31 Responses

1. James Lawley

   21|Jun|2011 1

   Thanks for making this material available. As you say Steve, “And like all such skills, it’s essential to be sensitive to the client’s response to using it; if it’s not working, try something else.” I agree and it begs the question how would the provocative therapist/coach know that? I have asked Frank Farrelly this and he just ran a provocative pattern on the question. Leaving me none the wiser.

   And therein lies the danger. ‘Resistance’ to the therapist/coaches approach can always be reframed as ‘the process working’ or as a signal to ‘play’ harder. That puts the client in a bind. When the client has volunteered to be a demo subject in front of a room full of people it’s really hard for them stop a session by “leaving the field” as Bateson put it. That puts them in a double bind.

   So how do experienced provocative therapists/coaches know when their approach is not working?

   All the best, James

2. Steve Andreas

   13|Jul|2011 2

   James:

   Please excuse the delay in responding; a family reunion and then a fever slowed me down, majorly.

   I agree that Frank Farrelly is not a good source for an answer, and with your description of your attempt to get one. He “does his thing,” and it is a very interesting thing, but it has also become a sort of a symptom for him. It is very hard to have a normal human conversation with him, and this has been true for some time, at least since I saw him in a one-day workshop in 1978.

   In general, of course, we hope to be sensitive to the client’s responses as an ongoing thing, in order to have feedback to know whether a method is working or not to help the client move closer to his/her outcome. And ideally this is based primarily on nonverbal signals of all kinds, because they are more spontaneous and trustworthy than verbal ones. The signals are always there, so it is a matter of training our perceptions in general, to hear tonal and tempo shifts in language, see changes in facial expression, body tension, etc. And it also requires calibrating those perceptions to the particular individual in front of us, because each person has their own unique “signature” in how they respond.

   Now let’s get specific to PCW. One of the methods, and goals, of this work is using humor to change the client’s state and offer a different “out of the box” perspective. (see my blog post on humor: http://realpeoplepress.com/blog/humor-the-brain-and-personal-change-nlp ) If the client isn’t laughing, or at least smiling, it probably isn’t working.

   Another major goal in making fun of the problem WITH the client is to pry them out of “victim space.” (“THEY should change so that I don’t have to.”) For most of us, when we have a persistent “problem”, we’re likely to be in a “victim space” about it, and PCW, when applied with that twinkle in the eye and affection in the heart which Nick Kemp speaks of, can provide a way out. However, if in response to PCW the person goes more and more into “victim space,” that is probably usually not a good sign. Some people will maintain their “victim” stance with a vengeance that Darth Vader would be hard pressed to match, and it is very easy to blame the therapist in the same way that they blame everyone else in their life. “See, the way you are making fun of my problem is another example of how everyone disrespects me and makes me feel bad.” But it’s the therapist’s job to help the person find a way out of that, not intensify it. So if this stance appears to be getting worse as the session goes on, it’s probably time to shift course, etc., etc.

   The answer to the fundamental question that you raise–what kind of feedback exactly do you use, and how do you respond to it–could probably fill a good-sized book. And in order to do a good job, the book would need to have a long DVD with many short examples of interchanges, with commentary, so that readers/viewers could see and hear exactly what was referred to in the book. I have a small example in the annotated transcript of a client session: http://realpeoplepress.com/blog/verbatim-transcript-of-limiting-beliefs-about-money-client-session-video-with-steve-andreas and an excerpt from this session is on youtube (linked to the transcript). We expect there to be live answers to this question in the upcoming training with Nick Kemp on PCW.

   Steve Andreas

3. Steve Andreas

   13|Jul|2011 3

   We’ve invited Nick to go the next step and respond to the question “What does the PCW therapist DO when what we’re doing now isn’t working?” There will be demonstration of this in the training of course. Here is Nick’s response:

   I think firstly it’s important to differentiate between a demo during a workshop and a private client session. A workshop demo will be a PT module of 25 minutes with the client and then follow up questions from the client and audience. This is a different dynamic to a private session which can up to two hours. It’s also useful to remember that not all change occurs during the session and in fact the PT process involves watching or listening back to the original session. The role of the PT therapist is to provoke responses in the client for the client to discover new insights into what was a stuck way of thinking. In PT and PCW there are a huge range of stances that the therapist can adopt to produce this result and in my experience it’s rare for a client not to experience some new insights, but as with all therapeutic approaches sometimes things don’t work out. In my PCW work I have the advantage of also using hypnosis and metaphor exploration alongside
   the provocative stances, so IMO this gives me more scope to assist the
   client.

   In PT and PCW the therapist only responds to the clients responses and has no advance plan of what they are going to do. The exchanges can be unpredictable and this unpredictability often provokes all manner of
   response during and after the session. Of course the client’s experience in a group session can be very different to those observing the session and it’s common in a workshop situation for the audience to interpret “what is going on” and to get a very different take to what the client is
   experiencing.

   Also it’s common for a client to experience real change when they watch or listen back to the session on their own now seeing it essentially from a third position. Of course some clients won’t watch sessions for a variety of reasons and have preconceptions ahead of time of what “a PT session should be like” which of course is often different to the actual session. I have seen Frank terminate a client session in a workshop situation for a variety of reasons and of course a client can do the same if they so wish. I have also curtailed private sessions if I believe I can’t help the client, but I can only recall this happening twice in over 3000 client sessions. One of these was when a client revealed that they had failed to disclose important medical info.

   When I find one PT stance isn’t producing a change in client state I switch to another and with over 36 positions it’s almost impossible for the client not to respond to some of them. Of course it would be easier to comment on a specific session as when someone says “What do you do when it’s not working?” that very question can of course mean many things.

   Regards

   Nick Kemp

4. James Lawley

   12|Aug|2011 4

   Thanks Steve for your reply and for giving some specific examples. I think it is only through specific examples that we can understand the dynamics of this phenomenon. In your ‘limiting beliefs about money’ transcript I really appreciate the frame you set at the very beginning:

   “I like to offer people things things to try. Sometimes they work, sometimes they don’t work. And I’m not interested in pushing anything on you that you don’t want to do. And so if anything we do during this hour or so doesn’t feel right to you, or you have some concerns about, let me know—we’ll do something else. Or we’ll talk about it, or whatever. But I really need that feedback. Of course I’ll be watching your nonverbals as well as I can, but I miss something sometimes; I don’t catch everything.”

