Paradoxical Interventions in Marriage and Family Therapy
Wednesday, January 17, 2024. Revised Sunday, January 21, 2024, because it required a poem…
Paradoxical Interventions in Marriage and Family Therapy
Because of my interest in spiritual thinking, I’ve been considering an intriguing therapeutic tool. That tool is the use of paradoxes and paradoxical interventions.
Paradoxical ideas and ways of thinking are as old as humanity, especially in Eastern philosophy.
The Tao Te Ching (Way of Virtue), written by the founder of Taoism, Lao Tzu, contains much paradoxical advice, such as the notion that one can attain a desire by being open to receiving its apparent opposite.
Buddhism similarly contains many paradoxical ideas. For example, a seeker of enlightenment will be unable to attain it because they will have a problematic attachment to the notion of enlightenment itself!
Even Christianity contains many paradoxical statements such as, “So the last will be first, and the first will be last” (Matthew 20:16).
In other words, paradox is similar, but not identical to reverse psychology, and many examples can be found in cross-cultural religion and myth.
Reverse psychology is a term that describes a situation in which encouraging one course of action persuades someone to do the opposite.
My favorite example is how Tom Sawyer persuading his friends to white wash his fence by reframing it as a delightful and rare opportunity, rather than a mundane task.
The history of paradoxes in Marriage and Family Therapy, traces its roots back to the pioneering work of Alfred Adler.
The foundation of Paradoxical Intervention laid by Adler…eventually leading to the rise of Strategic and Systemic Family Therapies, and the eventual paradoxical shifts found in Cognitive-Behavioral Therapy (CBT).
I’ll also briefly mention how Paradoxical Intervention is alive and well, (although in a milder version), in some post-modern applications and clinical innovations.
Along the way, we’ll also discuss the lingering critiques of ethical considerations, ultimately recognizing the utility of paradoxes as an integral part of therapeutic efficacy.
Adler’s thinking…
Alfred Adler, a key figure in the early history of psychology, introduced a holistic approach that emphasized social context and family dynamics. His theories laid the foundation for understanding individual behavior within the context of familial relationships.
Birth Order and Family Dynamics:
Adler's groundbreaking exploration of birth order theory shed light on the intricate influence of family dynamics on individual personalities. This conceptual framework became pivotal in understanding how familial roles shape interpersonal relationships.
Initial Explorations of Paradoxes:
Adler's recognition of paradoxical elements within family systems marked the initial forays into the application of paradoxical interventions in therapy. This nascent stage set the stage for future developments in the field.
The Rise of Strategic and Systemic Family Therapies:
Strategic Family Therapy:
The transition from Adlerian therapy to Strategic Family Therapy marked a paradigm shift. Figures like Jay Haley and Gregory Bateson played instrumental roles in introducing strategic approaches, which utilized paradoxical interventions to disrupt dysfunctional family patterns.
“In paradoxical therapies the task is to have the person “spontaneously” behave differently, not behave differently because he is told to.
The therapist wants the person to take the initiative for new behavior.
One way to achieve that goal is to provide an internal conflict of such a nature that the person “spontaneously” changes rather than continue the past behavior.
Then the new behavior does not occur because the therapist told the person how to act, but because the therapist inspired the person to take the initiative for new behaviors. “
Jay Haley, Ordeal Therapy (1984)
Paradoxical Intentions in Systemic Approaches:
Systemic therapy emerged with a focus on circular causality within family systems.
Paradoxical interventions became a strategic tool to introduce disruptions, offering therapists new ways to navigate and reframe established family dynamics.
The Paradoxical Shift in Cognitive-Behavioral Therapy:
Emergence of Cognitive-Behavioral Therapy (CBT):
The historical rise of CBT brought forth a shift in therapeutic paradigms. Initially met with skepticism, CBT gradually embraced paradoxical interventions as therapists recognized their potential to challenge and reframe maladaptive cognitions.
