Provocative Therapy - Articles

(also see articles by Nick Kemp on Provocative Therapy for Rapport under articles section at www.nickkemp.com)

An Essay on Provocative Therapy and Neurobiology
Humour affects the Limbic System
In the long, dim and quiet hallways of our holy places of wisdom – our universities! – humour is still considered as dangerous as a lethal virus and therefore it is usually exterminated. Many psychotherapists too still look upon humour as something evil in their work, because, when the client laughs, this means that he is not serious enough. Even if humour is not considered as that bad, for many therapists humour still is nothing more than a cause for a mild and forgiving smile about the clumsy colleague who believes in humour’s power! – Nevertheless, for decades humour and laughter have been considered crucial for personal change in Provocative Therapy. Recent research about the brain gives good reasons to use a lot of humour in psychotherapy, because humour affects the limbic system of the brain which is an important system for the organization of our behaviour.

Change in the Networks of the Brain is equivalent to Change in our Emotions
All of our behaviour is organized by complex neuronal networks in the brain. This applies to psychological and psychosomatic disturbances too, which can be seen as expressions of conflicts or of “faulty” emotional conditionings. They correspond to specific neuronal networks in the limbic system. Once established these networks might continue to exist for our whole life. Each time one is activated it will be strengthened, e.g. by each remembering of a bad experience. Even if the brain should be unable to forget a fact, it will remain able to build new networks compensating older ones till our last day on earth. Our brain has inconceivable possibilities for building fresh connections which shows its immense capacity of learning, adapting and healing itself. As specific emotions correspond to these networks a change in the networks has to go along with a change of the corresponding emotions. Thus, change is possible when a person who is experiencing a negative emotion of a conflict or a restricting conditioning is able to have a positive emotion at the same time. This new experience can be seen as cause for the growth of new neuronal connections in the limbic system around an already existing network. Then change can happen easily and happens on an unconscious level, which means without any further efforts. Probably only this will lead to stable change. Strong positive emotions in the right moment are crucial. Of course, the stronger the existing network the more repetition of this process will be needed in order to achieve permanent change. Gerhard Roth concludes that the positive effect of psychotherapy might be a consequence of positive transference. While talking about something that makes him feel bad the client also feels secure and safe with his therapist at the same time and therefore he trusts him.

Now, what can we conclude from that for the meaning of humour in psychotherapy? Evidently humour is a positive emotion and easier to observe than the quiet development of positive transference, because laughter is an external, loud and instant sign of an inner state. When Frank Farrelly provokes laughter over and over again while clients are in a restricted inner state – feeling fear, anxiety, anger or having tears in their eyes – sure enough new neuronal connections are going to build up in the limbic system at the same time. And because in Provocative Therapy humour is thoroughly provoked around specific negative emotional states, these connections are built up exactly at the right place.

Clients often tell me, that in these moments they are able to see themselves from outside and have to laugh about the absurdity they discover, when they look at their behaviour from that new point of view. Now this point of view is the perspective of the Neocortex, because only this structure in our brain allows us to look at ourselves from outside. Provocative Therapy not only affects the limbic system with adequate emotions for change at the right moment, it also affects the structure of the brain, which is the most developed one and which allows deeper understanding.

Fight and Flight – Using the strong Power of the oldest Structure of the Brain to Provoke Change
In Provocative Therapy you often see clients defend themselves and protest against or run away from their own inadequate behaviour. Such reactions – like laughter – can be understood as specific effects of this method. To interpret them referring to Neurobiology it is necessary as a first step to understand how three basic and very different systems are cooperating constantly in our brain.

The Neocortex – Location of Consciousness
The largest, youngest and most developed system or part of the brain – the Neocortex – is the location of consciousness. Here those events are represented, which happen outside of us – what we see, hear, smell, taste and perceive kinaesthetically – as well as everything that happens inside of us – bodily sensations, feelings, dreams, imaginations and wishes. The Neocortex enables thinking, memorizing, language, the experience of time and certain structures in the frontal lobe enable creativity, intuition and cooperation.

