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Neuro Linguistic Psychotherapy for Skin Conditions

by Alexandra Chalfont(more info)

listed in nlp, originally published in issue 60 - January 2001

Imagine dipping your body into a tub of paint the colour of your skin, then lying down and rolling over very carefully until you have pressed each part of your body, face, arms and legs onto the ground, so that there is a perfect imprint of all your skin, spread out like a map before you. Your skin is the largest organ of your body; it's amazing how much ground it covers. It describes the boundary between you and the air around you, protects you and constantly feeds information into your internal systems.

When this particular organ functions less well than the 100% we expect, the results may well be visible, to the world as well as to yourself. Psoriasis and eczema give physical discomfort and these physical effects may be accompanied by some degree of psychic discomfort, pain or anxiety. What do you do with these feelings? Let them be, perhaps, if they don't impair living too much. If physical or psychic discomfort becomes intolerable, what can you do to learn how to make it more acceptable or even appreciably diminish it? Note that we are not talking physical cures: it's essential to continue medical treatments and to get all the information you can to help cure or alleviate your physical condition, and no ethical psychotherapist would suggest otherwise.

Neural Image

The neuro linguistic model is a holistic one, which begins with the assumption of a mind-body connection: how we communicate with ourselves affects our body. Thus the neuro linguistic psychotherapist will explore with you the relationship you have with your skin and the dysfunction it may be suffering from, and how you can perhaps make changes in that relationship which can be beneficial.

Neuro linguistic psychotherapy works specifically with the links between the way we experience life events, how we process the information from these events internally in terms of feelings and sensory representations (images, sounds, movement, touch, taste and smell) and how we verbalize these experiences and give them substance and meaning. The meaning we give to our experience becomes internalized, and when we next have the same experience we may re-experience the same group of feelings, represent the experience the same way internally, and give it the same meaning, whether this is appropriate or not.

If someone is fair-skinned and vigilant in noticing changes in moles, for example, this behaviour may be entirely appropriate. If, however, this person becomes extremely agitated and flies into an state of panic at the sight of every new mole before examining it or going to the doctor, it may be more beneficial to learn a new strategy for reacting to the sight of new moles and bring about a change of behaviour.

Neuro Linguistic Psychotherapy (NLP)

NLP is about how to identify desired states or outcomes and achieve them. This often involves discarding unwanted behaviours. In this process you recognize how these unwanted behaviours have been serving you in some way, which is probably why you haven't changed them yet. It is also about giving yourself choices of behaviours, and about generating new behaviours and skills, using resources of which you were hitherto unaware.

The central contention of NLP is that people operate from and respond to their personal 'construction' of their experiences rather than from a single 'external' reality.

They have their own unique models or maps of the world and each one is different from every other. Everyone's 'map' is valid, while no map is fully able to represent the 'territory' or external reality itself.

In the early 1970s, at the University of California at Santa Cruz, Richard Bandler, an information scientist, and John Grinder, a linguist, began exploring how people effectively communicate with and influence one another; the aim was to duplicate their skills and behaviour and thus become just as effective.

The methodology they used to discover these skills is called human modelling – the process of building a model of how someone successfully practises or performs certain behaviours. This behaviour can be almost anything, flying a plane, playing an instrument, getting up on time in the morning, managing a team, spelling well or living healthily.

The idea is to find someone who does what you want to do extremely well, and find out exactly how they do it. This is achieved through asking lots of questions and carrying out careful observation followed by asking more finely-tuned questions, until your model of their skill is as accurate as it can be. You then try on the model for yourself, or teach someone else the skill you have modelled.

Very often people are not even aware of exactly how they do something so well (ask someone 'How do you dance like that?'), and the modeller needs to discover exactly those components of the skill that lie outside the conscious awareness of the person they are modelling.

In NLP modelling, this means not only studying the way the person behaves, but also how the person structures their thought processes and their internal experience. NLP is this skillful gathering of information to make a model.

The first people Bandler and Grinder modelled were particularly effective psychotherapists: Milton Erickson, a hypnotist; Fritz Perls, founder of Gestalt therapy; Virginia Satir, a developer of family systems therapy; and Gregory Bateson, anthropologist.

