title: Paradox in psychotherapy: a cybernetic perspective.
abstract: Recent uses of the term "paradox" in the field of psychotherapy have distracted attention from the concept's broader implications. All therapy can be seen as paradoxical because of the recursive nature of self-evaluation. Using agoraphobic problems as illustrative, and starting from the notion that the core issue for the agoraphobic is a demand for absolute control of his environment, we argue that therapy requires the bonding of two observers--the therapist and the "client-as-observer". Negotiations issuing from this bond are crucial to outcome, even when behavioral techniques, often considered to have automatic effects, are used. Behavior therapy, like all other psychotherapy, is not simply action--it is action contextualized by a specific, negotiated social contract.
mesh_terms: D000379:Agoraphobia / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods*; D003243:Consciousness; D003491:Cybernetics; D006801:Humans; D011369:Professional-Patient Relations; D011379:Prognosis; D011613:Psychotherapy / Q000379:methods