Magic in Practice (Second Edition)

Introducing Medical NLP: the art and science of language in healing and health

Garner Thomson, Dr Khalid Khan

• Publisher: Hammersmith Health Books
• Year: 2015
• ISBN:
  9781781610640
• Topic: Personal Development
• Subtopic: Mental Health & Wellbeing

This is the second edition of this highly respected introduction to Medical Neurolinguistic Programming, which remains the official handbook of the Society for Medical NLP. Based on the work of Dr Richard Bandler, Medical NLP has developed to become a discipline in its own right, guided by Garner Thomson. Revised and updated throughout, significant new sections have been added on: priming, breathing, heart rate, sleep, relationships and cancer, and lifestyle diseases. This is a key resource for all health practitioners who want to understand and improve the effects of what they communicated, consciously and unconsciously, to their patients/clients.

1

Towards Healing and Health: a solution-oriented approach

We cannot solve problems with the same level of thinking that created them.—Albert Einstein

Problem-solving is an energy-intensive approach that focuses on deficiencies in the hope of identifying and removing them. Solution-orientation explores and develops options, choices, and possibilities with a view to re-orientating the individual or group towards flexibility and growth.

Problem-solving is reactive, remedial, and piecemeal. Solution-orientation is active, generative, and holistic.

Problem-solving looks at people as a collection of ‘parts’. Solution-orientation sees the person-as-whole.

Problem-solving is external to the patient’s experience (both ‘cause’ and symptom are regarded as alien invaders, disrupting the integrity of the patient’s body–mind system). Solution-orientation is internal to the patient (the person who exhibits the problem is unique, and is as important as the problem itself).

Many of the current problems in healthcare derive from a reductionist, mechanistic view of humans and human nature that is several centuries old. Still largely committed to both a reductionist cause-and-effect model and the enduring myth of Cartesian Dualism, the separation of humans into mutually exclusive domains of body and mind, mainstream medicine has little power over the rising tide of complex, chronic, and inexplicable dysfunctions that can result in lifetimes of debility and pain.

People are living longer, mainly because of science’s massive advances in the areas of infection and acute medicine, but they are not necessarily enjoying a consistently better quality of life. The nature of the problems we now face is changing. Disease itself is changing. But we—health providers and patients—are not.

Today, a doctor may go through his entire career without ever encountering a case of smallpox, diphtheria, or epiglottitis, but he will almost certainly feel overwhelmed by the sheer weight of the conditions that now characterize the majority of the problems patients present.

In Britain, the Royal Society of General Practitioners has been reported as estimating that around 50% of the problems seen by general practitioners are social, 25% psychological, and approximately half of the remaining 25% are psychosomatic.35 In practice, physicians report that most of the remaining 12.5% of ‘organic’ disorders seen involve at least some aspects of the psychosocial dysfunctions mentioned above.

The cause-and-effect model, when routinely applied to some complex, chronic conditions, is contributing to a massive epidemic of new problems. Over-dependence on the ‘magic bullet’ approach contributes to tunnel vision; iatrogenic illness; antibiotic-resistant organisms; and reduction in treatment options for the practitioner. The complex, multi-factorial nature of illness and the inherent biological diversity of human beings are in serious danger of being ignored in the pursuit of a ‘perfect’ science.36^,37^,38 Meanwhile, misdiagnosed and under-treated anxiety disorders alone cost the United States’ economy $54 billion a year, with much of the economic burden resulting from patients seeking—and receiving—treatment for the physical symptoms of the dysfunctions.39

In England, the total cost of mental health problems has been estimated by the Sainsbury Centre for Mental Health at £77.4 billion, including £12.5 billion in care, £23.1 billion in lost output, and £41.8 billion in ‘hidden’ costs.40 Despite the best intentions of its practitioners, medical practice is morphing from the provision of ‘healthcare’ into costly, and often inadequate, attempts to manage or contain ‘dis-ease’, including distressing and incapacitating, but not necessarily medical, conditions.

WEIRD science and empty evidence

The rise of evidence-based medicine (EBM)—the standardization of treatments based on randomized controlled trials (RCTs)—as the only acceptable basis for healthcare is also giving rise to problems. Its application, to the exclusion of human qualities such as instinct, experience, and common sense, diminishes artistry and compassion, both qualities long accepted as significant adjuncts to the practitioner’s application of best available scientific knowledge.

