Independent evaluation of NLP training for mental health service users

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A case for using NLP in the NHS

 The Need for NLP in the NHS
By Henrie Lidiard  
(First published in NLP News: March 2005)

My own experience 
When my mother was in hospital and during her subsequent stay in a hospice, it seemed clear to me, both from her experience of care and from my direct experience of medical staff, that there were some areas that could really be helped by some awareness of NLP techniques.   When I asked staff directly at both the hospital and the hospice about areas they felt they would like some help in, three themes came up consistently.  They were:
1. dealing with high stress levels
2. ways of dealing with anxiety in patients and
3. ways to deal effectively with depression in patients. 
The only options that the nurses I spoke to said they had, were medication (and many patients in cancer wards are already taking a lot of drugs) or a sympathetic listening ear. They found that the latter didn’t always help patients and they didn’t always feel they had the energy to give it because of the toll on their own emotions. 

More and more change
The NHS in Britain is undergoing huge changes, not solely because of re-organisation of the way the Health Service is managed but also because of changes in the society we are part of.  
For instance: patients are in some ways better informed than they used to be (as a result of using the internet to research their condition). They may also, for similar reasons, have higher expectations than in the past. Patients also don’t seem to have such respect and deference for Health practitioners as they once did (RCGP 2002). In addition users of the health service seem to be becoming more litigious when things go wrong and cases are given a high profile in the media.
There are worrying life-style trends particularly amongst young people in Britain (for example binge drinking, poor diet, lack of exercise and smoking) which mean that problems such as obesity (and the attendant effects on heart disease, cancer and diabetes) are likely to put more strain on resources. Increasingly, as part of preventative medicine, doctors and nurses may be seeking to influence peoples’ decisions about the way they take care of themselves.
Stress and depression seem to have risen in the general population and prescribing for depression has risen to record levels. These factors combined with the aging population trend in Britain and difficulties in recruiting and retaining highly qualified staff suggest that there is likely to be more change ahead as we find ways to cope.

Stress in the health-care professions and its effects on staff and patients:
Stress seems to be an important issue for Health professionals. It isn’t only rising in the general population but it seems that it is increasing within the profession also. Some statistics suggest that 50% of GPs and a similar proportion of NHS managers and consultants are suffering borderline or more severe anxiety and a quarter of GPs have borderline or more severe depression (RCGP 2002). (I don’t have statistics for the mental health services but anecdotally the situation sounds similar). In addition, as a coping strategy 23% of GP’s drink to relieve stress and 7% are addicted to alcohol or other chemicals. (RCGP report 22). A BMA report 1998 found that ‘many senior doctors suffer high levels of stress and this impairs their health and also compromises their ability to provide high quality care to patients’.
Burn-out of medical staff is a recognised problem and can cause the following effects:

In one study of 16 Bone marrow transplant units half of all Doctors and nurses were sowing marked symptoms of burn-out (Molassiotis 1995).

There are potentially high costs associated with these levels of stress. These may include not only the suffering of the individuals involved but the costs of sickness absence, premature retirement, health-care and rehabilitation, even premature death. In addition as stress impairs performance a lowered standard of patient care can mean complaints, bad publicity, litigation and compensation (BMA 1998). It seems that there is a pressing need for medical staff to have access to effective strategies for managing their own emotional states and looking after their well-being. It is possible that if they had access to these, they might also be able to pass these on to their patients.
Some areas of the health service seem to work together more effectively than others. This is critical as research also points to an unequivocal connection between the impact of dysfunctional teams and patient mortality (Aiken et al 1994, West 2002). It is still all too common for breakdowns in communication to occur between different parts of the system e.g. between consultants and referring doctors (Tattersall and Ellis 1998 and Bain and Campbell 2000)
The needs of professionals in the cancer field:
This is captured in an excellent review by Sargent et al (2004). In summary, it seems critical that health professionals in the field of cancer care have access to ways of managing their own emotional wellbeing. The research also highlighted a need for  communication, inter-personal and
Psycho-social support skills in providing quality, patient-focused care. It also found, that despite official policy, health professionals were not yet receiving adequate communication and interpersonal skills training.

The needs of cancer patients/carers:
Patients value many things in their care, in addition to technical competence one study (Farrell 2001) found that they value:
These qualities and behaviours would all be harder to deliver if the medical staff were stressed, anxious, depressed or burnt-out. In fact descriptions of being treated like a symptom or a disease (a thing?) were all too common in the Patients’ and Carers focus group held in Ellesmere Port as part of the Living with Cancer research project (Sargent et al 2004).
It is interesting that where patients expressed views on how their care could be improved they do seem to mirror the symptoms of professional burnout.

