PCSP is a peer reviewed, open-access journal and database. It provides innovative, quantitative and qualitative knowledge about psychotherapy process and outcome. PCSP is published by the National Register of Health Service Psychologists.
February, 2025 -- see our newest case, Paradoxical Intention (PI) Combined With Hypnosis in the Rapid Treatment of Anxiety Disorders: The Cases of "Fran" And "Emily"
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Read below for the Editor's Announcement of the issue.
The Case Studies
February 19, 2026 -- FROM THE EDITOR
ANNOUNCING THE PUBLICATION OF OUR 72nd ISSUE (Vol. 22, Module 1)
Paradoxical Intention (PI) Combined With Hypnosis in the Rapid
Treatment of Anxiety Disorders: The Cases of “Fran” And “Emily”
*** Sam Hamburg, Independent Practice, Chicago, IL
Commentaries by:
*** Regina Roberg, Westchester Anxiety Treatment Psychological Services, White Plains, NY
*** William Buerger, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY
*** Clair Cassiello-Robbins, Triangle Area Psychology Clinic, Durham, NC, and
Unified Protocol Institute, Boston, MA
*** Jacqueline Bullis, McLean Hospital, Belmont, MA
EDITOR'S NOTE
Paradoxical intention (PI) is a psychotherapeutic technique that is intended to help clients become more flexible, or at least more open to thinking about their problems, such as anxiety, from a new perspective. In line with this, therapist and case study author Sam Hamburg has developed an approach that involves a “Panic Attack Time Line” (PATL). This PATL (a) helps the client visualize and understand what is happening during the panic attack, and (b) encourages them to understand why, when they start to have panicky feelings in their body, it will be paradoxically helpful to make these feelings worse, for example, if the attack makes their heart beat faster, they might be instructed to do jumping jacks. One of the important advantages of this PATL approach is that it can typically shorten therapy for treating anxiety disorders to just three sessions in comparison with traditional CBT protocols that typically require 6–20 sessions for achieving clinically meaningful change.
Two, 3-session adult individual cases, "Fran" and "Emily," are presented to illustrate the different ways that the PATL-grounded, PI approach can be combined with hypnosis to produce successful therapeutic outcomes. In Fran’s case, the PATL was used explicitly by itself with her and was sufficient to address her agoraphobia/panic disorder. Hypnosis was then used to extend the gains produced by PI. In the case of Emily's aviophobia, the PATL was not used explicitly with her. Rather, the paradoxical logic it embodies was used to create a paradoxical directive that was conveyed via hypnotic suggestion.
The Commentaries and the target case author's Response explore Hamburg’s paradoxical intention approach to the two cases from a variety of perspectives. These include the habituation versus Inhibitory Learning Model (ILM) approaches in traditional cognitive behavior therapy (CBT) theory; third-wave CBT frameworks like Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT); and David Barlow and colleagues’ Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP).
*** For a Table of Contents and pdf links to the articles, click on the upper left button labeled "Newest Case" or the button labeled "Current."
