Consulting with NLP

Neuro-Linguistic Programming in the Medical Consultation

Lewis Walker

• Publisher: CRC Press
• Year: 2017
• ISBN:
  9781315344164
• Edition: 1
• Topic: Business
• Subtopic: Industria dei servizi
• Index: Business

This extraordinary and practical book examines neuro linguistic programming (NLP) - the knowledge and skills to detect and affect thinking patterns - and applies it to each phase of the medical consultation. It outlines the NLP tools most useful to physicians who wish to understand and utilise the dynamic structure underlying the processes used by excellent communicators. It explains how improving communication skills and developing new models of consultation to incorporate into daily practice not only helps healthcare professionals become better communicators, but reassures patients, alleviating suffering and promoting healing. This book provides many case examples and includes skill based exercises to ensure easy and effective learning. There are unique, fresh perspectives on challenging areas such as anger and aggression, dealing with complaints, breaking bad news, the heartsink patient, uncovering hidden depression and telephone consulting skills. It is relevant to all healthcare professionals, and of special interest to general practitioners, GP trainers, counsellors and medical students.

CHAPTER 1

Before we start …

Introduction

Something attracted you to this book – perhaps something you have seen or read already, or maybe an idea in your mind. Perhaps you have been told a little about it, by friends or colleagues. Maybe you have been browsing through bookshelves, or found it in a catalogue, or maybe someone gave it to you. A present! Now you have picked it up, settled down to read through it, and perhaps you are wondering ‘What is it that makes good doctors turn into really great communicators?’ And perhaps also ‘What is it that these doctors are doing differently, that makes them stand out from the rest?’ And maybe even ‘How can I excel in the same way? How can I learn these skills easily and effectively?’

So why are you reading this book? Why have you picked it up? Why is it really important for you to know about this material? What are the benefits for you in utilising this knowledge? What reasons do you have that will ensure not only that you complete it, but also that you will also incorporate everything from your learning into your ongoing behaviour?

Perhaps, like me, you have had experiences that do not bear repeating. You know, the kind of dysfunctional consultations where the door slams, the chair is empty, and you are left bewildered, wondering ‘What on earth is going on here?’ You have not seen eye to eye, you are tuned to a different communication frequency, and things just do not seem to fit. Uncomfortably so. And you have thought to yourself ‘How can I really make a connection?’

And yet there are times when consultations flow, and they really flow. You know, the ones when you not only make an empathic connection, but you intuitively come up with the right diagnosis, almost as if no thinking is involved. You are there, in present time, paying attention to the here and now. And afterwards you wonder ‘What would it be like if I could do this every time?’

So what are your reasons for reading this book?

Perhaps you are a GP trainer or you are interested in education. You probably know the ins and outs of the various models of the consultation that have evolved thus far. You are likely to be the kind of person who is really enthusiastic about teaching and learning, and you are already beginning to think about how you can best incorporate what you are going to learn here for the good of your trainee registrars, your patients and even yourself. I promise you that there is a lot you can look forward to incorporating into your practice.

Maybe you are a GP registrar, fresh out of a hospital post and thrust into the world of general practice where uncertainty seems to be the order of the day. It is still early days, yet you may well be feeling overwhelmed, with so much to learn, so much to do and so little time. Ten-minute consultations – a complete contrast! Why are they here? Why now? And the vagaries of summative and formative assessments. Video recordings. Argh!! In these pages there is much that will help you to weather the seas of uncertainties and to cope with whatever happens.

Perhaps you view yourself as an ordinary GP (whatever that is!). You have been in the job for a number of years, and you can handle most things, or you know a man (or woman) who can. Although you may not be an ‘old dog’, you still wonder whether there really are any new tricks to learn. Perhaps you have browsed through other ‘consultation skills’ books before, but they have not exactly set the heather on fire. This book will help you to re-experience what you already do well in a way that will stimulate you to do more, and let it ripple into other areas of life as well.

Perhaps you are on the retainer scheme. Maybe you work part-time or have come back after some time off. You have several other demands on your time, and you may feel a bit like a juggler, which is OK until someone throws you an extra ball! Sometimes confidence can be an issue. Maybe you do not feel fully part of ‘the team’. Perhaps you occasionally question your ability to keep up with what is going on, and all of the new developments. I can assure you that the skills you will learn here will free you up to be more effective on many fronts, and to feel good in the process.

You may be a medical student, fresh from the life sciences, about to enter the world of therapeutic relationship for the first time. Your head is buzzing with scientific facts and data, details of examination and investigation, pathology and taxonomy of disease. So much to think about, yet on the wards and in your attachments to general practice you wonder about the wider aspects of illness and just how to approach this unique individual in front of you as a person, rather than as a collection of physical and psychological symptoms and signs. Breathe easy – the following pages will illuminate your path and help to integrate both task and relationship.

Are you a health professional from another discipline, perhaps a nurse, a counsellor, a psychologist, or from one of the many professions allied to medicine? Maybe you have started to flick through these pages and wonder if any of this applies to you in your own particular field. What exactly can you learn from Consulting with NLP? Well, you may or may not be surprised to find out that the deeper aspects of the processes involved in getting your message across apply to you, too. Be ahead of your field. Read on.

