Neurolinguistic programming (NLP)

[Nancy Blake]

This thread has been split from here

There is a thread elsewhere discussing my Radical Care Pathway for ME/CFS, (now only available via Positive Health e journal). Because in my work as a psychotherapist, I have used NLP, I have come under the suspicion which NLP seems to arouse generally. I would like to clarify this, and having written an article recently, attacking in the most courteous possible way the vile bilge that is the Lightning Process...the most abusive use possible of NLP, this seems a good place to post a link to my article. Hope this is OK.

http://www.positivehealth.com/artic...nd-the-lightning-process-in-the-looking-glass

And maybe these two further links to my most recent articles will clarify the matter further. (The biggest threat to us right now..two, actually...are Wessely’s creating the spurious classification ; Medically Unexplained Symptoms...and the fact that the NICE Guidelines Review ‘experts’ are three psychiatrists, two neurologists, a pediatrician and a patient. These have been anonymised for some reason but no prizes for assuming that the neurologists will be Jon Stone and Ben Carson, both fans of the ‘functional neurological disorder’ model, and that the pediatrician will be EC. So that is completely rigged...along with the predominance of psychiatric and psychotherapeutic ‘stakeholders’.

The MUS thing damages everyone who comes within the ME/CFS remit of the Institute of Medicine Report, which stated that these, and related conditions are not psychogenic, and that the defining feature of ME/CFS is that ‘exertion of any type - physical, cognitive or emotional - may adversely affect many organ systems...’. In other words, psychiatrists should be nowhere near us, and treatment must be as Ramsay and Acheson insisted—based on maximising rest and minimising exertion.

As I point out in my article on the financial fraud proposed in Wessely’s ‘Guidance for Joint Commissioners of Services for patients with medically unexplained symptoms, this harms us, amd it harms people who have genuine mental health problems, for whom the funding should be reserved.

Yesterday, I saw an ad for Pulse CPD modules on women’s health - they are offering 25, to educate G.P.s about womens’ medical problems. The ad said ‘50% of women make an average of 19 visits to their GP before receiving a diagnosis.’ One of the ‘symptoms’ of ‘MUS’ is ‘frequent help-seeking’. It seems that this 50% of women with a medical problem are in danger of being diagnosed with MUS. Which in the case of cancer, would be a death sentence.

http://www.positivehealth.com/artic...s-diverting-5-year-funding-from-mental-health

And

http://www.positivehealth.com/artic...-polio-connection-and-the-dangers-of-exercise

Hope this clarifies who I am and what I am about.

 

[janice]

I will admit to being very wary of an NLP supporter but having had a look at your site and learning that you have ME/CFS, I was willing to read a bit more and so read your link :-
"ME/CFS: Ethical and Unethical Uses of NLP"

I really liked this :

Time to Lie Down and Fight

Our metaphors about illness don’t help. When people die from cancer, it is inevitably described as ‘losing their fight’ against the illness. We can admire people who have a disability when we see them doing Olympic sports. If you are ill, or have a disability, you can only be respected if you are seen to be ‘fighting’ it. Most people who get ME/CFS will talk about struggling to keep up their job, or their education, while getting sicker and sicker, and eventually having to give it up. We are people who don’t believe in giving up or giving in - our self-respect, even our beliefs about ‘who we are’ depend on knowing that we do fight, we don’t give up.

Let’s use the way cats fight as our metaphor: when two cats fight, each one is fighting to get underneath - being on their back gives good purchase for using the hind legs to disembowel the opponent. So let’s fight the enemy by getting underneath, lying down. ME/CFS is an enemy that takes a long time to disembowel - we need to do it slowly, lying down a lot.

Some useful ideas?

 

[Barry]

The ad said ‘50% of women make an average of 19 visits to their GP before receiving a diagnosis.’ One of the ‘symptoms’ of ‘MUS’ is ‘frequent help-seeking’. It seems that this 50% of women with a medical problem are in danger of being diagnosed with MUS.

Lots of good things in your post @Nancy Blake, but the above quote stands out. It is yet another shining example of how so many psychiatrists seem hell bent on presuming a causal relationship of their own whimsical choosing. An equally possible, and to my mind very likely reason for women having to make so many visits to their GP before being diagnosed, is they are probably less likely to be believed by their GP just because they are women! They may be frequently seeking help because they so bl**dy infrequently get it! But the medical profession mindset would shy away from contemplating that kind of causal relationship.

