Seeking psychological help is a way to mitigate the suffering suffered by people with psychological problems. When a person goes to a psychologist, they go with the hope of finding effective solutions to their problems. Psychologists must be prepared to meet the demands of our patients and reduce and/or eliminate the psychological suffering for which they come.
But can you imagine that the psychologist instructs the patient to maintain the problem and even aggravate it? This situation can demolish the patient’s expectations and surprise them. If the psychologist implements this strategy, it would not constitute malpractice on the part of the professional, but rather falls within an intervention technique called paradoxical intention.
Keep reading this Psychology-Online article in which we talk to you about Paradoxical intention: what it is, examples and how to apply it.
What is paradoxical intention
The paradoxical intention technique was originally developed in the context of for the treatment of phobias.
This is a type of intervention that has been shown to be useful for patients who are resistant to change. This technique can be striking for the patient, since the therapist, instead of promoting the remission of the problem, will encourage its continuity and even its worsening.
The American Psychiatric Association defines paradoxical intention as that psychotherapeutic technique in which the patient is asked to magnify his symptoms so that he distances himself from them and become aware of the low probability of the catastrophic consequences they anticipate occurring.
- For example, let’s think about a person who has and cannot sleep. In order to fall asleep, he uses resources such as changing his position, turning the pillow, wrapping himself up, undressing himself… However, although he believes that these solutions are going to help him achieve his goal, the reality is that he still cannot sleep, which It can cause anxiety and thus distance you even further from falling asleep.
If the attempts to solve the problem are those that maintain the problem, asking the patient to stop issuing these solutions and maintain the problem will cause them to abandon, precisely, these attempts.
- In our example, If we ask the person to stay awakeyou will stop using all these resources to sleep and your anxiety will even decrease.
Paradoxical intention as an element in other psychological techniques
Paradoxical intention is, in itself, an intervention technique. However, we can find paradoxical elements in other techniques such as . In these techniques, used for the treatment of , the patient is exposed to the feared stimulus, which can be paradoxical.
- For example, in the case of the patient, the patient will be asked to remain at a certain height for a long time.
When trying to control anxiety, it can also happen that a certain paradoxical anxiety appears, that is, in our attempt to reduce our anxiety levels, precisely the opposite occurs and it increases.
How to apply paradoxical intention
The paradoxical intention technique follows a series of steps when applying it, which, based on Díaz, MI, Ruiz, MA and Villalobos, A. (2012), we explain below:
1. Problem assessment
First of all, the psychologist will carry out an evaluation of the behaviors that you are trying to control and/or avoid. The result of this evaluation will account for What are the responses and/or solutions that the patient tries to give to the behaviors? and how they are maintaining this problem. It will also provide data on its topography such as its frequency, intensity or duration.
- In our example about insomnia, the psychologist will assess under what circumstances it appears and what mechanisms the patient uses to fall asleep (bringing pleasant thoughts to mind, changing posture, turning on the television, etc.). Remember that these mechanisms are contributing to the maintenance of insomnia.
2. Redefinition of the symptom
In this second stage, the symptom will be redefined and a positive value will be given to it.
- In our example, we can tell the patient that there are advantages to staying awake, such as being able to read in bed.
3. Paradoxical change and conceptualization of change
This phase will consist of prescribing a paradoxical change to the patient based on the complaints they express. Although there are several methods, the most used is that of symptom prescription in which the patient will be asked to cause the symptoms or behaviors that he is trying to avoid.
- Following our example, we are going to ask you to stay awake.
The therapist will then reframe and reattribute the effects of the paradoxical intention. We will check if the technique has worked correctly and/or we will consider what could have gone wrong if the result was not what we expected.
4. Scheduling of relapses and end of treatment
The therapist must predict and schedule relapses if they occur. Finally, the step to follow will be to end the treatment once the technique has been explained to the patient and they have been told how to apply it autonomously.
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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Bibliography
- Díaz, MI, Ruiz, MA and Villalobos, A. (2012) Chapter 12: other intervention techniques in Cognitive Behavioral Therapy. In Díaz, MI, Ruiz, MA and Villalobos, A. (2012) Manual of Cognitive Behavioral Intervention Techniques. Bilbao: Desclée De Brower.
- Michael Ascher, L., & Turner, R. M. (1979). Paradoxical intention and insomnia: an experimental investigation. Behavior Research and Therapy, 17 (4) 408-411 https://doi.org/10.1016/0005-7967(79)90015-9