowered state and the orbits and system in a new aligned equilibrium. 

Figure 4.3 offers a “before and after” view of the targeted behavior of Venus. Here we see how the change that has occurred in Venus’s repetitive behavior. Initially the orbit is more restricted; however, once we alter gravity, the orbit expands. The model indicates how exponential change can be diagramed from a scientific perspective.

The orbits-gravity model is a metaphor for human personality systems in equilibrium. From a psychological perspective, the orbits-gravity paradigm advances the significance of attachment theory as initially described by John Bowlby (1969) and Mary Ainsworth (1989).

ADVANCED ATTACHMENT THEORY

The orbits-gravity model allows us to gain insight into the various repetitive aspects of  human personality systems. The model suggests that repetitive behavior, emotions and thinking can be viewed as orbits, while attachment and joining parallels the idea of gravity. While the work of Bowlby and Ainsworth focused on the nature of attachment between parent and child, within the clinical setting a similar process of attachment develops between client and clinician. In treatment, attachment is defined through the therapeutic alliance (Rogers, 1957, 1975). When Bowlby (1969) describes a healthy bond between parent and child, he uses words such as “safe”, “stable”, “trusting”, and “secure base”. In scientific language these words are equivalent to the word “gravity”. If we follow this line of thinking, we can match the three components of “orbits”, “gravity”, and “the system” with personality phenomena:

1. “Orbits” as represented by repetitive cycles of energy related to actions, emotions, and thoughts, self-esteem, and social skills. Orbits demonstrate the degree of a personality system’s flexibility through their movement, rate, and range. For the personality, the concept of flexibility is equivalent to the range of choices a person has in relation to his actions, emotions, and thoughts. 

2. “Gravity” as represented by the individual’s developmental range of attachment and trust. The greater the person’s level of “healthy trust”, the more he or she will function in a mature, secure, and socially appropriate manner.

3. The “system” is represented by the personality as a whole. Repetitive patterns (i.e., actions, emotions, and thoughts) along with attachment-trust are viewed as an integrated system. The model suggests that although these patterns and attachment can be discussed separately, in reality these aspects are intricately related, where “the whole is greater than the sum of his parts”. The model as a whole has the quality of an “alive system” that functions in a state of balance and equilibrium.

HEALTHY PERSONALITY SYSTEM

Using the solar system model as a template, we are able to diagram the personality structure of a healthy person as well as those who commit sexual harm. The visual aspect of the model provides clarity for ideas that have often been intuitively recognized, but which words alone do not adequately explain. Figure 4.4 indicates the Healthy Personality System (HP System):

This model shows a healthy personality that is flexible and relaxed. The central aspect of this personality is the dynamic of “supportive attachment”. This type of attachment provides a safe, stable, and secure base for the entire system. As the child develops, supportive gravity promotes a strong sense of bonding. This type of consistent parenting encourages the development of a secure personality that can function in a focused and relaxed manner.

In viewing this model, gravity indicates attachment that is safe, secure, stable, and supportive. Because the gravity is strong and supportive, the orbits can respond in a calm and easy manner.  The relaxed nature of these cycles is illustrated using gaps and spaces to show the openness of these orbits, and the ability to make flexible choices. 

As the healthy personality develops, the child’s external behaviors will reflect his underlying sense of safety and security. Just as Mercury, Venus, and Earth orbit with the most frequency, so too the healthy personality displays consistent and frequent cycles of trust, empathy, and social cooperation. While the illustration indicates this personality is also be ‘creative’ and ‘playful’, these orbits are on the periphery because they are less frequent, although integral to the system.                

TRAUMATIZED ATTACHMENT

The solar system model also gives us insight into the traumatized personality. This type personality is consistent with those who cause sexual harm. As is known, not all parental attachment and bonding results in “gravity” that is strong and supportive. When the attachment process is disrupted, “gravity” becomes traumatized or weakened. Traumatized attachment results from repeated or ongoing disruptions in the bonding process. Such disruptions undermine the child’s ability to receive nurturing, and feel supported.

Trauma occurs when there is a shock to the child’s experience of safety and security. One of the most significant factors regarding trauma is the age at which the event occurs. In more severe cases, trauma results from emotional and physical abuse or neglect. The main factor of trauma is that it leaves the person with a sense of abandonment and isolation. Trauma is always associated with a violation of trust.