They went on to model many other outstanding performers in different fields. NLP could model whatever was effective, in whatever field. NLP is currently applied in education and business, sports psychology and health. NLP practitioners and master practitioners may work within any of these fields. However, as Joseph O'Connor remarks: "NLP did not have a business background, but a therapy and interpersonal communication skills one."[1]

Neuro linguistic psychotherapists have committed themselves to a specialist route, fulfiling a high standard of postgraduate level training requirements that conform to those specified by the United Kingdom Council for Psychotherapy (UKCP).[2] Neuro linguistic psychotherapists are accredited by the Association for Neuro Linguistic Programming Psychotherapy and Counselling Services Ltd (ANLP PCS), and are then eligible to be recommended for UKCP registration.[3]

ANLP PCS also has a strict ethical code built into its constitution, which acts as a safeguard for the client. All members of ANLP PCS are bound by this Code of Ethics and are required to have supervision from a more experienced therapist.[4] There is a complaints procedure, which allows for informal mediation or formal disciplinary proceedings should a client have any concerns about the therapy or therapist.

Within the framework of the psychotherapeutic contract, a protective ethical frame and professional confidentiality, the focus of the work is turned to the achievement of goals in health and well-being. The neuro linguistic psychotherapist will ensure that work with the client proceeds safely and ecologically: this means that any changes must be truly representative of the whole person, and the therapist needs to work with an awareness of potential negative consequences of change.

The basic model to which a neuro linguistic psychotherapist will work is:

Present state + resources = desired outcome.

An example of one simple but effective process used with allergies is illustrated in the following case example of a session conducted by a colleague.

Case Study 1 – Emma

"Emma told me that whenever she visited her new boyfriend in his home she got a strong allergic skin rash, apparently an allergy to his long-haired cat. She feared this allergy might endanger her relationship, as she could hardly bear to go to his house. She wanted to be able to visit her boyfriend without experiencing the terrible allergic reaction to the cat. She agreed to bring along a few hairs of the cat in a plastic bag.

"I asked her what it felt like when she experienced the presence of the allergen, and what it looked like. As she answered, I closely observed her breathing and her physiology. Her shoulders hunched and her jaw became tight, her fists started to clench.

Cat

"I explained to her that sometimes immune systems could make a mistake, and consider something to be dangerous when in fact there was no danger. Her immune system had made a mistake about what to attack and what not to attack. I explained that we would retrain her immune system to react more appropriately.

"I then checked out with Emma whether there was anything she might lose if she didn't have an allergic reaction to the cat, asking her how she would then experience her visits to her boyfriend's house, and whether she thought there was anything positive which might come from having this allergy. She said that there wasn't, but I asked her again to double-check, as I would have had to ensure that any secondary gain[5] could be fulfiled in another way.

"For the next step I asked Emma to think of a counter-example to this allergy trigger – something that was similar to the cat hair, but to which her immune system reacted appropriately. She nodded and as she imagined a counter-example I asked her to put her right hand loosely on her left arm and hold it there throughout the process. This would then act as a trigger (or, in NLP jargon, an anchor) in future for the appropriate response.

"Next I asked Emma to dissociate herself from the scene, all the time with her right hand loosely touching her left arm. I told her to imagine a huge glass wall dividing the room, and herself on the other side of the glass wall with her immune system functioning properly. 'You can watch and observe the you which allows you to enter into the presence of allergens without reacting.'

"Now I gradually took the cat hairs out of the plastic bag and introduced them, saying to Emma: 'As you watch yourself over there behind the glass wall, slowly introduce these hairs that caused a problem for you. Let the allergen move behind the glass and give your immune system a chance to get used to it.'

"I waited and noticed Emma's physiology begin to shift, indicating that her immune system had begun to adjust. Next, I asked her immune system for a signal that it had assimilated the new information. Her hand tapped lightly on her left arm.

"Now, instructing her to keep her right hand on her left arm, I invited her to step into the Emma behind the glass wall, and experience the cat hairs that had previously caused her skin to react allergically. As she did so I observed carefully that her shoulders were lowered and her jaw relaxed; her right hand was open and loose, and her breathing had remained regular.

"As the last step in the process, I invited Emma to imagine the next time she would visit her boyfriend and notice that the cat hairs now have no effect. She did this several times and felt comfortable.