The Limbic System – Location of Emotions and Feelings
The limbic system is an older part of the brain, which we share with all mammals. Here is the origin of social behaviour, brooding, caring and playing. The limbic system operates partially on the basis of inherited programs; partially it is able to learn by conditioning – which means by reward or punishment. One main function of the limbic system is to compare constantly each single experience with former experiences and to guide our behaviour this way. This happens before we can build thoughts about a momentary experience. The limbic system operates unconsciously. We are becoming aware of this process through emotions and feelings with a short delay, which means after having already reacted, and we are becoming aware only of parts of this process.

The Brainstem – Location of Reflexes for Survival
The third and oldest part of the brain is integrated in the limbic system and regulates the most important functions of survival of the individual and of the species. This system works unconsciously, automatically and exclusively on the basis of inherited reflexes. It regulates the very strong functions of fighting, defending and fleeing and further of nutrition, digestion, breathing and reproduction.

Of course the three systems are connected together and are mutually influencing each other all the time. So you may imagine that the older systems, which operate unconsciously and automatically on the basis of fixed programs, could temporarily dominate the conscious process of thinking located in the Neocortex. In that moment they could restrict the activity of the Neocortex to simple loops of ‘thinking’, which we would repeat over and over again. As the older systems operate unconsciously we could be aware of our thoughts in such a moment, but without being aware of what is happening to our thinking right then!

Case study – Desperate Fighting against Laziness
How does the brain of a person operate who complains that she “desperately fights her laziness” instead of starting to do her work? The word “fight” is the representation of an activity of the brainstem in the Neocortex, the word “laziness” the representation of an activity of the limbic system. “Laziness” summarizes one or several undesired habits. These are based on conditioning in order to avoid frustration. In German we have a special noun for this – the ‘innere Schweinehund’. This represents the ‘marriage’ of two mammals inside of us – of a pig and a dog. As the brain of mammals essentially consists of the limbic system, the origin of this noun seems more than symbolic or accidental! – In our case the Neocortex seems to serve as a stage for a fight between the activities of two different structures of the brain: of the strong brainstem and the limbic system. A person fighting against her laziness has no chance to ever change her behaviour this way. On the contrary her intention to start her work will systematically be weakened this way. This is why she is feeling desperate.

Fighting and Fleeing in Provocative Therapy
In Provocative Therapy one often uses the strong power of the brainstem, however, in the opposite direction. One possibility is to direct the fight back against its source to produce a ‘mental short circuit’. The therapist praises the necessity of strongly fighting against oneself until the client begins to oppose. The other possibility is to provoke the client to run away from an inadequate behaviour, which also implies the use of a strong reflex built up for survival. – While listening to a student once who was talking about his fight against laziness I had the disgusting image of a little grey poodle with his hair done in a slushy way, wrapped in a pink blanket, smelling like sweet perfume, whining in a piercing tone and jumping up at the student’s blue jeans trying to sniff his genitals while salivating. The student cracked up with laughter and also reacted with a terrified and disgusted look. The sicker he looked the more detailed I imagined the horrible little dog. Repeatedly he requested me to stop talking about the poodle. Of course this only encouraged my imagination. Immediately after this session he started to study harder. He had run away from his laziness and therefore lost the orientation which had helped him to avoid work… So what else could he do now than to start working?

The fantastic thing about using the powers of fight and flight is that you use very strong, natural powers. Once you have cranked them up they will work by themselves. Why? I suppose because it is just the way our brain operates. Fight and flight are very old reflexes, which - once started - always work automatically. Thus, it is brilliant and comfortable at the same time to use these mechanisms in order to provoke change.

Now, this works really well, however, I suppose that simply reversing the direction of fighting or using fleeing is not always sufficient in order to create permanent change. Why? Looking at the example of the student you can figure out easily, that the laziness and all its conditionings have not really disappeared from his life. They are still very close – in the brain! How long will the change last? That might depend on how rewarding the student will experience his work. Will this experience be positive and strong enough to allow stable new networks to establish in the limbic system after a certain time? If not, he will fall back into fighting against himself.

