Existential Aspects of Paradigmatic Technique

Paradigmatic psychotherapy was developed by Marie Coleman Nelson, and her now classic paper “Externalization of the toxic introject” was the first report of her efforts at devising innovative techniques for treating the narcissistic disorders within the framework of psychoanalysis. In that paper Nelson offered a theory and a developing rationale for paradigmatic interventions to bypass the stalemates that occur in interpretive failures. Paradigmatic technique eschews direct interpretation and provides an optimal approach to the rational and healthy parts of the patient's ego, it offers the most control over the necessary tension for therapeutic interaction and management of the transference. Early on she attempted to adjust theory and therapy to cognitive psychology. With paradigmatic therapy she presents an indirect communication which does not join the patient's defense but bypasses it in a subliminal way, thus eroding the resistance.

The purpose of this paper is to explore what I believe to be some of the powerfully humanistic antecedents of the paradigmatic approach, a factor that is often overlooked when the technique is employed mindlessly or understood in a truncated way by practitioners, without appreciation of the theory on which the technique is based. (The unfamiliar reader is referred to the book Roles and Paradigms in Psychotherapy Nelson et al., 1968.)