Lastly, you may be a brave hospital doctor reading something outwith your specialist field – someone who wonders whether there really is anything to be learned from how effective GPs communicate with patients. Maybe you are interested in how to break bad news in a more caring way, or how to deal with angry or aggressive patients. Or perhaps you are one of those growing numbers of physicians, surgeons, obstetricians, gynaecologists, mental health professionals, paediatricians, and so on, who are gradually realising that whatever the speciality, the core fundamentals of effective communication are applicable across the board. Who knows, you may already be the one who has gained the most by choosing to read this now.

So what is your purpose in reading this book?

Once upon a time …

For the last eight years or so I have been using neuro-linguistic programming (NLP) in my daily consultations, with excellent results. In the rest of this book I shall be explaining exactly what NLP is, and just how you can use it to consult more effectively. You require no previous knowledge of the subject, as all will be revealed. As an overview, NLP is mostly an attitude of mind which has spawned a host of different techniques and approaches. It is an attitude that involves getting really curious, and wondering just how effective people get results. And wondering, too, just how you can change your world by expanding your possibilities, exploring new ways of thinking and enhancing what you already do well.

NLP is composed of three parts:

• neuro – how we use our neurology to think and feel
• linguistic – how we use language to influence others and ourselves
• programming – how we act to achieve the goals that we set.

I can still remember the intense feeling of excitement running through my mind and body when I read my first book about NLP, Frogs into Princes (Bandler and Grinder, 1979). You know that kind of feeling, when you have stumbled on something that you suspect may change your perspective forever. I just couldn’t put the book down. I read page after page after page. I had always wondered about what made people ‘tick’, why they did what they did, how we could exchange information more effectively and, most importantly, how we could change behaviours easily. From that first day no patient was safe from my wanton experimentation with this new model of communication!

I remember one patient who walked in, sat down, looked at me intensely and said ‘I want you to hypnotise me now to stop smoking!’ Now I knew that this guy was a polarity responder – someone who usually does the opposite of what other people say (more on this later). I viewed this, in the words of NLP co-founder Richard Bandler, as ‘an unprecedented opportunity to learn something new’.

So, as you can imagine, I looked him in the eye and, utilising my newly read and acquired language patterns, said ‘I don’t know if you’re the kind of person who can get really comfortable in that chair. And I’m really not certain whether you can begin to go into a deep trance. Now you probably won’t be able to let your breathing slow down, and feel the developing relaxing in your limbs. And I really don’t know if you can stop preventing yourself learning the kinds of things here that will last a lifetime.’

Anyway, he got a glazed kind of look in his eyes, stopped blinking and seemed to consider very carefully everything I said from then on. Now I don’t know about you, but for me it is important to find out what a particular symptom does for a person, before helping change to occur. So I asked him ‘What’s the best cigarette of the day, the one that you enjoy the most?’

He seemed to go inside himself, thinking for a moment, his eyes looking up to his left, and taking a deep breath before answering, ‘Well, the best one is when I’m rock-climbing, and I sit at the bottom, looking up, contemplating, planning my route, getting there safely.’

At that point I said in a voice tone that startled him ‘Well, after hearing that I’m not going to help you stop smoking. You could be on the rockface, not completely safely! I don’t want that on my conscience. In fact smoking, if you really, really think about it, could save your life!’

He looked at me completely bemused – you know, like times when you have been deeply confused about something, and he said ‘Call yourself a doctor? How could you say that? Is this some kind of reverse psychology?’.

To which I replied ‘Of course not (nodding yes with my head). What kind of a doctor do you take me for? Now just go and close the door behind you.’ And he left looking very puzzled.

Now the late great Milton Erickson MD, upon whose teachings much of NLP has been built, used to say that ‘Confusion is the gateway to learning’. He would get his patients into exactly the right kinds of states of mind and body that would allow them to learn what is really important. And there are many tales of how he helped his patients in unusual ways (described in My Voice Will Go With You by Sidney Rosen (Rosen, 1982). Here is one that I especially like. It highlights Erickson’s almost legendary ability to notice fine distinctions in behaviour patterns.

One day, Erickson’s wife Betty announced that there was a beautiful young woman waiting to see him – a striking blonde in a dark, two-piece suit, and stockings with seams that went all the way up. He said ‘Show her in my dear, show her in.’ As she came in, just as she was sitting down, she picked some lint off her sleeve. She then proceeded to tell him about all of the other doctors she had consulted, many of them his colleagues, none of whom had been able to diagnose or treat her condition. She finished by saying ‘I’ve come here to find out if you are the right doctor for me.’

Erickson looked her directly in the eye and said ‘Yes Madam, I am the right doctor for you.’

She looked back, equally directly, and replied ‘Isn’t that just a bit conceited, Dr Erickson?’

And he said ‘No, I’m just stating a fact. And the fact is, I am the right doctor for you.’

She still thought that he was terribly conceited, so he added ‘It’s not conceit, simply fact. And I can prove I’m the...