Fighting against oneself implies conflict. The automatic responses of fighting and fleeing may be intelligent reflexes of the brainstem, when our body is suddenly confronted with danger coming from outside. The intelligence of the limbic system consists in its ability to simplify daily life by using well adapted clusters of behaviour which – once established - will also work automatically after a certain time. However, can this be an intelligent solution to reduce the immeasurable Neocortex to an area for a battle among representatives of the two other systems of the brain? In the first place fighting against oneself leads to a waste of energy. Then fighting always strengthens the ‘enemy’, which here is another part of oneself! Third, remember that the repetition of an activity of the brain strengthens the network of all involved neuronal routines, in our case thoughts (activity of the Neocortex) about fighting (reflex of the brainstem) an undesired habit (conditioning in the limbic system). The logical consequence is that we will never solve a conflict this way, but, that we preserve, complicate and even strengthen it! Fourth, with our “solution” we have obviously added a lot of new problems to the original one, which consisted of the fact of avoiding work. Fantastic, isn’t it?

Liberation of the Neocortex of restricting Conflicts
This liberation assumes the end of the conflict and happens when the client no longer identifies alternately with one or the other side of a conflict but begins to see himself or herself and the whole conflict from outside – a process which is probably induced by the specific method of Provocative Therapy to mirror the client’s way of life in short vivid sceneries. And what is to be seen from outside? Strange but true: nothing else but the fact, that and how a person uses her brain to artfully construct a conflict in her mind! That is absurd and thus we laugh. This discovery seems to liberate the Neocortex immediately of the activity of neuronal connections, which restrict our thinking, and is opening it to a better utilization… Isn’t that a good reason to feel joy and to laugh?

Frank Wartenweiler, Zurich
(Improvement of language by Anke Könemann, Munich)
Literature
Damasio Antonio R. The Feeling of what Happens. Body and Emotion in the Making of Consciousness.
New York: Harcourt Brace & Company 1999
Farrelly F., Brandsma J.M. Provocative Therapy. Cupertino, CA 95015/USA: Meta Publications, Inc. 1974
Hüther Gerald. Wie aus Stress Gefühle werden. Göttingen: Vandenhoeck & Ruprecht 1999
Hüther Gerald. Bedienungsanleitung für ein menschliches Gehirn. Göttingen:
Vandenhoeck & Ruprecht2001
Hüther Gerald. Die Macht der inneren Bilder. Göttingen: Vandenhoeck & Ruprecht 2004
Krishnamurti Jiddu. To Be Human. Shambala Publications, Inc. © 2000 Krishnamurti Foundation Trust, Ltd.
Ramachandran Vilayanur. The Emerging Mind. London: Profile Books Ltd. 2003
Roth Gerhard. Das Verhältnis von bewusster und unbewusster Verhaltenssteuerung. In: Psychotherapie
Forum. Themenheft: Neurowissenschaften und Psychotherapie. Wien: Vol. 12. No. 2, 2004
Slade Neil. The Frontal Lobes Supercharge. Copyright © 2003 Neil Slade.
Servan-Schreiber David. Guérir le stress, l’anxiété et la dépression sans médicaments ni la psychoanalyse.
Paris: Editions Roberts Laffont 2003
Wartenweiler Frank. Provozieren erwünscht ... aber bitte mit Feingefühl. Paderborn:
Junfermann Verlag, 2003
Wartenweiler Frank. Zauber-Spiegel Spiegel-Zauber. Spiegeln in der Kommunikation: symmetrisch und
antisymmetrisch. Paderborn: Junfermann Verlag 2006.
In English the title means: “Magic mirror – the Magic of Mirroring. About symmetric and
antisymmetic Mirroring in Communication.” Unfortunately only available in German. Translation
pending…

First ‘Case Study’: At the Palace of Louis XIV
One day a Marquis entering his room found his wife in the arms of a bishop. He went to the window calmly and started to bless the people down in the street. Scared his wife asked: “What are you doing?” – “Monsignore is executing my duties, so I execute his duties”, answered the Marquis. (Reported by Hargittai István und Magdolna in their book Symmetrie, Reinbek bei Hamburg, Rowohlt Taschenbuch Verlag 1998)
Antisymmetric Mirroring – What is that?
Mirroring is a concept of natural science and geometry, which has a lot to do with symmetry and therefore with aesthetics too. Since decades it has also been used in a simplified manner by social science to describe certain aspects of relationships between two or more individuals. Once somebody knows the concept he also can use it to improve relationships. Mirroring posture and gestures is a well known nonverbal technique. Carl Rogers’s technique of verbalization is a way of mirroring with words the inner process – especially feelings – of another person. Because we believed that mirroring was just mirroring, we have overseen the differentiation of symmetric and antisymmetric mirroring and therefore identified all the time mirroring only with one of its possibilities: with symmetric mirroring… …except Frank Farrelly of course! Having observed him over years at work I had some ideas about his method, but there still remained a number of answers he gave, which I never was able to put in its proper place, when I was looking for a system. Long time for those statements there seemed to be no system at all.