The "Interior" beckons:
In short there are several areas where there seems to be an increasing need for skills in the health service, they include:
All of these needs reflect the "interior subjective" or the "interior collective" aspects of the system (Wilber 1988, 2001). This intangible aspect of our interior experience is the very one science has for a long time pretended doesn’t really exist because it is hard to measure. It is also the aspect of health-care that medical practitioners currently feel ill-equipped to deal with (Department of Health 2000).

NLP can help:
NLP can be of profound and practical help in this area as it provides not only a logical and consistent understanding of the structure of subjective experience but also a systematic and effective way of working with it to make positive changes. 

Aiken L.H. Smith, H.L., Lake E.T., 1994 Lower medicare mortality among a set of hospitals known for good nursing care. Medical Care 1994. Vol. 32: (8) p 771 – 787.
Bain N.S. .Campbell N. 2000. Treating patients with colo-rectal cancer in rural and urban areas: a qualitative study of the patients perspective.   Family Practice Vol. 17: (6) p475 – 479.
British Medical Association report 1998 by BMA Health Policy and Economic Research Unit. Work related stress among senior doctors: Review.
Department of Health 2000. The NHS Cancer Plan. A plan for investment. A plan for reform. Department of Health London.
Farrell C. 2001. There is no system to the whole procedure: Listening to patients views and experiences of NHS cancer services in NHS Cancer services. Supporting paper: 1 NHS cancer-care in England and Wales. London: Commission of Health Improvement.
Molassiotis A. ,Vander-Akker O.B., Boughton B.J. 1995. Psychological stress in nursing and medical staff on bone marrow transplant units. Erratum in Bone Marrow Transplant Vol. 15: (3) 328 .
Royal College of General Practice. 2002 Information sheet No. 22. Stress and General Practice. 
Sargent, P., Thurston M. ans Kirby, K. 2004   An evaluation of the Living With Cancer Project. Using NLP techniques to maximise the coping strategies of carers and patients living with cancer in Ellesmere Port. ISBN: 1-902275-34-9.
Tattershall M. and Ellis P. 1998 Communication is a vital part of are. Britishe Medical Journal Vol. 316: p1890 – 1893.
West M. 2002 A matter of life and death. Article in People Management magazine February 2002 p 30 – 36.
Wilber K. 1988 The marriage of sense and soul. Integrating science and religion. New leaf. Dublin.
Wilber K. 2001 Eye to Eye: the quest for a new paradigm. Shambala Publications Inc. Massachusetts.

Making changes with NLP using the "Trauma Cure"


My experiences of the VK double dissociation Trauma Cure (from the inside!)
Claire Lewin
Clinical Nurse specialist in Mental Health, B. Nurse Hons.
Department of Psychiatric medicine John Radcliffe 2. Oxford.

Four years ago I gave birth to twins, Joe and Ruth. They were born at 32 weeks gestation and although both good weights my daughter developed severe respiratory distress syndrome. She did recover, as did her brother, and after a difficult first year both thrived. However the experience took its toll on me and by the time they were 2 years old I had begun to despair of ever getting over it.
When Ruth was in the special care baby unit she was very poorly and I was told that she might die. I have a very visual memory and was left with very intrusive imagery of Ruth covered in tubes, gasping for breath, crying and oedematous in her incubator. I carried this image with me constantly and was desperate to stop seeing her in this way. Over a period of 2 years I tried psychotherapy (Jungian), acupuncture, talking to numerous counsellors and friends. I even visited the SCBU in order to confront the anxiety but these still didn’t shift the image and the feeling that went with it.
I was extremely sceptical about NLP but I did trust Henrie and was willing to give the trauma-cure a try. Immediately and to my absolute surprise I felt better. I just don’t recall that feeling in the same way, instead I can describe all the events that took place around her birth objectively and when I look at my Ruth now, all I see is my happy, healthy 4 year old.
From this experience, I am extremely interested in finding out more about NLP and how I can use these tools in my own work. I also hope to be able to collaborate on future research in the area of NLP and mental health.

