Dereflection — Yalom's Existential Psychotherapy

The opposite of paradoxical intention: instead of amplifying attention on the symptom — a redirection of attention away, onto objects, people, activity, the surrounding world. Hyper-reflection (self-focused attention) blocks natural processes: falling asleep, sexual arousal, spontaneous speech. Frankl's technique restores automaticity through a change in the object of attention from "me" to "the world".

Step-by-step guide

Diagnose hyper-reflection: is the client constantly observing themselves?
Explain the mechanism: attention on the symptom amplifies it; automaticity requires letting go of control
Formulate the task: redirect attention onto a concrete outer object (partner, conversation, nature)
Practice the redirection in session (a brief exercise)
Reinforce through connection to values: onto what is it worth looking, instead of at oneself?

When to use

Hyper-control and constant self-observation
Hypochondria (tracking bodily sensations)
Insomnia from control of falling asleep
Sexual dysfunction from performance anxiety
Social phobia with self-observation in contact
Psychosomatic disorders with excessive attention to the body

Key phrases

The more you look at yourself, the less you see life. Let's flip it: what would you rather look at instead?

Follow-up questions

Your body knows how to sleep. The problem is that you keep checking on it.

What is happening around you right now? Describe to me what you see.

Alternative phrasings

For sexual dysfunction: "Try to put all your attention on your partner — what do you notice in them?"

For insomnia: "Instead of checking on sleep — listen to the sounds outside"

Warnings

⚠️ Do not use in severe depression (turning away from the self may amplify estrangement)
⚠️ In PTSD, redirecting attention may be a form of avoidance of the trauma
⚠️ In active obsessions, dereflection may become a compulsion of avoidance

Source: Frankl, 1988 — The Will to Meaning; Lukas, 2000 — Meaning in Suffering