"After the process was complete we tested the cat hairs several times to see if Emma's immune system was responding appropriately. Now it was time to put her work to the test in the actual situation. She phoned me to say that she had walked into her boyfriend's house and remained symptom-free. A month or so later she reported that she could even sit next to the cat on the sofa with no adverse reaction."[6]

Now, this intervention or pattern went smoothly, almost mechanistically in my colleague's work with this particular client, and it may work like that sometimes. We humans are complicated creatures, and our subconscious (or unconscious) doesn't always play ball at every step of the way. Often even more searching and sometimes almost spiritual work is more appropriate. It is important also to realize that the way we talk in NLP about the conscious and unconscious mind, and its parts, is just a model that allows us to develop ways of working that may suit particular clients, and not reality, or 'the truth'. Often we may need to work on deeper levels to find out whether the client might have underlying reasons for repeating the symptom pattern, reasons which they may not hold in their conscious awareness.

Case Study 2 – Jude

Jude's father had died a few weeks before she came to see me, and she was holding things together for the family, working full-time and looking after her own ten-year-old child.

Psoriasis had spread all round her hairline, on the left side of her nose, and a particularly large patch had developed on her forehead going down between her eyes.

What did she want as an outcome for this session?

"To be able to show myself and feel free."

Her shoulders were hunched, her head slightly down. How would she know if she were able to show herself and feel free?

"I would have a clear, clean face."

I invited Jude to focus her attention inwardly and go on an internal search to find other examples of psoriasis in her past.

She located a past occurrence and then two others before that, until she felt she had found the very first time she learnt this pattern of behaviour, of getting psoriasis. We focused on this first time and she explored when exactly that was, how and where it happened, and when she may have become consciously aware that it was happening. It was a surprise to her to discover when it was – she thought she had always lived with psoriasis.

She was 16, had worked hard to pass her exams for her parents, but had failed and needed to continue working hard for the retakes. Could she identify what happened just before the psoriasis started?

"I heard my father's voice saying: you have to work a bit harder so that we can be proud of you."

I invited Jude to thank that part of her which had taught her how to have psoriasis, and to ask it what benefit it had intended for her in giving her this.

"It wanted to give me more time."

And having given you more time, what more would it want for you?

"For me to be allowed to be me."

This is the existential core, the identity issue in this pattern for Jude.

You can thank that part for giving you psoriasis; it has done good work for you in giving you more time and allowing you to be you.

Now you can turn to that part of your unconscious which is the creative part, and ask it how many other, different ways it might find to give you more time and to allow you to be you.

Jude went even deeper into her internal journey, her facial muscles relaxed and her eyes de-focused.

"Many."

You might want to ask it to choose at least six alternatives and ask it if it is willing to try out these behaviours now.

Jude internally experienced these different ways and came up nodding.

"It works."

Now you can go in again and check out whether there is any part of you that still needs the psoriasis, or some little part of it. You can check this a couple of times, until you are sure.

You can now test these new behaviours and how well you learned them back there in the past just before that first experience. And as you notice how well you learned that new lesson back there in the past, you can be surprised how well you know that new behaviour now in the present, here, as you integrate all the learning you have experienced on this journey.

Jude was now sitting relaxed and upright, her shoulders down and looking at me directly, nodding.

Her psoriasis healed almost completely within four weeks, leaving very pale pink patches. Occasionally, under stress, she gets some round her hairline, though the patches on her forehead and on the side of her nose have not reappeared.

The particular skin problem Jude had come with had been well enough resolved, and that was her immediate goal. In further work we went on other issues, integrating the benefits she had gained from her work with psoriasis, and helping her locate and build more resourceful ways of resolving her problems with living.

In Heart of the Mind,[7] Connirae Andreas, a respected NLP developer, presents a technique she discovered for the promotion of health with respect to illness in general.

