PARADOXICAL INTENTION

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Steps

STEP ONE: Make plans to take a paradoxical approach to your problem.

 As implied by the various examples given above, there are many paradoxical techniques but they can be lumped roughly into three major approaches:

  1. Paradoxical intention --try to go in the direction opposite of what you want or fear. This method focuses on the underlying fear, not the surface symptom.

    • Trying to do the opposite of what you feel compelled to do now, which is closer to what you really want to do in the end. Examples: An overly orderly and perfectionistic person should insist on experiencing the feared messiness and failure, the student obsessed with getting "A's" might try for some "C's" and "B's." A person afraid of the water should go swimming 3 or 4 times a week. A shy person should greet people, get involved, express opinions, and generally be assertive. A folk remedy for hiccups is to offer a dollar if the sufferer can produce 10 realistic hiccups in a row without any occurring accidentally. Tics too have been cured by voluntarily producing them.

    • Trying to do the opposite of the frustrating habit or urge, which is not what you want to end up doing. Examples: if you want to be happier, concentrate on learning how to be deeply depressed: feel helpless, remember all the mistakes you've made, feel lonely and different, dwell on your faults and guilt. If you can't get to sleep, change your goal: try to stay awake. If you feel guilty about masturbating, try feeling more guilty by masturbating twice as often as usual for a while. If you are afraid of the dark, you should frequently, say 2 or 3 times a night, experience the darkness, not because you want to be in the dark every night but because you want to be less afraid.

    • Give up struggling for some goal. Examples: the insomniac stops trying to go to sleep and finds something interesting to do. An impotent male stops trying to get an erection and focuses on having fun and pleasing the partner. The overly picky lover gives up looking for the ideal partner. A love relationship improves after giving each other some space (Brenner, 1985). The tennis player does better when he/she gives up self-criticism and awfulizing (Gallwey, 1974). Therapists occasionally make suggestions that they expect the clients to resist, i.e. the paradox is they are told to do one thing, but they do another. Example: a bright, unhappy housewife is encouraged to "do everything for your husband" but the result is, as expected by the therapist, she soon starts a career outside the home.

    • Give up impossible dreams. Look for the negative consequences of having your wishes come true. Examples: suppose you want to feel superior rather than inferior: you wouldn't be liked, it would be hard to accept others, there would be no competition. Suppose you would like for your partner to be perfect instead of with faults: you would be inferior and he/she would likely go looking for a better lover, all problems would have to be your fault, and perfection might get real boring.

  2. Symptom prescription --doing the unwanted habit to get rid of it.

     Carry the behavior to a ridiculous extreme. Chapter 5 describes overcoming a fear of coming home after dark by telling oneself exaggerated horror stories about the dangers that might lurk in the dark. Other examples: If you worry excessively or have an obsessive thought, set aside five minutes every waking hour to do nothing but worry or have this unwanted thought. Carefully schedule the "worry time" and insist that the time be entirely used for worrying, no matter how hard or boring it becomes. McMullin calls this method "forced catastrophes," and he might ask a client to take 3 or 4 hours to "go crazy" if that is what he/she is afraid will happen. Other behavioral examples are if you compulsively bite your nails, clean your house, check the locks, wash your hands, etc., try to increase the habit by 50% each week until it becomes overwhelming and impossible. If you sweat so much it is embarrassing, try to sweat even more.

     Lazarus (1971) calls this the blow-up method because the behavior is blown up to such an extreme that it becomes humorous or ridiculous. He describes a young man with sweaty palms. Lazarus told him to avoid wiping his palms and, in fact, to try to flood the other person with his sweat. He also had the young man imagine perspiration gushing out of his palms, spraying all over other people, and flowing across the floor. He might even imagine going outside and washing the cars with the endless sweat pouring out of his palms and so on, until the fantasy becomes crazy and funny.

  3. Taking a different view --turning the undesirable into the desirable and other ways of challenging irrational ideas.

     A sense of humor helps here too. Think of how you can make an already bad situation much worse. At least think of ways to give up resisting the unwanted habit. Or, think of ways to stop trying to change. Examples: Instead of constantly dieting, occasionally try to gain two pounds in three days. If you have been arguing with someone a lot, try to pick even more arguments (hopefully some of the comments will be rather silly and funny making the situation lighter). If you swear too much or spend money (small amounts) carelessly, tell yourself that cussing is healthy, cathartic and honest communication or that shopping is good, inexpensive treatment for depression.

     This paradoxical redefining the problem as being something tolerable is clearly reflected in the RET saying, "It ain't awful, it is lawful." Or, in some cases a fear can be turned into a wish. Patients have turned feared panic attacks into wishes that the heart will beat wildly which stops the panic (Frankl, 1985). More examples: when an obnoxious teenager argues and fights about everything, especially homework and chores, and you think the situation is hopeless, try to see the situation as one in which the young person is preparing to become an independent adult or attempting to get love and attention. This is called "reframing" (see chapter 15). Most of the techniques in method #3 of this chapter are paradoxical, i.e. one learns to think differently. Some paradoxical therapies promote valuing contradictions and prizing an inquiry into the many mysteries and paradoxes that exist in the world.

