The Mandala of Psicoterapea

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Psychotherapy Volume 26/Fall 1989/Number 3

THE MANDALA OF PSYCHOTHERAPY: THE UNIVERSALUSE OF PARADOXNEW UNDERSTANDINGAND MORE CONFUSION

GERALD J. MOZDZIERZ, JOSEPH LISIECKI,AND FRANK J. MACCHITELLIHines VA Hospital

Regardless of differences in definition,paradox is widely practiced and writtenabout in the psychotherapy literature.This article suggests a graphic"mandala" as a way of examiningparadox based on three dimensionsinvolved in the paradoxicalintervention: type of delivery ("hard" or"soft"); type of patient ("neurotic" or"psychotic"); degree of explicitnessor implicitness. The implications of thismanda la for therapists are discussedincluding the need to heightenawareness of the little understood anddelicate interaction between thetherapist's personality, the type ofclient, and the strategic paradoxicalinterventions used in treatment.

The mandala in its various forms symbolizes thedifferent levels of energy locked in the human or-ganism. . . . A properly drawn mandala is a bookin itself containing a great deal of information buthe who would read the symbols must learn the lan-guage. Jaco bs, 1961, cited in DeRopp, 1968Jay Haley (1963) described the paradox in psy-

chotherapy in a s imple yet e legant way: "Whena therapist indicates he will help a patient over aproblem and within that framework he encourages

Correspondence regarding this article should be addressedto Gerald J . Mozdzierz, Psychology Service, VeteransAdministration, Edward Hines, Jr. Hospital, H ines, IL 60141.

the patient to have the problem, he is posing aformal paradox . . . defining the situation as be-nevolent the therapist provides an ordeal" (p. 66).Since Haley's landmark w ork, the professionalliterature (e.g., Selvini-Palazzoli et al., 1978;Watzlawick et al., 1974; Weeks & L'Ab ate, 1981)has been inundated regarding the concept of par-adox in psychotherapy. Controversy regardingprecisely what constitutes and what does not con-stitute paradox in therapy has also been abundant(Dell, 1981; Jessee & L'Abate, 1981; Selvini-Palazzoli, 1 981; Wa tzlawick, 1981).A number of attempts in the literature (Fisheret al., 1981; Johnson & Alevizos, 1975; Om er,1982; Raskin & Klein, 1976; Rohrbaugh et al.,1977, 1981; Weeks & L'A bate , 1979) have beenmade to systematize thinking about the paradox.While the paradox defies a definitive description,over the years it has seductively invited descriptionsand elaborations of its essence in what amountsto a "tower of theoretical B abe l." That is , paradoxis something that innumerable therapists have de-scribed using different languages based on theidiosyncrasies of particular theories, heuristicbiases, and so on to explain very much the sameconcept. While specific use of paradoxical strat-egies/approaches/techniques in psychotherapy forpurposes of behavioral change has been discussedin the literature under a variety of names for over70 years (Mozdzierz et al., 1976), we agree withWatzlawick et al. (1974) that "little serious andsystematic inquiry has been focused on this wholematter, which has remained as puzzling and con-tradictory as ever" (p. XIII).A num ber of years ago we began searching fora way of categorizing what we considered to beaccounts of explicit paradoxical strategies/inter-ventions in psychotherapy (Mozdzierz et al., 1973).The essential purpose of the exercise was to develop

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G. J.Mozdzierz et al.some understanding of what we perceived to bethe different ways in which a variety of practitionerseither explicitly used paradoxical interventions orwere implicitly paradoxical in their therapies asHaley (1963) suggested. Since we were personallyacquainted with several of these practitioners itseemed self-evident that some of them could neverdo with clients what others of them did withaplomb. Over a period of time we organized thework of a sample of clinicians with whose writingswe w ere familiar into a threefold graphic schematicwhich we have designated the "mandala of psy-chotherapy." The purpose of this article is to de-scribe this mandala and some of the implicationsof how it is organized for clinicians.The Universal Use of ParadoxMany of the practitioners represented in themandala of Figure 1 practiced from widely di-vergent frames of reference, although some arefrom the same school of psychotherapy. Para-doxically, even though some of the practitionersin Figure 1 are from the same school, they practicedin diverse ways. The reader will note that thereare three basic reference dimensions to our mandala:the Horizontal Axis, the Vertical Axis, and theConcentric Circle Dimension.Horizontal Axis: Neurotic/Psychotic

