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Healing Neurology With NLP

Dr Richard Bolstad



Re-Programming The Brain

Imagine being able to sit down with someone who has suffered serious brain trauma and guide them not merely to tie their shoelaces again, but to actually consciously direct the process of tying their brain back together.

The very name "Neuro-Linguistic Programming" implies that NLP ought to be able to assist in cases where a person has suffered Neurological Damage. But what do you actually do when confronted with the many real life problems such a person may face? As an NLP trainer, I'm often asked what I would recommend NLP Practitioners to do in cases of brain injury from Cerebrovascular Accident (stroke) and other internal problems, or from external trauma such as motor vehicle accidents. One of the original models studied by the developers of NLP, Dr Milton Erickson, worked extensively with such cases (Erickson, 1980, p 281-328), but there has been very little discussion of the matter in the NLP community since his work. In this article I want to go step by step through a format for working with such cases, based on Erickson's work, on the recommendations of people who have recovered from brain injury, and on the recent research into the brain's incredible adaptability.

I will structure my suggestions using the RESOLVE model, previously described in my book "RESOLVE: A New Model Of Therapy" (Bolstad, 2004)

Resourceful State For The Practitioner; Know That Change Is Possible

Milton Erickson knew from his own experience that the brain could relearn after severe damage. Erickson was paralysed after a polio infection when he was 17, and taught his body to walk again over the next year. "In my own experience with myself it seems to be a matter of learning to use muscles in a different way. When I was 60, I went for a physical, and the examining neurologist found that I had divided some muscles into halves, some into thirds. One-third of a muscle was realigned to pull against the outer two-thirds of itself. One-half of a muscle was pulled against the other half." (Erickson, 1980, p 327).

Working with others who suffered such neurological damage, Erickson searched for a way to prove to other practitioners what he himself already knew from his life experience - the brain can heal. In the literature, he came across some ethically disturbing experiments which had been done using brain surgery on rats and monkeys. He explained "Seeking a possible basis and rationale for treatment, the writer called to mind Lashley's research on maze learning in rats, with subsequent relearning after surgical destruction of various areas of the brain, as well as the implications of his research for the utilization of alternate neurological pathways after brain damage." (Erickson, 1980, p 315). Karl Lashley's research in the 1920s was followed up by Michael Merzenich in the 1970s (Doidge, 2007, p 55-59) and by Edward Taub in the 1980s (Doidge, 2007, p 136-143). In 1981, thankfully in my opinion, animal rights activists intervened and Edward Taub was convicted of 6 charges of cruelty to animals for this series of studies. Taub responded by shifting to much more ethical studies with consenting human beings.

Before discussing the more acceptable studies with human beings, let me summarise what the earlier researchers had learned in their work with monkeys. The studies by Ashley and Merzenich showed clearly that a specific area of the brain which ran, for example, the outside of a monkey's hand on one day might not run it the next day. If nerve connections to that part of the hand were severed, then within 24 hours the monkey's brain would have reassigned those brain cells to give it a more exact ability to move a nearby area of the hand which still had connections, or to give better movement in the other hand. Edward Taub also showed that a monkey's brain rebuilt any severed connections to the hand soon after surgery.

The question Taub then sought to answer in his human studies was: why do human brains not simple reconnect after a stroke has produced paralysis? He eventually demonstrated that the only reason this didn't happen was that the brain began to assume that the damage was permanent. If an arm was unable to be moved for a few days, the damaged brain would reassign those brain cells which used to run that arm, and have them run another part of the body more fully. Unless the person with a stroke actually tried very concertedly to move their paralysed arm again, it would simply remain "turned off" as part of the brain attempting to get the best use out of its cranial real estate.

In 2005 and 2006, Taub and his colleagues published studies on his method of actually constraining a person's functional arm in order to "force" their brain to re-grow the neurological map of their "paralyzed" arm. Even people whose paralysis had lasted many years were able to benefit from this process. In a similar way, Taub has people who cannot speak (due to damage to the speech centres in the brain) put in situations where their nonverbal requests are ignored. To eat, they must ask verbally. This is exactly what Milton Erickson did with post-stroke clients back in the 1950s and 1960s, as we shall see.

Since the 1980s, more and more precise ways have been developed to study neurological plasticity (the ability of nerve tissue to adjust like a plastic material) in the functioning human brain. In the 1990s Alvaro Pascual-Leone at Harvard Medical School used transcranial magnetic stimulation (TMS) to scan the brain of blind people as they learned to "read" Braille with their fingertips (Doidge, 2007, p 197-204). His studies showed that the more the person attempted to read Braille, the larger the area of brain devoted to their Braille-reading fingertips became. The changes happened overnight as the brain made continuous re-decisions about how much area to assign to each task.

