145: The TEAM Therapy Paradoxes

Hi Listeners:

Many of our podcasts are inspired by listeners like you who send us really cool emails with show ideas. Sometimes the emails are from people wanting self-help with emotional or relationship conflicts. And sometimes, they are from therapists wanting more training and information about TEAM. Rhonda and I love your emails!

Yesterday, I got the following email from Dipti Joshi, one of our listeners and TEAM-CBT therapists from India. Dipti flew all the way from India to Canada with her lovely daughter last summer for my Intensive in Whistler, Canada. I am hopeful that Dipti will one day create the first TEAM Treatment and Training Center in India. How cool would that be!

Here’s the email that Dipti sent me:

Dear David,

I am really enjoying all the educational materials available on your website. Thank you! I will soon be taking my Level 3 TEAM certification exam, and am seeking your kind blessings for the same!

Also, I have a special request for you. Is it possible to have a workshop or podcast on “paradoxical techniques?” I feel this is a very challenging area, and that a lot of skill is needed. Perhaps you can also talk about why paradoxical techniques can be so effective.

Meanwhile can you suggest me something to read or listen to for this?

Regards, Dipti 

Thanks, Dipit! Today’s podcast will be an introduction to the use of paradox in TEAM therapy, a kind of overview. When my new book, Feeling Great, comes out, I am hoping to do a series of workshops on a variety of powerful paradoxical techniques. And of course, the new book will have a great deal of instruction on paradoxical techniques as well.

These are the four key components of TEAM:

T = Testing

E = Empathy

A = (Paradoxical) Agenda Setting

M = Methods

In today's podcast, Dr. Rhonda and I will explain why each of these components is inherently paradoxical. For example, when you do the T = Testing, you assess changes in the patient’s symptoms from the start to the end of the session, and the patient rates you on the Empathy and Helpfulness scales as well, When you look at the ratings, you will probably discover that you aren’t helping your patient much, if at all. You may also discover that your perxceptions of how the patient feels, and how the patients feels about  you, are off-base, and sometimes alarmingly so.

This can be very disturbing, especially if you’re not use to this kind of information. However, in TEAM, we are actually hoping for failure, and welcome that kind of "disturbing" information. Why is this? Isn’t therapy all about recovery and making positive changes? Why in the world would the therapist want to know that he or she is not helping?

It's because many of the most important breakthroughs in therapy come from the therapist's discovery that he or she is failing. We WANT to fail! Why? 

David illustrates this paradox by describing his discovery that he was not actually helping a patient he thought he’d helped enormously. David explains how and why this shocking information led to a tremendous breakthrough.

When you review how your patient rated you at the end of the session, you may discover that your patient gives you failing grades on the E = Empathy scale. The patient’s ratings may indicate that he or she didn't experience you as sufficiently warm and caring, or completely trustworthy, and that you didn’t really “get” how she or he was feeling inside.

Once again, as TEAM therapists we welcome failing grades on the Empathy Scale. Why? It’s because your worst therapeutic failure will nearly always be your greatest success in disguise.

How can this be? It seems absurd, or impossible. Karl Rogers told us that empathy is the necessary and sufficient condition for personality change. So why would a TEAM therapist hope to discover that he or she is failing in this category?

You’ll discover the explanation for this paradox on today’s podcast.

When the patient asks for help during the A = Agenda Setting phase of the session, the TEAM therapist doesn’t jump in and offer to help, using this or that therapy method. In fact, the TEAM therapist will often assume the role of the patient subconscious resistance and argue for the status quo, sincerely encouraging the patient to cling to the feelings of depression, anxiety, shame, worthlessness, hopelessness, and anger. The therapist will bring out all the reasons why the patient should RESIST change.

Why in the world would a therapist want to do that? It sounds crazy! You'll find out on this podcast.

And finally, during the M = Methods phase of the session, the TEAM therapist will be working with the patient on his or her negative thoughts, like, “I’m worthless,” or “I’m not as good as I should be,” or "I'm hopelessly damaged because of the abuse I experienced as a child." And the TEAM therapist’s goal is not success, but rather failing as fast as you can, trying technique after technique that DOESN'T work and the patient's belief in the Negative Thought is still 100%.

Why would a therapist want to fail over and over? Isn’t that the opposite of what a skillful, compassionate, and effective therapist would want to do?

Listen to this podcast and you’ll discover the answer to these questions. You’ll also see that the patient, not the therapist, is the expert in TEAM, and discover how the patient, and not the therapist, guides all the changing.

David and Rhonda talk about the important difference between healthy and unhealthy use of paradoxical ideas and techniques in therapy, and describe how narcissistic therapists may use paradoxical techniques in an effort to manipulate “resistant” or annoying patients. This dysfunctional use of paradox is unfortunately common, and will rarely or never be effective. 

David and Rhonda