   I think this does many things in one go: It gives the client permission to speak up in their own interest, it asks for feedback, it says you will respond to that feedback, it establishes a collaborative relationship, and it says you are not all-knowing and can miss things. That, in my opinion, is highly respectful.

   You mention that some clients start in a “victim space” and that raises an interesting point. A client who strongly maintains a victim stance cannot easily stop a session or give clear feedback that something isn’t working for them, since that would mean that were not being a victim anymore. I can see how a Provocative approach might seek to deepen the victim stance in an attempt to push the client though it and out the other side – perhaps with a show of defiance. And therein lies my concern. If it works, the therapist can argue that the ends justified the means. However, UNTIL it works, how does the therapist know that what they are doing is benefiting the client rather than making it an unpleasant experience at best and bordering on abuse at worse?

   In the Frank Farrelly example I mentioned to you previously http://www.cleanlanguage.co.uk/articles/articles/299 I’m prepared to believe Frank genuinely thought he was helping the client.

   I have no idea whether he read the signs that the client was having (as she reported later) “the worst therapeutic experience of my life”. What I do know is that there was no room for the client to give Frank feedback at the time. Instead her several attempts were met with Frank positioning his face directly in front of hers and loudly telling her to “Shut the fuck up”.

   Recently I met someone else who described a similar experience when being a demonstration subject with the leading proponent of another therapeutic method. The client is a big guy with a huge presence and again very experienced in his own personal development – not a man easily cowered. He reported, “I lost all access to my normal physical responses and all I could do was sit and endure.” He said that the experience badly affected him for sometime after. Interestingly, although on the inside he was “enduring” he recognised that he was not displaying overt signs of distress on the outside. This was also true of Frank’s client.

   So now I have two examples of highly resourceful and self-developed people having counter-productive experiences with well-known therapists. Both therapists appeared to miss the subtle signs that what they were doing was definitely not working for their clients. These might be extreme examples, and we can learn a lot from them since it brings into relief that which is hard to detect in less extreme cases.

   Experts say that because they’ve been doing it for X decades or seen thousands clients they can read the client’s nonverbals, but the two examples I cite above show that being an expert is no protection against missing or ignoring the signs. And what happens to therapists’ clients BEFORE they become an expert?

   When I attempt to fathom what might be behind these therapists’ behaviour, the word that comes to mind is ‘arrogance’; in the sense of pushing their (hidden) agenda and thinking they know what’s best for the client. I contrast this with your framing of a session which humbly acknowledges that you might miss something and that you need help to do your job.

5. James Lawley

   12|Aug|2011 5

   Nick, I appreciate you taking time out of your busy schedule to respond. Steve formulates my question as: What do you DO when what you are doing isn’t working? I think that is the easy part. More difficult, and it seems to me more important, is to answer: How do you KNOW when what you are doING isn’t working? If we can’t answer the second question the first becomes irrelevant.

   Thank you for differentiating between a demo of Provocative Therapy/Change-Work (PT/PCW) and a private session. However I can’t see that it materially affects my question. If anything I would expect a therapist in a demo to be MORE careful that what they are doing is working for the client, since they are meant to to be demonstrating ‘best practice’.

   I agree that “a client’s experience can be very different to those observing” and this also applies in demos of Symbolic Modelling. Usually the audience does not realise just how much value the client is getting from the session. However, in the Frank Farrelly case I mentioned (where you were also an observer) I believe the audience underestimated the difficulty the client was having. I know I did. Even so, I could sense the session was not being productive for the client which is why I attempted (unsuccessfully) to intervene. I spoke to several workshop participants afterwards and while they knew something not like the other demos was happening, they didn’t know quite what. So the signs were there. Whether Frank saw them I don’t know. If he didn’t, that concerns me. If he did and chose to carry on, that really concerns me.

   To say “in PCW the therapist only responds to the clients responses” seems like a wonderful thing. But in this instance Frank clearly responded to the client’s responses by doing more of the same. The meta-message was: the more you try to tell me what you think or want, the more I am going to do my technique harder. My guess is that Frank thought the client saying what SHE wanted was the problem, and was attempting to, as you say, “provoke responses for the client to discover new insights”. Can you see how this puts the client in a bind? How can they tell the therapist their intervention is not working, if doing so provokes the therapist to do their intervention more strongly? Repeatedly interrupting the client to tell them to “Shut the fuck up” became, in my opinion, verbal abuse. I’ve tried to find less provocative words but I can’t come up with a better description. My dictionary says abuse can range from “speaking in an insulting and offensive way to or about (someone)” to “treating (a person or an animal) with cruelty or violence, especially regularly or repeatedly”. Because of the incessant nature of what happened, I would say it was closer to the latter than the former.

   This example, and the “All I could do was sit and endure” example I discuss in my reply to Steve, have convinced me that to say “of course a client can do the same if they so wish [to terminate a session]” is to deny the client’s perspective.

   I would be interested to have some examples of when and how a client terminated a PT/PCW session. And given that, as you say, “as with all therapeutic approaches sometimes things don’t work out”, could you please give some examples of this happening in PT/PCW – in particular when and how it became apparent that things were not working out. This will give us something definite to discuss. (I appreciate it behoves me to give examples too, and I shall.)

   As therapists and coaches we need to recognise the potential for what psychologists call “self-serving” and “self-confirmatory” bias. An example of the former would be believing that I’m not subject to the common shortcomings of other therapists, and the latter interpreting all evidence as the process working. These well-documented biases are one of the reasons why many schools of therapy insist on their therapists being in supervision. But since most supervisors never see what actually happens in their supervisee’s sessions, they can’t know the half of it. [Don’t get me started on this one!]

   I am grateful to see that this issue will be raised by you and Steve on your future training. As responsible trainers if we don’t discuss these issues and let our students know that there are circumstances, albeit rare, where things can go badly wrong (even for the most experienced facilitators), and support them to recognise the early-warning signs, then we are doing them and their clients a disservice.