Establishing Rapport

The effective use of rapport with the person who has brain damage involves getting very clear that this person is not you. That means that they don't need to get fixed in order to make you feel better. That means, on the one hand that you don't need to be compassionately sorry for them, and on the other hand you don't need to demand that they get their act together. You are offering likely, but not guaranteed, results, if they are willing to do whatever it takes to change their brain. Changing their brain is not something you can do for them.

Explaining his success with one client, Milton Erickson said "It is true that the patient's progress might be attributed simply to the increased individual attention she received. However, it is also true that she had received an immense amount of individual attention from numerous relatives, friends, and her family, all of which did not prevent the development of a vegetative state. Also, she received extensive and highly skilled nursing and medial care and attention, all to no avail. But all such care and attention had been based upon concern, sympathy, fear, worry, helpful protective attitudes and a despairing concept of her as helplessly and hopelessly invalidated, despite the diminution of her hemiparesis. Such attention was always accompanied by sympathetic and encouraging assurances in the face of obvious and unmistakable disability and therefore was patently false and expressive only of the wishes of others and an unintentional emphasis on her invalidism." (Erickson, 1980, p 308-309)

Gail Denton sounds a very clear warning to helpers about the simple "positive thinking" cure. "Some days there is the irresistible urge to think that if you could only get a jump start, you could get going again". The jump-start is your internal wish to get on with it. The "bootstrap lecture" is what you get from people who don't understand your experience. Because you look fine, there are people out there, the rugged individuals, who think you should be able to "get over it," "get with it," and "get on with it." These people are clueless." (Denton, 1999, p 182). A successful helper is offering real help, knowing that it will not be easy and that the client themselves will be doing all the real work! This is the difference between empathy and sympathy.

Specifying Goals: Assessment and Reassessment

This step of helping the person to set goals really involves two processes. The first process is the assessment of what is actually happening now for the person. The second process is the reassessment of what they actually want in life now. The first process is largely based on an evaluation of what has been lost and an attempt to return to the person's previous way of functioning. The second process is based on a re-evaluation of what really matters and feels enjoyable to the person now, and is an attempt to create a new life which may be fundamentally different to the one the person had before. The difference between these two processes is poignantly demonstrated in the 1991 movie "Regarding Henry" (starring Harrison Ford as a successful lawyer, Henry Turner, who recovers not only physically but spiritually after a gunshot head injury). If you haven't seen that film, get it out now.

Usually, when a person comes for NLP based coaching or therapy, they have clear ideas about what is not working, if not clear goals about what they want to achieve. The brain-injured person may not realize which tasks they previously took for granted and are currently having challenges because of the lack of. The inability to think of the right word to say (a cognitive task) may appear as the inability to speak (a physiotherapeutic task). The inability to control frustration (an emotional task) may appear as the inability to explain ideas (a cognitive task).

The effects of brain injury may show up in the following cognitive systems amongst others:

Clarifying the second process involves finding out what the person values and what they enjoy. These clarifications can be done as standard NLP values elicitations, asking for example:

Opening Up The Client’s Model Of The World; Redefining The Healing Task As Their Own

Frequently the brain damaged person comes to an NLP Practitioner with the hope than NLP will rescue them from their frustrating situation and return them magically to the remembered ease of their previous life. They expect the Practitioner to perform magic, whereas my plan is to show them how they can perform magic. "Leading the patient to "See what I [the patient] can do," is much more effective than letting the patient see what things the therapist can do with or to the patient." (Erickson, 1980, p 291).

Letting the client see what they can achieve through therapy requires allowing them to notice what they cannot achieve at the start. Anyone who has watched a little child learning to crawl and then to walk will be struck by the immense frustration which impels this learning process. We need not shelter our clients from the frustrating reality of their situation any more than we need to carry a child all the time; to do so would be to shelter them from much of the natural source of healing and learning. It would mistakenly encourage them to lean on our own non-damaged cognitive abilities, rather than developing theirs. Edward Taub's constraint of the person's functional arm (described above) "forces" them to move their "paralyzed" arm. In the same way, Erickson's therapy involved putting the person in cognitively frustrating situations so that they were "forced" to re-grow cognitive areas in the brain. Making the person more aware of their need for change paradoxically allows them to change. Erickson was able to do this with great empathy, because he himself had put himself in challenging situations to "force" his brain to re-grow after his own polio-induced paralysis.