I gathered many, many examples of such miraculous sentences, till one day I discovered the principle of antisymmtric mirroring. Suddenly I knew: That’s what Frank does, when I don’t understand anything more!

Visualization of the Two Principles of Mirroring

Symmetric mirroring Antisymmetric mirroring

In Words
In both forms of mirroring the form is kept up, in symmetric mirroring also all other qualities like colour, patterns etc. In antisymmetric mirroring at least one quality is reversed into its opposite; in our example white turns into black.

Second Case Study: Mobbing or How to Deal with a difficult Boss.
If you have a boss persistently devaluing you, nagging at you everyday and criticizing little details of your behavior whenever possible, the most common reaction is to protect and defend yourself. But this still leads to a larger disaster. Confronted with someone, who wants you to feel like a stupid little child, this person will do everything to let you know, that you are wrong, whatever you do. So by defending yourself you have a good chance to lose again and to finally end up in feelings of helplessness. Imagine using symmetric mirroring:

If your boss criticizes you, when you don’t deserve it...
...now you are going to criticize him also, when he doesn’t deserve it!

Uups! Well if you want to ruin your career, go for it. That will certainly work. Of course there are other possibilities of symmetric mirroring, finer ones as many psychologists taught us, where you carefully seek for the right words to say it… I wouldn’t recommend them either. They may work in the idealistic atmosphere of a psychological seminar, but in real life?

Now imagine using antisymmetric mirroring. How to do that? – Wait patiently until your boss does obviously a big mistake that nobody can oversee – all of us do such faults, bosses also! That will give you a nice chance to give him a compliment in public, which he really doesn’t deserve. The formula:

If your boss criticizes you, when you don’t deserve it...
...now you are going to praise him, when he doesn’t deserve it!

One of my clients exploded in laughter already by imagining the reactions of his narrow-minded and mean boss, when he would excuse him for having distributed money to several people in the wrong moment. With a warm smile on his face my client would interpret this fault as a sign of great generosity.

The nice thing of this way of answering is that you remain polite and friendly and your behaviour can always set an example to others. At the same time such an answer is so crazy and distorted, that our restricted brain simply must start to look for new possibilities of understanding and reacting. Antisymmetric mirroring therefore is recommended in highly difficult relationships – not only in therapy! That means, when you have to deal with or even are victim of another person making excessive abuse of projection, denying and devaluation.

Frank Farrely's artful way to transform presuppositions of clients statements into the opposite

When the client complains about suffering from the worst evil possible expecting relief from the therapist…
...the therapist explains the suffering as the best possibility of the client warning him in a friendly tone that he could only hope the disaster would not get worse!

Examples: “Some people wouldn’t have any luck at all if they would not at least have bad luck.”
“Your future? – At fifty years of age, you’re future is all behind you, my Irish daddy used to
say.”
”Without this symptom you could get disoriented.“
”You would like to overcome your phobia of deep water and you would like to swim there? You must be crazy. At least you have already thought of the dangers in the deep water. But there is more to it than that. Have you ever considered that even in the pool for non-swimmers you could slip and drown? And this is only one of many, many possible hazards.”

Are you getting curious about this phenomenon and want to know more? Then read my book Zauber-Spiegel Spiegel-Zauber. Spiegeln in der Kommunikation: symmetrisch und antisymmetrisch. Paderborn: Junfermann Verlag 2006. In English the title means: “Magic mirror – the Magic of Mirroring. About symmetric and antisymmetic Mirroring in Communication.” Unfortunately only available in German. Translation pending…

Frank Wartenweiler, Zurich

by Andrew T. Austin

The unfortunate lady say before me might be considered by many doctors and therapists as one of those “heart sink” patients.  A “heart sink” patient is one who displays an apparent inability to connect consciously with anything that might improve their seemingly hopeless life.