The Neurotic/Psychotic horizontal axis of themandala represents the basic continuum of patient

HARD

SOFTFigure 1. Proposed distribution of a sample of clinicians' useof paradox along three dimensions: patient behavior (neurotic/psychotic), personal approach of therapist (hard/soft), andstructure of the paradoxical intervention (implication/explicit).

behavior encountered by the therapist-theoreticiansdistributed throughout the figure. Psychotic refersto the most stubborn, confused, chaotic, aso cial,resistant, and at times bizarre behaviors encounteredand written about by these authors; neurotic refersto the more subtle sufferings of people anxiously(or depressively) struggling to find their place inlife's arenas of work, intimacy, family, and friends.The authors cited to the left of the vertical axisdescribed patients who were primarily neurotic.Those authors to the right of the vertical axisdescribed (or worked with) psychotic patients.Milton Erickson can actually be cited throughoutthe figure since his range of therapeutic skill,talent, and flexibility in relating to a wide rangeof patients under a variety of clinical circumstancesis legendary and generally acknowledged to betruly exceptional (Barker, 1986; Beahrs, 1971;Haley, 1977; Hammond, 1984). Farrelly is citedin both the neurotic and psychotic dimensionssince Farrelly is presumably paradoxically pro-vocative to all patients.Vertical Axis: Hard/Soft

The Hard/Soft vertical axis represents the basiccontinuum of the therapist's type of delivery orstyle of paradoxical intervention. W e propose thatit is based, in part, on the characteristics of thattherapist's personality. The delivery to or inter-vention with the patient could be soft or hard.Soft refers to the gentle, kind, persuasive, en-couraging, subtle, and rational, approaches ofpractitioners such as Alfred Adler, Victor Frankl,Rudolph Dreikurs, and Kurt Adler, who mightencourage patients to view their anxiety as a reliablefriend who will be there when the need arises.Hard refers to the more dramatic, confrontational,challenging, provocative, and active therapeuticapproaches such as those demonstrated by Rosen(1953) and Kraupl-Taylor (1969) who deliberatelysought to provoke patients into action or opposition.Hard interventions cited, in general, tend tomatch the more dramatic and bizarre patient be-haviors, in other words "meeting fire with fire."These interven tions are proportionate to or greaterthan the degree of symptomatic patient behaviorin question or offer the patient a worse/differentalternative by placing the patient's behavior in alarger context/frame. To summarize this hard/softdistinction, Frankl might explain the rationale forhis intervention as if the client were a colleague;he would attempt to persuade gently. On the otherhand, Kraupl-Taylor advocated therapeuticallyprovoking patient rebellion away from their

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The Mandala of Psychotherapysymptomatic behavior by associating their symp-toms with unacceptable sexual mean ings. W e hy-pothesize that it is not simply a difference in the-oretical perspective that allows for such hard versussoft differences in delivery; we hypothesize thatthe personality of the practitioner also plays arole. Some practitioners would be more comfortablewith one type of approach and some more com-fortable with another.Circle Dimension: Implicit/Explicit

To complete the description of our proposedmandala, paradoxical interventions can either bevery explicit or subtle and implicit. From the centerof the figure radiating outward are a series ofconcentric circles. The center circle representspractitioners who were implicitly paradoxical asHaley (1963) suggested. Thus Freud and Rogersrepresent orientations that are intrinsically/im-plicitly paradoxical; in effect, they are paradoxicalby the nature of their activities. For example,Freud (1977) cautioned h is early audiences to re-ceive his controversial psychosexual theories withskepticism lest they become outcast from theirprofessional communities and that psychic traumamust somehow be reexperienced (prescribed) inorder to be resolved. That which patients havestruggled so much to avoid must be reexperiencedin order to receive help a "benign ordeal" (Haley,1963, 1984).At the outer circle, the use of paradox by thepractitioners listed can be depicted as explicit.Haley (1963, 1984), Erickson (1959), and B eier's(1966) names are synonymous with overt para-doxical interve ntions. Rosen (1953) at the explicitperimeter of the circle talks about dealing withdelusions ("tricks") through use of exceptionallydramatic, deliberately rehearsed, and orchestrated,paradoxical interventions which he labeled a "trickagainst a trick." In locating Rosen within the m an-dala, the reader w ill note that he is in the "ha rd,""psychotic," and "explicit" axes of the figure re-garding his unusual methods.Examples from Around the Mandala

