Techniques of Logotherapy

Techniques of Logotherapy

Paradoxical Intention
The therapist encourages the patient to intend or wish for, even if only for a second, precisely what they fear. oUsed for obsessive, compulsive and phobic conditions (not for suicidal or schizophrenic patients). oUseful in cases of underlying anticipatory anxiety, often works very quickly. oMobilises the human capacity for self-detachment, often with a sense of humour oHans Gerz claims that paradoxical intention is successful in 80-90% of cases
The case of the sweating doctor (from Pyschotherapy and Existentialism, p 139)
A young doctor had severe hydrophobia. One day, meeting his chief on the street, as he extended his hand in greeting, he noticed that he was perspiring more than usual. The next time he was in a similar situation he expected to perspire again, and this anticipatory anxiety precipitated excessive sweating. It was a vicious circle … We advised our patient, in the event that his anticipatory anxiety should recur, to resolve deliberately to show the people whom he confronted at the time just how much he could really sweat.A week later he returned to report that whenever he met anyone who triggered his anxiety, he said to himself, "I only sweated out a litre before, but now I'm going to pour out at least ten litres !" What was the result of this paradoxical resolution ? After suffering from his phobia for four years, he was quickly able, after only one session, to free himself of it for good.
You are the logotherapist
In the following cases, what paradoxical intention, if any, would you recommend ?
i)A man is fearful that he will die from a heart attack. Physical check-ups reveal him to be in good health. ii) An obsessive-compulsive comes to you because she is concerned about the number of times she washes her hands each day. iii) A young man comes to you for help with stuttering. What do you advice ? iv) A schizophrenic is anxious that the people he sees on the tube are out to get him.
Dereflection
The therapist diverts the patients away from their problems towards something else meaningful in the world. oused specifically for sexual dysfunction. Deflection indicated because (e.g.) the more you think about potency during sex, the less likely you are to achieve it, oNo use just telling them to stop thinking about something – need to substitute something positive ( e.g. insomniac -don’t just tell them to stop trying to sleep, tell them to count sheep). oMore generally, logotherapy can be seen as dereflecting the patient away from their presenting problem towards searching for meaning. Patient is dereflected from their disturbance to something other than themselves.
Frankl's advice to Anna, 19-year old art student who displays severe symptoms of incipient schizophrenia. She considers herself as being confused and asks for help.
Patient … What is going on within me ?
Frankl: Don't brood over yourself. Don't inquire into the source of your trouble. Leave this to us doctors. We will steer and pilot you through the crisis. Well, isn't there a goal beckoning you – say, an artistic assignment ?
Patient: But this inner turmoil ….
Frankl: Don't watch your inner turmoil, but turn your gaze to what is waiting for you. What counts is not what lurks in the depths, but what waits in the future, waits to be actualised by you….
Patient: But what is the origin of my trouble ?
Frankl: Don't focus on questions like this. Whatever the pathological process underlying your psychological affliction may be, we will cure you. Therefore, don't be concerned with the strange feelings haunting you. Ignore them util we make you get rid of them. Don't watch them. Don't fight them.
Imagine, there are about a dozen great things, works which wait to be created by Anna, and there isno one who could achieve and accomplish it but Anna. No one could replace here in this assignment, They will be your creations, and if you don't create them, they will remain uncreated forever…
Patient : Doctor, I believe in what you say. It is a message which makes me happy.