The solar model provides clarity in understanding the personality structure as it relates to trauma. It is the function of the “personality system” to maintain equilibrium. If gravity for any reason is reduced or weakened, the system as a whole will adjust and compensate for the loss. On the unconscious level the child will reduce or constrict the flexibility of his behavior, emotions, and thoughts in an effort to keep the integrity of his system intact. For the child that has experienced trauma, rigid orbits of behavior often become a “normal” part of his daily routine.

Over time, unresolved trauma results in personality systems that exhibit constricted and rigid patterns of behavior. Rigid patterns can take the form of addictions, compulsive behaviors, personality disorders, and repetitive criminal behavior. However the person may believe his behaviors are an expression of his personal free will. He may insist that his use of alcohol, drugs, anger, and so on, is an expression of his own “freedom of choice.” While the person may believe he is making choices, those who observe his behavior recognize the predictable and rigid nature of his personality.

SEXUAL HARM PERSONALITY SYSTEM 

The solar system model allows us to identify the general personality characteristics of those who commit sexual harm. As previously noted, traumatized attachment gravity dominates this type of personality system. Figure 4.5 is a diagram of the Sexual Harm Personality System (SHP System).

The illustration indicates a severely traumatized system and emphasizes the prominence of rigid types of behavior. Due to the weakness in attachment, the system constricts as a way to perpetuate equilibrium. The solid and rigid orbits in this system suggest an inability to make flexible choices, as compared to the HP System. In viewing this model, gravity indicates attachment that is insecure and weak. The numerous sharp edges represent attachment that is the opposite of welcoming. Such attachment can be seen as alienating and heightening the child’s experience of isolation. This type of empty attachment leads to insecure bonding, and an experience of being disconnected from others. As the child continues to develop, his orbits of behaviors will reflect this underlying core of insecurity. The inner orbits which occur more frequently relate to “anger and mistrust”, “defiance-poor social skills”, and “low self-esteem”. The outer orbits of “manipulative behavior” and “sexual harm” are patterns that occur less frequently, but are an integral part of the system.

TREATMENT AND PARADOXICAL INTENT

Through the orbits-gravity model we can hypothesize the intent of successful treatment with the SHP System. The model indicates that by simply strengthening the therapeutic alliance and raising the client’s experience of attachment and bonding, this will automatically influence a shift in rigid orbits of behavior.

Just as the solar system model suggests that altering gravity will effect the orbits and overall equilibrium of that system, so too, the clinician’s ability to strengthen the therapeutic relationship through “joining” will impact orbits of destructive behaviors. The model here is supported by research regarding the therapeutic alliance. Numerous studies indicate that the alliance between client and clinician is the most significant factor for successful treatment outcome (Horvath & Symonds, 1991; Orlinsky, Grawe, & Parks, 1994). Studies also indicate that the therapeutic alliance is more important than the method of therapy (Frank, 1973; Kanfer & Goldstein, 1991; Safran & Muran,1995; Schneerson, 1969; Yalom, 1980).

By strengthening the therapeutic alliance, the clinician is able to shift “attachment-gravity” between himself and the client. The strengthening of this bond influences change in the client’s “status-quo equilibrium.” Rather than addressing isolated aspects of the client’s behavior, emotions, and thinking, the model hypothesizes that a shift in the alliance influences a change in all these areas simultaneously.  Interventions impact the client in a manner that reorganizes his world outlook and self-perception. The result of treatment is that change occurs in the whole personality system without any forethought or planning.

Due to the dominant nature of gravity, it should be understood that the offender does not have full and conscious control of his range of rigid behaviors. Since he functions within his own personal state of equilibrium, he will be unconscious of the rigidity of his own patterns. Generally the offender is unaware of the rate and frequency of his anger and mistrust, defiance, poor social skills, and so on.

It is these unconscious rigid patterns that make it possible to formulate paradoxical interventions. Because the client’s constricted nature makes his actions very predictable, this allows the clinician to accurately forecast behavior. Through paradoxical interventions that predict behavior, the clinician “joins” in a manner that dissolves the client’s experience of being “disconnected” from others. Through the non-threatening act of joining, the clinician is able to quickly bypass the client’s defenses (see Case Example).            

