‘Insight out’ psychotherapy takes you into the world of paradoxical interventions as a unique way to help the criminally insane, severely mentally ill, and even outpatients.   These interventions are more than just reverse psychology.  They involve twisted, seemingly irrational ways to address psychosis, personality disorders, and other mental health diagnoses for the specific purpose of quickly and effectively decreasing acute dangerousness and resistance to change.   These approaches are integrated with more standard interventions, such as behavioral, cognitive behavioral, systems, and gestalt pathways for change.   The reader will follow in my psychologically strategic footsteps through firsthand interactions in dealing with those who committed murder, arson, and other serious felonies.   How I address dangerous delusions, hallucinations, extreme paranoia, and other disorders for patients who have shown minimal improvement from the more traditional methods of treatment offer a refreshing view to motivate movement out of helplessness and hopelessness.  The treatment settings range from a specialty unit for treating psychiatrically acute prisoners who were too dangerous and destructive in their assigned prisons to be safely managed without the services we provided, an elite forensic hospital with similar cases in which I worked for 32 years as a frontline psychologist and ultimately as a clinical supervisor and consultant, and how I integrated many of these approaches for outpatient cases in the community.