Integration of Paradoxes in CBT:
Pioneers like Albert Ellis began incorporating paradoxical techniques within the CBT framework. This integration represented a departure from traditional cognitive restructuring, providing therapists with additional tools to address complex issues.
Contemporary Applications and Innovations of Paradoxical Interventions…
Gottman Couples Therapy:
In martial arts such as judo and jujitsu, if you are pulled, you push… and if you are pushed, you pull.
The ‘problem’ (of your opponent’s force) isn’t resisted, but rather encouraged and then directed. You now control the force of the problem. Gottman calls this “yield to win.”
When we use paradoxical intervention we recruit the ancient awareness of the counterintuitive.
Narrative Therapy:
Narrative therapy, with its emphasis on storytelling and deconstruction of narratives, naturally incorporated paradoxical elements into therapeutic conversations. The narrative approach allowed for the exploration of paradoxes within the stories clients tell about themselves and their families.
Solution-Focused Brief Therapy:
The brief history of solution-focused therapy introduced a pragmatic approach to therapy. Paradoxical techniques within this framework aimed to shift the focus from problems to solutions, aligning with the brief and goal-oriented nature of the therapy.
Postmodern Influences:
Postmodern perspectives on paradox and contradiction added another layer to contemporary family therapy. Therapists began to explore how acknowledging and navigating paradoxes aligns with postmodern notions of embracing complexity and multiple perspectives.
The Paradox of ongoing challenges and ethical considerations…
As paradoxical interventions gained popularity, therapists grappled with ethical considerations. The potential benefits of these interventions needed to be balanced with concerns related to client autonomy, consent, and especially the potential for unintended consequences.
Cultural Sensitivity:
Recognizing cultural nuances in the application of paradoxical interventions became imperative. Therapists needed to navigate diverse cultural perspectives to ensure that interventions were sensitive and respectful of each client's unique background.
Geez… that seems needlessly risky, we thought…
At some point, in the community of practice, old school, Haley-esque Paradoxical Interventions fell out of favor, and sometimes were dismissed as a vestige of the dark ages of of a more manipulative approach to family therapy.
Final Thoughts
“If you try to fail, and succeed, which have you done? – George Carlin
I like Victor Frankl's comments about using paradox. Frankl attributed the success of paradox, in part, to a sense of humor.
Frankl also believed that paradox allows humans to place distance between themselves and their situation.
Novel, and light-hearted perspectives allow clients to sometimes surrender their symptoms.
Frankl thought paradoxically assisted attitude adjustments could be deep and abiding, and not merely a superficial, temporary change.
“Paradoxical interventions should not be seen as miracle interventions”, said Frankl. Paradox must be used skillfully, with the right human, at the right time, and often in conjunction with other clinical approaches.
Paradoxical intention is successful because it utilizes the human capacity for self-detachment. By laughing at yourself, you put a distance between your own sense of being, and the symptom.
Thought leaders have various reasons to explain why paradoxical intention works. However, what Frankl says about humor offers the most compelling explanation.
Putting something in a humorous way restores a “basic trust in being.” It is in this sense, says Frankl, that paradoxical intention is a therapeutic process in the truest sense.
From Adler's foundational work to the contemporary integration of paradoxical interventions, therapists continue to navigate a dynamic and changing landscape against a backdrop of occasional ethical peril.
The persistence of paradox serves as a testament to the resilience and adaptability of these ideas in Marriage and Family Therapy.
Paradoxical interventions offer compelling, but challenging avenues toward healing and growth within the complexities of intimate bonds.
I’ll offer the last words on paradox to the great Cummington poet, Richard Wilbur…
A Milkweed
Anonymous as cherubs
Over the crib of God,
White seeds are floating
Out of my burst pod.
What power had I
Before I learned to yield?
Shatter me, great wind:
I shall possess the field.
Be Well, Stay Kind, and Godspeed.
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