The process of joining thereby engages the client on three separate levels simultaneously: (1) it dissolves the debilitating belief that he is alone and disconnected from others; (2) it strengthens the client’s awareness that he is connected to others more than he previously recognized; and (3) it spontaneously motivates him to regain true “freedom of choice” by undoing predictable and habitual behavior patterns.

In treating SHP Systems, it should be noted that the focus of treatment is always on less dangerous, and preferably noncriminogenic behaviors. Because we recognize that by shifting any one of the inner orbits of “anger-mistrust,” “defiance-poor social skills,” and “low self-esteem” the clinician will have simultaneous impact of the outer orbit of targeted sexual acting out, it is unnecessary to use paradox to address volatile sexual behavior directly. In fact, the appropriate use of paradoxical interventions should never directly target volatile sexualized behavior, as the offender may easily twist the intervention and use it as an excuse to engage in harmful behavior with the claim the clinician said it was “okay.” The advantage of the educated use of the paradoxical approach is that it allows the clinician to focus on the more frequent aspects of noncriminogenic behaviors but to recognize the simultaneous impact it has on harmful sexual acting-out behaviors. 

WIN-WIN DOUBLE BINDS

The success of the paradoxical approach is based on creating “win-win double binds” that strengthening the therapeutic alliance. This is accomplished with interventions that “join the resistance”. Because the nature of the involuntary and oppositional client is to avoid the alliance, the paradoxical process “imposes” the alliance. By “imposing attachment” the clinician places the client in a win-win double bind that destabilizes the client’s status quo equilibrium. This status quo equilibrium relates to the client’s normal perception of himself and the outside world. The “win-win” places the client in a position that no matter which way he turns, he will gain a heightened sense of joining.  In other words, the client cannot escape the strengthening of the therapeutic alliance. In this manner the ever-present shadow of the clinician “standing over his shoulder” becomes unavoidable. 

An example of this type of win-win can be seen in an intervention with an oppositional adolescent who habitually curses as a way of maintaining distance from adult authority figures. Using a paradoxical intervention, the clinician might impose attachment by “prescribing” the client to “curse even more”. Such an instruction creates the following double bind: If the adolescent were to continue to curse, then he would be following or “joining” the clinician’s directive, which the oppositional teen wants no part of.  On the other hand, if he undoes his cursing, he demonstrates “free will” to undo his predictable behavior, thereby “proving the clinician ‘wrong.’” In either case, there is a win-win aspect that leads to joining. By imposing attachment in the form of a win-win double bind, treatment impacts the client to undo behavior without convincing or instructing the client to change.   

INTERVENTIONS AND TECHNIQUES

There are numerous theorists and clinicians who are known for their work using paradox. They include: Alfred Adler, Victor Frankl, and more recently Jay Haley, Salvador Minuchin, and Milton Erickson. Alfred Adler (1956) was one of the first theorists to document his work using paradoxical interventions dating back to 1923. Adler’s work is noted for avoiding power struggles with patients. His strategy was to shift the patient’s uncooperative behavior into one of cooperation. Adler advocated that the clinician should never fight or struggle with the client, but rather “join with the resistance”. As a result, his methods focused on “attaching” or “joining” as a way of enhancing the therapeutic alliance. Victor Frankl (1965, 1978) is also credited as an early pioneer. He recognized the importance of humor as part of the paradoxical process. He is known for the development of logotherapy, whose goal was to help the client accept personal responsibility. Although Frankl did not treat sex abusers, he felt that the depth of the paradoxical process had the potential to impact a broad range of disorders and conditions.

As stated, the underlying dynamic of all paradoxical interventions is to strengthen the therapeutic alliance. This is done through treatment that avoids power struggles and focuses exclusively on joining. The following are ten interventions that enhance the process of “joining”:

