Leading Integrated Healthcare

Provocative Therapy

Dr Brian Kaplan on Provocative therapy

Provocative Therapy is a branch of psychotherapy that uses reverse psychology and humorous insights to provoke positive behavioural change. It is brief, only requiring a few sessions, and produces results that tend to be durable and long-lasting.

Why is it called ‘Provocative Therapy’?

Provocative Therapy was developed in the 1970’s by Frank Farrelly. He called it Provocative Therapy from the Latin pro vocare meaning, to call forth. The therapeutic objective is to provoke, or to call forth, the appropriate behaviour in any given situation.

Many people have insight into their problems but remain unable to act or change accordingly. For example, most people know what they need to do in order to lose weight but may be stuck in acting upon that knowledge. In Provocative Therapy, the therapist will provoke the articulation and often immediate enactment of the appropriate solution to the problem. Many therapies help you understand your problem better but Provocative Therapy aims to catalyse rapid behavioural changes.

This warm-hearted process is always carried out with your explicit permission and the therapist holds the therapeutic objective in mind at all times.

Why is it needed?

Provocative Therapy is an excellent option for many people. Other approaches such as medication, psychoanalysis, analytic psychotherapy, cognitive behavioural therapy are useful in some situations but Provocative Therapy brings a new approach into the psychotherapy arena. It is contrarian, dynamic, warm-hearted and can even be fun. It has been likened to Aikido in its deft use of reverse psychology while always remaining client-centred and result-oriented. Above all, only a few sessions are required to achieve this change.

Who can it help?

Provocative Therapy is useful in a wide range of problems. Relationship issues (including not having the desired relationship); work-related challenges; losing weight; addiction issues including alcohol and nicotine; and generalised anxiety disorders including phobias, generally respond well to Provocative Therapy. It can also be helpful in certain types of depression. It is suitable for teenagers, couples and families.

Interestingly, this process may be ‘witnessed’ by others such as friends or family and this can also help the patient in different ways. There will always be a discussion and agreement of these boundaries prior to beginning the work.

How does it work?

The provocative therapist will discuss your problems with you in quite a different way from what normally occurs in most therapeutic situations. Using sophisticated language techniques based on reverse psychology, the provocative therapist – by pointing out the funny/absurd side of your problem provokes you to realise and articulate the appropriate solution to your problem. Doing this makes it much more likely for you to enact that solution in your daily life. In its contrarian way it works because it provokes you to defend yourself appropriately and immediately by confidently asserting the true solution to your problems, This diagram shows the process of how the therapist provokes the patient to assert his/her own solution.

Is it suitable for everyone?

Provocative Therapy is useful for a wide range of problems. However there are some people for whom it is not suitable. This will be discussed at the initial assessment. If you have a condition for which other treatments are preferable, you will be informed of this in the initial consultation.

All patients assessed as suitable for a course of Provocative Therapy need to give prior consent for the process. Nobody is ever ‘ambushed’ or provoked gratuitously.

How quickly can I expect results?

Provocative Therapy may leave you feeling elated or energised and determined to implement immediate changes. Occasionally you may feel a little tired and confused. This feeling usually settles quickly and is followed by the emergence of a new determination.

This process can sometimes produce dramatic and long-lasting results in just one or two sessions. However a course of four sessions is usually recommended. At this point results are often self-evident in the majority of patients. Some may require a continuation of more sessions either on a regular or on an’if and when needed’ basis. Routine follow-up evaluations are recommended every 3 to 6 months, in order to ensure that positive results are durable.

Recording of sessions

The purpose of recording is to enable you to develop a deeper understanding and to allow for an enrichment of the process. Many people have derived great benefits from listening to and seeing themselves negotiate solutions to their problems and observing their own reactions in the sessions.
Comments taken out of context, especially absurd provocations, can mislead others and this can undermine what is essentially (and unusually) a transparent process. You will be asked to sign a disclaimer including an assurance that you will not under any circumstances make any of the recordings public.

All psychotherapy sessions are confidential and no recordings are shown to others. However if you prefer not to have your sessions taped, this is not a requirement.

A course of provocative therapy

The suggested format for a course of Provocative Therapy is as follows:

  • Session 1: Recorded on audiotape which will remain with Dr. Kaplan until Session 2.
  • Session 2: (ideally 2-4 days after Session 1): Recorded on audiotape. You are then given the audiotape to listen to before the next session. You will be recommended to listen to what you say in response to the Provocative Therapy and importantly to the quality of your tone of voice.
  • Session 3: (90 minute session – ideally one week after session 2): Recorded on DVD which you can collect in person or be sent to you by recorded delivery. Now is your opportunity not only to hear what you say and how you say it, but also to observe vital information conveyed by your body language.
  • Session 4: (One month after Session 3): Discussion, assessment and follow-up.
  • Further Sessions: To be discussed with Dr. Kaplan. Some patients may need more sessions either weekly, fortnightly or monthly but all patients should be followed up in 3 – 6 months to confirm that the effect of the Provocative Therapy is being sustained.

Reading: Provocative Therapy, Frank Farrelly and Jeff Brandsma, Meta Publications, 1974.


Provocative Therapy: It can be fun

I had a lot of fun in those sessions, I felt they were very enjoyable - the lightness and laughter of it made touching on uncomfortable and painful issues easier, and the benevolence you bring to the process (aka Unconditional Positive Regard) was palpable.  I could see how the strange mental-emotional convolutions that happen when experiencing the inner friction set up by the provocations would over time promote real change.

Experiencing Provocative Therapy

Provocative Therapy has had a significant and ongoing impact on me. The session itself forced to the surface a few truths about myself and my life which I had previously been reluctant to admit to myself. That I found helpful and enlightening. However the real shock came when I watched myself on film afterwards. I was rather dreading having to view myself, especially in such an open and vulnerable position. But nothing prepared me for the shock I had when I firstswitched on the tape. For the first time, I think ever, I was able to view myself objectively. It was not like looking in the mirror or seeing myself on film; never before had I seen myself interact naturally like that. I was surprised how pertinent the contradiction was between the idea I had of myself and how I really appeared. This initial jolt certainly had the most impact but now I’m grateful to have the film so that I can revisit it whenever I need to. Each time it’s almost like going through another session. It forces me toreally look at myself and listen to what I’m saying and to understand that there is a difference between my own, often warped perspective, and the truth in front of me. Louisa Gamon - London