At this point the reader may find it helpful tosee concrete examples of how some of the therapistsin the mandala prac tice their paradoxical/dialecticapproaches. A clinical sample of a paradoxicalresponse to a patient and the rationale for thatresponse from Farrelly & Brandsma (1974) andtheir Provocative Therapy we locate in the "hard/explicit/neurotic" sector of the mandala. This in-tervention is the exact dialectically opposite and

paradoxical response from what a client mightexpect:Another patient asked, "Well, wh y am I this way?" Therapist(with professional profundity): Well, it's very clear. Obviouslyyou had crooked chromosomes to start off with, your motherblighted your life, and your environment chew ed up what wasleft! So what the hell chance do we have of changing you!"(p. 74)Their rationale for this intervention is straight-forward:The inferences and constructs used to provide answers are notimportant in themselves, only to the extent that they takeimportant aspects o f behavioral and social reality into account.The provocative therapist, therefore, will offer and often bur-lesque explanations of all types. The burlesque will clearlyindicate that behavior is more important than explanation, (p.74 )

The hardness of this confrontation and its ex-plicitness constitute what can be considered anoutrageously paradoxical response to a patient en-quiry; it is a response and an explanation to thepatient but not the kind that he expected. Webelieve that Farrelly is not the least bit malevolentin responding this way.Still another hard and explicit intervention, butthis time with a psychotic patient, can be seenfrom the work of Rosen (1953) and his "directpsychoanalysis":A patient had successfully denied his psychotic behavior byinsisting his trouble was malformation of the spine with anextra bone sticking out in back. He also had a most unusualspringing step which he partly attributed to the spinal defect.On the day when I recognized that I was admitted to hispsychosis, I was impressed by two new things in his attitude.He kept turning his head toward me instead of not looking atme as was his custom and when I asked him to let me feelhis hand (cold and moist), he extended his hand to me whereasheretofore I could only examine it by force. Addressing myremarks to two other doctors and his nurse, I stated: ''Let mesee, walking on my toes. I did that when I was crazy. Whatwas it my psychiatrist said to me oh yes, I recall. You'retrying to be a woman. You walk as though you had high-heeled shoes on. But I don't believe in that nonsense. (To thepatient): Would you like a cup of coffee? I think we have somecake in the house." The patient remarked, 'Wo, were youreally insane, Doctor? D id you really have that foot pull? Itseems to pull up from the muscles of my leg. You never hada spine disease." I replied: "Neither have you. A person whohas been through your insanity understands these things, butenough of this psychology nonsense." I then addressed myselfagain to the others, ignoring the patient's manifest interest inmy alleged symptom. After a few minutes of talk about baseballand politics, the patient interrupted, "How can you believethat I want to be a girlT I bade the patient good nigh t, offeringto shake his hand in leave-taking, but he withdrew it, stating,"/ do that with ordinary people. I don't care to leave. Youare the only one who has ever been sincere." (pp. 19-20)

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G. J.Mozdzierz et al.The reader will observe that Rosen's interventionis far from "benign" or "tame"; to the contrary,it is very dramatic; in fact the above vignette isin our opinion not one of the more dramatic ex-amples he cites. His explanation for "lying" to

the patient represents a different view from thoseof Farrelly & Brandsma (1974) but a paradoxicalone nevertheless:In every case where the patient persists in denying the existenceof the psychotic basis for his behavior, when I can, I makebelieve I was once psychotic and had just those symptoms.The patient must face the fact that I am not crazy now. If Iever was crazy with those symptoms, I got well. Why shouldn'the get well too? If he thinks that maybe I'm lying to him, hetakes it for a kindhearted lie and many times after psychosis,with good humor and just a little ashamed, he will assert, "Iknew it was a big lie. Maybe it wasn't true, but it surelywarmed me toward you." (p. 20).A patient's delusions are seen as a "trick devisedby his unconscious censorship faculties to hidefrom consciousness something basically moredangerous to him than the delusion itself" (p .148). In turn, Rosen uses a "trick against thetrick" (his dramatic, staged, rehearsed paradoxicalconfrontations) which don't "cure" but which helpspush patients toward greater insight.As an example from the explicit, soft, neuroticaxis of the mandala we offer a clinical vignetteof a paradoxical redefining of symptoms fromKurt Adler (1972):For this girl, for w hom her parents represented her only security,to take a definitive step towards independence, away fromthem, and join her life to a stranger (by getting married), wasmore than she dared. H owever, social pressures, competitionwith her sister, and her self-image of a mature, efficient person,which she felt she had to uphold at any cost, put her on thehorns of a dilemma. At that moment, her long trained andoften proven mechanism of mobilizing anxiety came to heraid, like an old trusted friend. Because no w, it was not herself,but her sickness that prevented her from doing what she wasin reality not prepared to do. Since she is not conscious ofthis, she can easily delude herself, and hopefully also others.That was the time to tell her, "You know, that reminds meof your early recollection, when you were little, and yourmother wanted to leave you alone. You would cry, and showsuch fears until your mother decided to stay home with you.And now, you are thinking of leaving your mother, and avery similar anxiety appears to come over you. You have,evidently, still not really prepared yourself for sufficient in-dependence. Nobody can do what he has not prepared himselffor. And you had alw ays been such a good girl, different frommany others; you never rebelled against your parents, whoover-protected you; where should you have prepared for in-dependence.

