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Author Goldsmith, David
Title The impactful paradoxical intervention in individual psychotherapy: A phenomenological approach
Descript 547 p
Note Source: Dissertation Abstracts International, Volume: 51-05, Section: B, page: 2620
Director: Anthony Barton
Thesis (Ph.D.)--Duquesne University, 1989
The study was undertaken in order to elucidate the experience of the impactful paradoxical intervention (PDI) in individual psychotherapy. Existing empirical studies focus on questions of efficacy, omit the patient-perspective, and rely on theoretical hypotheses regarding mechanisms of change. In order to achieve a fuller comprehension, an empirical-phenomenological approach was utilized. Therapists and patients in ongoing psychotherapy provided open-ended descriptions of PDI. The analysis yielded three General Structures--Therapist, Patient, and Dyadic--which reveal the interrelated constituents of PDI
PDI is a relational process, which must be understood in the context of the patient's personal history and the specific therapeutic relationship. Therapists and patients have multiple intentions. The therapist's primary intention is to disrupt the patient's habitual constellation of ambivalence in the hope that healthier restructuration will occur, while the patient ambivalently intends to be free of and to retain the problematic behavior. Therapists express a tragicomic vision of healing, and convey a sense of indeterminacy through PDI. Four circular, overlapping phases are--quizzical protest, compliance, acceptance, and partial integration--which emerge from personal meanings evoked by the intervention. Neither patients nor therapists have complete control over or complete access to the meanings of the intervention. The PDI can be described as a metaphor which disrupts the patient's constellation of ambivalence and creates confusion from which novel meanings may emerge. The PDI results in the ironic reversal of a network of interrelated behaviors rather than being confined to the focal problematic behavior. While there is temporary and lasting impact, the participants agree that the patient attains greater insight, control, freedom, and unity between thought, affect, and action
The findings contribute to psychology in theoretical and pragmatic ways. Several concepts are introduced--constellation of ambivalence, therapist indeterminacy, ironic reversal, tragicomic vision, and PDI as metaphor--and the General Structures offer a contextual view of PDI. Therapists can familiarize themselves with the unfolding phases and attitudinal constituents. PDI is neither ethical nor unethical in-itself, but must be viewed in the relational context. Further studies should examine PDI in contexts other than individual psychotherapy
School code: 0067
Host Item Dissertation Abstracts International 51-05B
Subject Psychology, Clinical
Alt Author Duquesne University
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