Using BrainGym® within an NLP Training for long-term mental-health service users:

Changing state:
Using BrainGym ® and NLP with mental-health service users:

By Dr Henrie Lidiard 
Go Beyond Coaching, Training and Consulting
Many NLP News readers will have had some experience of Brain Gym® and still more will have heard of it. However a relatively small number of NLP practitioners have a real appreciation of this branch of kinesiology and what it can achieve. This article sets out to give a very brief overview of the subject and to give a flavour of how very effective we have found it to be as part of our NLP training in the mental health context.
What is Brain Gym®?
Brain Gym is a simple and highly effective set of (circa 25) physical exercises (Dennison and Dennison 1997) that can enable us to change state rapidly and to make profound and lasting changes in our internal representations, behaviours and the quality of our experience. 
Where did Brain Gym® come from?
Brain Gym® is a part of a discipline called Educational Kinesiology which is itself an offshoot from the vast discipline of Applied Kinesiology. To have a sense of the breadth of Brain Gym® and the many strands of research and expertise that have informed it here is a brief history of it’s development (summarised from Charles Krebs excellent account in his book ‘A revolutionary way of thinking’ Krebs 1998):
Applied kinesiology was founded upon the work of Dr George Goodheart and a body of other chiropractic physicians. Goodheart was a synthesising thinker who brought together several disciplines, namely:
1. The in depth analysis of the exact motion of muscles and the way they move joints (or ‘academic kinesiology’, Kendall and Kendall 1949).
2. He developed the technique of working with the origin and insertion points (i.e. both ends of the muscles) to improve muscle function and correct movement of joints. (Goodheart 1986).
3. Through his practice, and observations of his clients he made the connection between the functioning of certain muscle groups and the function of particular organs of the body (Krebs 1998).
4. He drew on the work of Chapman and his work on the lymphatic system (Krebs 1998)
5. He used the work of Bennet who had discovered certain reflex points which affected blood flow in the body (Bennett 1977)
6. He later added Chinese knowledge about energy meridians in the body and acupressure points (Goodheart 1966, Mann 1962).
These weren’t just ideas to Goodheart, his work was based on systematic observation and testing. His synthesis of all these findings later became the core of Applied kinesiology.
Touch For Health
A member of Goodheart’s ‘dirty dozen’ chiropractic research team was John Thie. He had a particular interest in the Chinese energy system and developed Goodheart’s work to be accessible to anybody, not just highly trained chiropractors. He did this by formulating the discipline of ‘Touch for Health’ (Thie 1979).
Educational Kinesiology (EK)
Dr Paul Dennison brought together the discipline of educational kinesiology following his Ph.D. in experimental psychology from USC. He became interested in Touch For Health and in addition had a strong interest in education as he was dyslexic and had for many years been helping children and adults at the Valley Remedial Group Learning Centre in California. He combined a series of cross-lateral body movements (such as ‘cross-crawl’), emotional stress release tools (which made use of two of the Bennets neuro-vascular reflex points) several simple acupressure techniques, some standard remedial education techniques and several yoga asanas (namely adaptations of the cobra, neck rolls, the forward stretch and the warrior pose). One of the brilliant things about brain gym® is this elegant simplification. A collection of movements/activities which are easy to learn and explain and which enable general use in a way that makes a big difference to a great many people.
When we talk about Brain Gym® we are really referring to just this series of simple energising activities (Dennison and Dennison 1994). These activities may also be used within a simple and effective 5-step ‘balance’ process that comprises Educational Kinesiology (Dennison and Dennison 1997).
Educational kinesiology is an outcome-oriented change process which uses before and after calibration and contrast frames (in this respect similar to NLP). Dr Paul Dennison’s work is continually developing and encompassing new applications, refinements and understandings as neuroscience progresses. His thinking and practice of this movement-based change-process have been influenced by a great many people, including: Alexander, Feldenkrais and Milton Traeger.   It is also important to note that the whole field of Educational Kinesiology is much broader and richer than the Brain Gym® exercises alone.
Why does Brain Gym® work?
In NLP we are generally familiar with the idea of the mind body system and the fact that the one affects and influences the other. And also in NLP we are familiar with the Mercedes model. It may be useful for NLP practitioners to have a somewhat expanded model of the body (though whilst expanded, I must stress that it is still a grossly simplified though somewhat functional model !!) . It might be useful also to have some sense of how these aspects of our physiology can affect and be affected by our mind and emotions.
When our brains are functioning well for many tasks, even simple ones we are using multiple areas of our brain, which are constantly interrelating through complex integrative pathways (Krebs 1998). When we find learning or carrying out particular tasks joyful and easy we have few functional blocks in our mental processing. However it is also an almost universal phenomenon that we find some things easier to learn and do than others. Many of us are also familiar with the experience of having ‘on days’ and ‘off days’ in terms of doing things that are familiar to us or in terms of learning. In NLP we are aware that our state is critical to good performance and effective learning. 
