Paradox/Anti-Suggestion
Note: Page numbers enclosed in parentheses are citations from The Individual Psychology of Alfred Adler: A systematic presentation in selections from his writings. (H. L. and R. R. Ansbacher, Eds.). © 1964, Harper & Row, Publishers, Inc. Used by permission of Perseus Books Group.
Dreikurs saw these terms as descriptive of Adler's catching the imagination of the client and redirecting his or her attention from the useless to the useful side. Regarding a particular symptom, against which the client has been fighting a losing battle, Adler asked (for example, about a nervous tic), "How bad does it get? Can you show me how it looks when it is worse than it is now?" Suddenly the field shifts. The heroism of resistance is put aside for a deliberate performance of the symptom for clinical examination. The power of the symptom until now has been its involuntary "possession" of the person, and his or her valiant but unsuccessful struggle against it. Now the client finds he is unable to proceed. He is embarrassed. His conscience holds him in check, and he feels as if "caught out" by his own awareness of his responsibility.
As remarkable as it was then for Adler's students first witnessing the technique, paradox is commonplace in counseling today. A. Maslow, R. May, and C. Rogers, recognized as "the major theorists . . . to have prepared the ground for Humanistic Psychology" (Aanstoos, C., Serlin, I., & Greening, T., 2000, Contents section 1, ¶4), all studied with Adler (Ansbacher, 1990): It is fair to assume that they passed on his interventions, which are now part of everyday practice for counselors in the United States and elsewhere.
According to Mozdzierz, G. J., Macchitelli, F. J., and Lisiecki, J. (1976, p. 169), while paradox (also called anti-suggestion) is part of Zen tradition, Adler was the innovator of its use in psychiatry in the West. The purpose of paradox is to purge the symptom, either by encouraging the client to practice it, or by predicting its eruption. By performing the symptom, the client demonstrates control over it; by predicting the emergence of the symptom, the therapist challenges the client to exhibit the symptom as predicted and so to confirm the therapist's skill, which the client is reluctant to do. An example is Adler's telling an anxious patient, who was gulping air when feeling conflicted, to "swallow some air quickly" at those times. Adler reported that, after this advice, the client "began to control himself, and discontinued the habit" (Adler, 1964, p. 346). Wexberg (1970), using the term "negationary tactics," tells of a patient who reports that, after a long period of dependency, he is going to go back to work. Wexberg says the therapist may respond with skepticism, saying that returning to work is only an intention, and besides, "It is too soon . . . [you] must not be too hasty" (pp. 90-91). B. H. Shulman, in a footnote to this case (p. 92), states “When the therapist ‘suggests’ to a patient that perhaps he should remain dependent and continue to avoid responsibility, it often becomes a matter of pride to the patient to prove that he can be independent and responsible. Thus, if the patient improves, it becomes the patient's triumph, not the therapist's. This tactic uses the patient's own oppositional tendencies . . . to induce the patient to 'put down' the therapist by changing his relation to life for the better." Carich (1997) states "Paradoxical interventions are based upon 'AS IF' philosophy and future orientation." In paradoxical intention, "the client is told to behave 'AS IF' he has the symptoms." In paradoxical prediction, therapists disrupt a pattern by predicting the recurrence of the symptom. In both cases, "The goal is to allow the client to experience the problem in a different context" (p. 157).
In counseling a schoolgirl who makes trouble at school, Adler suggested saying, “‘School is the most important thing in the world, and if I were you I would make even a greater fuss about it.' By this reductio ad absurdum I would spoil her pleasure in her tactics" (p. 398). [See Spitting in the Soup.)
If one succeeds in persuading a patient to produce the symptoms deliberately, they will disappear (Dreikurs, 1973, p. 129).
[A technique] which not only yields results with amazing promptness but affords theoretical insight into the mechanism of the "nervous" symptoms was described repeatedly by Alfred Adler and has been called by Erwin Wexberg "anti-suggestion" . . . . The patient is advised . . . to practice the very thing which up to now he has apparently been fighting against . . . . One can observe again and again . . . that the symptom diminishes in intensity when the patient consciously tries to intensify it . . . . When he ceases to struggle [against the symptom] and the tension abates, the symptom too, disappears (Dreikurs, 1973, p. 129)
See “Paradox,” (Sherman, R. & Friedman, N. (1986), pp. 199-228.
© Griffith, J., & Powers, R. L. (2007). The Lexicon of Adlerian Psychology: 106 terms Associated with the Individual Psychology of Alfred Adler (2nd ed.). Port Townsend, WA: Adlerian Psychology Associates (p. 78).
Definitions of concepts are used by permission of Jane Griffith. A comprehensive list of concepts and definitions can be found in The Lexicon of Adlerian Psychology: 106 Terms Associated with the Individual Psychology of Alfred Adler by Jane Griffith and Robert L. Powers, available for purchase on Amazon.com.
References
Aanstoos, C., Serlin, I., & Greening, T. (2000). History of Division 32, Humanistic Psychology, of the American Psychological Association. In D. Dewsbury (Ed.), Unification through division: Histories of the divisions of the American Psychological Association, Vol. V. Retrieved April 9, 2007, from http://en.wikipedia.org/wiki/Humanistic Psychology.
Adler, A. (1964). Problems of neurosis. (P. Mairet, Ed.). New York: Harper & Row. (Original work published 1929)
Ansbacher, H. L. (1990). Alfred Adler's influences on the three leading cofounders of
Humanistic Psychology. Journal of Humanistic Psychology, 30( 4), 45-53.
Carich, M.S. (1997). Variations of the ‘as if’ technique. In J. Carlson & S. Slavik (Eds.), Techniques in Adlerian Psychology (pp. 153-160). Washington, DC: Accelerated Development.
Dreikurs, R. (1973, Rev. ed.). Psychodynamics, psychotherapy and counseling: Collected papers of Rudolf Dreikurs, M. D. Chicago: Alfred Adler Institute.
Modzierz, G. J., Macchitelli, F. J., & Lisieki, J. (1976). The paradox in psychotherapy: An Adlerian perspective. Journal of Individual Psychology, 32(2), 169-184. Nelson, J. (1996). Positive discipline. New York: Ballantine.
Sherman, R., & Fredman, N. (1986). Handbook of structured techniques in marriage and family therapy. New York: Brunner/Mazel.
Wexberg, E. (1970). Individual Psychological treatment. (A. Eiloart, Trans.). (Revised and annotated by B. H. Shulman.). Chicago: Alfred Adler Institute. (Original work published 1929)