Erickson gives many examples of this method of working with one woman suffering from a severe stroke. For instance "A newspaper was shown her, and she was asked to read an account of her favourite baseball team. She futilely attempted to do so, whereupon the author read it aloud to her, actually paraphrasing it into a most derogatory account. She snatched the paper from the author and haltingly and imperfectly reread the article aloud correctly, half amused, half angry at the author. This measure served to convince her that she could read "if you make me mad enough"." (Erickson, 1980, p 301)

Erickson concludes "Therapy would be oriented about her helpless condition, and use would be made of every possible pattern of reaction and response that she had retained without regard for banal social conventions, and a demand was made that she give her solemn promise to abide by whatever therapeutic measures the author might propose. It was pointed out simply and emphatically that to date all conventional therapies had failed, that there would be no loss entailed by new measures, and that a therapy designed to meet the actual reality she represented instead of the lost realities of the past might conceivably serve a useful purpose. (Later the patient stated that this frank, nonreassuring offer to give help, but a refusal to promise it, influenced her to take hope and to give and to keep her promise of cooperation despite the anger, frustration, and displeasure the author's methods occasioned. As she explained later, "It didn't make sense most of the time, but I couldn't help noticing that I was doing better. But you did make me just awful mad, and after a while I discovered it [being angry] helped. Then I didn't mind how mad you got me. But it was awful at first." (Erickson, 1980, p 303-304).

To convey a sense of how the person themselves will be in charge of what we do, I recommend using the pointing exercise: "Stand up with your feet slightly apart, and with space around you in front and behind. Bring your left arm straight up in front so it's horizontal and pointing to the front. Now, keeping your feet still, turn your body to the left, pointing with the finger as far as you can comfortably turn. Be careful only to go as far as you can before it gets tight. Notice, by the point on the wall, how far round you are pointing when it's tight. Next, turn back to the front keeping your feet still. Now, close your eyes and make a picture of what you would see if you turned again, but this time with your hand going 40 centimetres further round. Imagine where on the wall or window that would mean your hand is pointing. Sense what it would feel like to be that much more supple, so that your body just flowed around. Imagine what you would say to yourself if you could go that much further. Now open your eyes and physically turn again to the left. See how much further you have turned. Imagining yourself going further causes your brain to make the adjustments to create that in reality."

In summary, at this stage I want to establish with the client a relationship where they will commit themselves to sustained action to achieve apparently magical results. These results emerge from the natural ability of the brain to adjust which brain areas perform which tasks, on a day by day basis, and not from some magic ability of mine.

Leading To The Person’s Outcomes

The person recovering from a brain injury can take advantage of many different therapies and use many different coaches. The healing modalities available include physical therapies, massage and acupuncture-based therapies, nutritional therapies, exercise therapies (including pilates, yoga and chi kung), surgery and other orthodox medical treatments, and other alternative healing methodologies. As an NLP Practitioner, I would encourage clients to utilise such other help, especially adding omega 3 oils (from flax oil or fish oil) and other brain nutrients to the diet, and doing chi kung daily.

There are four main ways in which time with an NLP Practitioner could be most effective using NLP within this range of intervention choices.

Summary

Resourceful State: The first thing to understand about using NLP to assist someone in recovering from brain injury is that the brain is constantly adapting and changes physically from day to day as we learn new physiological and cognitive skills.

Establish Rapport: The kind of empathy that works with people who are healing from brain injury is empathy based on a respect for their challenges and their own ability. This requires stepping back from trying to magically heal the person.

Specifying Goals: At the beginning of your work it will be useful to check which areas of cognitive Functioning have been affected by the brain injury (including memory, attention, language, vision, emotional management, calculations, planning, and lifestyle changes) and which things are most important to the person in terms of healing. The second issue with goalsetting is to help the person re-invent their own values and goals for life

Opening Up The Client's Model Of The World: The aim f NLP is not to magically heal the person, but instead to show them how to access their own amazing inner resources. These resources include the energy that is generated by their frustration with their current ability.

Leading to the Person's Outcomes: In the context of the many therapies that will be useful for the person recovering from brain injury, there are four main processes that an NLP Practitioner can contribute:

  1. Visualising Healing. This includes general healing visualisations like the Inner Smile, and visualising the brain reconnecting using metaphors like the Phone Repair Service or Hall of Answers.
  2. Pain Relief. Showing the person how to use trancework to remove pain, by methods such as indirect suggestion, creating numbness or analgesia, displacing or dissociating from the pain, or altering time perception.
  3. Brain Retraining. Teaching the person to sequence their memories in a Time Line, to use Futurepacing to ensure they remember tasks, to control their internal dialogue in order to be self-nurturing, to clear traumatic responses with the NLP Trauma Cure, to enjoy life and to laugh daily, and reality test so as to separate hopes and dreams from shared reality.
  4. Tasking. Setting any of the above methods as a task for the person to complete on their own involves ensuring the task is chunked and sequenced carefully, is futurepaced to everyday triggers, and is undertaken with an understanding that progress needs self-care.

Verifying Change: Keeping a journal allows the person to express their emotions, clarify what is happening, monitor change over time, and inspire themselves and others.

Ecological Exit: The coaching process is complete once the person can continue it on their own. Healing and improvement in functioning are lifelong experiences. The person who recovers from brain injury does so with a unique experience of what it is to be human and this may expand their future life immeasurably.

Richard Bolstad is an NLP trainer and Registered Nurse. He teaches on several continents each year.

Richard Bolstad, Transformations International Consulting & Training Ltd