1. Prescribing the client to engage in symptomatic behavior;

2. Predicting previous cycles of behavior;

3. Permission to continue symptomatic behavior;

4. Positive reframing; explaining to client the benefits of a given symptom.

5. Overstated agreement with the client’s reasoning and thinking;

6. Encouraging the exaggeration of symptoms;

7. Encouraging client to improve or practice his symptomatic behavior;

8. Scheduling client symptoms, (when, where, how, and with whom);

9. Clinician mirrors back or ‘takes-on’ client symptoms;

10. Interactive role-playing to enhance and perpetuate symptomatic behavior.

From a clinical perspective, Arnold Beisser (1970) discusses the intent of the clinician who promotes paradox, and how it differs from traditional approaches. While usually the clinician takes an active role in guiding the client toward positive change, paradoxical interventions do not reward, convince, or offer insight. Here the role of the clinician is to simply help the client accept himself in the “here and now”. As such, the role of the clinician is not to work toward change, but rather identify the specific details of habitual and repetitive behavior that perpetuate the status quo. The paradox, of course, is that the more the clinician “joins” the client in defining and perpetuating his “stuck” behavior, the more quickly the client takes responsibility to disengage from that behavior. Also, because the method specifically seeks to “avoid power struggles”, when done properly, such interventions are effortless for the clinician.

 

CASE EXAMPLE -TREATMENT RESISTANT 12 Year Old - SHP SYSTEMS  

In treating the involuntary offender we cannot rely on his cooperation and ‘good will’. The motivation of the involuntary offender is invested in keeping the clinician and treatment at a distance. Within this agenda, he is often under the impression that he is making a ‘personal’ choice to protect his status-quo equilibrium and comfort zone. Effective treatment depends on the clinician’s ability to bypass the resistance. In so doing, treatment needs to alter the offender’s experience and perception that his comfort zone is comfortable. It is through the process of joining that the offender unexpectedly experiences his status-quo equilibrium disrupted. The following is a case example of working with an aggressive youth with sexualized ideation:

Bert is a 12 year old boy who was admitted for residential treatment in late January 2007. The record indicates that he was living with his grandmother. Bert had a history of cutting school and excessive fighting. Little could be substantiated about his sexual background or whether he had been abused sexually; however, Bert’s ideation was clearly sexualized and was boastful about his sexual prowess. He was referred for problem sexual behavior (PSB) therapy after submitting a “composition” to his teacher (Figure 4.6).          

During my initial interview, Bert freely admitted that he “liked fighting”. Although he had been previously advised that such behavior was inappropriate, he openly stated during this interview that he had no intention of stopping. He also stated he “could f**k 10 girls at once”. It was this clinician’s impression that his identity and “self-esteem” were primarily wrapped up in his physical and sexual prowess. 

In working with Bert, I asked him if he could tell me the three kids who most annoyed him in his “home” cottage, and who he would “go after” once he had the opportunity. He had no trouble identifying Eric, Peter, and Kevin as the most worthy of his punishment. During our sessions in the crisis residence I went “overboard on agreeing” with his logic and thought process. I agreed that each boy he identified could be “extremely annoying” and certainly “deserved what was coming to him”. I also noted that although it was not my want for him to fight these boys ( I didn’t want to fall into the trap of “Dr. Kaplan said it was OK to hit him!”), I understood that this was his only way to deal with them. Bert was surprised by this, stating that he “could choose other ways if he wanted”. In going overboard, I took the position that because he was a “fighter” and everyone knew he was a fighter, he really had no “free choice” except to fight them. Bert appeared confused by this as he started becoming aware of the “corner he had put himself in.”

Within two weeks of being sent to the crisis residence, Bert’s behavior stabilized to the point that the decision was made to send him back to his cottage. Although his attitude was more calm, he verbally stated that he had a “list of people” to beat up. Eric, Peter, and Kevin were still at the top of the list. At this point treatment focused on the ordeal of creating a “fighting scheduling”. Of the three mentioned I asked Bert to rate who was first, second and third in being annoying. He stated that Peter was the first, Eric was second, and Kevin third. I informed him that if this is the case, it was only appropriate that we schedule Peter to be first in line to get beat up and Eric second. As part of the scheduling I also let him know that if Kevin annoyed him first, he would have to tell Kevin to wait in line, as the schedule was for him to fight Peter first. As I went over the “schedule” and repeated numerous rules with Bert - “who he could and couldn’t fight, and when and where he would fight” it was clear that Bert did not like the “formality” of organizing his predictable behavior. I told him that by scheduling his fighting we would make sure that he “was fair to everyone”.  The more I made the schedule into an ordeal, the more Bert became clearly uncomfortable with it.

