Avoiding the "sameness frame":
Some valuable distinctions to consider regarding NLP training within the health context.
By Henrie Lidiard
 
If we propose to gain wider interest in NLP approaches within the healthcare arena, research is not the only thing we need to consider. It is also important to spell out how NLP differs significantly from other disciplines and approaches that it might otherwise be confused with.  From our experiences in the medical field, here are some potential ‘confusions’ and some contrast frames that it might prove helpful to make.
 
How NLP differs from other ‘Communications skills programmes’:
One of the generic terms used in the description of NLP applications is ‘communication skills training’. There are many communication skills trainings available and many focus on very different aspects of the process of communicating. E.g. assertiveness, interviewing, counselling, listening etc. These may teach components of NLP however more commonly they are based on formulaic, interpretive models of communication. NLP differs here in several main ways. 
 
  1. Firstly NLP encourages a reflexive, outcome-focussed and flexible approach to communicating. (this can be summarised: know your outcome , use your senses to determine whether your behaviour is getting that outcome, if not change your behaviour). This is radically different from many other communication approaches.
  2. NLP moves away from an interpretive approach to ‘body language’ (i.e. a ‘this means that’ model) and towards the focussed use of your senses to open a continuous and responsive feedback-loop between yourself and the person/people you are communicating with. This helps to prevent the common (and often inaccurate) assumptions and judgements that can impair communication.
  3. NLP gives specific tools and techniques for building rapport and creating trust and understanding (these include matching and mirroring).
  4. NLP focuses specifically on the impact of your language and enables communicators to be very much more specific and purposeful in the use of particular language patterns in particular contexts. (For example, the use of "meta-model" questions to elicit specific information about experiences in a way that enhances understanding and loosens limiting beliefs. Or the use of the softer more generalised language patterns of the "Milton model"  that can help someone make more helpful choices, feel more in control and have access to more of their resources).
  5. NLP gives us a model for understanding the processes that are occurring as we communicate with each other. When the many factors are understood, they provide even more systematic options for behaving more flexibly when communications don’t go the way we expect.
 
NLP also differs from traditional counselling approaches in a number of very important ways:

  1. Some counselling approaches teach the importance of creating empathetic connections to the client, but without teaching practitioners how they can manage their own emotional state. NLP enables these connections to be made very quickly to establish trust and understanding. However it also enables the NLP practitioner to look after their own emotional state both at the time and afterwards with quick and simple strategies.
  2. Some counselling approaches can involve the lengthy description of problem states (and the history of achieving them) without necessarily moving towards the client’s solutions. Research has shown that client centred and psychodynamic approaches to counselling which focus on the problem in this way can actually be harmful to patients experiencing depression. (Griffin and Tyrell 2000) and critical incident debriefing as an approach to trauma may also worsen symptoms of post traumatic stress (Spiegel et al. 1988, Wessley et al. 1999). NLP approaches quickly and gently help a client to orientate themselves towards solutions. It also provides strategies for feeling better quickly, releasing negative emotions, overcoming trauma, overcoming phobic responses and generally having more choice over emotional states (e.g. Rushworth 1994)
  3. One of the most marked differences to counselling is the time it takes to make positive changes. Many counselling interventions assume and predict weeks and months (or longer still) to produce gradual changes, NLP can provide people with very much more rapid positive and lasting changes. In the increasingly time pressured environment of the health consultation, rapid strategies for assisting a patient to feel more resourceful may prove useful.
How NLP differs from traditional models of education:

NLP also provides different approaches to learning than are traditionally found in education. Much traditional learning in schools and universities has relied upon a didactic ‘teacher-tell’ approach. 
 
1. NLP encourages a more varied approach to learning. Didactic presentations of theories, concepts, principles and procedures (the assimilating learning style) are an important part of an NLP training. However it also encompasses 3 other major learning styles (Kolb 1984, Mc Carthy 1981). These are the divergent learning style (why are we doing this? What are the potential benefits?), the convergent learning style (how do we do this?) and the accommodating learning style (where else? What other applications can this be put to?). 
The use of all aspects of learning in this way is critically important for the training of NLP and also for research into the perception of its effects and potential uses. There are several reasons for this, however probably the most critical one is the apparent simplicity of NLP processes. It is common that when NLP is only explained or talked about it seems ‘too good to be true’. It is critical that we enable learners to experience the effects of some of these processes first hand, i.e. to enable them to do their own ‘research experiments’. This builds a body of ‘reference structures’ ( Woodsmall 1988) in the learners experience from which they are able to generalise ways of using them. 
 
Research has shown that many people who go on to higher education have a preference for the assimilating learning style. It is important to note that one of the main ways that assimilators like to learn, is to rely on the words of an authority and also to have access to an authoritative body of research findings. Hence if a training only describes NLP and the research findings don’t exist yet, assimilators who haven’t completed the practical assignments and built up the necessary reference structures can find the idea of NLP unconvincing. The research element of the Living with Cancer Project  is critical therefore in starting to provide the necessary evidence to influence this ‘chicken and egg’ cycle.
 
NLP can also be incorporated into learning by paying attention to:
 
  • Group cohesiveness and rapport,
  • The state of the group and the individuals in it,
  • Teaching both logically and metaphorically at the same time and at every opportunity to be demonstrating the practice of these principles. 
  • Loosening limiting beliefs (e.g. about communicating or about being able to assist clients quickly and easily),
  • Developing attitudes and mental approaches that have been shown to be helpful in effective communications
  • Developing high levels of skill and proficiency in using the techniques and principles and
  • Developing the confidence to use them appropriately.
References:
 
Griffin J. and Tyrrell, I. (2000) Breaking the Cycle of Depression: a revolution in psychotherapy. European Therapy Studies Institute Monograph No. 3 p.16)
 
Kolb, D.A. (1984) Experiential Learning: experience as the source of learning and development, Prentice-Hall 
 
McCarthy, B. (1981) The 4-Mat System: Teaching to learning-styles with Right/Left mode techniques   published by Excel Inc.
Rushworth, C. (1994), Making a difference in Cancer Care: practical techniques in palliative and curative treatment   Souvenir Press.
 
Spiegel, D., Hunt, T. and Dondershine, H.E., (1988) Debunking Debriefing The New Therapist vol 7, 1, 8. Disociation and hypnotisability in post-traumatic stress disorder. American Journal of Psychiatry 145, 301-305., 
 
Wessely, S.Rose, S., Bisson, J.A. (1999) A systematic review of brief psychological interventions (‘debriefing’) for the treatment of immediate trauma related symptoms and the prevention of post traumatic stress disorder. In Cochrane Collaboration. Cochrane Library, Issue 4. Oxford.
 
Woodsmall: (1988) Strategies Self Published booklet Washington USA

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