Mark Evans describes how working imaginatively with rewards and punishments has helped his clients achieve very swift change.

Beer, curry and sex. Not your idea of a good night in? Well, it was for David, a warehouse manager  whose anger was getting dangerously out of control, and it proved to be the turning point for him. It was the reward element of the reward and punishment strategy I have devised, which I have found highly effective in my work with a range of clients.

When David came to see me, there was little of his house that remained undamaged by his fists or feet, and his partner, to whom he was supposed to be getting married, was threatening to leave him. For some time, he had been denying that he had a problem. It was only at the continual urging of his fiancée that he finally agreed to seek help and, by the time he arrived to see me, was very upset about his lack of control.

I asked when it was that he lost his temper. He replied at once, "All the time." "So, you lose your temper at work, with your boss?" "Ah, no, not with my boss." "With your colleagues?" "Er, no." Nor, he realised, did he lose his temper with family or friends, although he could get a bit edgy with them. When he thought about it more closely, he recognised that his out-of-control anger occurred only at home and only with his partner, over the minutiae of household life. This made him realise that he was already exerting a degree of control over his anger, in that he chose where he would unleash it — at home, where he felt safest and most accepted. But his partner was not accepting anymore.

I asked David what he thought would happen if he carried on in the way he was going. He admitted that he feared it was only a matter of time before he became physically violent towards his partner. He would lose the person he loved and would have nothing. "If your anger wasn't there, would anything be missing from your life?" I asked him, and then I led him through how well his needs were being met. Nothing crucial was missing. He enjoyed his job, loved his partner and was looking forward to their life together and the plans they had made for the future. He was desperate to change his behaviour.

I taught David anger-management techniques and, in guided visualisation, had him rehearse controlling his anger when flashpoints occurred at home. Then, for some reason, the idea of reward and punishment popped into my mind. I asked him to come up with a reward for himself, if he succeeded in controlling his anger till our next session in a fortnight, and a punishment, if he didn't. Initially we struggled to come up with either, so I asked him what he really looked forward to each week. He told me that he loved nothing more than watching TV on a Saturday night with his fiancée, while they shared a few beers and a curry. I suggested to him that his punishment could be to sacrifice this weekly pleasure, and his reward to keep it. He readily agreed. As a further incentive, I proposed that his partner also be deprived of the much enjoyed Saturday ritual, if he became angry. (I knew she would be willing to go along with that, as she had been the one initially to contact me, desperate for help.) David was more reluctant to accept this but I managed to get him to agree, as I knew that he loved his partner and that he didn't want to deprive her of one of the now few pleasurable times they spent together, thus creating a particularly powerful incentive to deal appropriately with his anger. As yet another incentive, now that he was in the swing of it, David agreed that an angry outburst would also lead to a ban on sex for two weeks, as sex was something else that was good about the relationship. 

By the end of the session David had a big smile on his face. He said, "This punishment idea really finds out who you are, doesn't it?" I asked David what he stood to lose. He was silent for a while and then said, "Quite a lot". For he realised that the effectiveness of the strategy lay not just in the unpleasantness of the chosen punishment, but in what the actual carrying out of the punishment represented. For him, with a house smashed to pieces and a partner about to walk out in fear of her life, the punishment he chose symbolised a devastating real-life consequence. 

Two weeks later he reported back positively. He admitted that he had become angry once, but did not get aroused to the usual level. He went for a long walk to calm himself and, while out, decided that, given this dramatic improvement, he had earned his reward. I saw him a month later, and still there had been no need for the punishments to kick in. Life was so much happier and more harmonious at home that he felt less and less desire to get angry. Through our sessions he had come to realise that his inappropriate anger stemmed from childhood, when, at around the same time, his parents divorced and he himself was diagnosed with diabetes. An unvoiced reaction of "It's not fair!" and "Why me?" had manifested itself in anger towards those closest to him, even over minor things such as whose turn it was to do the washing up or whether he had done it properly. Gradually, it became habitual. However, he found — through the rewards and punishments — that he could let it go.  

Since then, I have worked quite a lot with what I describe to my clients as a reward and punishment strategy, whereby positive thinking and behaviour are rewarded and negative thinking and behaviour are punished. I tell them that this is in line with the way that the brain works — the reward makes it more likely that the positive behaviour will be repeated, further reinforcing and strengthening the associated connections in the brain, while the prospect of punishment lessens the negative behaviour, making it less ‘advantageous' to repeat and thus weakening the connections in the brain. I find that explaining the physiology — I often talk about which bits of the brain light up when reward circuits are stimulated and so on — further helps clients ‘buy into' the idea and commit to carrying it through. 

Powerful concepts

Perhaps its success has to do with the fact that the concepts of reward and punishment are powerful ones. In my experience, the strategy helps people to focus less directly on their difficulties and more on what they stand to lose or gain by dealing positively or not dealing positively with them — another way of creating the all important reframe. Asking clients to come up with a reward and punishment usually results in their pattern matching to something they know they love or hate doing, which gives them the motivation. As Joe Griffin terms it, they now have the ‘carrot and the stick'.1 As to its long-term effectiveness, I make no bold claims but, in conjunction with all the other ‘tools' that form part of the human givens repertoire, I have found this a useful strategy to employ.

It is interesting to observe the trouble clients often experience in thinking up a reward for themselves, a difficulty that seems to affect them less when deciding on a punishment. This makes sense to me, if it is true that negative emotional states can literally prevent us from accessing positive memories. Time and again, I have to leave clients to think of a reward, after they leave the session. 