     Think of ways to confront or contradict an idea or behavior, perhaps you can switch roles with a friend and practice arguing against your own irrational ideas. Perhaps you can carry your irrational ideas to an extreme and, thus, see that your thinking is faulty (and relationships unreasonable). Example: if you believe that people are always responsible for their own problems, then try proving that being born retarded, deformed, poor, schizophrenic, or with an alcoholic parent was the person's own fault.

     McMullin (1986) provides several examples of "self flimflam," i.e. fooling one's self. This might be someone who exaggerates how important it is that he compete and win (for praise and ego inflation), exaggerates how tolerant he is of a lover exploring another relationship (so he will look kind and self-sacrificing and she will feel guilty), or over plays how unhappy he is--the "poor me" role--(to get comfort and sympathy). Such a person, looking for the flimflam, will start to recognize how phony he is being, see the sought-after pay offs and, hopefully, give up the "act" and try to be honest. In other cases, where false beliefs cause problems, trying to prove these beliefs with evidence and logic can often result in clearer thinking.

     Students who can't study because of all the fun distractions have been helped by being told that they can't, under any circumstances, study more than 2 hours per day. This is reversing roles: you can only do this good thing--study--for a limited time and you must do other things--socialize or play--all the rest of the day.

STEP TWO: Put your paradoxical plan into effect--do it with zest.

 Paradoxical intention: Do what you fear! (Don't try to increase the fear reaction.) Worry even more! Try to stay awake! Try to like a messy house! Like dirty floors and dishes! Avoid trying to have a climax!

 Symptom prescription: Increase the unwanted behavior! Increase the fear! Do the feared action more often! What do you have to lose? You have been doing the unwanted behavior anyway! If you have no trouble producing more unwanted behavior, do more! Since that damn, lousy habit wants to occur so badly, make it occur over and over! Do it until you are sick and tired of it (like the boy caught smoking and forced to smoke three strong cigars, one after another).

 Changing your outlook and goals: What seems crucial to you at one time may paradoxically become unimportant in the long run. Small breast development may humiliate a girl at 16 but please her at 35. You may long to be the best guitarist, basketball player, or sex object in school but get very little satisfaction out of that skill when you are 50. It might be nice to have someone's love but it isn't a necessity! It hurts to be rejected but it isn't the end of life! Challenge your harmful irrational beliefs!

STEP THREE: Keep following the plan until the desired goal is reached.

 In several of the paradoxical methods there is a strange situation, namely, you are trying to produce acts you really do not want to continue. Thus, you actually win by failing, i.e. you finally stop producing the unwanted behavior and it does not occur as often as it did before. In effect, you will threaten to begin producing the unwanted behaviors in excess again if the behaviors do not go away and stay away. At this stage, you will often find your acts or your worries somewhat silly or humorous and certainly unnecessary. If so, you are successful.

Time invovled

 It may take only a few minutes to say, "to hell with struggling with this problem any more" and think of ways of increasing or exaggerating your problem. Ordinarily, the results will come in a week or two and, occasionally, even sooner. Sometimes you will need to read about the method and put considerable effort into producing the unwanted habit ad nauseam.

Common problems

 This method, thus far, has almost entirely been used by therapists with clients. In most cases, the therapist does not explain the method to the client but instead with tongue in cheek prescribes more and more ridiculous behavior. For example, a therapist may seriously tell a compulsive housekeeper that cleanliness is important and perhaps she should get up at five AM to do a couple of housecleaning chores before breakfast, then wash and vacuum the floors every day, wax all the wood work, and hire a cleaning person once a week to wax her floors, take the wax off the woodwork, and clean the silverware. Furthermore, throughout the day she should take five minutes every hour to tell herself how important it is to everyone in the world that her house be spotless, that her dishes sparkle, etc. Eventually, as more and more cleaning is added to the daily schedule, the patient realizes that the therapist is being facetious. This kind of playful teasing and ridicule may not be possible in self-help, certainly you can't deceive yourself about the purpose. But you can learn to laugh at yourself.

Effectiveness, advantages and dangers

 Many therapy cases have demonstrated that paradoxical methods work, but case studies are open to a lot of misinterpretation. Frankl (1975) also mentions that many people have simply read about paradoxical methods in his books and applied the methods in their own lives.

 In the last ten years, more research has been done (Weeks, 1991). One finding is that different methods are needed with resistive clients (those who rebel against the therapist's directions). For instance, when procrastinating students were told to "try to bring about your procrastination deliberately," only the resistive ones procrastinated less. The non-resisters didn't reduce their procrastination (Shoham-Salomon, Avner, & Neeman, 1989). Paradoxical methods have been shown to work with insomnia and maybe agoraphobia and other fears but many studies have design faults. We need better controlled studies and research that compares a variety of treatment methods, including self-application or bibliotherapy.

 The greatest advantages of these methods are their simplicity and speed (when they work).

 The greatest danger, obviously, is that trying to make the problem worse may work. It would be foolish for a suicidal person to attempt to make him/herself more depressed and destructive. There is no data, to date, indicating how often paradoxical intervention (in therapy or self-help) exacerbates the problem. This is crucial information to get.


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