Woman

Case Study 3 – Connirae

While breastfeeding her second baby, as with the first, she suffered repeated bouts of severe breast infection, each time having to resort to antibiotics to recover. Ill once again, she tried many NLP techniques with no success, and so experimented with something else. She realized that, when she thought about recovering, her internal picture of herself was lying in bed, looking ill. No wonder she didn't get better. She then asked herself what she knew absolutely that she would recover from automatically, without her doing anything about it. Cuts and scrapes, flu and colds came to mind. She decided on flu, and imagined herself resting in bed, getting better naturally. She realized she experienced this as a short movie, off to her right, when in a time-lapse sequence she saw herself getting better in a single second in her mind. She then began thinking of her breast infections as being 'like the flu'. Her internal representation of the breast infections was as a slide. She took this in her mind's eye and moved it over to the location of the movie of recovering from flu, changing it to a movie of automatically recovering from breast infection. She gave the breast infection movie exactly the same qualities as the flu movie, the same size, colour and speed of movement. She noticed that her body was already beginning to feel different.

She made another movie of healing from breast infection, and placed it in her past. She writes: "Even though I knew I had just made up that experience, my body experienced it as real." She told herself that since she had done it before, she would, of course, be able to do it again now.

Over the next day or two the lump and red spot disappeared, and she got better. With her third baby she rarely even experienced the preliminary symptoms of a breast infection.

Connirae then taught this general healing pattern regularly on seminars, and writes about several people's experiences as examples. One of these was Peter, who when he attended a seminar had a two-month-old skin cancer on his nose. He experienced it as an 'ugly' feeling. This was the third cancerous mole he had got, and he had treated the first two successfully with cortisone. Sitting in the seminar audience, Peter tried out the self-healing pattern for himself while Connirae demonstrated it with someone else. He visualized his cancer during the seminar as being very warm, with a plaster over it, not expecting anything to happen. About two weeks after the seminar the cancer growth fell off, without treatment.

Of course, this method may not be a cure-all; it might not work for everyone all of the time. It is just one example of one pattern that some people can use effectively.

In NLP it is important to think systemically; that one part of our system has an influence on another part, and all are inter-connected. Keeping an ecological balance in the changes and shifts brought about during therapy can be enhanced through the skilled facilitation of a neuro linguistic psychotherapist, who will work safely and carefully with the client's internal and external systems, at an appropriate conscious or unconscious level.

Further Information

For more information on a neuro linguistic psychotherapist in your area, or training to become an neuro linguistic psychotherapist, contact Amanda Shribman on 020-8444 1110.

If you would like to know more about neuro linguistic programming in general, contact Gordon Lorraine at ANLP, 7 Cremorne Drive, Stafford, ST17 ODR; tel: 01785 665463. www.anlp.org email glorraine@cremorne.freeserve.co.uk

Notes

1. From an article by Joseph O'Connor: The Future of NLP: NLP as a Meme. Visit his website at www.lambent.com
2. Details and accreditation guidelines are available from the ANLP PCS Chair of Accreditation, Dr Susi Strang, at 31 High Street, Skelton, Saltburn-by-the-Sea, Cleveland. Tel: 01287 654175; email: DrSusiStrang@aol.com
3. The ANLP PCS is a member organization of the UKCP, belonging to the Experiential Constructivist Section, together with Personal Construct Psychology and The Society for Existential Analysis.
4. Not everyone in ANLP PCS is working towards UKCP registration. This does not imply that they might be less competent therapists. Many excellent therapists choose to work independently of larger systems. The client might wish to make his or her own enquiries and decisions about who might be the right therapist to work with.
5. 'Secondary gain' is jargon for an extra benefit you get in addition to the behaviour itself.
6. The pattern my colleague used is described in Hall LM. The Sourcebook of Magic (see Further Reading). (Based on a source in Heart of the Mind.)[7]
7. Andreas C and Andreas S. Heart of the Mind. Real People Press. 1989.

Further Reading

Feltham C and Horton I (Eds). Handbook of Counselling and Psychotherapy. Sage. 2000.
O'Hanlon WJ and Hexum AL (Eds). An Uncommon Casebook. The Complete Clinical Work of Milton H Erickson. Norton. 1990.
Rossi Ernest Lawrence. The Psychobiology of Mind – Body Healing. Norton. 1986.

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About Alexandra Chalfont

Alexandra Chalfont has a background in philology (language), linguistics and intercultural communication skills training for managers and professionals. For eight years now she has worked as an Ericksonian and NLP hypnotherapist in private practice. She is managing editor of the Journal for Humanist Psychology, Self & Society, and researches in psychotherapeutic modalities and applications. She is currently Chair of ANLP PCS Ltd. She can be contacted on tel: 020-8948 6844, or email: achalfont@lineone.net

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