6. James Lawley

   12|Aug|2011 6

   I also have some general comments. My aim in raising the topic of how we know when things aren’t working for the client and with the examples I give is to to draw out some general learnings. Over the last year I’ve learned much from my personal discussions on this topic with many therapists, a workshop I ran at the annual NLPtCA conference, and a day with advanced practitioners of Symbolic Modelling. Penny Tompkins and I have written up the results of our investigation so far at: http://www.cleanlanguage.co.uk/articles/articles/308/

   On reflection it seems to me that:

   – The question of ‘how do you know when what you are doing IS working?’ is equally useful and structurally no different from the question about when it is NOT working.

   – The vast majority of facilitators, regardless of their training, cannot answer these questions with anything other than generalities. (I list some of the answers given in our paper cited above.) Unfortunately these prove to be of little help to others attempting to acquire the skill to recognise the signs.

   – Answering these questions is not easy, and as Steve says, specific examples are required because in-the-moment the individual context is oh-so important.

   – Not noticing the signs and not responding to them can have very real consequences. See the recent case of James Arthur Ray who kept doing his sweat lodge process despite the feedback and evidence that some of his participants were in serious difficulty, resulting in three of them dying: http://www.guardian.co.uk/world/2011/jul/08/james-arthur-ray-sweat-lodge-arizona

   – There is often a reluctance to discuss the ‘not woking’ issue in terms of what the therapist is doing (it’s much easier to say the client is ‘resistant’). How many videos and transcripts have been released of a session going badly awry? None of mine for a start. To his great credit David Grove issued a video (in 1991) where he points out a serious error he made. The experience of the client’s childhood sexual abuse was unwittingly reenacted within their metaphor. (David mistakenly took flowers in a garden as resources when in fact each one symbolised an act of sexual abuse.) The client doesn’t say anything at the time but clearly withdraws psychologically and emotionally. David recognised the shift in the client and gently, gently rebuilt rapport with the client’s symbolic child. In the feedback afterwards the client reported that at that moment she lost trust in David but that this was regained so the session could continue to a useful conclusion. David reflected on the consequences of his mistake “It took six months for the client to disentangle me, the therapist, from the roll of perpetrator that I took on when I accidentally misunderstood her words”.

   I will continue my research on this rarely mentioned topic in the hope that together we might be able model and produce something valuable.

7. Nick Kemp

   12|Aug|2011 7

   I have seen Frank many times and have never heard him say “Shut the fuck up to a client” I also have client sessions on audio and video dating back to 1970s and can’t find him doing this either
   I agree that “Not noticing the signs and not responding to them can have very real consequences.” and of course those of us working with clients on a daily basis appreciate that we can each only do our best and none of us know ultimately how the client will respond. In PT and PCW workshops it’s very common for attendees to have a very different impression of the experience in watching than the client has during and post the session.
   To date I have conducted over 3000 client sessions and know the dangers of generalizing about what happens. Often clients will report great results from listening back to a session from a third position and having a very different experience. This listening back is of course part of the process in PT and PCW

   My first experience of PT was back in 2006 in a 4 day event. It then took me some time to really appreciate how this process works and IMO people only get a real insight into the provocative process when they experience being a client! Frank of course worked for years in Mendota Mental hospital so he has far more experience of what works with clients many of whom were considered unbeatable by other therapies

   Best Regards

   Nick

8. James Lawley

   29|Oct|2011 8

   Thanks for your reply Nick. I’m afraid I am none the wiser about how Provocative Therapists/Coaches know when what they are doing isn’t working for the client.

   I am pleased that some clients get lots from watching the video AFTER the session. What you and Frank continually fail to give is any any guidelines for budding Provocative Therapists/Coaches who, DURING the session, are not only failing to help the client but potentially doing them harm.

   If you believe it is not possible for this to happen in PT/C then I would appreciate you saying so.

   However, if you think it is possible (even if has never happened in a single one your 3000 client sessions), can please say when would a PT/C know to stop what they were doing because it was not helping the client?

9. James Lawley

   29|Oct|2011 9

   Also, I have recently written two blogs that relate to the debate:

   1. Pathological altruism – when ostensibly generous ‘how can I help you?’ behavior is taken to extremes, misapplied or stridently rhapsodized, it can become unhelpful, unproductive and even destructive.

   http://www.cleanlanguage.co.uk/articles/blogs/60/Pathological-altruism.html

   2.The illusion of validity – when evidence of our failure should shake our confidence in our judgments, but it does not.

   http://www.cleanlanguage.co.uk/articles/blogs/61/The-illusion-of-validity.html

   The first blog is an explanation of how some well-meaning people can unwittingly end up hurting the people they aim to help.

   The second is an explanation of how being overconfident in our ability can blind us to contrary evidence, even when we know we subject to this “cognitive fallacy”.

10. Nick Kemp

    29|Oct|2011 10

    Hi James

    Have you read Frank’s book “Provocative Therapy”

    Best Regards

    Nick Kemp

11. Nick Kemp

    29|Oct|2011 11

    I had a lot of misconceptions about Frank’s work initially and realized that I needed to do more than read the original book and attend a few days training to appreciate how this therapy works.

    Both Frank and I give extensive advice for those wanting to learn these skills in our respective trainings. The AFPT of course also has a clear set of ethics for all who wish to be members and train in this work.
    I’m also not sure how you can conclude what you imagine Frank or I “continually fail to do” as as far as I’m aware you have only ever attended one 2 day introductory PT event! LOL

    Finally Dr Graham Dawes article on Frank’s work is useful reading
    http://www.provocativetherapy.info/articles/2009/10/a-bermuda-triangle-of-the-mind.htm

    Warm Regards

    Nick Kemp

12. Nick Kemp

    29|Oct|2011 12

    PS For the sake of clarity it would be useful if you could specifically detail what you actually mean by

    “know when what they are doing isn’t working for the client.”

    Without referring to a real life a specific client session, this could mean all manner of things and IMO becomes a bit like a “what if?” question

    Best Regards

    Nick Kemp
    http://www.nickkemp.com

13. James Lawley

    04|Nov|2011 13

    Nick, what I mean by “know when what they are doing isn’t working for the client” is how would a Provocative Therapist/Coach know when the effect they are having is unhelpful, unproductive or even destructive as far as the client is concerned?

    What I am hoping is that you have some guidelines for what Provocative Therapist/Coaches should look out for that would indicate the client was finding the process at best unhelpful and at worse abusive.

