But Does It Work in Theory? and The Case of Simone: Paradoxical Intention in a Case of Post-Traumatic Panic Disorder

Abstract

I gratefully acknowledge the thoughtful and perceptive comments and criticisms of Roberg and Buerger (2026) and of Cassiello-Robbins and Bullis (2026) in response to my case studies on the therapeutic use of Paradoxical Intention (PI) with "Fran" and "Emily" (Hamberg, 2026).  Both commentaries note that the theory underlying the current Cognitive Behavior Therapy (CBT) approach to panic disorder is not habituation, as I had proposed, but the Inhibitory Learning Model (ILM). In line with Toulmin’s (1953) view of theories as conceptual maps, I argue that the advent of a new theory does not necessarily render an older or alternative theory incorrect or obsolete. Rather, different theories can be seen as equally valid maps of the phenomena under consideration, e.g., a street map of San Francisco versus a topographical map of the city, and thus have differential pragmatic value depending on the use to which they are put. Habituation would seem clearly useful in the traditional desensitization situation, while ILM would seem more useful in accounting not only for the effects of CBT for panic disorder but also for the effects of Paradoxical Intention (PI) procedures like the ones I used in the cases of Fran and Emily. Roberg and Buerger are correct in pointing out some points of similarity between PI and CBT, especially in my flight phobia case of Emily. While Cassiello-Robbins and Bullis argue that PI and CBT are more similar than dissimilar, I present a view emphasizing their differences.