What is the Paradoxical Intention Technique?

· January 4, 2019

The tools that psychologists work with are what we call psychological techniques. These techniques should only be used by specialists in the mental health field. One clear example of these techniques is paradoxical intention.

More often than not, these techniques are useful for psychological treatments and interventions. Furthermore, psychological treatments could belong to different psychology disciplines. For example, cognitive-behavioral, systematic, Gestalt, and psychoanalysis, among others.

In this sense, psychological treatment is a professional intervention. This intervention is based on clinical psychological techniques. For example, a hospital, private consultation, support groups, and mental health centers, among others. During these treatments, a specialist seeks to eliminate a patient’s suffering.

A person in therapy.

Some examples of this could be to help someone overcome depression, teach family members to communicate better, or even teach a teenager to relate to their classmates in a less aggressive way.

A psychological treatment implies closely listening to what the patient has to say. Additionally, the therapist must identify the personal, social, and family aspects that generate the problem. The psychologist must also tell the patient how to resolve their problems and employ specific techniques.

Here are some examples of these psychological techniques:

  • Breathing and relaxation exercises.
  • Paradoxical intention.
  • Resolution of interpersonal problems.
  • Questioning erroneous beliefs.
  • Social skills training.

Psychological treatments must be conducted by psychologists, who are professionals in behavioral problems. These professionals use evaluation and treatment techniques that have been backed up by scientific data.

The paradoxical intention technique

This technique is a form of humanist-oriented psychotherapy attributed to Victor Frankl’s logotherapy (1999).

In cognitive behavioral therapy, paradoxical intention is the cognitive intervention that is used to overcome the resistance to change.

To define this technique, let’s assume that a paradox is something opposite of what we consider true. A paradox, from the Latin word paradoxus (that also has a Greek origin), consists of using contradictory expressions.

In other words, beyond contradicting conditions, the presented factors are valid, real, or possible. The paradoxical intention technique seeks to confront the patient’s common sense. With the use of paradoxical intention, therapy can encourage a patient to do what they’re afraid of (Frankl, 1984).

Paradoxical intention can help overcome fears.

The overall goal of paradoxical intention

The overall goal of paradoxical intention is to provoke certain changes in the patient’s attitude and their reactions to stress. This means that it seeks to eradicate vicious cycles that the patient’s fears develop.

Here’s an example to help you better understand this concept. An insomniac patient makes an effort to go to sleep every night. With paradoxical intention, this same patient will now do the exact opposite. They have to concentrate on trying to stay awake for as long as possible.

This allows the patient to forget how hard it is for them to fall asleep. This way, they’ll fall asleep because they’ll stop fighting against falling asleep a lot sooner.

Why does this technique work?

Despite its efficacy, there are no clear studies that study the reasoning behind it. However, there are some models that try to explain its effects.

Certain variants of the technique use control mechanisms to stimulate behavioral reactions. In other cases, they resort to changing expectations and boosting self-efficacy.

Here are some of the theoretical models that seek to describe the technique:

  • Double bind theory (Watzlawick, Beavin, and Jackson, 1981)
  • Symptom decontextualization theory (Omer, 1981)
  • Recursive anxiety theory (Ascher and Schotte, 1999)
  • Ironic process theory (Wegner, 1994)
A woman with a drawn cloud over her head.

How to apply the paradoxical intention technique

When applying this technique, patients are asked to not attempt to stop their symptoms and even to exaggerate them.

The procedure requires two changes in the way the patient currently deals with problems. The first change is that the patient must stop trying to control the problem. On the other hand, the patient must increase their symptoms and exaggerate them.

Both go against the patient’s logic. Thus, the therapist must explain this new concept to the patient to convince them that it’ll be helpful for their treatment.

Procedure

  • Evaluation of the problem.
  • Redefinition of the symptoms according to the data of the evaluation. In this step, the psychologist aims to give new meanings to the symptoms.
  • Indication of the paradoxical changes depending on the issue.
  • Conceptualization of the changes according to the paradox.
  • Prevention of relapses.
  • Follow-ups.

The effectiveness of the paradoxical intention technique

Despite its utility, it may be one of the difficult techniques to apply in cognitive behavioral therapy. Aside from knowing the logic behind it and the procedure, the therapist must have enough experience to detect the correct moment to apply it.

Thus, the therapist’s communication skills and clinical experience will determine the success of this treatment. The therapist’s assertiveness, security, conviction, and skills are fundamental elements to encourage the patient to do the opposite of what their intuition tells them to do.

This technique has yielded great results in the field of psychotherapy. However, it’s perfect for the treatment of insomnia.

Finally, it’s important to emphasize the importance of applying this technique under the direct guidance of an experienced therapist. Otherwise, if wrongly applied, the problem can worsen and become more resistant to other interventions.

Azrin, N. H. y Gregory, N. R. (1987). Tratamiento de hábitos nerviosos. Barcelona, Martínez Roca.

Bellack, L. (2000). Guía de preguntas del manual de psicoterapia breve, intensiva y de urgencia; Ma. Celia Ruiz de Chávez. (1ª Ed., 6ª. Reimp) México: Ed. El Manual Moderno.