While I often use the reward/punishment strategy with private clients, I do so with less frequency than with the student clients I see, through my work as a counsellor in higher education. I suspect that this may have something to do with the client group, as almost without exception the students are enthusiastic and willing participants in developing their own particular version of the strategy. They have brought forth some ingenious rewards and punishments, conjured from their own imaginations. It is then their reward and their punishment and, on the whole, they tend to go through with it.

The household chore

Victoria was a second-year business studies student who had fallen far behind with her studies, due to depression. When I put the strategy to her, she had suggested some sort of household chore as her punishment for not getting down to work: the house she shared with fellow students was a serious health hazard. I often discuss with students some of my own university experiences as a good way to develop rapport, and it was a story of my own about the rather unhygienic bathroom facilities of my second-year accommodation that led her to choose her punishment. She immediately volunteered that she found toilet cleaning particularly unpleasant. They had a cleaning rota but never stuck to it, with the result that the toilets (they had two) were "disgusting". To her credit she gamely agreed that, if she did not make a serious effort to get back on track with her studies, she would clean the toilets for her fellow housemates — for a month! 

Sometimes, I do a little acting, playing the part of the client's brain as if it were talking to them. With Victoria, it went something like this: "So you make me stay in bed all day, throw away my degree, stop me seeing my friends and then, as if all that weren't bad enough, you go and kick me when I'm down by forcing me to clean toilets for a month. You'll forgive me if I appear ungrateful." We then worked out a study timetable that mapped out exactly what work needed to be done and by when, and I led her through guided imagery, in which she saw herself in the library completing the agreed tasks. We arranged to meet in two weeks. 

At our next session a smiling Victoria announced that she hadn't cleaned a single toilet! More importantly, she was getting out of bed at a respectable hour of the morning and heading off to do her study work.

Another household example was one of my own devising, to help a student presenting with long-term clinical depression. When I saw Jessica for the first time she was so very low that the whole room was permeated with her depression. She had been suffering this way on and off for five years and her boyfriend had just left her, unable to cope any longer with her depression and consequent self-harming. She told me that all she wanted was to be able to get up in the morning with her friends and make it to university. She had four other housemates, all of whom were keen to help, as her depression was causing them all distress. Working on the hypothesis that most students might consider it a welcome treat if a nice cup of tea was brought to them in bed each morning, I proposed as her punishment that she get up especially early and make all of her housemates tea in bed if, on the previous day, she had failed to get up to go to university. Her housemates were told that this was part of her attempt to lift her depression. I left Jessica to come up with her own reward.

To help her start to make small changes to her routine, we agreed that she would set her alarm clock and put it on the other side of the room, next to a piece of paper on which were listed all the reasons for staying up and getting on with the day, instead of going back to bed.

In our second session a week later, Jessica bounced in with a huge smile and announced that the whole mood of the house had changed, including her own. She had not got out of bed as intended on the first morning but so obliged had she felt to honour her commitment to her friends that it had been relatively easy for her to get up early the next day and make and dispense the tea. This caused much laughter with her friends. Once up, of course, it was much easier to decide to head off with them to university. She soon got into the routine of making everyone tea, even though she didn't need to, and the result was that she felt connected to her friends again, simply through this small gesture. What had started off as a punishment soon became transformed into something much more like a reward. (Interestingly, she hadn't managed to come up with one.)

In her third and final session, Jessica decided to write to her ex-boyfriend, just to let him know that she had turned things around for herself. She wasn't expecting that he would return to her; she just wanted him to have a different picture of her in his head, from the miserable, insecure young woman who couldn't understand why anyone would want to know her. (We had done a lot of work on challenging negative beliefs.) Writing down all the positives about herself for him to read made her feel good too, of course.

 Hopping happy

Georgina gave me the idea for using hopping therapeutically. She came to see me at the university for help with obsessive behaviour, which manifested itself in the compulsive checking of her work (anything up to 100 times) and overwhelming anxiety when it came to actually handing it in to her tutors. She had reached the stage where so anxious did she become that she was unable to hand in any work at all. I explained the reward and punishment strategy to her in our first session, and she said that she would give it a try. We agreed that she could check her work a maximum of three times to earn her reward, but, if she checked a fourth time, she would need to suffer her chosen sanction. If she checked her work no more than the maximum times allowed but then failed to hand it in, the sanction would still apply. She couldn't think of a punishment or reward on the spot, but undertook to do so after the session. (In my experience, clients do keep their word, once they have agreed to the strategy. That is, they always think of a punishment. Sometimes, as mentioned, they don't come up with a reward, and it doesn't seem to matter.)

I saw Georgina a week later and was informed that her obsessive behaviour had disappeared. She had chosen for her punishment hopping up and down on one leg 100 times and for her reward a cup of green tea. (This was a real treat because green tea is more expensive than normal tea

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©Human Givens Journal and Mark Evans (2007)

This article first appeared in Volume 14, Issue 2 (2007) of the Human Givens journal. (Formally The Therapist)

Mark Evans is a counsellor at De Montfort University, Leicester. He holds the Human Givens Diploma.

> More information on the human givens approach can be found in the following books both by Joe Griffin and Ivan Tyrrell

Dreaming Reality: How dreaming keeps us sane or can drive us mad

Human Givens: A new approach to emotional health and clear thinking

Return to top

> More information on the human givens approach can be found in the following books both by Joe Griffin and Ivan Tyrrell

Dreaming Reality: How dreaming keeps us sane or can drive us mad

Human Givens: A new approach to emotional health and clear thinking

Return to top