Now she has official permission, doctor's advice to postponewhat she is so afraid of doing, (p. 167)The reader will note that Adler uses no humor

in this vignette, he is supportive of the patient'sbehavior, gentle and persuasive but neverthelesssuggesting to this patient that her anxiety is herfriend who returns to her when she really needsit.Still another example from the soft, explicit,neurotic sector of the mandala can be found inthe therapeutic w ork of Victor Frankl (1955) whoutilizes a more grandfatherly approach in dealingwith essentially neurotic, middle-class patients.His patients are described as professional peoplewho fear public speaking, airplane trips, socialengagements, operas, and so on. His patientspresent three basic conditions: a "fear of fears,"which produces avoidance patterns of behaviorsor a flight from fears; a "fight against" obsessive-

compulsive behaviors or an attempt to suppressurges; and a "fight for something," which attemptsto produce something but actually prevents itsoccurrence.Frankl (1955) invites his patients to seek whatthey have been avoiding, to invite what they'vebeen fighting, and to replace a fear with a wish.He has instructed his patients to "resolve delib-erately to show those whom he was with at thetime how much he could really sweat . . . myheart should beat even faster . . . or try very hard

to be as panicky as possible ." Symptoms w ere tobe exaggerated to the point of absurdity.Frankl's paradoxical intentions were alwaysdelivered with a good deal of humor w hich helpedto promote a necessary self-detachment in viewingthe symptom as opposed to Kurt Adler's approachnoted above, which was persuasive and morestraightforward and "serious." Frankl (1955)maintained that "when the patient began to laughabout his neurotic symptom, humor entered inand helped to put distance between himself and

his neurosis." Hum or was antidote to what Franklidentified as Heidegger's "sorrowful concern per-meating the human condition." Frankl's collegialrelationship with his patients is captured in hisadvice: "The therapist must never tire of encour-aging the patient to continue to use paradoxicalintention over and over just as his neurosis pro-duces the symptom over and ov er." As one patientremarked , "W henever I deliberately tried to trembleI was unable to do so."DiscussionTo this point in our presentation the reader, asa devotee of the paradox, may ask, "So what?"In response to this question we reply that our

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The Mandala of Psychotherapyintention in this article is to expose the reader toseveral hypotheses, namely: 1) paradox is a universal tool of encouragement in psychotherapythat is used and written about by innumerablepractitioners under a variety of names almost sincethe inception of psychotherapy; 2) of necessity,there is an interaction between the type of patient/behavior, the personality of the therapist, and thetype of paradoxical intervention; 3) the mandalasimply represents one way of graphically repre-senting this interesting dynamism; and 4) theseobservations have implications for our under-standing of this fascinating tool of therapy andits use with patients.Relative to the last point above, obviously, thereare any number of practitioners whose names andwritings have not been included in our "ma ndala."Also a therapist of the stature and genius of M iltonErickson could adopt paradoxical interventionsseemingly without limit to any number of patientsand their behaviors. His exceptional flexibilityand ability to form intense rapport/relationshipswith patients appears to be the essential key tounderstanding his phenomenal success with hispatients (Barker, 1986; Hammond 1984). Perhapsthat represents the essence of the "world class"psychotherapist. Although it is probably difficultfor us as a group to admit, most therapists havea more limited range of abilities to relate andadapt interventions (paradoxical or otherwise) tothe particular peculiarities and circumstances ofthe patients, problems, and behaviors they en-counter. As Cummings (1986) has said:It is a propensity of psychotherapy that every patient whowalks into a therapist's office receives the type of therapy thepsychotherapist has to offer. If the therapist is a Freudiananalyst, he or she does not care what the patient hasal-coholism, m arital problems, or job proble ms that patient isgoing to get the couch. If the therapist is a Jungian analyst,the patient is going to paint pictures. If the therapist is abehaviorist, the patient is going to get desensitization. (p.429)