My heart actually did sink during the telephone conversation that followed her telephoning me to book an appointment.  Her high expressions of anxiety about treatment, the large number of demands for reassurance and a shamefully pitiful tone of voice led me quickly to conclude that this lady was a prime candidate for a provocative approach.

When she arrived at my office her eyes had that “mad dog” look of the desperate.  Her eyeballs appeared to actually vibrate and her body posture was one of abject helplessness.  And that incessantly pathetic tone of voice?  Well, it actually started to affect me and not in a particularly good way.  I did start to wonder what effect it would have on anyone’s neurology having to listen to that tonality from the inside all day and every day.

It was clear to me that this was one lady who did not find living very easy.

I made some tea and we went over and sat down in my office.

“So Little Miss Anxiety, what can I do for you?” I asked with a smile.  

“I don’t know…I thought you could help me.  Do you think you can help me?”

There was that demand for reassurance again.  Based on my previous telephone conversation with her, I suspected that I might need to cut through this game straight away.  I didn’t want to spend the hour trying to win her approval by giving her the right kind of reassurance that she was seeking.

So, did I think I could help her?

“Well,” I said, “sometimes I get lucky and I can help the client.  Other times, I just look at them and think, ‘oh God! If only they didn’t fill me with such dread and pity, then I could get them back week after week and have this damned mortgage paid off!’”

She laughed at this and said, “So you think there is hope for me then?”

“Hope?” I laugh, “Not hope, certainly not!  What I have here is an opportunity to experiment though, that is sure!  As one of my trainers said to me, ‘Andy’ he said, ‘When you find yourself that truly helpless and wretched case, know well that that is your chance to try out the stuff you’ve been too scared to try with any other client!’ – nothing to lose, see?”

She laughed at this and visibly relaxed, “I can see why they told me to come and see you!” she told me.

“Ah,” I reply, “They probably just know that I’m desperate for the clients.” Which elicited more laughter. “So,” I continued, “What’s the problem?”

Her state immediately changed and her face and body posture demonstrated a person who felt a serious emotional pain.

“If I tell you what I did, you’ll think I am such an awful person.” She told me as she struggled to control her weeping.

“Oh no!” I exclaimed, “not another one!”  Throwing my arms in the air and looking upwards as though to address the Lord, I say, “Lord, why do you send me these people…the child abusers, the killers, the sodomites, the bastard French…why Lord, why?  What did I ever do to deserve this?”

I suddenly shift state and look her straight in the eye, point my finger and say in my sternest and fiercest voice, “Look lady, if you are going to tell me that you keep small, underfed and tortured children locked in your cellar, I’m going straight to the police, do you understand me?”

She changed state again and she laughed, “It is not that bad,” she said.

“Oh here we go again,” I say again melodramatically as though to the Lord, “another guilty one trying to make her heinous crimes just sound ordinary!”

I look at her again and ask, “Do you know the reason that most serial killers give for actually killing their victims?”

She shook her head and looked at me quizzically.

“Because after all that torture and torment, their victims just get plain annoying…” and I trail off looking to her expectantly for a response.

“Can I tell you what happened?” She asked as though she was expecting that I wasn’t ever going to actually give her the opportunity to do so.

“Go ahead…” I offer, “But please go easy on me.  You know my nerves are shot to pieces by this line of work.  It is no wonder I’m usually so heavily medicated.” And I slump back in my chair as though dejected and exhausted.

Briefly her story was this.  Her role in life is a rescuer.  She has taken in homeless people, distant relatives, strays, cats and dogs.  Despite her apparent weakness and vulnerability it appeared that she had great resolve in assisting other people who were down on their luck and seeing them through the hard times.  As Frank might say, she is a “national resource”.  But, one time it went wrong and it was her reaction to this event that was destroying her.

She had acquired a rescue dog.  When she received it the dog demonstrated all the signs of an animal that had been horribly abused over a protracted period of time.

Two weeks later during a walk in the park, it ran out into the road and was killed by a car.

“So, after just two weeks you got annoyed enough with it to let it be killed?” I proffered.

