Consulting with NLP: neuro-linguistic programming in the medical consultation

313 Pages·2017·2.462 MB·English

by  Walker, Lewis

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Consulting with NLP
Neuro-linguistic programming in
the medical consultation
Lewis Walker
Forewords by
Ian McDermott
and
John Duncan
CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742
© 2002 by Lewis Walker
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Contents
Forewords iv
About the author ix
Acknowledgements x
1 Before we start … 1
2 Overview of neuro-linguistic programming 13
3 Initiating the session 43
4 Gathering information 71
5 Building the relationship 111
6 Explanation and planning 145
7 Closing the session 183
8 Special situations 197
9 Developing personally 231
10 Before we finish … 257
Further training in NLP 267
Glossary 269
Bibliography and other resources 273
Appendix 1 Great states 281
Appendix 2 Submodality charts 283
Appendix 3 The meta-model 285
Appendix 4 Meta-programs questions 289
Appendix 5 20-Day skill builder 291
Index 295
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Foreword
Some years ago I was asked to create a training programme on Improving
Bedside Manner. One sceptical physician who declined a colleague’s invitation
to attend made his position quite clear: ‘Look, one of the best things about
being a surgeon is that I have most contact with my patients when they are
unconscious.’
Certainly working with patients – conscious or unconscious – can be de-
manding and sometimes extremely stressful, and over time it can take a heavy
toll. One of the real contributions I have seen NLP make to those physicians
with whom I have worked was to give them both new ways to manage the stress
of their calling and new protocols to use with patients.
In fact, it was these twin concerns that gave rise to my first meeting with
Lewis Walker. He and his colleagues invited me to work with them on the ap-
plication of NLP to working with difficult patients. In the training that ensued
we explored examples of patients who seemed to be very ‘stuck’ and kept coming
back, but with no real change. It became very clear that it was not just the
patients who were stuck – their GPs were, too. Feeling stuck is disempowering.
The most effective intervention is to free the GP. To do this we used many of the
NLP tools outlined in this book. Once they were ‘unstuck’, these physicians felt
empowered again and their consultations changed dramatically.
What ‘unstuck’ them was a different way of thinking, combined with specific
practical techniques which they could adapt to particular patients. This com-
bination of approach and technology is known as NLP. You will find it expertly
delineated in the pages that follow.
This book is called Consulting with NLP– dictionaries tell us that to consult
is to seek the advice of another, to confer or take their counsel, and that a
consultant is someone who gives professional advice. Certainly patients do
consult their doctors in order to seek advice. However, the finest doctors do so
much more than simply dispense advice when consulting, because they engage
with much more than just a physical ailment. They enter into a relationship
with someone who is troubled and vulnerable, and they attempt to remedy or
at least alleviate distress.
I know from personal experience that this can happen in the space of a brief,
single consultation. In December 1997, I started experiencing a pain in my
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Foreword v
left testicle. It was a time of acute stress, as I thought I might be witnessing the
financial meltdown of the training organisation I had founded and nurtured
over many years. My GP did a thorough examination, of course, and told me
that there was nothing untoward organically. This was a huge relief – but what
made my visit of such value was what happened next. First, he told me how
men can register stress in this way and so put my experience in a larger context.
Then he asked me ‘How long is this stress going to continue?’. I said that I
would know the score by mid-February. He suggested that I should contact him
if the pain worsened before or continued after this time. In fact, it disappeared
very quickly – because, I think, his question had suddenly given me a time
perspective on my crisis. Now I could see that I had been too wrapped up in it,
and I now realised that I would emerge from the tunnel one way or the other,
and I knew when.
It struck me at the time that my GP had not just examined me – he had also
given me reassurance, information and a more healthy perspective. Without
the examination I would not have felt safe. However, if that had been all he
had done I would have left mystified and uneasy. I would have had a physical
symptom which had no explanation or, to put it another way, no meaning. This
would have left me disconnected from myself, like an examined object. I was
instead able to make sense of my experience – I felt engaged with, and was able
to renew my engagement with myself in a more healthy way. So often, I think,
it is this combination of physical and psychological aspects that makes for
effective interventions and allows maximum healing to take place.
However, with many ailments such explanation and meaning are not
so easy to come by. Our level of knowledge still seems to be rudimentary, and
medical science may just not know why some disease has occurred in this
person at this time. The consequent feeling of helplessness which many doctors
have described to me can be profoundly stressful and debilitating, causing some
to retreat into the role of a technician. However, on talking with patients it
becomes very clear that these are the times when a doctor’s capacity to engage