The result of this intervention was that Bert’s aggressive behavior dramatically dropped. The cottage staff reports that although he still gets into minor scrapes, for the most part he is no longer considered an aggressive threat. In addition, sexualized comments and ideation also became less.

In follow-up sessions with Bert, as in most situations, I do not directly compliment the client for changing his behavior. The reason for this is that it is important that the client take full responsibility for his new behavior. If I, as the clinician, compliment his change in behavior, it opens up the question whether he made the change for me or himself. Often I will acknowledge the client’s change by letting him know that “I thought I knew you, but now I see you’re not so predictable.” The nature of the intervention gives the client responsibility for undoing habitual behavior, which in turn allows him to experience an increase in self esteem. It is this increase in self-esteem that often is the reward that perpetuates the new level of behavior to remain intact.

The following is a review of Bert’s intervention, using a solar system model to diagram the shift that occurred:

Figure 4.7a indicates Bert’s initial status-quo equilibrium before the intervention. The second orbit represents of the repetitive degree and frequency of “fighting behavior.” Bert overtly states at the outset of treatment that he “likes to fight” and has no intention of changing. Sexual ideation (fifth orbit), although not as frequent as his fighting, is also an integral part of his personality system. Bert’s comfort zone is accepting and encompassing of both fighting and sexual ideation. In this status-quo equilibrium he has no conscious desire to make any changes. 

Figure 4.7b shows the clinician’s intervention. The arrows indicate paradoxical interventions designed to “join”. In this example the clinician joins Bert by “agreeing with” and “scheduling” his fighting. In so doing, the clinician “imposes attachment”.

Figure 4.7c indicates a shift in the attachment-gravity. The void inside the gravity has become smaller, and the outer edges have become less sharp.  This change in gravity indicates that Bert experiences a “reorientation” to his status-quo equilibrium. With this primary shift in gravity, the entire personality system shifts. As gravity alters, there is a secondary automatic shift in all orbits.

Figure 4.7d indicates the resulting realignment of the system that matches the new gravity. At this point, the entire system moves to an expanded level of equilibrium. While the potential for Bert to fight still exists, the fact that the orbit has “stretched” means that the frequency of fighting will dramatically decrease. Because a shift has occurred to the entire system, we also recognize that Bert’s pattern of inappropriate sexual ideation has stretched as well. As the model indicates, this change in behavior will not happen gradually, but rather as an exponential shift. Because Bert was not told or instructed to behave differently, such movement can be viewed as occurring of his own free will.

If we compare Figure 4.7a with Figure 4.7d, we can see the overall change that has occurred in the system. Compared with Figure 4.7a, Figure 4.7d indicates an increase in Bert’s flexibility and openness. While Bert still exhibits a fair amount of rigidity, we can expect an overall improvement in his ability to demonstrate more flexible choices and behavior. As Bert integrates this new level of equilibrium, he will gain perspective that his old “comfort zone” (Figure 4.7a) of fighting was actually a constricted and limited way to live. 

CONCLUSION

Although paradoxical interventions have been shown to be effective in treating various types of oppositional and involuntary clients, such interventions have not been used with a sex offender population. The main difficulty has been the lack of a theoretical framework to support the use of such interventions.

This chapter offers the science of orbits-gravity phenomena utilizing the solar system model to support a viable framework to define a process for nonlinear change. The model indicates that by shifting “attachment-gravity” it is possible to effect multi-orbits of behavior simultaneously. The model identifies the “active ingredient” of treatment as the clinician’s ability to attach or join with the client. While the voluntary client invites the clinician to join, the involuntary client attempts to avoid the therapeutic alliance. In working with the involuntary client, paradoxical interventions are particularly effective because they bypass resistance and promote a process that “imposes attachment”. Through this process, even the client who has no desire or intent will be influenced to shift his behavior without forethought or planning.

The model recognizes that while it is inappropriate to use paradoxical interventions to directly target primary sex offense behaviors, it is appropriate and recommended to use the methods in addressing non-criminogenic and secondary behaviors related to anger, social skills, low self-esteem, and so on. The solar system model suggests that when these secondary behaviors are affected, there will be a simultaneous shift in primary targeted deviant behaviors. This model appears to support the existing research of Marshall (1997; Marshall, Cripps, Anderson, & Cortoni, 1999) and others that indicates that it is possible to impact targeted offender behavior in an indirect manner. 

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