    This is not a ‘what if’ question because I know there are cases were this has happened and I’m aiming to reduce the incidence of it happening again.

14. Nick Kemp

    04|Nov|2011 14

    You asked

    “how would a Provocative Therapist/Coach know when the effect they are having is unhelpful, unproductive or even destructive as far as the client is concerned?|”

    Lots can happen in sessions and of course every client is different.

    However here are a few thoughts –

    No therapist can “know” 100% what a client is experiencing, but they can note verbal or non verbal behaviours and respond accordingly

    Changes in client behaviour occur after sessions and part of the provocative process is for the client to listen back to the session.

    I have had clients be frustrated during a session (I may deliberately provoking this state) to then be delighted with their insights post session and/or having listened to the session from a third position afterwards. A good recent example of this is my work with Pete Windridge-France who I coached to swim the English Channel using my PCW approach. In this interview you will hear him voice being frustrated at times during the initial session but then realise that I had provoked him into a more useful way of thinking, see http://www.youtube.com/watch?v=ddQSNr2DXTs&feature=player_embedded

    In an extreme situation If a client walked out of a session they would be voting with their feet! I have never had this happen personally, but I have heard this can happen in therapeutic situations. Sessions can also be concluded ahead of time for a variety of reasons and I have seen Frank do this for a variety of reasons which of course is his prerogative. I have also terminated sessions if I think they are unproductive for either party (it’s not of course only all about the client) including when a client requested he be hypnotised so he could forget he was ever married!

    I reserve the right to terminate sessions at my discretion and make this very clear in all my communications before agreeing to take on a client.

    As for “destructive” well any communication could in theory be destructive as any suggestion could unwittingly create an adverse reaction, but let’s remember that clients who seek out a provocative therapist normally do so in order to experience being provoked into a new way of thinking.

    Many therapists are well meaning but can unwittingly actually be destructive by not engaging the client in open and honest communication but rather talking about problems in a very abstract manner . I have seen a great deal of problems created by this style of working but let’s remember that everything we are saying here is generalised observations.

    Most of Frank’s work was in Mendota mental hospital where he dealt with chronic cases that nobody else was able to handle using any other approaches including heavy medication.

    Have you read Frank’s book Provocative Therapy?

    If not I suggest doing so to get a better insight into how provocative therapy works in a therapeutic context.

    My own Provocative Change Works is different in many ways, (see http://www.provocativechangeworks.com/the_difference_between_PCW_and_PT.php ) from Frank’s work.

    I think its useful to discuss what can happen in sessions but those of us who see clients on a daily basis appreciate that there a re thousands of potential scenarios and all of us can only work to the best of our ability. I blogged recently on the nonsense of 100% success claimed by some practitioners and noted that real life situations are a world away from often what is taught in classroom situations! See

    http://www.nickkemp.com/blog/2011/10/the-myth-of-100-success-in-therapy-and-nlp.htm

    Best Regards

    Nick Kemp

15. Nick Kemp

    13|Nov|2011 15

    Hi James

    What cases are you referring to?

    Regards

    Nick Kemp

16. James Lawley

    14|Nov|2011 16

    Nick, are you going to answer the question I have been asking on this blog since 21 June or not?

17. Nick Kemp

    14|Nov|2011 17

    I replied on Nov 4th and has sent a copy by e-mail

18. James Lawley

    15|Nov|2011 18

    Thanks for sending me a copy of your Nov 4th post which of course I hadn’t seen. I think this is such an important topic that is rarely aired and I appreciate you engaging in the discussion.I have asked Steve to post it to this site so I can reply online.

19. Nick Kemp

    16|Nov|2011 19

    .

    James

    The reply is now live as no 14 in this thread. I am happy to discuss this area, BUT I am mindful that without referring to any specific client sessions we could endlessly speculate about what a client or therapist “could be” experiencing…

    You refer to “cases”, so it would be useful to know which cases you mean so I can get some reference on how you are coming to what seems to be a series of conclusions which are very different to what I have discovered in the last 7 years of studying this approach. Of course no approach will suit everybody and clients can respond in a variety of ways for a variety of reasons.

    You will also have the Provocative Change Works for Anxiety DVD set I gave you a year ago

    On watching this 4 DVD set you will see a number of real life client sessions and responses, both in a live training and two client sessions where what you see is the whole interaction I had with each client without any editing.

    All clients reported very favourably on the sessions as well as in writing some weeks later.

20. James Lawley

    22|Nov|2011 20

    It was good to see you at the NLP Conference in London this weekend Nick.

    I have read your 4th Nov reply very carefully and I can’t see that you are answering my question. You give examples of sessions going well, of the client getting value post-session, of Frank and you terminating sessions because you didn’t like what was happening. But nowhere do you address the context where the therapist/coach is ok with what is happening but the client is not.

    You are right that clients very rarely terminate a session early or walk out. If what the therapist/coach is doing results in the client accessing a highly unresourceful state, at that moment they often do not have the wherewithal to assert their right to stop the session. I suspect that when the context is a demonstration in front of a group it is even harder for the client to terminate or walk out. Three highly resourceful individuals who have had bad experiences with leading therapists all said they felt they had no option but to endure what was happening. Not saying ‘stop’ or walking out does not imply the client wants to continue. In these cases it was quite the opposite.

    I want to reiterate that I am not singling out Provocative Therapy/Coaching because my question is applicable to all types of therapy/coaching. However, given that a PT/C aims to ‘provoke’ a reaction in a client, and given a therapist/coach can’t control that reaction, sometimes they must (unwittingly) provoke unhelpful and even harmful states. How would they recognise this was happening?

    My concern is that if therapist/coaches don’t notice that a client is having an unhelpful, unproductive or even destructive experience, continuing will likely make it worse.

    I know this happens because I observed it in one of Frank Farelly’s demonstrations (at which you were present). As I have reported, the client took several weeks to recover her state (even to be resourceful enough to watch the recording of the session). Her experience in her words were:

    “For the first 5 minutes or so it seemed to be ok, there was humour, but then something switched. It got so bad that I went between shock, paralysis, severe conflict, head-spinning and I don’t know what else. I noticed Frank’s hands and thought ‘Dear lord if there is help or healing power in them, I need it now’ and I kept grabbing for them because I was just so desperate. But there was no help for me in those hands. Anything I said or did just brought more attack and, to use his word, cruelty. It seemed relentless. Even after the contracted 25 minutes, I didn’t get to give my reactions to him – he kept going on and on. I became numb.”

