top of page

Paradoxical interventions

the best thing to do is let others talk about themselves and just listen openly and honestly. For this you must be fully present, in mind, body, and spirit. However, listening is just the first stage of communication. Once you have listened to the person, in the proper way, you then have the opportunity to speak. This is when you must uplift and validate that person. To uplift someone is to bring a positive energy to that person that will help him or her find a positive energy of their own. If anything that they spoke of was negative, try to turn it into a positive.

When you validate someone, you will draw on what that person said and you will make him or her feel good about it. This is about praising what people have done, the progress they have made, and conveying your understanding of their concerns, opinions, and goals.

LISTEN There are two critical things that you absolutely must remember when it comes to listening to someone: You are not speaking. You are fully present.

When you are listening, you are not speaking. A good way to remember it is that you can’t really listen to someone with your mouth open. If you have something to say, then be patient and wait until the person is done speaking. You will have your chance to speak when the time is right and we will talk about what to say a little further on.

The second thing that you must do in order to truly be a good listener is be present. This means being present physically, mentally, and emotionally.

Physical presence: You need to be there, with the person. You are not up and about, doing chores, checking your email, or reading a book. You are sitting with the person and being attentive. Your eyes should be on the person who is speaking.

Mental presence: When someone is talking to you, you should be listening to what they are saying, actually hearing the words. This means you are not making a grocery list in your head, wondering what you are going to do this weekend, or planning your afternoon schedule in your head while the person is talking.

Emotional presence: When someone is speaking to you, you should not allow yourself to be distracted by your own emotions. This can be difficult if there is something emotionally significant going on in your life, or in theirs, whether it is positive or negative. In addition, you should try to empathize with the person who is speaking, trying to understand how he or she feels and how you might feel in the same situation.

Being present is the opposite of being distracted. Being present is having a focused connection with another person that ensures the person you are listening to feels valued, heard, and acknowledged.

Paradoxical interventions involve prescribing the very symptom the client wants to resolve. It's a complex concept often equated with reverse psychology. For example: the client fears failure, so the therapist asks the client to fail at something. A man has problems with procrastination, so the therapist asks him to schedule one hour a day to procrastinate. Your four year-old resists brushing her teeth so she's told she isn't allowed, and may end up doing it out of spite. Or a woman who can't initiate ​sex with her husband is advised not to initiate for a month. Don't think about a purple elephant. It's asking for something in order to achieve the opposite result.

The underlying principle is that we engage in behaviors for a reason, which is typically to meet a need (rebellion, attention, a cry for help, etc). In prescribing the symptom the therapist helps the client understand this need and determine how much control (if any) they have over the symptom. By choosing to manifest the symptom, they may recognize they can create it, and therefore have the power to stop or change it.

1. When would ​you use a paradoxical intervention?

​When there is a clear symptom or presenting problem that the ​individual believes is an involuntary behavior, such as depression, fears, pain, even seizures.

2. What does it look like?

The therapist asks the patient to deliberately have the symptom at the therapist's office and/or outside the office. Family members may be asked to encourage, advise or reward the behavior. The idea is that, if a symptom is involuntary, having it voluntarily means the behavior can be controlled and is no longer a symptom. If the person can have it voluntarily, this means he/she can also not have it voluntarily. A variation is to ask the patient to pretend to have the symptom. When a person is pretending to have a symptom, they are not having the real symptom. Secondary gain or positive reinforcement can be arranged for the pretend behavior, so that it replaces the involuntary behavior. The involuntary behavior is no longer needed in order to obtain the secondary gain.

3. How does it help?

It helps the ​patient to be in control of his/her behavior and experiences.​

bottom of page