Studies on organizational paradoxes often explain paradox salience exogenously, as a state of latency awaiting detection. Based on social systems theory, this process study develops an explanation of paradox salience and latency beyond an actor’s cognitive ability to think paradoxically. Such an explanation lies endogenously within the interactions of actors coping with paradox. Analysing the discussions of a hospital executive board during a change initiative reveals how factual, social and temporal references surface and submerge contradictory tensions. The proposed model for visibilizing and invisibilizing paradox explains salience and latency – even if individuals are aware of paradox – as integral to coping with paradox. As a paradox invisibilizes in an interaction it resurfaces somewhere along the line and thereby transforms within an organization