Her face registered both shock and laughter. “I didn’t mean for that to happen…” she started to say.

“Oh sure, you didn’t mean for it to happen…how many prisons the world over are full of both “innocent” people and those who are clearly guilty but are claiming, ‘I didn’t mean for it to happen…’?

“It was just an unfortunate thing…it wasn’t…” she protested, but I interrupted her before she could finish.

“…it wasn’t murder?” I suggested, completing her sentence for her.

“Now look!” she said firmly but smiling.  “It was an accident, the dog got excited and chased a squirrel into the road.  I couldn’t have known…” She trailed off.  Her state changed again and she looked down mournfully.  I mirrored her posture and raised my eyebrows to indicate for her to say more.

“It is just so sad that it only had two weeks of a good life before…” she trailed off again.

“You killed it…?”

“You really think it was my fault?” She asked.

“I’m not sure yet,” I tell her, “but there is another possibility…” she looked up at me expectantly.  “You have to think about the part that the dog played in all of this...maybe it was suicide?”

She laughed again.  An implication here was that the dog, having been abused by its previous owners was depressed and so committed suicide.           

“I mean,” I continue, “the poor pooch is sat in the pound relieved that the traumatic life it had before is over and then…oh, no…it gets you! Arrghhhh!” I say this with great animation.

She laughed at this and with great emphasis said, “Now listen here, you, I am a good person!  I was the best opportunity that poor animal had! It just got excited and chased a squirrel!”

”So,” I say lowering my voice and adjusting my posture to that of a “professional” psychotherapist, “what appears to be the problem?”  

The sudden change of direction acts as a virtual trance induction.  Her eyes glaze over and she becomes very thoughtful for a moment.  I’ve seen this reaction occur when Frank is working.  Often the response is “I don’t know…” or, “I’m not sure any more…” Sometimes they just look concussed and bewildered.

“You know,” she said slowly, “I can’t believe I’ve been so stupid, I’ve been such a door mat…”

“There you go!” I say quickly, “Insight!”

And on the session went for another 20 minutes in a similar vein with each step this previously emotional frail lady becoming increasingly animated and forceful.  Each time she made a negative suggestion about herself it would be reframed to something either ludicrous, into some kind of resource or into something far, far worse than it could possibly be.  It is worth noting that at no point did I give any form or reassurance or even attempt to “help” or advise this client in any way.

The session lasted 40 minutes in total and at the 40-minute mark I cut it dead without any attempt to “round it off” or find conclusion.  In true Farrelly style, I smile and ask, “So, did you have any reactions to me in this [session]?” which of course elicited great laughter.  She did of course have many reactions – one of which was of course the realisation that she let “people walk all over” her and take advantage of her vulnerable nature.  She highlighted her realisation that although she spent her life helping other people, those people rarely offered anything back, using the resources she offered then moving on in their lives when they no longer needed her.  She realised that everyone else was moving on, except her.

The next 40 minutes were spent discussing, with a fair degree of provocation, her motivation strategies and relationships with other people.

What this session demonstrated so nicely was how the provocative therapy approach forced the client to think outside of here usual patterns.  She had attended many dozen therapy sessions with a number of different therapists and all without success.  What I suspect all the previous therapists had in common was that they offered help and advice and responded to this lady’s extreme prompting for reassurance, thus confirming the reality of her fears.

In a single session lasting approximately 90 minutes from start to finish a former “heart sink” patient and regular attendee to her GP surgery gathered together enough resources to put some bigger life changes into place.  Regular follow up via telephone over an 8-month period, with 2 quick and informal meetings demonstrated the changes continued to develop with a marked change in voice tonality, change in appearance and a quite noticeable playful and flirtatious manner.    
 
Clinical Hypnotherapist and Master Practitioner of NLP
Chichester, West Sussex
Tel: 07838 387 580
Email: diggingahole@hotmail.com
This article is included in the excellent "The Rainbow Machine" which is a collection of stories by Andrew Austin
See http://www.therainbowmachine.com and the book can also be purchased from http://www.realpeoplepress.com/rainbow-machine-tales-from-neurolinguists-journal-p-64.html?osCsid=189d4c8ef426bd7407dc6e765459985d