Prescribing the Symptom

Artwork Interpretation

The image features an ouroboros—an ancient serpent devouring its own tail, forming a perfect circle. It symbolizes self-perpetuating cycles, feedback loops, and the paradox of transformation through repetition. In the context of therapy, this image evokes the essence of Prescribing the Symptom: leaning into the very pattern a client seeks to escape in order to subvert it. The snake, both predator and prey, represents the tension between control and surrender, pathology and liberation. The closed loop dares the system to notice itself—and break.

Core Technique

Prescribing the Symptom is a paradoxical intervention where therapists intentionally direct clients to exaggerate, schedule, or consciously engage in a problematic behavior. It forces awareness, disrupts resistance, and reveals choice.

Clinical Function

This technique undermines symptom logic by reframing it as voluntary. It exposes patterns, externalizes control, and often leads to spontaneous reduction of the problem. It’s especially effective for oppositional dynamics or automatic behaviors.

Therapeutic Roots

Prescribing the Symptom was developed within Strategic Family Therapy, particularly by the Milan Group and Jay Haley. It draws on systems theory, paradox, and the idea that problems persist due to their embedded function in a system.

Use in Session

Therapists might say: “Set aside 10 minutes tomorrow to worry as intensely as you can,” or “Schedule your next fight for Thursday at 8pm.” The instruction is given calmly, without sarcasm, to provoke insight and shift the system’s rhythm.

Ideal Situations

Most effective with clients who feel out of control, oppositional, or stuck in rigid patterns. Also useful when traditional problem-solving has failed, or when clients are ambivalent about change.

Cultural Considerations

Therapists should assess the client’s cultural comfort with irony, authority, and indirect methods. Some may perceive this technique as dismissive or manipulative if not framed clearly. Consent, transparency, and tone are essential for effectiveness and trust.