Blocks to learning and processing/functioning/performing can be usefully thought of in two forms:
1. Organic or physical blocks (caused by in-utero problems, or physical trauma from birth resulting in minute areas of brain damage, or physical trauma or areas of hypoxia in brain tissue later in life). These kinds of blocks are relatively rare. Far more common are the 2ndkind.
2. Functional blocks: these occur when areas of the brain cease to communicate with each other in their usual effective manner. However there is no physical cause in the brain tissue, it is simply a case that the electrical/chemical signals are not transmitted effectively. It seems that functional blocks caused by physical or emotional stress are a great component of poor performance and difficulties in learning (Krebs 1998).
Among other things, these functional blocks may be generated by:
Very simply put, when these blocks occur, communications in the brain can become impeded in one or more of 3 “directions”. There are specific kinesiology interventions that seem to help with particular blocks, however it is useful to note that pretty much any movement at all is helpful to a degree. Also each brain gym exercise can actually affect a number of the body’s systems simultaneously. 
“Left-Right Hemisphere blocks” (logic/gestalt functions)
This is sometimes called the “laterality dimension” (Dennison and Dennison 1997) and relates to our ability to communicate effectively, to access and use language, spatial skills that involve crossing the midline and our ability to access both whole picture and detail. There is a great deal written about the preferences between left and right hemisphere processing, (Hanaford 1997) e.g. left hemisphere involves logical, linear processing, facts, details and abstraction. The right hemisphere involves simultaneous processing, global chunking, spatial/visual skills, colour, form and pattern, tonality and metaphor. However many of these simple generalisations re: left/right are contradicted and expanded by research cited by Jensen (1996) and by Krebs (1998). Whilst recognising that there may be more subtle and complex interactions between left and right occurring during particular tasks, it is still useful for us to be moving towards accessing our ‘whole brain’ for learning/processing.
Brain Gym® involves a series of exercises that cross the body’s midline and may facilitate more effective communication between the right and left hemispheres of the brain via the corpus callosum.
“Blocks between the thinking and feeling brain” (i.e. upper-brain/ neo-cortex and mid-brain/limbic system)
This is sometimes called the “centering dimension” (Dennison and Dennison 1997) and may also be connected with our ability to organise ourselves, things and information. When a functional block occurs between these two aspects of the brain it can result in someone having a sense that they are ‘stuck in their head’ and cut off from their body and emotions, or alternatively stuck in their emotionality and unable to organise their thoughts. It is possible also to experience confusion between upper and lower body movements. For anyone experiencing this kind of block, There are a series of useful exercises (Dennison and Dennison 1994) that can calm and balance the emotions. 
“Blocks between the fore brain and the hind brain or brain stem”
This is sometimes called the focus or comprehension dimension and affects forward –backward motion of the body and our ability to move forward and take action (Dennison and Dennison 1997). In addition, and interestingly for NLP, this functional block may have a significant effect on our perception of time. In particular this block may cause people to feel that they have lost contact with the present moment, either by being too focussed on forward planning or by being stuck in the past and unable to move on (Krebs 1998). For anyone experiencing these symptoms, gentle lengthening activities (Dennison and Dennison 1994) which act on the muscles and tendons up the back of the body may alleviate the “block”.
In addition to these 3 “directions” of “functional blocks” there are 2 other phenomena that can occur with stress to affect our physical and energetic body.    When we understand these ways in which our physiology is responding to our mental/emotional state, we can have even more choice in ways we can intervene and change the way our system is functioning.
Polarity switching:
The Chinese acupuncture system maps out energy meridians on the body with specific acupressure points. These energy meridians have particular directions of flow and also relate to particular organs in the body. This system recognises 12 major energy meridians in the body plus the 2 major energy reservoirs: the “central vessel “(flowing up the centre of the body from the pubic bone to below the bottom lip) and the “governing vessel” (flowing up the back of the body from the tail bone and up and over the back of the head and down the face to the point beneath the nose and above the top lip).
It seems that we all have an optimal distribution of positive and negative charges over the surface of the body. These have been measured by skin conductivity and also by measuring the ionisation of the air in each nostril. (Yoga uses breathing techniques such as alternate nostril breathing to regulate and balance activity between the brain hemispheres and also the body’s energy system). When we are under stress (mental/emotional/physical) it is possible for our energy system to become disrupted,. This is sometimes described as “polarity switching”. Whilst this is a symptom of stress it is possible to work very simply with the energy system to restore balance and alleviate stress by stimulating particular acupressure points or tracing the flow of certain energy meridians.
The Tendon Guard reflex (TGR):
