Negative practice

Domain II · Behavioural & cognitive · Knight Dunlap · 1928

What it is

Negative practice is a single behavioural technique, not a complete therapy: the client deliberately and repeatedly performs an unwanted habitual response (a tic, a habitual error, a habit such as teeth grinding) in order to eliminate it. Dunlap defined it as the elimination of habitual responses…

Format

• Session count and length. No standard exists. The SAGE entry states that the therapist must set the number or duration of repetitions and rest intervals, that general rules may not help, and that parameters should be tailored to each individual; in principle more repetitions with less rest produce…

Who practises it, and how they are trained or regulated

• Status today (context only). For tics, massed negative practice has been superseded by habit reversal training (HRT) and the Comprehensive Behavioral Intervention for Tics (CBIT); guideline reviews list it among techniques with little supporting evidence. Dunlap also applied it to sexual behaviours (masturbation, homosexuality) that are not legitimate treatment targets today; those uses are excluded from this guide.

Evidence status, as the guide reports it

• Indications described in sources: motor tics, including tics in Tourette syndrome (single cases; inconsistent evidence); nocturnal teeth grinding; habitual performance errors in typing, shorthand, spelling, piano or organ playing; maze-learning errors; pica; nail biting; thumb-sucking; stammering.…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the client treating practice as rehearsal or performance; scepticism or feeling mocked (see section 5); shame about displaying the habit.
• exaggeration that risks strain (neck, jaw, eyes, voice); a copied tic that differs from the involuntary one; urges or anxiety rising sharply.
• spontaneous recovery after rest (if counts rebound, the parameters or the method need changing); clients cutting rest short to "get more done".
• bursts becoming frequent enough to add up to many more repetitions than intended; social embarrassment; it turning into a compulsion-like ritual.
• skipped practice, practice done half-heartedly or in public settings where it causes embarrassment; children needing a parent to prompt but not to police.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.