“Paradox psychology”的意思、由来-开放百科全书

Paradox psychology is an approach that aims to advance the general field of psychology and treatment. These advances include: An approach that specifically addresses a 'hard-to-treat' or resistant client; A scientific understanding that supports a process for 'spontaneous change'; Unifying behavioral, cognitive, and psychodynamic orientations under a single umbrella theory; A science-based model showing how treating secondary non-criminogenic behaviors (i.e.: anger, low self-esteem, poor social skills, etc.) will impact primary targeted (volatile) criminogenic behaviors (i.e.: violence, problem sexual behavior (PSB), fire setting, etc.)

In addition, paradox psychology 'solves the mystery' regarding the counter-intuitive nature of paradoxical interventions. In doing so, the approach represents the logical extension of attachment theory as described by Bowlby and Ainsworth.

While there are many treatment theories that address separate aspects of behavior, emotions, and thinking, this approach focuses on the obvious fact that human's entire existence is a 'living paradox'. This paradox is evidenced by the fact that we live in an animal body, but we walk upright with our 'mind in the clouds'; our DNA is programmed to function via instinct, yet we prefer to assert free-will; we are smart enough to 'know better', but quite often repeat past mistakes. As such, it could be argued that the study of 'man as a paradox' is most closely aligned with our 'essence' as a human being.

Master therapists

While the paradoxical method was documented by Adler as early as the 1920s, its counter-intuitive style has always been difficult to explain. Adler once described the method as "spitting in the patient's soup"; meaning that the method had the ability to impact behavior without 'convincing or rewarding' the patient to change.

From the 1960s through the 1980s many 'master therapists' incorporated the method with great success. They include: Milton Erickson, Viktor Frankl, Jay Haley, Salvador Minuchin, Fritz Perls, and others. The method proved to have a consistent ability (as described by many for) 'amazing results' with clients who presented a wide range of disruptive behavioral issues.

Research

Unbiased research indicates that behavioral, cognitive, and psychodynamic methods show success rates that are statistically equal when working with motivated clients.^[1]^[2]

Paradoxical interventions were shown to have the highest success rate with oppositional and treatment-resistant clients.^[3]^[4]^[5]^[6]

Scientific and evidenced based

Even though the method was documented to be successful when working with treatment-resistance, paradoxical interventions lost favor in the late 1980s and '90s. This was due to the fact that the psychology field desired to present itself as science oriented, and pushed for 'evidence based' approaches. Since the underlying theory and mechanism for the paradoxical approach had remained an 'unsolved mystery', there was no way to promote the method in a concise and logical manner.

However, more recently, Eliot P. Kaplan, PhD has been able to provide a simple scientific framework that provides a grounded understanding for this seemingly complicated approach. In his work treating adolescents with problem sexual behaviors (PSB), he has been able to show that a basic orbits-gravity model allows us to unravel the puzzling nature of the approach. The model identifies the process between repetitive energy / behavior (orbits) and the strength of attachment (force of gravity) as gauged through the therapeutic alliance. The model incorporates this scientific construct to identify the 'active ingredient' that allows the method to be consistently effective in disarming and bypassing treatment resistance.

An exciting aspect of the approach is the humor and absurd quality of counter-intuitive interventions. It is often this unexpected humor that 'breaks-through' the client's usual attempts to keep the clinician at a distance and defend against treatment. Some of the better known interventions include: Prescribing the symptom; predicting behavior and outcomes; exaggerating symptomatic behavior; symptom planning and scheduling, etc.

Reverse psychology

Those who lack knowledge as to the depth of paradoxical interventions have tended to dismiss the approach simply as reverse psychology. While a paradoxical intervention and reverse psychology may seem similar on the surface, their underlying intent and direction are very different. In reverse psychology the clinician hopes to manipulate the client to follow his planned and preset agenda. (He tells the client to 'go left' with the 'plan' the client will resist his directive and 'go right'.)

However, a 'pure' paradoxical intervention seeks to only strengthen the alliance without an ulterior motive. This is done with the understanding, that by 'shifting gravity-attachment' the client will spontaneously make changes of his own desire and free-will. (Here the clinician expresses unconditional positive regard. He acknowledges that the client's habitual pattern is to 'go left', and truly accepts that the client will most likely do this pattern in the near future. However, paradoxically now that the client's behavior has been predicted and the future outcome has been accepted, the client is in a position to make a 'free-will choice' to undo the forecasted behavior.) The difference here is that paradoxical interventions support the client's ability to take responsibility for his own actions, while reverse psychology focuses on the ability of the clinician to 'trick' the client – a subtle but important difference. The advantage of the method is the ability to approach the client in a non-confrontational and non-threatening manner in such a way that it 'forces' the treatment-resistant client to take responsibility for his habitual reactions and patterns.

Paradoxical interventions should not be used to directly target dangerous or criminogenic behaviors. In such situations clinicians need to use strategic interventions that target secondary non-criminogenic behaviors, but as a result will impact primary targeted volatile behavior.

References

1. ^{{cite journal | title=The Effectiveness of Psychotherapy: The Consumer Reports Study | author=Seligman, Martin E. P. | journal=American Psychologist | year=1995 | volume=50 | issue=12 | pages=965–974 | doi=10.1037/0003-066X.50.12.965 | pmid=8561380}}
2. ^{{cite book | title=The benefits of psychotherapy | publisher=Johns Hopkins University Press | author=Smith, Glass, & Miller | year=1980 | location=Baltimore MD}}
3. ^Sheras, P. L. & Jackson, S. R. (1978) Paradox as an Intervention Strategy with Emotionally Disturbed Adolescents. Paper presented at the Annual Convention of the American Psychological Association, Toronto, Canada, August 1978
4. ^Shoham-Salomon, Avner, & Neeman, (1989) You're changed if you do and changed if you don't; Mechanisms underlying paradoxical interventions, Journal of Consulting and Clinical Psychology, 57, 590-598
5. ^Horvath & Goheen, (1990) Factors mediating the success of defiance and compliance based interventions. Journal of Counseling Psychology, 37, 363-370
6. ^Beuter, Moleiro, & Talebi (2002) Resistance in Psychotherapy: What conclusions are supported by research, Journal of Clinical Psychology, 58 (2), 207-217