 

[Barry]

I hope you don't mind me reproducing a couple of excerpts from your Aug 2014 article "ME/CFS: Ethical and Unethical Uses of NLP" @Nancy Blake, which for me especially hit the spot:

This article will not be welcomed by those who practice and believe in the use of NLP as an effective treatment for Myalgic Encephalomyelitis / Chronic Fatigue Syndrome - ME/CFS. ME/CFS is a complex, autoimmune disorder in which a range of physiological abnormalities have been reported,[1] including autopsies showing spinal cord lesions consistent with the symptoms.[2] Causes of death in people who have ME/CFS include heart failure, cancer and suicide - deaths from heart failure occur thirty years earlier than would be expected in the general population.[3]

NLP, used by an effective practitioner, can be very powerful in encouraging a patient to change beliefs, become highly motivated, full of enthusiasm and conviction. If this power is engaged in persuading a person with ME that all will be well if they just deny their illness, give up the habits of rest and energy conservation they have learned to use, and any aids they may also rely on, the patient may be carried along and attempt to overcome their illness in this way. The long term consequences can be disastrous. All too often, moderately severe ME/CFS, after a programme of exercise, becomes severe and apparently irreversible.[6]

[My bold]

http://www.positivehealth.com/article/cfs-me/me-cfs-ethical-and-unethical-uses-of-nlp

 

[Valentijn]

But even if NLP isn't applied to ME or altered to be the form used in LP, hasn't the research shown it to be useless in general?

Wikipedia states:

NLP has since been discredited scientifically,[9][10] but continues to be marketed by some hypnotherapists and by some companies that organize seminars and workshops on management training for businesses.[11] There is no scientific evidence supporting the claims made by NLP advocates and it has been discredited as a pseudoscience by experts.[9][12] Scientific reviews state that NLP is based on outdated metaphors of how the brain works that are inconsistent with current neurological theory and contain numerous factual errors.[13][14] Reviews also found that all of the supportive research on NLP contained significant methodological flaws and that there were three times as many studies of a much higher quality that failed to reproduce the "extraordinary claims" made by Bandler, Grinder, and other NLP practitioners.[10][12] Even so, NLP has been adopted by some hypnotherapists and also by companies that run seminars marketed as leadership training to businesses and government agencies.[11][13]

Scientific criticism
In the early 1980s, NLP was advertised as an important advance in psychotherapy and counseling, and attracted some interest in counseling research and clinical psychology. However, as controlled trials failed to show any benefit from NLP and its advocates made increasingly dubious claims, scientific interest in NLP faded.[88][89] Numerous literature reviews and meta-analyses have failed to show evidence for NLP's assumptions or effectiveness as a therapeutic method.[90] While some NLP practitioners have argued that the lack of empirical support is due to insufficient research testing NLP,[91] the consensus scientific opinion is that NLP is pseudoscience[92] and that attempts to dismiss the research findings based on these arguments "[constitute]s an admission that NLP does not have an evidence base and that NLP practitioners are seeking a post-hoc credibility."[93] Surveys in the academic community have shown NLP to be widely discredited among scientists.[94] Among the reasons for considering NLP a pseudoscience are that evidence in favor of it is limited to anecdotes and personal testimony,[95] that it is not informed by scientific understanding of neuroscience and linguistics,[96] and that the name "neuro-linguistic programming" uses jargon words to impress readers and obfuscate ideas, whereas NLP itself does not relate any phenomena to neural structures and has nothing in common with linguistics or programming.[97] In fact, in education, NLP has been used as a key example of pseudoscience.[98]

So it seems that the scientific consensus is that NLP is pseudoscience. If you disagree, could you explain your basis for that disagreement?

 

[Keela Too]

. . .and the fact that the NICE Guidelines Review ‘experts’ are three psychiatrists, two neurologists, a pediatrician and a patient.

As I understand it these were the "experts" consulted during the review processes. I think, and perhaps somebody else can clarify on this, that these will not be the same experts used for the creation of the new guideline?

 

[Keela Too]

Regarding "lying down to fight", I love that idea.

 

[TiredSam]

I'm not very happy with the disembowling thing, and don't see how it's a helpful metaphor.

 

[Trish]

So it seems that the scientific consensus is that NLP is pseudoscience.

I'm a bit wary about believing Wikipedia, given what it says about ME/CFS.

But if we are to take NLP seriously, we need to see high quality clinical trial evidence supporting it, not anecdotes and wishful thinking.