    To this day, a year later, she still regards that session as “the worst therapeutic experience of my life”.

    It seems to me that we either ignore this client’s experience (and the similar experience of other clients with other therapists), or we say: this is something that happens, albeit rarely; it needs to be brought into the open; we need to recognise when it is happening; and we need to find ways to reduce the frequency or intensity of such client reactions. That is my aim.

    I have had no trouble finding clients who have have had similar unpleasant and unhelpful sessions. I have had great difficulty finding therapists/coaches who are prepared to acknowledge it has happened or could happen with THEIR clients.

21. Nick Kemp

    22|Nov|2011 21

    Hi James

    I don’t comment on other people’s work specifically but do note that there were many different and varied responses from those who witnessed this session.

    Clients will have all kind of experiences and I encourage clients to feedback honestly to whoever they are working with. I think it’s also important to clarify that this was a session in the context of a workshop as well and although I could go into detail about my own thoughts about this, I am mindful not to do so in the public domain. I can’t mind read if in this instance if the client’s responses were ignored or not, but when I see clients I give them ample opportunity to feedback throughout any interaction we have as any session involves us both working together to produce useful change.

    Those of us who see clients on a regular basis appreciate that of course anything can happen in a session and there is no 100% way to predict what occurs. We work with best intentions and proceed accordingly. I will adapt my responses according to the client’s responses and of course each situation will be different. I’m not sure what else I can add as this single example is not IMO representative of a provocative approach and as I mentioned at the time no single session would in itself be a template for all such sessions.

    I would ask though whether the individual watched the session back later and if so what he/she observed as this 3rd position is often what is most useful for clients who have experienced for decades.
    I appreciate the discussion and am happy to clarify further anything else you might ask.

22. Nick Kemp

    22|Nov|2011 22

    PS I see on re reading the client did watch the session. I’m sorry they feel they had an unhelpful experience.

    I always suggest that unhappy clients direct feedback to their therapist rather than third parties as a matter of professional etiquette.

    This then allows for more constructive and useful communications and prevents unwittingly calling a therapist’s reputation into question in a manner where they either can’t respond or may be totally unaware that the client is even unhappy.

    Regards

    Nick Kemp

23. Andrew T. Austin

    23|Nov|2011 23

    I thought I might offer a few observations to add to the discussion. Firstly, I ought to state that my awareness of the discussion is incomplete owing to not being aware of the client sessions in question and the generalisations that are built from those.

    Something I’ve been exploring a lot recently is the question of how we measure change. Much to my disappointment, it appears that for so many practitioners I have seen the only measurement is that of a subjective kinaesthetic assay. This assay usually follows some cleverly worded wizardry that takes the form of, “So, when you think about the problem now, how do you feel?”
    Any positive change is usually attributed to the cleverly worded wizardry and a successful outcome is usually declared. Of course, the positive change in kinaesthetics might actually be the result of any number of variables and have nothing to do with the interventions that were offered at all. Additionally, they may be far from permanent, lasting only as long as it takes for the client to drive home again.
    The giveaway for this kind of situation is when the client asks, “Will it last?” Which for me suggests that change hasn’t really happened at all – the client lacks any new found skill, insight or learning that will enable them to operate more successfully and independently of the practitioner in the future in the content of their reported difficulty. At best they have a temporary hope that things will change.

    So a question I have been asking a lot of practitioners during workshops is, “How do you measure change?” The most common answer is, “I ask how the client feels after the session.” The current difficulty that I have at this moment is putting words to how I measure change with clients. It isn’t an easy thing to answer, but I’m working on it. I suspect the answer won’t be a brief one.

    The problem about measuring change kinaesthetically is that it is just too limited. Certainly in some instances, for example simple phobias, a kinaesthetic assay is all that is required. A client I saw recently for a simple phobia of spiders was only seeking change with specific regard to that difficulty. Now, it was fairly obvious to me that she was quite a nervous person, she was overly eager to please and she would undoubtedly benefit from modifying some of the values and beliefs she held about herself. But she was quite clear about what she wanted from me – “I want to stop freaking out when I think about spiders” and I didn’t see it to be appropriate to foist a greater type of change upon her. So, a simple V-K dissociation and a small amount of eye movement work were duly delivered and out to the garage we went to find a spider. Locating a decent size beast, I offered it to her and asked, “How do you feel about spiders now?” She didn’t look overly confident but at least she didn’t freak out or run away which is what she tried to do earlier when I just showed her photos of spiders.

    Visibly there was a clear change in behaviour, but her reporting of how she felt remained largely unchanged.

    Herein lays a dilemma. I’m quite satisfied that the client has got a change, but the client who is measuring kinaesthetically is not.
    Follow up two weeks later was interesting. The client was still not satisfied with the result, but when asked, “So what happens when you think about spiders?” she answered, “Nothing, I’ve hardly thought about them since seeing you.” What was interesting here is the criteria for measuring change. Hers clearly differed from mine. Simple omission on my part at the beginning of the session, “how will you know when you have got the change that you want?”
    But, having worked with enough clients – both the worried well, and the psychotic – I often wonder if we can in fact trust the client to know what they want. For the psychotic depressive who says, “I just want to be happy”, this might seem reasonable enough. But this might translate to, “I don’t plan to change my life, my behaviour, my verbage, my relationships or any aspect of what I contribute to my situation, I just want to you provide me with happiness.” I’ve met more than enough people who present with this, and it is a notion that is largely encouraged by the self-help industry, especially hypnotherapists.

    “Just sit back, relax, sleep, no nothing. Your life will change.” This seems to be the most common advertising message from hypnotherapists. And it is a message that is so eagerly embraced by significant numbers of the population who wish for a better life. Oh, if only it were this easy! There are of course people who tell me that it is and that I am mistaken, but I’ve yet to see any consistent evidence of such. My observation is that the proponents of this “quick and easy” change approach to problems are measuring problems far, far differently than I am. So many of these practitioners are dealing with such low level problems whilst charging such a high fee that they have a significantly different client group than I do.