When we are stressed we can experience the “fight or flight response”. As part of this automatic survival reflex there is a tightening or shortening of the tendons down the back of the body that prepares to remove us from danger. This affects the tendons from the achilles tendon at the back of the heel - all the way to the tendons at the base of the skull and neck. These patterns of muscle tension are generally unconscious and depending on the general stress levels in someone’s life may be very strongly habituated. This TGR whilst again being a symptom of stress, can be worked with directly and easily to release stress, free up thinking, enable someone to move on. They also help people to speak more articulately, listen, access memory, enhance both their gross and fine motor skills, and to pay attention more effectively. The section of brain gym involving gentle lengthening activities (Dennison and Dennison 1994) releases the TGR. 
The importance of alleviating these functional blocks in the field of Mental-health:
If we put all these things together it is not hard to see how such effects of the Brain Gym® exercises could be of massive benefit in the mental health arena, not solely for mental health service users but for everyone living, working and relating in a stressful environment. 
Imagine the mental health benefits of being able to:
How we have used Brain Gym® in the Mental Health NLP Diploma training:
We regularly use Brain Gym® activities as part of all our trainings These help to ‘tune- up ‘ in order to get ready to learn and also they act as very rapid and helpful state changers. We find that when used in an outcome focused way e.g. in relation to how people want to feel about particular issues or how they would like to be applying their NLP in the world the results are stunning and highly consistent. 
We have found Brain Gym® particularly helpful in enabling participants to become more ‘literate’ in how to use their own mind-body system to help themselves. As part of this learning process we invite participants cleanly to create their own contrast frames. We ask them to take careful before and after observations of their mental state, emotional state, how they feel in their body, the level of internal dialogue etc. Occasionally we will do this simply for how they feel right now, and increasingly often, we invite them to think about a particular problem they’d like to handle more resourcefully or to have a specific outcome in mind. Working on particular issues in this way gives incredibly strong contrast frames on the efficacy of Brain Gym® and also acts as an effective way of fulfilling the participants convincer strategies prior to them leaving the training room. We see more and more evidence that this has enhanced the application of their learning away from the training room and also in their lives between and since the training sessions.
Benefits of a physical approach in a mental domain:
It may be that in the mental-health context certain habitual cognitive strategies haven’t always served the participants too well in feeling resourceful and in control. It makes sense that a different modality may prove an easier entry point for change. We have found that the speed and simplicity of using a purposeful physical approach to achieve an immediate and helpful state shift is a huge benefit. Having rapidly achieved a more resourceful state participants have found it even easier to consciously apply the more cognitive strategies of NLP. E.g. focussing on outcomes, changing submodalities, reframing inner dialogue etc.  
Specific Brain Gym® activities and their effects:
We used “PACE” ( the 4 step- ‘tune up’ - involving drinking water, stimulating two acupressure points [K27s] just below the collar bone, doing “cross crawl” and sitting for a few moments in a calming posture called a “hook-up” Dennison and Dennison 1997) at the very start of the training, prior to everybody introducing themselves.    Straight away participants were reporting that they felt “calmer more relaxed, quieter inside, as if what they had to do was ‘no big deal’, that they could cope, alert but calm at the same time” etc. We used PACE twice in every training session at the start and after lunch. Participants had such strongly positive and convincing experiences of PACE that many subsequently used it everyday in the morning as part of a routine to help them feel resourceful between training sessions. Many shared their experience of this simple skill with others, either friends, family members (some who had also been experiencing mental-health difficulties) or in some cases with fellow users of the mental-health service that they had contact with in a voluntary capacity. One lady reported that when she showed it to a man who hadn’t come out of his room for several years he actually moved to another room in the building and was talking about what it would be like to go outside.
 Here are some excerpts from participants’ home-play about their use of PACE between sessions:
Using Pace
“My friend and myself were asked to do a talk at the vale day care centre. We hadn’t very long to prepare for this, so on the morning of the meeting, we met up a few hours earlier to put together the speeches we had written. When my friend arrived she was very upset because she had lost all her notes on the train the day before. We were both getting very nervous and agitated as the time drew nearer, I remembered the brain gym exercises I had been taught called pace. We found a quiet spot and I showed my friend how to do them. We practised for about 15 minutes. I found it helped me greatly. My friend was amazed and relieved at how much calmer she felt. From then on everything just fell into place, and the talk went really well." Rose Walker
“I try to do the P.A.C.E exercises every day and find them really helpful.
My thoughts seem sharper. I feel more motivated and more positive. I feel able to cope to cope with everyday things like reply to letters, and pay bills”