 

[TiredSam]

I have seen studies showing that some of the various claims made by NLP don't stand up to scrutiny, for example the one about which way your eyes are pointing being related to how you're thinking.

 

[Barry]

I don't know about NLP, and when I read up on it I realise that two somewhat contradictory thoughts come to my mind:

1. I know for sure, from my own past experiences, that it is possible to be thoroughly screwed up due to deeply ingrained behaviours that you have no immediate conscious control over. Being able to reprogram (and to me, looking back, the word 'reprogram' is a very good word) those behaviours is crucial to getting over such problems. And I am talking about stuff way deeper than classic teenage issues. Some people can manage this on their own, but I'm sure others could not; and those who can can do it on their own might achieve it much quicker with help. Needing help with such behavioural issues is something no one will have much real inkling of if they have not experienced it, so I earnestly urge people to be very careful about inadvertently trivialising it if they have not, in the same way we know how wrong it is for someone to trivialise ME because they don't have insights into it.
   
   
2. I really don't know if NLP is what it claims to be. Some of what I read sounds good, other stuff sounds gimmicky and very hard sell, which always makes me very wary. But @Nancy Blake's words really ring true with me, and for that I trust Nancy's sincerity and insights. From this I'm confident there are aspects of NLP that are good, but I can't square that with just blindly accepting all of it is good - I just don't know.

Given that I am sure at least some of NLP is good, versus claims it is total quackery and pseudo-science, I am pretty sure there are truths on both sides. If I were to spell out (which I'm not) all the things I did to help myself many years back over a good number of years, none of it would be scientific. It would be a combination of common sense, a somewhat analytical mindset, objectivity about self, etc. It would in its way be pseudo-science, because it would have no scientific underpinning nor validation. So because I know it helped me, I would not call it quackery even though I accept it would be pseudo-science; need to be very careful about presuming both the same, even though they often might be. So in this case pseudo-science was fine when I applied it to just me. If I were to try applying it to others in any formalised and widespread way, it would then be wrong to do so without acquiring more scientific proofs.

For any trials assessing NLP, the first thing I would want to be really sure of is that the subjects were right, and I'm not sure that would be easy. Firstly they need to be people whose fundamental problem is deeply ingrained behaviours that are screwing them up. And also (and I'm really sorry about this cliche that often validly is so much mocked), they need to be people are prepared to give it a shot; if I had had a total no-can-do attitude, I would have got absolutely nowhere. I worry that any trials in the past may have committed the familiar sin, of presuming an outcome from the start, invalid cohorts, possibly badly run, etc. But I'm also keenly aware that NLP may try to promote its benefits to those who might not really benefit, and might also over-blow its own trumpet anyway. Brash marketing of health remedies never impresses me. But @Nancy Blake does .

But I must emphasise most strongly, that all the above relates to fixing problems with screwed up behaviours, and nothing to do with fixing physiological issues!

 

[Barry]

I'm a bit wary about believing Wikipedia, given what it says about ME/CFS.

But if we are to take NLP seriously, we need to see high quality clinical trial evidence supporting it, not anecdotes and wishful thinking.

Yes I agree with this. And I would also like to know if there ends up being many different 'dialects' of NLP, depending on who applies it.

 

[Trish]

Interesting thoughts, @Barry, thanks for sharing them.

I'm sure none of us would trivialise the difficulties many people have that may be helped by learning to think differently or see things differently, or by changing our way of thinking and acting.

And it is perfectly possible that there are techniques that, when used appropriately by a therapist who has a good empathetic understanding of people, may help. Even reading of techniques in self help books can help some of us to put a different perspective on things or give us techniques that help us cope and change. But that is all anecdotal, not scientific.

I am not questioning the need, or the possibility of change, or the possibility of particular methods helping to achieve change. Nor am I questioning the sincerity and experience of a particular practitioner, or how convincing they might be. That is not my point.

What I am questioning is the specific claims made about the specific techniques used in a particular brand of therapy/training called NLP. Can anyone point us to any well conducted clinical trial that demonstrates that NLP works? Is it more effective than CBT, ACT, meditation, counselling, reading Shakespeare, talking to an understanding friend...?

The answer is, I don't know.

There is a crisis in psychology research at the moment, as it is discovered that many experiments cannot be replicated. I don't think we really know whether any therapies work.