with their patient as a person is what makes all the difference. In the face of an
incomprehensible experience, the reassertion of care and relationship means
that the patient no longer feels alone. If patients are to be believed, this is a
powerful intervention in its own right.
Building on the Calgary–Cambridge model, Lewis Walker has outlined some
of the NLP tools that are most useful to physicians who wish to engage their
patients’ physical and psychological ability to self-heal. In addition, he has also
demonstrated the way of thinking that makes NLP so effective. In my experience
– both as an NLP trainer and as a patient – the results speak for themselves.
There is less wear and tear for all concerned, and better and more effective practice.
This is why it is truly a pleasure to introduce a book that offers pragmatic tools
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in the service of that highest calling, namely the desire to alleviate suffering and
promote healing.
With this technology, that surgeon I mentioned earlier might even have
come to enjoy his patients while they were conscious!
Ian McDermott
Director of Training
International Teaching Seminars
May 2002
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Foreword
Cum Scientia Caritas(the motto of the Royal College of General Practitioners)
meaning care with science, or sometimes care with compassion, sums up the
dual nature of the work in general practice – applying the science of therapy
within the empathetic environment of the doctor–patient relationship. The
consultation is the framework within which this relationship is developed
and increasingly has become patient centred.
This approach allows for the exchange of information between patient and
doctor and enables decisions to be reached that are realistic, shared and agreed.
The limits of professional responsibility can then be negotiated. In this way,
the practitioner can apply evidence-based medicine within the context of the
patient’s needs, wants and experience. Doctor and patient can decide together
the most appropriate therapeutic action that will have meaning and purpose
for the patient.
It is important for the doctor to be self-aware through reflection since the
therapeutic relationship is likely to be influenced by the practitioner’s own
personality and his/her perceptions of his/her task.
Consulting success therefore relies on the willingness of both parties to
share their views so that the doctor can attain a fuller understanding of what
the patient is going through and offer acceptable options for change.
To achieve this goal is a complex undertaking and requires competence and
expertise in communication skills as well as capabilities in effecting change.
Lewis Walker combines his experience of consulting as a general practitioner
in the North-East of Scotland with his undoubted abilities and knowledge
gained from extensive training in neuro-linguistic programming (NLP) to
illustrate how these capabilities and expertise might be realised.
Whilst much has been written on the structure of the consultation, less
attention has been paid to the dynamics of communication at work during a
doctor–patient interaction and how this might influence the therapeutic
outcome. Dr Walker aims to open up the processof consulting and employ the
tools and techniques of NLP to show how a better understanding of what is
going on in the consultation can lead to greater benefits for the patient and,
in turn, provide deeper job satisfaction for the doctor. The educational value
of this book lies in the achievement of these aims for the reader.
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The author covers all aspects of the consultation and acknowledges the
impact that the doctor’s own story might have on the proceedings. Special
attention is paid to those situations that require particularly skilful communi-
cation such as dealing with anger and aggression, breaking bad news and the
heartsink patient.
This is a book packed with practical advice and a welcome feature is the way
the author relates his message to everyday problems and concerns that patients
bring to the surgery. It contains powerful tools for change to be used ethically
and with compassion.
The visionary thoughts and ideas of Dr Walker in integrating the field of NLP
into the current models of the consultation may lead doctors to transform the
way they conduct their consulting with patients.
Dr John Duncan
General Practitioner
Woodside Medical Group
Aberdeen
May 2002
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About the author
Dr Lewis Walker FRCP (Glas) graduated from Aberdeen University in 1981,
and spent the next five years training in hospital general medicine, initially at
Glasgow Royal Infirmary, where he obtained the MRCP (UK) in 1984, then
subsequently at Raigmore Hospital, Inverness. In 1986 he began vocational
training for general practice, and in 1989 joined what is now a seven doctor
training practice at Ardach Health Centre, Buckie, on the Moray Firth Coast.
He was elected Fellow of the Royal College of Physicians of Glasgow in 1998.
In the early 90s, fascinated by what makes people ‘tick’, he developed a keen
interest in behavioural change mechanisms, which led him to study both
classical and Ericksonian hypnosis, together with neuro-linguistic program-
ming (NLP). To date he has undertaken certified courses at the level of
Practitioner, Master Practitioner, Health Practitioner and Trainer of NLP. With
numerous other short courses in addition attesting to his wide experience, he
has also trained with many of the leaders and developers in the NLP field. He
holds the Certificate of Accreditation of the British Society of Medical and
Dental Hypnosis (Scotland), and is also a Trainer of Hypnosis.