Some researchers, including Professor John P.A. Ioannidis, of the Department of Hygiene and Epidemiology at Greece’s Ioannina School of Medicine, believe that most published research findings are false, for a variety of reasons, including the fact that the researchers may simply be measuring accurately the ‘prevailing bias’. This is another way of saying heuristical (rule of thumb) thinking predisposes people—even scientists—to verify what we already believe.41

Behavioral science has provided the basis for many drug-based treatments now accepted as gold-standard in Western medicine. The only problem is, when they are applied to an undifferentiated patient population, they often don’t work … perhaps because we’re all just too WEIRD.

University of British Columbia psychologists have coined the acronym to help explain why results from behavioral studies on people in Western nations don’t usually represent the rest of the world.

According to the study, research subjects are drawn entirely from Western, Educated, Industrialized, Rich, and Democratic (WEIRD) societies (probably around 12% or less of the world’s population). Researchers—often implicitly—assume that all human populations respond identically to these ‘standard subjects’, whereas the comparative behavioral sciences database suggests that not only is there considerable variability in experimental results across populations, but that WEIRD subjects are particularly unusual compared with the rest of the species—what the researchers call ‘frequent outliers’.42

Given that the volunteers used in these studies are often young male undergraduates in good health, the proportion of ‘representative’ subjects drops even more. However, the generalization from the few to the many—from a handful of WEIRD young men in good health to the human race as a whole—is a fundamental aspect of RC testing.

Treatments not easily validated by traditional research procedures are largely ignored—despite the fact that much of our historical success in defeating disease has arisen from trial and error, based on bold hypotheses, rather than from RCTs. Many treatments still in use, and unlikely soon to be abandoned, derive from ‘another kind’ of evidence. These include antibiotics, insulin, tracheostomy (to relieve tracheal obstructions), the draining of abscesses, vaccination, and even the use of aspirin.

Some scientists—even those from within the ranks of EBM—are beginning to suggest that certain classes of evidence, other than that provided by RCTs, warrant acceptance. Professor Paul Glasziou, Director of the Center for Evidence-Based Medicine at the University of Oxford, together with three colleagues, has developed a simple and elegant algebraic formula for measuring what they call the ‘signal (treatment effect) to noise (natural outcome) ratio’. A high signal-to-noise ratio, they say, reflects a strong treatment effect, even in the presence of confounding factors, such as the natural progression of a disease.43

We continue to argue that an outcome that satisfies an individual patient’s needs (and does no harm) should be the prime objective of every consultation. ‘Flow’ (a relatively unselfconscious day-to-day existence) and ‘functionality’ (the patient’s own measure of her ability to operate effectively in her own world) are key objectives Medical NLP espouses.

Many studies now emerging help give direction and substance to the Medical NLP proposition that whole-person health is both possible and applicable—with some adjustment to current opinion. Some of these suggest that:

• ‘health’ does not necessarily follow from the removal of the symptom;
• many ‘dysfunctions’ are, in fact, adaptive responses that have helped humans survive and flourish as a species;
• a purely medical response to some of these may actually damage the individual’s overall ability to resist and progress towards healing and health;
• bodies, brains, and especially immune systems, need to be challenged in order to function effectively. Removing challenge may impair the ability to respond and survive;
• while one gene may predispose the carrier to a particular disease, many of the factors that influence gene expression—whether some conditions develop or not—lie within ...

Table of contents

• Cover
• Title Page
• Contents
• Acknowledgments
• Comments on the Second Edition
• Foreword to the Second Edition
• Foreword to the First Edition
• Overview
• 1: Towards Healing and Health: a solution-oriented approach
• 2: Stress and Allostatic Load: the hidden factor in all disease
• 3: Avoiding Compassion Fatigue: the dark side of empathy
• 4: Words that Harm, Words that Heal: neurolinguistics in the consultation process
• 5: Primes and Priming: the secret world of indirect influence
• 6: Structure, Process and Change: the building blocks of experience
• 7: Taming the Runaway Brain: three thinking tools
• Phase 1: Engagement
• Phase 2: Alignment
• Phase 3: Reorientation
• Glossary
• Appendices
• A: In the Eye of the Storm: activating the Relaxation Response
• B: The On-line Brain: cross-lateral exercises
• C: Medical NLP Algorithm: managing pain
• D: Strategies: the sequencing of experience
• Index
• Copyright