 

[Nancy Blake]

I don't know about NLP, and when I read up on it I realise that two somewhat contradictory thoughts come to my mind:

1. I know for sure, from my own past experiences, that it is possible to be thoroughly screwed up due to deeply ingrained behaviours that you have no immediate conscious control over. Being able to reprogram (and to me, looking back, the word 'reprogram' is a very good word) those behaviours is crucial to getting over such problems. And I am talking about stuff way deeper than classic teenage issues. Some people can manage this on their own, but I'm sure others could not; and those who can can do it on their own might achieve it much quicker with help. Needing help with such behavioural issues is something no one will have much real inkling of if they have not experienced it, so I earnestly urge people to be very careful about inadvertently trivialising it if they have not, in the same way we know how wrong it is for someone to trivialise ME because they don't have insights into it.
   
   
2. I really don't know if NLP is what it claims to be. Some of what I read sounds good, other stuff sounds gimmicky and very hard sell, which always makes me very wary. But @Nancy Blake's words really ring true with me, and for that I trust Nancy's sincerity and insights. From this I'm confident there are aspects of NLP that are good, but I can't square that with just blindly accepting all of it is good - I just don't know.

Given that I am sure at least some of NLP is good, versus claims it is total quackery and pseudo-science, I am pretty sure there are truths on both sides. If I were to spell out (which I'm not) all the things I did to help myself many years back over a good number of years, none of it would be scientific. It would be a combination of common sense, a somewhat analytical mindset, objectivity about self, etc. It would in its way be pseudo-science, because it would have no scientific underpinning nor validation. So because I know it helped me, I would not call it quackery even though I accept it would be pseudo-science; need to be very careful about presuming both the same, even though they often might be. So in this case pseudo-science was fine when I applied it to just me. If I were to try applying it to others in any formalised and widespread way, it would then be wrong to do so without acquiring more scientific proofs.

For any trials assessing NLP, the first thing I would want to be really sure of is that the subjects were right, and I'm not sure that would be easy. Firstly they need to be people whose fundamental problem is deeply ingrained behaviours that are screwing them up. And also (and I'm really sorry about this cliche that often validly is so much mocked), they need to be people are prepared to give it a shot; if I had had a total no-can-do attitude, I would have got absolutely nowhere. I worry that any trials in the past may have committed the familiar sin, of presuming an outcome from the start, invalid cohorts, possibly badly run, etc. But I'm also keenly aware that NLP may try to promote its benefits to those who might not really benefit, and might also over-blow its own trumpet anyway. Brash marketing of health remedies never impresses me. But @Nancy Blake does .

But I must emphasise most strongly, that all the above relates to fixing problems with screwed up behaviours, and nothing to do with fixing physiological issues!

This final sentence is the essential point!

 

[Nancy Blake]

This final sentence is exactly the point!

 

[Arnie Pye]

Yesterday, I saw an ad for Pulse CPD modules on women’s health - they are offering 25, to educate G.P.s about womens’ medical problems. The ad said ‘50% of women make an average of 19 visits to their GP before receiving a diagnosis.’ One of the ‘symptoms’ of ‘MUS’ is ‘frequent help-seeking’. It seems that this 50% of women with a medical problem are in danger of being diagnosed with MUS. Which in the case of cancer, would be a death sentence.

Where did the bit I've put in bold come from? I've already received the stuff from Pulse via email, and I'd like to keep it together with the bit I've put in bold.

I posted about the Pulse email on Thursday : https://www.s4me.info/threads/mus-medicine-has-a-sexism-problem-by-maya-dusenbery.2815/#post-50930

 

[Nancy Blake]

But even if NLP isn't applied to ME or altered to be the form used in LP, hasn't the research shown it to be useless in general?

Wikipedia states:




So it seems that the scientific consensus is that NLP is pseudoscience. If you disagree, could you explain your basis for that disagreement?

If you read my article on the Lightning Process (totally unethical and abusive use of NLP) you will find that, in the empirical spirit of NLP, I have mentioned a few of the concepts used, and then given some directions about ways to test for yourself whether these ideas work for you. Whatever the scientists (and we all know about the ‘science’ used in psychiatry) prove or disprove, the tools of NLP enable me, as a therapist, to be able to teach my patients a few simple things they can do to minimise their emotional suffering...always checking that my suggestions do fit with their experience.

I am old-fashioned enough to believe that mental health problems don’t just fall out of the sky, there is a narrative that makes sense of them, and if there isn’t, I send my clients to a doctor for a medical diagnosis.