The morning before my daughters S.A.T’s tests, age 11, I went through the brain gym exercises. Together, we did the exercises (left arm, right leg and vice versa) using hands to knees, elbows to knees and arms out in front legs behind. We did this for approximately 5 minutes.I taught her how to cross her fingers and turn her hand under her chin. I told her to sit with her hands under her chin, her ankles crossed and take deep breaths whilst she sat waiting for the test to start. She did this before each test and said she did well. We are just awaiting the results now.” Carole
We used ‘Positive points’ or ‘emotional stress release’ points on the forehead in conjunction with ‘hookups’ (Dennison and Dennison 1994, 1997) in order to alleviate stress. This simple routine allowed a rapid and comfortable state change from significantly unresourceful states (e.g. tearfulness, anxiety, anger) to more resourceful states of calm and relaxation. One participant used this on numerous occasions to help to manage their response to chronic pain.
 Here are some participant accounts of their use of Positive points and hookups:

“I have been concentrating on my hook ups, positive points, my brain gym and tuning in to my good state. With these I have found a big difference, more confidence, better posture, thinking more clearly. Concentration has been a lot better and the feeling of being really relaxed this is very important to me being totally relaxed, and this is something I can do where ever I go. You can just put your fingertips together, your tongue to the top of your mouth and breath in through your nose and out through your mouth. I am putting this into my everyday life. So if you see me on a bench somewhere fast asleep, I will have been doing my hook up!”   Maureen
“I have learnt more brain gym exercises and have put them to good use.
I have found that they have helped myself to feel better and cope with things a lot easier, and I have found with great delight I have been able to help others by teaching them some Brain Gym®. Just this week my daughter came to me with quite a bad problem with her partner she was very upset and stressed. I tried stress release with the positive points, which helped her get things into perspective, helped her to relax and enabled her to sort things out easier”. Rose Walker
“When I am feeling stressed, hurt, unwell, I massage my ears and unravel them. I turn my head to release any tension or stress. I also take the edge off stress by using stress release points, by placing and holding my hands on my forehead. This prevents the stress response and allows me to feel less stressed and more calm and relaxed.” 
Kay Kemp
We used an adapted version of a process called the ‘Dennison Laterality Re-patterning’ or DLR (Dennison and Dennison 1997) to help integrate the participants’ learning. We also used it with a specific outcome in mind about how the participants would like to apply their NLP in the world after the course. Among other things the DLR involves a combination of cross-body movements, homo-lateral body movements, eye movement patterns and a brain integration metaphor that is somewhat similar in nature to the NLP technique visual squash. 
We encouraged the participants to calibrate each other in addition to calibrating their own experience before and after the process. People consistently reported that their partners looked more resourceful, and more relaxed after the process than before and in addition they referred to their own internal experience of applying their NLP as being ‘no big deal’ , ‘like it is definitely going to happen’, ‘happening already’ ‘relaxed’ ‘knowing how’, and ‘confident brighter and clearer’.
We used a selection of gentle Lengthening activities (Dennison 1994, 1997) to release tension in neck and shoulders, back and legs.  This not only alleviated stress and tension, but aided concentration, listening skills and promoted relaxation and body awareness. Becoming aware of the contrast between the sensation of habitual muscle tension and that of specific muscle relaxation can help to give a conscious cue to begin relaxing in situations where tension has previously been an unconscious response. One participant also reported that a longstanding problem with her neck felt significantly more comfortable and free.
We used a series of exercises for Crossing the midline of the body   (Dennison and Dennison 1994, 1997) in order to prepare for writing and doing ‘home play’.   Many of the participants were somewhat concerned about the idea of producing written home-play because of a lack of confidence in this area (presumably derived from school experiences). It is worth mentioning that despite this initial trepidation we have been inundated with high quality written home-play, some typed, most hand-written and much of it lavishly illustrated and attractively presented.
From our experiences we believe that the purposeful use of the physical aspect of the mind-body system is incredibly helpful in teaching and learning NLP in the mental health context. We also feel that it is an invaluable adjunct to NLP for mental-health service-users in the management and promotion of their own mental and emotional well-being.

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