'Paradox: a pivotal point in therapy'

This paper describes a family who had been known to the professional caring agencies for some five years. At the time of treatment, the family had fifteen-year old twin sons whose frequently aggressive behaviour was the focus of the referred problem. It was agreed that the author would attempt to work with this family should they be re-referred, with a view to offering an alternative mode of treatment. A structural framework of therapy was tried, but very shortly therapeutic attempts to help solve the problems were assimilated by the family and seemed to serve only to ensure their continuation. At this point, a powerful paradoxical intervention was tried in order to free both family and therapists from perpetuating a 'more of the same'. This tactic allowed time for treatment from a more structural base to continue. In this context, consideration is given to the nature of pathological and therapeutic double binding. Some of the difficulties inherent in attempting new methods of treatment from within a traditional casework setting with its statutory responsibilities are also discussed.