    Another message that is commonly promoted by therapists is that change is “easy” and “quick” (primarily by the NLP practitioners and many of the NLP off-shoots) and “gentle” and “relaxing” (most common in the more ‘alternative’ methods such as tapping). This is part is a reaction to the message of the old-school therapies that advocate long term, introspective and sometimes arduous sessions in order to create “insight” as a tool for change. I believe it also reflects, to a degree, the gullibility of so many people who attended overly hyped but somewhat brief trainings in the hope of becoming amazing themselves, and failing to rationally examine the claims being made for the “tools” taught on the training course.

    These advertising messages affect expectations, and many clients expect to: 1. Enjoy the change process, 2. Expect change to be neatly packaged into one or two sessions and 3. Not actually do anything pro-actively themselves to create change.
    I am sure I am not the only therapist to get frustrated with absurd client expectation sets and even more frustrated with the therapists who encourage such absurdity.

    Anyway, moving on. Another thought I have is about when is the therapist’s intervention done and completed. Is it at the end of the session when time is up? Once the client arrives home? When?

    So for the measurable outcome, how soon after the therapist stops talking is this change supposed to be measured? For example, I’ve had clients walk out at the end of the session really quite pissed off at me, only to report on follow up that they’d been thinking about some of the things I’d said and as time passed it made more sense. I generally find that clients that report this kind of experience report bigger change and are usually the ones that refer other people to come and see me.
    Less commonly (I can only think of two examples) are the clients who leave the session really pissed off at me and stay feeling that way. But on follow up they report that the presenting problem is no longer an issue, but for them, that isn’t what is important. What tends to be most important for them (remember, I only have two examples of this) is how they feel about me, not how they feel about the presenting problem itself. (There’s that kinaesthetic assay again).

    The converse of this is the small percentage of clients who think I’ve lovely but report no benefit whatsoever.

    Then of course there are those clients who dislike me, dislike the work I did and report no benefit whatsoever; I average about 2-4 a year. I sometimes joke on training workshops that I am the only therapist I know who has sessions go badly! Everyone seems to get amazing results all the time and all their clients are highly grateful and think their therapists are amazing.
    The majority of sessions and clients experiences are of course in the mediocre to mostly positive range – basically, ordinary.
    But anyway, back to the issue of “when”. When does the change need to occur to be attributed to the session? Some sessions don’t create any change at all – instead, merely the conditions of change are created. Thus suitably motivated the client leaves the session and begins the process of change, which might be something that happens quickly, or is a lifelong process of living differently. Or something else. I cannot think of a decent generalisation here, as it is so different and unique for each person.

    I’ve known one or two NLP trainers who take the view that having met them just one time, they take credit for everything good that happens in the person’s life forever more. Slightly egotistical, and certainly rather arrogant, but, I suppose, at least it’s positive. I see the same egotistical and arrogance in others who take a rather less optimistic view and hold themselves responsible for everything bad that happens to the client forever more. Delusions of grandeur are not always positive delusions.
    The media quite like to take this view too when it comes to psychiatry and patients who kill. Somehow the psychiatric teams are supposed to be able to predict every action the patient takes forever more and worse, be responsible for such actions. After all, the legal point of view is that the insane are not responsible for their actions. Their psychiatrists are.

    And worse than that, they are supposed to prevent the patient from making bad choice, behaving in detrimental ways and so on. To invoke Rosenhan’s ‘false patient’ experiment for a moment, one of the psychiatrists criticised by the study declared words to the effect of, “When you reported to our emergency clinic saying that you heard voices, what exactly did you expect us to do?”
    Rosenhan’s study is so commonly invoked to demonstrate how awful psychiatrists are. Personally, I think it is a good demonstration of what happens when people intentionally deceive psychiatrists. Rosenhan’s study seems as realistic to me as setting a bunch of people out to wave toy guns at policemen. The results will inevitably be messy. Yet this is not the populist view, nor the view promoted by psychiatrists or therapists themselves.

    What all this adds up to is the view that patients are largely helpless, vulnerable and innocent. The clinician/therapist is powerful and potentially dangerous. Thus the endless discussions on ethics and what is right and wrong begin in order to limit the damage that therapists can inflict upon their patients. Bandler’s assertion that there are no resistant clients, only inflexible therapists is a nice ideal for the training room but not one that is borne out in real life in my experience. I’d be delighted to hear from anyone who disagrees with me, because I have a nice list of people that I can send their way.
    So, it is with all this in my mind that I consider James’s excellent question: “How do you know when what you are doing isn’t working?” It’s a tricky question, and I find it as difficult to answer as the question, “How do you measure change is you don’t measure it kinaesthetically?”

    The problem is one of definition. It’s on that word, “working.” What do we mean by “working” – presumably, effective and presumably this involves “outcomes.” Now the ideal scenario, which does happen, is that the therapists’ outcomes for the session happen to align with the clients’ outcomes for the session and/or vice versa. This is often an essence of rapport that is so often neglected to be mentioned in NLP training where the emphasis can be on a vacuous matching and mirroring approach.
    Aligning outcomes is the easy part, and it might mean that one or both parties need to compromise, but I can see a problem here. So often the client’s outcome is not feasible or realistic. Such a situation can have a wide range of variables and a wide range of possible solutions, but two that occur to me at this moment are:
    1. The client’s outcome would be detrimental to the client, even though at that point of time the idea of it seems appealing and realistic. (Anorexic: “I just want to die.”)
    2. The client’s outcome is not achievable within the boundaries of the session or within the capabilities of the therapist and/or client in that session. (Depressive: “I want my father to love me.”)

    Reframing is often the tool that gets used here, a methodology of which I have long been critical about in terms of how practitioners use it. My common experience of practitioners use of reframing is that it is used as a point scoring where the therapist raises their status and virtually dismisses the client.

    What happens is that the surface communication follows the lead of the therapist, with the client loosely agreeing, nodding, conceding and so on, creating the illusion that things are changing. But actually, the whole thing is a façade.