Thus, as we see it, it is not unreasonable toexpect that the limitations of therapists' framesof reference and their general personalities certainlyinfluence not only what they practice bu t also howthey practice and more specifically how they "de-liver" paradoxical interventions to different pa-tients. A paradoxical intervention/prescription canbe presented to a patient or client as the truth; anoutrageous and absurd lie; simply another way oflooking at things; a suggestion possibly havingvalue; a challenge; a provocation; a twist of irony;

a humorous "nudging"; and so on.We believe that therapists are most likely touse the type of paradoxical interventions that arecompatible with their own personalities. For ex-ample, Farrelly is probably more comfortable thanmost therapists in being ab le to engage in the typeof nimble-tongued, witty, "burlesque" paradoxicalinterventions for which he is noted. Correspond-ingly, Frankl might be very uncomfortable in usingsuch interventions. On the other hand, O'Connell's(1967, 1969) empathic, philosophical, therapeuticuse of paradoxical wit is in keeping with the breadthof his natural humanistic identification.We conjecture that effective and caring therapistsmost likely modulate their paradoxical interventionsin keeping with the vicissitudes of each patient'sunique situation and the limitations of their ownpersonalities. That is, if therapists are optimallyflexible (an obviously ideal good toward whichwe strive but do not attain), they are most likelyto modify the "delivery" of a paradoxical inter-vention in keeping with and respect for the per-sonality of the patient as well as their situation.If they are m inimally flexible, therap ists are likelyto deliver paradoxical interventions in a rathermechanistic cookbook manner as a "technique."It is our opinion that paradox cannot be mechan-istically applied but must rather be strategicallyrelated to the patient and the dynamics of his orher personality and situation. In this regard, wehave heard such naive practices expressed by novicetherapists in comments such as, "I paradoxed thatpatient!"We note with interest that, outside of MiltonErickson, Farrelly, Rosen, Jackson, and Goldstein,the practitioners distributed in our mandala tendto cluster themselves within the neurotic/soft/ex-plicit quadrant, while few practitioners can befound in the psychotic/hard/explicit quadrant. Wesuggest that this may be so because paradoxicalinterventions with psychotics are very difficult.Such patients are oftentimes so very concrete intheir thinking, and therapists' personalities havelimitations in the degree of flexibility and therange of interventions which they can employwithin their theoretical frames of reference in re-sponse to bizarre psychotic patient behaviors.The paradox is a powerful and ubiquitous eh-couragenic therapeutic tool for promoting change.In that regard it is not unlike the story of the blindmen who each have hold of a different part of anelephant and therefore describe and interpret thecreature at hand from their own point of view. It

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G. J.Mozdzierz et al.is our contention that more attention needs to begiven to the dynamism that we suggest is createdbetween the patient, his or her situation, and thetherapist's personality in understanding paradox.It is incumbent upon therapists who are familiarwith the paradox as a therapeutic tool to examinethe parameters within which they operate whenusing paradoxical interventions. From a more co-herent understanding of this ubiquitous vehiclefor change can emerge a more enlightened, sen-sitive, effective, and ethical clinical use.ReferencesADLER, K. (1972). Techniques that shorten psychotherapy:Illustrated with five cases. Journal of Individual Psychology,28 , 155-168.BARKER, P. (1986). Milton Erickson's contribution to psy-chiatry. British Journal of Psychiatry, 148, 471-475.BEAHRS, J. O. (1971). The hypnotic psychotherapy of MiltonH. Erickson. American Journal of Clinical Hypnosis, 14,73-90.BEIER, E. (1966). The Silent Language of Psychotherapy:Social Reinforcement of Unconscious Processes. Chicago:Aldine.CUMMINGS, N. (1986). The dismantling of our health system:Strategies for the survival of psychological practice. AmericanPsychologist, 41 , 426-431.DELL, P. F. (1981). Some irreverent thoughts on paradox.Family Process, 20, 37-42.DEROPP, R. S. (1968). The Master Game: Beyond the Drug

