Paradoxical intervention

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A paradoxical intervention is usually understood to mean various psychotherapeutic methods that seem to contradict therapeutic goals, but which are actually designed to achieve these goals.

Demarcation

The concept of paradoxical intervention is much broader than the concept of paradoxical intention according to Frankl . The latter is listed as a particular technique in many classifications of paradoxical interventions . According to Watzlawick , it is identical to the method of prescribing symptoms. According to DeBord, it differs from the symptom prescription in that the mode of action can be made transparent for the client.

Paradoxical intervention techniques

Different authors agree that the following techniques belong to the paradoxical interventions :

Symptom prescription

When prescribing symptoms , behavior that is understood to be problematic is encouraged. So z. B. the therapeutic prescription in a couples therapy , in which she accuses him of doing nothing in the household, consist in the following instruction to him : Until our session, refrain from any activity in the household. The real problem (namely the thought that he has to do something all the time) is resolved.

If the client does not manage the symptom prescription comply and execute the symptom at will, then he experienced a weakening of the symptoms. If he manages to bring about the symptom willingly, this leads to an increased expectation of self-efficacy . This method can be particularly effective if the fight against the symptom has helped to maintain it.

Paradoxical intention

With the paradoxical intention , the patient is asked to paradoxically wish for exactly what he is afraid of. This is based on the idea of ​​breaking through the existing self-affirming vicious circle of fear in this way. The paradoxical intention is a method of Viktor Frankl's logotherapy .

reinterpretation

In the case of reframing or reinterpretation , according to Watzlawick, the aim is to replace conceptual or emotional background assumptions in which a situation is experienced and assessed. Schlippe and Schweitzer (2003) give the following example: Client: My daughter is losing weight more and more! Therapist: Was it before or after your breakup that she decided not to eat anymore? The therapist reinterprets this by interpreting the daughter's anorexia as a decision.

A certain subtype of reframing is the positive connotation . In this case, a symptom is positively reinterpreted.

More paradoxical techniques

There are a number of other techniques that are considered paradoxical interventions in the literature. These include, among other things , relapse prediction, relapse prescription, ordeals, family rituals and preventing change . A consistent classification of these various methods has not yet been able to establish itself.

Paradoxical sanction

The British educators Homer Lane and Alexander Sutherland Neill responded to violations of rules by young people by rewarding or reinforcing the problematic behavior.

Lanes “punished” lawbreakers with vacation or asked a boy who had smashed the dishes to break his watch as well.

Neill supported rebellious youths in their anti-social behavior, as he assumed that their rule-breaking often happened out of defiance against the repressive educational methods of post-war society. For example, he went back there with a child who had stolen in a retail store to steal more with him (after informing the store owner beforehand). Such surprising interventions made the perplexed young people open up to him. By undermining the role model of the tough, overstrict parenting persons with whom the young people had dealt up to then, he was able to communicate with them on another level.

effectiveness

In 1987, Shoham-Salomon and Rosenthal were able to demonstrate in a meta-analysis that paradoxical interventions (symptom prescriptions and reframing) were just as effective as traditional interventions. In severe cases, the paradoxical interventions were even more effective.

See also

literature

  • Viktor Frankl : Medical pastoral care. Basics of logotherapy and existential analysis , Deuticke Zsolnay, 11., revised. New edition, Vienna 2005 (1946), ISBN 3-552-06001-4 .
  • Mara Selvini Palazzoli , Luigi Boscolo, Gianfranco Cecchin, Guiliana Prata: Paradox and counter-paradox. A new model of therapy for families with schizophrenic disorder. 2nd Edition. Klett-Cotta , Stuttgart 1978, ISBN 978-3-608-95375-6 .
  • LF Seltzer: Paradoxical strategies in psychotherapy: A comprehensive overview and guidebook. John Wiley & Sons, 1986.
  • V. Shoham, MJ Rohrbaugh: Paradoxical Intervention. In: WE Craighead, CB Nemeroff (Ed.): The Corsini Encyclopedia of Psychology and Behavioral Science. 3rd edition. Vol. III. Wiley & Sons, New York 2001, pp. 1129-1132.
  • Paul Watzlawick , Janet H. Beawin, Don D. Jackson : Human Communication. Forms, disorders, paradoxes. 6th edition. Huber Verlag, Bern - Stuttgart - Vienna 1982, ISBN 978-3-456-83457-3 .
  • Paul Watzlawick, John H. Weakland , Richard Fisch: Solutions. On the theory and practice of human change. 8th edition. Huber, Bern 2013, ISBN 978-3-456-85229-4 .
  • GR Weeks, L. L'Abate, K. Brandt: Paradoxical Psychotherapy: Theory and Practice in Individual, Couple and Family Therapy. Enke, Stuttgart 1985.

Individual evidence

  1. ↑ M. Rohrbaugh, H. Tennen, S. Press, L. White: Compliance, defiance, and therapeutic paradox: Guidelines for strategic use of paradoxical interventions . In: American Journal of Orthopsychiatry, Vol 51 (3), 1981, pp. 454-467.
  2. ↑ a b V. Shoham, MJ Rohrbaugh: Paradoxical intervention. In: WE Craighead, CB Nemeroff (Ed.): The Corsini Encyclopedia of Psychology and Behavioral Science. 3rd edition. Vol. III. Wiley & Sons, New York 2001, pp. 1129-1132.
  3. ^ Paul Watzlawick , Janet H. Beawin, Don D. Jackson : Human Communication. Forms, disorders, paradoxes. Huber, Bern, Stuttgart, Vienna 1969.
  4. ↑ a b J. B. DeBord: Paradoxical interventions: A review of the recent literature. In: Journal of Counseling & Development , 67 (7), 1989, pp. 394-398.
  5. ↑ a b L. F. Seltzer: Paradoxical strategies in psychotherapy: A comprehensive overview and guidebook. John Wiley & Sons, 1986.
  6. ↑ V. Shoham-Salomon, R. Avner, R. Neeman: You're changed if you do and changed if you do not: Mechanisms underlying paradoxical interventions. In: Journal of Consulting and Clinical Psychology, 57 (5), 1989, p. 590.
  7. ↑ See Frankl 2005 (1946): pp. 243-263.
  8. ^ Paul Watzlawick, John H. Weakland , Richard Fisch: Solutions. On the theory and practice of human change. 8th edition. Huber, Bern 2013, ISBN 978-3-456-85229-4 , p. 118 f.
  9. ↑ A. von Schlippe, J. Schweitzer: Textbook of systemic therapy and advice. Vandenhoeck & Ruprecht, Göttingen 2003, ISBN 3-525-45659-X .
  10. ↑ V. Shoham-Salomon, R. Rosenthal: Paradoxical interventions: a meta-analysis. In: Journal of Consulting and Clinical Psychology, 55 (1), 1987, p. 22.