    My best example of this, and one that I have experienced and witnessed numerous times first hand is that of reframing anxiety to “excitement.” It seemed that for a while a common cliché that was in heavy circulation around the NLP and hypnotherapy scene was that anxiety was just excitement by a different name. Additionally the cliché had it that it was good to have a little bit of anxiety. In my 20’s when I was actively seeking help for panic attacks and anxiety, I lost count of how many times I heard this nonsense from people claiming to be helping me. All harmless stuff, but if we consider what was “working”, well the reframes were delivered word-perfect and my state certainly changed. I never once had a panic attack or anxiety episode in any session I attended and I soon stopped arguing with therapists and ended up loosely agreeing with them. As time went on my confidence grew and I became certain that I would be a better therapist than any of the practitioners that I had experienced. The anxiety and panic attacks continued unabated though.

    In 2005 I attended a presentation about how give presentations, delivered by two fairly well known NLP trainers. Well, the presentation was so unbelievably bad I was tempted to ask for a refund there and then. I didn’t. Because by the end of that experience (which was like watching a car crash in slow motion) I knew that I would make an excellent presenter myself since I knew there and then that I could make a better trainer than the two men on the stage. Attending that presentation changed my career path dramatically.

    So, I was left thinking – were those two trainers actually far smarter than they pretended to be? After all, I walked out of there a changed person.

    Sadly, I’ve seen them both present since then and I must say they are truly dreadful. But they did prove to be an excellent catalyst for me. So, to where should I attribute the change?
    Now back to the question, how do we know when what we are doing isn’t working? I think possibly an equally difficult question is how do we know when what we are doing is working? And of course, how do we know to what to attribute the positive or negative change?
    In the exchange between Nick and James what I observe is a difficulty in that the roles cast are that James is being aligned with the client, and Nick is being aligned with the therapist. I wonder how different the exchange would be between the actual client and the actual therapist?

    A question I would address to the client at the centre of the discussion is the classic, “So when you think about the presenting problem now, how does it compare to before the session.”
    There are three variables I can immediately think of: it’s better, it’s worse, or it is unchanged.

    For me, this is an important starting point. Clearly the client did not enjoy the session, but at this stage, I’m not that there is sufficient data to warrant discussion on the approach that was used until we know if there was a change in the presenting problem.

    If there is no change, or there is change that is negative and directly attributable to the session then clearly there is a problem that merits evaluation. BUT, I have to question whether that is for us to do in such a forum – well, not unless both therapist and client get the opportunity, and have the desire, to discuss such things.

    So, back to the question, how do you know when what you are doing is not working? Can we begin with a definition of what is meant by “working”?

    Regards,

    Andy Austin

24. John Moore

    23|Nov|2011 24

    IMHO “Working” is the process of undoing a learned helplessness and then the client subsequently demonstrates an adaption to changes, however this may take some time.

    In the short term observing the clients body language signals given off in a session may only determine that the pattern that they running has been accessed. The astute practitioner will pick up this state and attempt to embed a new behaviour that is in their opinion more appropriate. However once the client has settled back into their usual routine environment they must remember to repeat the new process or they will resort back to the old pattern as it is a) more familiar and b) parsimonious compared to the extra glucose required for paying attention to practicing the new behavioral strategy.

    What most therapists fail to remember is that when we are born we come with a whole set of evolutionary programs embedded into our DNA. The fear response is handed down our genes like a baton in a relay race. Once we pick up the baton we’re running and making adjustments to the world around us in the flesh and traumatic memories are generalised and underpinned by this fear response. If we attempt a task and repeatedly fail we may learn helplessness which in turn spreads to eat away at our confidence.

    Most of the time we have the ability to use language to describe in details our fears, however under duress articulation is demoted to bursts of emotional reactions and more primitive sounds will represent our feelings, this also resonates in facial expressions, tonality change and inappropriate actions.
    Evoking this state and having sufficient sensory acuity in a session is the signal for the therapist to change that process the client is running.

    Whether we react to fight, flight, freeze or fawn depends on whether we have sufficient confidence in a situation to deal with the event which is present. Giving options how to respond instead of react is the essence of how a therapist can help the client. Testing the response is the only way to really know if a new learned behaviour has been embedded. Which is why follow up sessions are essential, other wise how will you know if what your doing is really working.

    There is an interesting discipline emerging around the nature/nurture argument and may yet reveal how change occurs over generations. Meet the Epigenome: http://www.time.com/time/magazine/article/0,9171,1952313,00.html

25. Joe K Fobes

    23|Nov|2011 25

    @Andy I liked your comment. I especially appreciated the bits about ‘quick and easy change’. You might find this article http://wikihyp.com/techniques/nlps-fatal-flaw/
    interesting.

    @James Before we answer your question, well who’s to say that Frank damaging that client means his approach should be changed? Say we had a cure for infection that worked instantly (instead of the few days that most antibiotics take), but it killed one out of every million users. Who is to say that one life is not worth the massive gain that we get from cutting infections down from 5 days to nothing?
    If Franks stuff works double as fast as what someone else does, well who’s to say that even if he does damage one out of a hundred that it wasn’t worth it? Surely the existence of therapists makes people who would have stayed home during the day go out on the roads to go to therapy. Surely some of them get into auto accidents and die. Does that mean it’s time to stop offering therapy?

26. Nick Kemp

    24|Nov|2011 26

    I think Andy’s makes some really interesting points. All too often “progress” is linked to “feeling good”

    I had one client who had been smoking cannabis for 30 years on a daily basis whose sister paid for me to see her. The cannabis smoking sister turned up 20 minutes late stoned. During the session was unsurprisingly vague in her responses. I used the same PCW approach that I use with all clients and she left with a recording of the session. Five days later she rang up stating that during the session I had suggested she was a bad mother! I replied that I had in fact commented that “some daughters follow mother’s examples” and this is clearly indicated on the recording. She stated she wouldn’t be attending the follow up session and I commented that this is entirely her right. Two weeks later the sister who paid for the session commented “X is really furious about your session!” I enquired how the cannabis smoking behaviour was since the appointment. She replied “Oh she’s not doing any of that anymore, she just keeps saying I’ll show him who is a good mother…”

27. James Lawley

    24|Nov|2011 27

    Ok Nick, I won’t ask you to comment on other’s work. And I know you can’t mind-read (in this case you don’t need to because the client has given a clear description of her subjective experience). Instead I’ll ask you to comment on YOUR experience.

    Did you notice at the time that the client was having such a difficult time?

    If you did, what did you notice? And given that you noticed that something was amiss, what would you have done?

    If you didn’t notice anything untoward happening in the session, what can now be learned given that we know the client experienced it, both during and after, as a “relentless attack”?