And true to the spirit of NLP, if it works for you, do it: if it doesn’t work, stop doing it. We don’t have to get into any theoretical arguments or complicated research protocols.

Here’s an example of something you can try out for yourself: most, or all of us have a kind of internal background tape (‘inner dialogue’, ‘talking to ourselves’) and for most of us, it is pretty self-critical, and it may contribute to lack of self-confidence and low self-esteem. Check to see whether you are aware of such an inner voice. (Being extremely self-critical is a feature of depression. Changing this inner self-critical dialogue is therefore an effective way to help a depressed person.) If you do have this going on, NLP asks you to think about this voice in a practical way, (after first asking whether it is giving you some good advice that would be worth taking!): Which direction is it coming from? Is it loud or soft, slow or fast? If it seems to be coming from a particular direction, what happens if you move it to a different place? What happens if you make it louder...or softer? What happens if you speed it up - slow it down? What happens if you change its critical tone to the tone you would use to a puppy or a kitten? If you systematically try out each possibility, you may find one or two that would make this self-critical voice less oppressive, and lift your mood and feelings of confidence. If so, you now have a direct way to take control over how you feel about yourself. Testing NLP concepts in this way is how I would invite you to make your judgements about it.

We PWME know that exertion makes us worse. So we stop doing it. There is no theoretical or empirical justification for increasing exertion. The psychiatrists observe all our symptoms with no psychological cause whatever...so it’s clearly a medical problem. Instead of admitting that, they declare that because ME/CFS patients don’t have any narrative that could account for the sudden and complete incapacity that occurs in ME, it must be possible to have a psychiatric condition without having an explanatory narrative. Now that’s science for you!

 

[Nancy Blake]

Lots of good things in your post @Nancy Blake, but the above quote stands out. It is yet another shining example of how so many psychiatrists seem hell bent on presuming a causal relationship of their own whimsical choosing. An equally possible, and to my mind very likely reason for women having to make so many visits to their GP before being diagnosed, is they are probably less likely to be believed by their GP just because they are women! They may be frequently seeking help because they so bl**dy infrequently get it! But the medical profession mindset would shy away from contemplating that kind of causal relationship.

It’s clearly misogyny, no doubt about it.

 

[TiredSam]

Here’s an example of something you can try out for yourself: most, or all of us have a kind of internal background tape (‘inner dialogue’, ‘talking to ourselves’) and for most of us, it is pretty self-critical, and it may contribute to lack of self-confidence and low self-esteem. Check to see whether you are aware of such an inner voice. (Being extremely self-critical is a feature of depression. Changing this inner self-critical dialogue is therefore an effective way to help a depressed person.) If you do have this going on, NLP asks you to think about this voice in a practical way, (after first asking whether it is giving you some good advice that would be worth taking!): Which direction is it coming from? Is it loud or soft, slow or fast? If it seems to be coming from a particular direction, what happens if you move it to a different place? What happens if you make it louder...or softer? What happens if you speed it up - slow it down? What happens if you change its critical tone to the tone you would use to a puppy or a kitten? If you systematically try out each possibility, you may find one or two that would make this self-critical voice less oppressive, and lift your mood and feelings of confidence. If so, you now have a direct way to take control over how you feel about yourself. Testing NLP concepts in this way is how I would invite you to make your judgements about it.

I'm a bit concerned that a vulnerable person who hasn't thought much so far about having such a voice, might create one and imbue it with certain characteristics (critical or not, loud or soft, fast or slow, coming from X) when it is suggested to them, out of willingness to take part in the process. How can you be sure that the therapist and patient aren't just inventing a voice and a narrative together? Worse things have happened, in the field of recovered memories for example, with horrific consequences. Introducing a patient to the concept of their inner voice and defining its characteristics together must come with a huge responsibility.

 

[Barry]

most, or all of us have a kind of internal background tape (‘inner dialogue’, ‘talking to ourselves’) and for most of us, it is pretty self-critical, and it may contribute to lack of self-confidence and low self-esteem. Check to see whether you are aware of such an inner voice.

What I have always called "the conversation in my head".

I'm a bit concerned that a vulnerable person who hasn't thought much so far about having such a voice, might create one and imbue it with certain characteristics (critical or not, loud or soft, fast or slow, coming from X) when it is suggested to them, out of willingness to take part in the process.

I'm not sure if it is possible to just create one out of thin air? But I nonetheless fully agree there is huge potential for misuse/abuse if not very careful.