Frank Farrelly - Originator Of Provocative Therapy

Described by one of his clients as:

The kindest, most understanding man I have ever met in my whole life, wrapped up in the biggest son of a bitch I have ever met.

Frank Farrelly - Live in New York 2006 (2 mins)

Excerpts From “Provocative Therapy” by Frank Farrelly & Jeff Brandsma, 1974

chronicles the adventurous, warm and humorous journey undertaken by Farrelly in his highly successful quest for tools… These tools were forged in the experiences of more than 20 years of work both with the traditional hard-core institutionalized patients and with clients in private practice.

Excerpt 1:

T (Disgustedly): Well, I see what you’re talking about. My God! Nobody but a sex maniac could go out with a gal like you, with big feet, thick ankles, bulging calves, bowlegged …
Pt (Nervously laughing): No, I’m knock-kneed.
T (In an annoyed, disgusted tone): Okay, okay, you’re knock-kneed, you’ve got fat thighs, sagging buttocks, a protruding abdomen, thick waist, flat chest, broad shoulders, a lantern jaw, jug ears, bulbous nose, furry eyebrows, two little pig-eyes, and hair that looks like an abandoned rat’s nest. But I’ll say one thing for you, your teeth sure look good.
Pt (Laughing explosively): They’re false!
(T and Pt dissolve in laughter)

With relative quickness she changed her thirty year old personal myth about her attractiveness.

Excerpt 2:

T (Incredulously): You must be a sex maniac. How often do you have sex?
Pt (Muttering): Three times a week over the past 14 years.
T (Pauses, does some calculating): Well that’s almost 2200 screws over the past 14 years. How many orgasms have you had?
Pt (Grimly): Five!
T (Surprised): Five? How do you know?
Pt (Again with assurance): Because I counted them.
T (Still questioning): Sure?
Pt (Firmly): Absolutely!
T (In a laughing aside to staff): That’s a pretty thin reinforcement schedule as the operant conditioners would say. (Group of staff observers in the room burst out laughing along with the patient and therapist).

I interviewed them both, and immediately started off by summarizing the first part of the previous interview for him, and then stated that we had finally discovered the cause of his wife’s depression which precipitated her three hospitalizations.

Her husband inquired as to what this might be, and the therapist responded (grimly and with disgust), “The truth of the matter is, is that she has a lot of dirty, sexy feelings and thoughts and desires toward you which she feels unable to express.”

The husband immediately leaning forward in his chair, grinning, and looking from his wife to the therapist, said, “Oh yeah? O.K., Oh yeah?” The therapist burst out laughing, the husband was laughing, the staff observers were laughing and even the patient, blushing furiously and hanging her head in shame, was laughing in spite of herself.

The therapist then told the husband that he was calling her the case of “Mrs. Absolute Zero” because she was “beyond frigidity” with her rate of orgasm - five in fourteen years and 2200 acts of intercourse.

T (To husband): Would you get disgusted with her and vomit all over her if she helps you get her aroused to orgasm?
(The husband, who was almost drooling by this time, assured her convincingly that it was “fine, really fine with him”. The husband asked if she could go on a home visit. The therapist agreed to this with the provision that she do some “homework”.)
Husband and wife (Simultaneously): What?
T (Straightforwardly): I want you to do three things: 1. Fuck! 2. Fuck! 3. Fuck! You have four days to do it in, and I’ll see you Monday evening.

The following Monday the patient and her husband were seen along with the staff observers. Quite briefly, she had equalled the frequency of the past 14 years in 4 days and experienced 5 orgasms in 7 acts of intercourse.

Excerpt 3:

The provocative therapist attempts to provoke the client to engage in five different types of behavior:

1) to affirm his own worth both verbally and behaviorally;
2) to assert himself appropriately;
3) to defend himself realistically;
4) to learn necessary discriminations to respond appropriately;
5) to engage in risk-taking in relationships.