28. Nick Kemp

    24|Nov|2011 28

    Hi James

    I’m happy to reply but first would be interested in your response to Andy’s question as this is IMO a key factor to usefully and objectively discussing this without emotional bias.

29. John Moore

    24|Nov|2011 29

    Thanks to Duff McDuffee for approving my earlier post :)

30. Jane James

    25|Nov|2011 30

    I hope you will excuse an interjection from an interested and rather bemused bystander. I’m responding because I have actually had two sessions with Frank Farrelly and coincidentally was also at the workshop that’s been referred to in this thread.

    I read Frank’s book some years ago and first saw him in 2004 at a similar event to the one under discussion. I didn’t know anyone there and had never met Frank. I was the first demonstration subject, so Frank did a 25 minute session with me straight off. I was pretty anxious at the start of it as his book gave the impression that he was very tough and uncompromising But I really wanted the issue sorted so I went with it.

    In the discussion afterwards, several delegates suggested to Frank that he had been cruel and berated him for talking to me as he did.

    Which made me pretty cross! It was it a terrific session, which has effected lasting change on what was a big, screwed-up part of my life.

    Was the session painful for me in parts? Yes it was. Was it uncomfortable for others to watch? Clearly so, but it wasn’t for their benefit and it wasn’t for them to judge. (It was also very funny and very warm and friendly in parts, too). Did I know what was happening at the time? No I didn’t.

    Seven years on and I still thank God for that session. (And for the second one on a different topic a couple of years later which also effected lasting and powerful change).

    Had anyone who was observing the session decided to intervene because they perceived I was having a difficult time, I would have been extremely angry. Although several people thought there was “something amiss”, they weren’t in a position to make that judgment. I was.

    So I guess what I’m saying is that unless the therapist is stabbing the client with a knife, I’m not sure how as an onlooker, I can or even should make a judgment about what a client is experiencing and whether an intervention is appropriate. Certainly people who watched my session with Frank weren’t good mind-readers!

    Maybe I’m a masochist, but I’m also mindful that very painful things have happened in my life that I might have chosen to stop at the time. But later I’ve realised that the learning and the opportunities from them has on the whole been greater than from some of the soft, fluffy, lovely moments.

    My final thought is that no one strategy, therapy or approach to life is 100% effective for 100% of people. If this client feels that the therapist was unprofessional or unethical, then isn’t that something that should be dealt with through the appropriate professional channels? If it was unpleasant and ineffective, that’s hugely regrettable, but provided no lasting damage has been done, maybe it’s a “horses for courses” thing?

    Thank you for letting me comment. I’ve become fond of Frank over the last few years. I know his ideas and approach can be challenging. But part of my fondness for him is because in putting aside the need to be likeable, and in holding a mirror up to me, he helped me to make major and worthwhile change.

31. Piotr Jaczewski

    27|Nov|2011 31

    Hi, maybe I will help and answer, if my language skills let me.
    my primary language is Polish, treat me gently ;)

    I’m using in my work, both:
    A) soft core language, friendly, symbolic modelling goal oriented methods based on questions & feedback(like clean language or core transformations)
    B) hardcore PT, PCW orientation trained on workshops of Andrew Austin, Nick Kemp, Frank Farrelly. with vague or sharp language & marginalising client feedback (except congruent reactions to the reported feelings)
    And when I work with some educational matters (how to understand my life experience, how can i work better, positive double bind: it can be ok or better) I use A, and when client needs change(it can be bad or worse) I use B.
    For me it’s one spectrum of hypnotherapy, getting unconscious responses on one side:
    A) lightly, to the consciousness of client, talking & discussing psychic events and observations.
    B) hardly, big physiological change, even without consciousness of client or feedback self-awarnes of his reactions.
    And for me in both sides I’m doing the same process, but in different mode of communication eg: In mode A) I can help client to set goals and teach how to.. in mode B) I challenge client to set goals & defend them against me.

    By example: My personal experience: when I have client reporting me “I hate husband, I love another” i will never, never again use A. Its common:
    Client get strong positive insights, be so happy on the session, thank full & go out, and do most stupid worse nightmare thing I can imagine… (eg, telling immediately to husband, and reporting to me: it’s worse now ) And yet it never happens when I’m using PT/PCW approach. And this make sense for me: one fantasy land here in life, one fantasy land in session. Nice fantasy land so it was really stimulating to go there..
    And here I agree with Andrew, it’s all: quite pissed off at me, often after long time reports big positive changes.

    how do experienced provocative therapists/coaches know when their approach is not working?
    For me ? When I notice I lost my rhythm & start mirroring and following client (stopped provoking), & experience being hypnotized by client, naturally reacting to content
    or when i don’t notice physiological changes: going into trance like states & going out smiling, bantering or showing emotions.
    Which makes one conclusion: its not working, when I’m not provoking…and when im provoking, I’m focused on “what works” what gives me reactions?
    Common sense answers, positive or adequate emotions, defending themselves, questioning stupidity, recognizing paradoxes, friendly bantering…
    and it’s my opinion, that’s basicly all they need to solve problems and live happy life even if some problems cannot be easy or fast solved.

    And yes. It’s very arbitrary and belief based decision on my side: if i’m provoking in session then it works in outside world, and client has effects faster and more resourceful: feeling that is only their effort. And it’s based on assumption that: client can get better even without therapy, coaching, it’s matter of time. So my job is provoke, evoke from client “solution like behaviours” here and now, accelerating natural process.
    And being angry, or frustrated, or crying(never happen on the end of session) lisening to painful things is often natural part of that natural change.

    I think that “culture of growth” “culture of therapy” “culture of coaching” is a matter of lifestyle, not “evident based, proved process that works”, causing for people both benefits and troubles, sometimes more problems then benefits even with declarations of really ecological, rational change .Provocative style is really based on natural mode of communication: straightforward, childlike, curious, funny, quarrelsome…really good for cultural based plastic problems with cultural based long, expensive, but valued and certified, proven professional solutions.
    eg: Nick is doing “blushing therapy” (great idea:)), but I seen many times “school group blushing provocative natural bantering therapy” and it’s worked fine: It was not nice, but also not agressive and too much hurting and done only by means of natural group joking & making fun and liking each others.