Experience. New York: Delta Book/Dell Publishing.FISHER, L., ANDERSON, A. & JONES, J. (1981). Types ofparadoxical interventions and indications/contraindicationsfor use in clinical practice. Family Process, 20, 25-35.ERICKSON, M . (1959). Further clinical techniques of hypnosis:Utilization techniques. American Journal of Clinical Hyp-nosis, 1, 3-21.FARRELLY, F. & BRANDSMA, J. (1974). Provocative Therapy.Cupertino, Calif.: Meta Publications.FRANKL, V. (1955). The Doctor and the Soul. New York:Alfred A. Knopf.FRANKL, V. (1960). Paradoxical intention: A logotherapeutictechnique. American Journal of Psychotherapy, 14 , 520-

535.FREUD, S. (1977). Introductory Lectures to Analysis on Psy-choanalysis: A General Introduction to Psychoanalysis. NewYork: Liveright.HALEY, J. (1963). Strategies of Psychotherapy. New York:Grune & Stratton.HALEY, J. (1977). Uncommon Therapy; The Psychiatric Tech-nique of Milton H. Erickson, M.D. New York: W. W.Norton.

HALEY, J. (1984). Ordeal Therapy: U nusual Ways to ChangeBehavior. San Francisco: Jossey-Bass.HAMMOND, C. (1984). Myths about Erickson and Ericksonianhypnosis. American Journal of Clinical Hypnosis, 26, 236-245.JACOBS , H. (1961). Western Psychotherapy and Hindu Sadhana.

London: Allen & Unwin.JESSEE, E. & L'ABATE, L. (1981). Comments on Dell's paper.Family Process, 20, 42-44.JOHNSON, S. M. & ALEVIZOS, P. (1975). Strategic therapy:A systematic outline of procedures. Unpublished manuscriptportions of which were presented at the Ninth Annual Con-ference of the Association for the Advancement of BehaviorTherapy, San Francisco.KRAUPL-TAYLOR, F. (1969). Prokaletic measures derived frompsychoanalytic technique. British Journal of Psychiatry,115, 407-419.MOZDZIERZ, G., MACCHITELLI, F. & LISEECKI, J. (1973).Workshop on The Paradox in Psychotherapy. Howard John-son's Motor Lodge, Desplaines, Illinois.MOZDZIERZ, G., MACCHITELLI, F. & LISIECKI, J. (1976). Theparadox in psychotherapy: An Adlerian perspective. Journalof Individual Psychology, 32, 169-184.O'CONNELL, W. E. (1967). Spitting and stroking. IndividualPsychologist, 5, 29-31.O'CONNELL, W. E. (1969). Humor: The therapeutic impasse.Voices, 25, 29-31.OMER, H. (1982). Paradoxical treatments: A unified concept.Psychotherapy: Theory, Research and Practice, 18 , 320-324.RASKIN, D. E. & KLEIN, Z. E. (1976). Losing a symptomthrough keeping it: A review of paradoxical techniques andrationale. Archives of General Psychiatry, 33, 548-555.ROHRBAUGH, M ., TENNEN, H., PRESS, S., W H I TE, L., RASKIN,P ., PICKERING, M . & WATZLAWICK, P. (1977). Paradoxicalstrategies in psychotherapy. Symposium presented at theAnnual M eeting of the Am erican Psychological Association,San Francisco.ROSEN, J. (1953). Direct Psychoanalysis: Vols. I & II. NewYork: Grune & Stratton.SELVINI-PALAZZOLI, M. (1981). Comments on Dell's paper.Family Process, 20, 44-45.SELVINI-PALAZZOLI, M. S., BOSCOLO, L., CECCHIN, G. &

PRATA, G. (1978). Paradox and Counterparadox. NewYork: Jason Aronson.WATZLAWICK, P. (1981). Comments on Dell's paper. Family

Process, 2 0 , 4 5 - 5 1 .WATZLAWICK, P., WEAKLAND, J. & FISCH, R. (1974). Change:Principles of Problem Formulation and Problem Resolution.New York: W. W. Norton.WEEKS, G. R. & L'ABATE, L. (1979). A compilation of par-adoxical methods. American Journal of Family Therapy,7, 61-76.WEEKS, G. R. & L'ABATE, L. (1981). Paradoxical Psycho-therapy. New York: Brunner/Mazel.

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The Mandala of Psicoterapea