In the initial interview, the client is precipitously provoked into a series of experiences that tend to leave him astonished, incredulous, uncertain and even at times outraged. He experiences a marked clash of expectational systems; his expectations of the therapist’s role are not only disconfirmed but are almost reversed. He will typically tend to react with such statements as, “What kind of therapist are you? I’ve never heard anybody talk like you.” He will also characteristically tend to be astonished and surprised at the intensity of some of his own reactions when the provocative therapist quickly bypasses his defensive sets and succeeds in provoking him into immediate affective experiencing. His new found spontaneity has, as a corollary, uncertainty

Despite all the foregoing reactions, the client is almost invariably intrigued by the therapist’s approach to his problem.

(1) “Something happened here, and fast.” Clients tend to feel that some very real, gut level issues are immediately engaged by the provocative therapist, and although these are anxiety provoking, clients also experience this as deeply supportive and relief-giving.

(2) “I don’t like what you’re saying, but I’ll say this for you, I don’t have to sit around wondering what you’re thinking of me like I did with my other therapist.”

(3) “I found out I could twist other therapists around my little finger, easily embarrass them and make them blush. I can’t bully you - and that’s good. And when I come in here and try to embarrass you with all that I’ve done sexually, you don’t get embarrassed; you make me blush at your responses! And you know, that’s good - you and Hank (her boyfriend) are the only persons I’ve found that I can’t make jump through hoops.”

(4) “You always say exactly how I’m thinking and feeling toward myself”, and “You must have talked to my family - that’s exactly the way they see me.”

(5) “Of course! This is the first time I’ve ever been the central object, of a really funny floor show!”

Excerpt 4:

Q: How do you know that you were the one who caused the changes in the client?

A: I don’t. Not for sure - I’m never that certain. Another point to consider here is that we’re not dealing with metaphysical certitudes in therapy but probabilities, and the probabilities are that if he thinks he’s changed, and I think he’s changed, and if significant others (family, co-workers, etc.) think he’s changed, and if he pays my bill, then the evidence suggests that the client has changed.

Q: How do you get away with saying what you say to clients?

A: Because basically it’s the truth. I am not saying anything to them that they either haven’t already said to themselves or that isn’t first cousin to what they’ve already said to themselves, or it’s what they think other people are thinking or feeling towards them, or, finally, what other people have already said to them. So that when I am saying these things to clients in therapy it sounds like old home week to them, and is not as startlingly new or overwhelmingly confronting as it might appear to an outside observer who is watching the therapy or reading a transcript.

Q: Why the heavy emphasis on the present in provocative therapy?

A: Because the reality is that the present is all we’ve got to deal with. Clients are not trying to resolve past conflictual situations such as Oedipal complexes. They are hung up now in their feelings, for example, about authority and their feelings towards the opposite sex. And I would agree strongly with Ellis that it is the current self-talk that clients engage in that helps to maintain their problems. The provocative therapist will use the client’s past to point out how they developed their screwball attitudes and behaviors, or to simply demonstrate for how long a time a client has been self-defeating. And he will also frequently use the future to run different scenarios past the client, wild, implausible themes based on the client’s present attitudes and behaviors, to provoke the “Ugh!” reaction in the client, to sensitize him to the probable consequence of his presently held idiotic ideas and zany behaviors.

Q: You seem to be saying that if you just had enough techniques, you could damn near cure everybody.

A: In some ways I really do believe this. That may very well be true. Techniques are crucial because they operationalize and implement the therapist’s attitudes; otherwise you can end up just being concerned but inept. Furthermore, we want to describe techniques at length, because a lot of books on therapy describe extensively the therapist’s philosophical stance but say damn little about what he actually does. However, we do not wish to create the illusion that technique is everything. It’s got to flow from what you are or from an aspect of you.

Frank Farrelly 2009 (7 mins)

Nick Kemp - Demonstration of Provocative Change Works™ from AMT 2010 (7 mins) Teeth grinder